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F U L L & F I N A L S E T T L E M E N T
Employee Code : Run Date :

Name of the Employee : Mr.xxxxxxx Date of Join :

Designation : XXXXX Date of Resign :

Department : XXXXX Date of Leaving :

Payable Month : January-07 Total Payable Days :

Salary Particulars : ( A C T U A L S ) Rs.

BASIC :
HRA :
Convey. Allow :
Medical Allow :
Special Allow :
Project Allow ;
OTHERS if any….
TOTAL Rs. : 0.00

DEDUCTIONS : ( - )
Provident Fund : (Including Encashble leaves)
Professional Tax :
TDS :
Salary Advance :
Others.. If any (specify)

TOTAL Rs. :

ADDITIONS : ( + )
No.of Encashble Earn Leaves : 0 (PF deductions not shown here)
Gratuity :
( Eligible No.of years ) 0
Telephone Reimb., ;
Petrol Convey., :
Reversal of PF Deductions
Other.. If any (specify)
TOTAL Rs. :
NOTICE PERIOD / RECOVERY ( - )
No.of Braking days
Payment in lieu of One month Notice
0
period
Recovery Amt towards Damages or if
0.00
any…
Other.. If any (specify)

TOTAL Rs. :

TOTAL AMOUNT ( PAYABLE / RECOVERABLE ) Rs. :

( In words…… Rupees Ninteen thousand Eight hundred and Fifty Only )

Prepared Verified Reviewed

( ) ( ) ( )

Enclousers :

Approved Resignation letter - Attendance Reprot - Leave Card - Payslip - Support Doc., towards Recovery -No Dues Certificate ( Found / Not Found / Partial Doc., )
For Finance & Accounts Department Use :

Paid Amount through : CASH / DD / CHEQUE DD / CHEQUE Number : Bank :

Received CASH / DD / CHEQUE from Emp.. DD / CHEQUE Number : Bank:

D E C L A R A T I O N

I, ______________________________________________ received / paid the Amount towards my Full & Final Settlement as mentioned abo
also I checked this statement throughly and declare that no further complications / complaints regarding this settlement.

SIGNATURE & DATE

 1/2/2007

1/1/2000

1/1/2007

1/1/2007

31

( E A R N E D ) Rs.
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

0.00
0.00 0
0.00 0
0.00 0
0.00

0.00

0.00 0

0.00 0
0.00
0.00
0.00
0.00
0.00
 0.00 0

0.00
0
0.00

0.00

0.00

ly )

Approved

( )

Found / Not Found / Partial Doc., )

Date :

Date :

Final Settlement as mentioned above

ttlement.

IGNATURE & DATE