Full & Final Settlement Template

{Insert Company Name}

INSERT COMPANY LOGO 316,Prabhadevi Industrial Estate,
Prabhadevi, Mumbai - 400025
Maharashtra

Statement of Full & Final Settlement for May’2017

Employee Name Nilesh J PF Number MHBAN/12345/00/001
Employee Code QC001 UAN Number 2154648888
Date of Joining 6/3/2010 Designation Legal Advisor
Last Working Date 5/24/2017 Reason for Leaving Resigned
Location Mumbai Notice Days 15
State Maharashtra Leave Encashed Days 35
Total Days In Month 31 Absent Days 0
Days Paid 24 Arrear Days 0

Payment Head Amount(Rs.) Amount(Rs.)

CTC Salary details Earned Salary details
Basic 45,000 34,839
HRA 22,500 17,419
Conveyance allowance 1,600 1,239
Medical allowance 1,250 968
Special Allowance 12,500 9,677
Gross Earnings 82,850 64,142
Full & Final payment details
Notice Period Pay Out 41,425
Leave Encashment 52,500
Incentive -
Statutory Bonus 3,250
Gratuity 157,500
Total FnF Settelment 254,675
Provident Fund 1800
Professional Tax 200
Income Tax 3256
Gross Deduction 5256

Net Amount Payable 313,561

Amount in words Three Lac Thirteen Thousand Five Hundred Sixty One only

For Quikchex Pvt Ltd

Place : Mumbai
Authorised Signatory Date : 31th May'2017

I acknowledge the copy of my Full & Final settlement & declare that I do not have any claim from the Company
Signature of employee
Nilesh J

© Quikchex India Pvt. Ltd. Not to be distributed or duplicated without permission