Resignation / Termination Form (Form B)
Page No. Page 1 of 1 RESIGNATION / TERMINATION FORM Form No. OGLD - 1175 (Form B) Rev. No. 5 Effectivity March 04, 2025 Name of Company: Business Address: Contact Number: NAME NATIONALITY POSITION REASON FOR TERMINATION EFFECTIVITY DATE Instructions: 1. Changes in format are not allowed. All fields should be properly filled out. 2. List should be submitted strictly monthly, every 30th of the month (pdf and excel file). 3. Accomplished Resignation/ Termination Form (Form B) should be signed and notarized upon submission. Certification: This is to certify that the information provided herein has been carefully verified and found to be updated and accurate. I understand that misdeclaration and incorrect information may lead to imposition of administrative penalties. Prepared by: ____________________________________ DATE: (Please Sign over Printed Name)
Page No. Page 2 of 1 RESIGNATION / TERMINATION FORM Form No. OGLD - 1175 (Form B) Rev. No. 5 Effectivity March 04, 2025
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