Departmental Clearance Form
Complete this Departmental Clearance Form to document and confirm department clearance steps before an employee exits or transfers.
Employee Full Name
*
First Name
Last Name
Employee ID
*
Current Department
*
Exit or Transfer Type
*
Exit
Transfer
Effective Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Supervisor Name
*
Supervisor Email
*
example@example.com
Outstanding Items or Obligations (if any)
Department Clearance Confirmation
*
Cleared
Not Cleared
Additional Notes
Submit Clearance
Should be Empty: