FULL AND FINAL SETTLEMENT STATEMENT
Prepared on cessation of employment (resignation / retirement / termination) to settle all outstanding dues and recoveries.
[Company Name], [Address]
| Employee Name | [Employee Name] | Employee Code | [EMP-____] |
| Designation | [Designation] | Department | [Department] |
| Date of Joining | [DD/MM/YYYY] | Last Working Day | [DD/MM/YYYY] |
| Reason for Exit | [Resignation / Retirement / Termination] | ||
| Amount Payable to Employee (₹) | Amount Recoverable from Employee (₹) | ||
|---|---|---|---|
| Salary for [___] days (unpaid) | [Amount] | Notice pay shortfall | [Amount] |
| Leave Encashment ([___] days) | [Amount] | Advance / Loan outstanding | [Amount] |
| Gratuity (if eligible) | [Amount] | Asset / ID not returned | [Amount] |
| Bonus / Incentive due | [Amount] | Excess reimbursement | [Amount] |
| Total Payable (A) | [Amount] | Total Recoverable (B) | [Amount] |
Net Amount Payable (A − B): ₹ [Amount] ( Rupees [Amount in words] only )
I confirm that I have received the above amount in full and final settlement of all my dues and have no further claim against the company.
_______________________ _______________________
Employee Signature & Date Authorised Signatory / HR
Compliance note: F&F including wages should ordinarily be paid within 2 working days of the last working day where feasible; gratuity is payable within 30 days under the Payment of Gratuity Act, 1972. Deduct and deposit any TDS on taxable components.