Resignation form for Employee


1 Name of the applicant  
2 Designation  
3 Department/Section  
4 Place of posting  
5 Date of joining in service  
6 Date of leaving the service  
7 Mode of leaving (Resignation/
Retirement /Termination)
8 In case of resignation, has the employee submitted prior notice as stipulated, if not,
give reasons why the amount for notice period is not recovered from his/her dues


1 Salary Payable (From the date of last salary drawn to the date of resignation)  
2 Security deposit held, if any  
3 Balance of Privilege leave, if any  
4 Bonus payable  
5 Statutory retirement benefits  
6 Is the employee eligible for Gratuity, if so, amount payable  

Place: Sign:

(for Office Use Only)

All the sectional heads are requested to give NOC for relieving S/Shri/Smt.______________ . Before issue NOC, please check and recommend recovery of dues, if any, dues against the employee.

  Manager (Administration) :

  1. Reporting Officer of the employee
  2. Correspondence officer (HR)
  3. Asstt. Manager (Sales & Accounts)

  Manager (Administration) :

The NOCs have been received from the above officers, if approved, the employee may be relived after paying the amount as per No Due Certificate placed with NOC.

C.E.O. Manager (Administration) :

Amount paid vide cheque no._______________dated________drawn on________________ as per No Dues Certificate and reliving order of the employee issued.

S/Shri/Smt.______________ Manager (Administration) :