NO OBJECTION CERTIFICATE (NOC)

Employee Name : Designation :

Employee Code : Department :
DOJ : Place Of Posting:
DOR : Mobile No :
DOL (LWD) : Personal Mail ID :
Address for Comm:

S No.Department Name Concerned Department's HOD's

1.a. Concerned Department's HOD's Remarks :
- Internal Mail id : …………………………………………………………………………………………..
- External Mail id : …………………………………………………………………………………………..
- To Be Blocked : Yes / No
- To Be Redirected to ……………………..…..............................................
- Backup of Computer/Laptop Data: To be copied on the System of …….....…………………
- On CD : Yes / No No. of Copies………........………….
New RO for reportees
Signature - Section Incharge
(If required) Yes / No _______________
Signature Section Incharge Signature HOD
b. NOC's to be obtained from : ……………………………………………………………………………………………………………..
S No.Department Name Mr. Kapil Dev, D-18/2, 2nd Floor
2. IT Infrastructure N/A,Yes/No Amount (in Rs.) Remarks
1 Laptop / Netbook / PC ……………. …………………………. …………...………………
2 Others Assets ……………. …………………………. …………...………………

3 Software.......................................................................................................
4 Documents in Fire Proof Cabinet ......................................................................
5 Service Department (a) Inventory………………………………………………………………………………….
(b) e-Service…………………………………………………………………………………. ______________
6 Internal Mail id : Blocked/Redirected to ………………………………………………………………….. Signature

Note: All departments concerned with the employee to be mentioned above. Moreover NOC to be taken compulsorily
from HR, Admin, IT, F&A and Stroes & Logistics.
S No.Department Name Concerned Department's RO/HOD's
3. Distributor NOC (Yes/No/N/A) …………………………………………………………………
a) Name & Address of the distributor
b) Month wise (Item Commitment ) :

Signature: _________________
S No.Department Name Mr. Naveen Kumar, B-74, G. Floor
4. Administration :
a) Accessories Handed Over :
N/A,Yes/No Amount (in Rs.) Remarks
- Handset ……………. …………………………. …………...……
- Sim Card ……………. …………………………. …………...……
- Mobile Bill ……………. …………………………. …………...……
- Data card ……………. …………………………. …………...…… ______________
- ID Card ……………. …………………………. ………………….. Signature
S No.Department Name Mr. Narender Gaur, D-18/2, G. Floor
5. Stores & Logistics : Mr. Mukesh Bhardwaj, D-18/2, G. Floor
Items to be recovered which are issued on Returnable Basis.
S No. Item Name Quantity Amount ( in Rs ) Remarks
1 ……………. …………………………. …………...…… …………...……
2 ……………. …………………………. …………...…… …………...……
3 ……………. …………………………. …………...…… …………...…… ______________
Signature
S No.Department Name Mr. Harish Raheja, D-18/2, 2nd Floor
6. Finance & Accounts :
N/A,Yes/No Amount (in Rs.) Remarks
A) Imprest ……………. …………………………. …………...……
B) Staff Loan ……………. …………………………. …………...……
C) Unpaid Salary ……………. …………………………. …………...…… Signature: _________________
D) Incentive ……………. …………………………. …………...……
E) Others ……………. …………………………. …………...……
E) TDS ………… …………………… …………...……Mr. Amit Singhal, D-18/2, 2nd Floor
Signature: _________________
S No.Department Name Mr. Ravindra Kumar, B-74, G. Floor
7. Human Resource:
a) HR - C&B Dept. N/A,Yes/No Amount (in Rs.) Remarks
Notice Pay to be deducted ……………. …………………………. …………...……
Leave Encashment (Days) ……………. …………………………. …………...……
Salary for Current Month ……………. …………………………. …………...……
Bonus ……………. …………………………. …………...…… ______________
Signature
S No.Department Name Ms. Manisha, B-74, G. Floor
b) HR - TM Dept.
i) Exit Interview Forms have been submitted back to HR on ….…./…..…/………….……
ii) Performance Assessment - KRA rating of Team member (if applicable)…………………………… ______________
iii) New RO/ HOD reporting structure (if applicable) Signature
Team Member Old RO New RO Team Member New RO New RO
Code Name Code Name
1 5
2 6
3 7
4 8
* If team members are more in no., then kindly attach annexure as per format
Kindly attached the copy of resignation with acceptance of your RO/HOD
Note: Please submit your investment proofs as per your investment declaration
Employee's Signature