Personnel File Review Request Form

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Personnel File Review Request Form
Employee/Former Employee Name: ______________________________________________________
Home address: _______________________________________________________________________
Telephone: (work) ____________________ (Mobile) ___________________
Email address: ________________________________________________
I am requesting to:
Review my personnel file
Obtain a copy of my personnel file
Obtain copies of specific documents from my personnel file listed below:
Employment Status:
Current
Former
I understand the following:
If I am reviewing my personnel file, I may not add, remove or revise any documents.
If I do not agree with documents in my personnel file, I may submit a statement in writing.
Generally, the University will respond to my request completed within 30 calendar days.
Documents Requested from File
Entire personnel file
Vanderbilt Employment Application
Employment Offer Letter
Performance improvement plan or disciplinary letter
Authorizations for a deduction or withholdings of pay
Employment History (including salary information)
Required Certifications and Job Related Certifications
Performance Development Documents (including orientation records)
Mandatory Continuing Education Records
Open Enrollment/Fringe Benefit Information
Retirement Application
You must present a valid driver’s license or other government issued identification with a photograph for identification purposes.
AUTHORIZATION OF EMPLOYEE:
By my signature below, I certify that the contact information provided is accurate and that I have requested, reviewed and/or
received a copy of my personnel file:
Employee Name: _________________________________________________ Date: ____________________
OFFICE USE ONLY: FILLED OUT BY HUMAN RESOURCES
Date and Time Requested: ________________
Date File Picked Up: _____________
Processed By: ______________________ ID confirmed: ________________
Assigned Consultant: _______________________ Sr. HR Consultant: ________________________

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