Unable to understand your requirement. If I am not wrong you require a format of relieving letter.
In general once an employee is resigned and after serving the required notice period and completing the handing over formalities, obtain the no dues certificate from all the concerned departments like his own department, stores, accounts etc and approaches HR for the relieving letter. The HR will issue a relieving and service certificate. The relieving letter is a proof for the out going employee that he has competed all the handing over formalities and no dues with the company, in additon to this the company will issue a service certificate also - kameswarao