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Part I. Request for Clearance (To be completed by Administrative O cer or equivalent) Instructions for Administrative O cer or Equivalent: Initiate this form 5 days prior to an employee's separation. Advise the separating employee on local procedures for the clearance process. Ensure that the employee signs this form in Part II and that the form is forwarded to the Servicing Human Resources O ce before the employee separates. 1. Name of Employee 2. Social Security Employee ID Number 4.
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