Pharma Phils., Inc.

Suite 2002, 20F Prestige Tower Bldg., Emerald Ave., Ortigas Center, Pasig City . Tel. No. : 6367997

EMPLOYEE CLEARANCE FORM

INSTRUCTIONS: Resigning employee must personally attend to the processing of this clearance form to ensure its immediate
completion.

Name: _____________________________________ Position: ____________________________

Effectivity Date of Resignation:_________________ Date Prepared:_______________________

Immediate Superior: _________________________ Department: ________________________

Remarks/ Signature Date

1. Sales Department ______________________________ ___________
Detailing bag ______________________________ ___________
Report Forms (ER,DCR,etc.) ______________________________ ___________
MD Cards ______________________________ ___________
Master Work Plan ______________________________ ___________
Samples / Supplies ______________________________ ___________
Training Manual ______________________________ ___________
Others: ___________________ ______________________________ ___________
2. Marketing
Detail aids/ service items ______________________________ ___________
Equipments ______________________________ ___________
Others: ___________________ ______________________________ ___________
3. HR
Resignation letter ______________________________ ___________
Company ID ______________________________ ___________
Philcare ID ______________________________ ___________
Others: ____________________ ______________________________ ___________
4. Accounting
Car Key ______________________________ ___________
Balance of Car Lease ______________________________ ___________
Unliquidated Balance of CA ______________________________ ___________
Outstanding loan/ STP accts ______________________________ ___________
Others: ____________________ ______________________________ ___________

__________________________ ___________________________ _______________________

Employee’s Signature/Date Immediate Superior’s Signature/Date President or VP-Sales/ Date

Distribution: Original: Finance Duplicate: 201 File Triplicate: Employee