No Dues Form

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Scalene Works People Solutions LLP

No Dues Form
Employee Details
Employee Name

Emp Code

Designation

Date of Joining

Department / DU

Location

Date of Resignation

Date of Relieving
Personal Details

Personal Email ID

Alternate Email ID

Mobile No.

Alternate No.

Address for
communication
No Dues
(to be conducted as per the approved list)
Department

Particulars
Time Sheets Submitted

Reporting
Manager

Project Related Docs


Returned
Drop Box Access
Removed
Knowledge Transfer
Insurance Card
Collected
Photo ID Card Collected

Facilities &
Admin

Swipe Card Deactivated


Mobile Phone, Sim Card
collected
Data Card Collected
Laptop/Desktop, Mouse,
Adaptor Returned
Network ID Deleted

IT Support
Mail ID Deleted
System De allocated In
the Asset Register
Paybooks

Requests Closed
Paybooks credentials
Deactivation-verified

Conducted By

Signature

Remarks

Scalene Works People Solutions LLP

Department
Re-Solute

Particulars
Login Credentials
Deleted

Conducted By

Signature

Remarks

Resolute Updated with


LWD
Human
Resource

Relieving Letters Issued


Notice Period: Served /
Recovered / Waived Off
Dues from employees
Dues to Employees

Accounts &
Personnel

Leave Balance
Yes
No

IT Claims proofs receipt

Final Settlement
A. Company Owes

B. Employee
Owes

Amount

Salary for the month of ______

Amount

Advances

(Details as per payslip)


Reimbursements

Dues

Any other:

Notice Pay
IT deductions

Gratuity, if Applicable
Leave Encashment

Any Other
Deductions

______ days

Total(B)

Total(A)
Final Amount Settlement
Signature (payroll dept)

(A-B)
Name:

Date:

Signature:

Expected date of disbursement


Instructions By Employee

Details
Provident Fund
Final settlement

Options
Transfer
Withdraw(please mention)
Cheque
Transfer to the Bank Account

Employee Comments

No Dues Conducted by :_________________________________( Name & Signature)

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