Stamford University Bangladesh
Clearance Form Date
: ………..Name : ……….. ID No………
Position : ………. Section/Dept………....
Date of Joining : ………. Date of Resignation/ Termination: ………...
E-mail : Phone :
The individual must take clearance from the following sections
Department / Section :
Mention the assigned incomplete responsibilities (if any) _______________________________
Remarks : ……… Name & Signature Dept./ Section Head ……….
Library :
No. of book(s) issued during his/ her tenure: …………..
No. of book(s) returned: ……..………...
No. of book(s) remain with him/her (if any), give details
Remarks: ……… ________________________________
Name & Signature Dept / Section Head Return Library Card:
IT Section :
Give the particulars of issued Computer, Multimedia & OHP (if any) _______________________________
Mention the discrepancy (if any) Name & Signature Dept / Section Head
Accounts :
Mention the amount of advance and / or loan (if any) Advance: ………...
Loan: ……… _______________________________
Amount of PF (if any): ……….. Name & Signature Dept / Section Head
Exam Office:
(Applicable for only teacher)
Answer Script Remain with (if any):
Undelivered Result (if any):
Pending any dissertation grade: _______________________________
Name & Signature Dept / Section Head Remarks: ………...
………...
Registrar’s Office :
Return ID.
Remarks (if any): ……… ________________________________
……… Name & Signature Dept / Section Head
Registrar
: ………Yes No Yes No Yes No
Yes No Yes No
