To,
The HR Manager,
__________ (Name of the Company)
__________ (Company’s Address)

Date: __/__/____ (Date)

From,
__________ (Name)
__________ (Address)

Subject: Request for the clearance certificate

Respected Sir/ Madam,

Most courteously, I would like to inform you that my name is __________ (name) and I have been working in __________ (department) of your reputed company as ________ (designation) since ________ (duration).

I would most humbly inform you that this letter is to request you issue a clearance certificate in my name. Most respectfully, I resigned from my duty on __/__/____ (mention date). Also, I have cleared all my dues. Therefore, it is to request you kindly issue a clearance certificate in my name as this would help me in _________ (mention reason – why you want the clearance certificate).

I shall be highly obliged for your kind support. In case you have any queries, you may contact me at _________ (mention contact number).

Yours truly,
________ (Signature),
________ (Name),
________ (Contact Number)

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