Employment Verification Letter Request

EMPLOYMENT VERIFICATION LETTER REQUEST

NAME:

EMP NO.:

PHONE:

DATE:

(PLEASE CHECK)

CLASSIFICATION TITLE

MONTHLY SALARY

EMPLOYMENT DATE (Original/Continuous Service)

EMPLOYMENT STATUS (Perm., Temp.)

(PLEASE CHECK ONE)

TO BE PICKED-UP (Must show /D at time of pick up)

TO BE MAILED TO HOME ADDRESS (Must be same as in HR record):

CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY

KNOWLEDGE.

EMPLOYEE'S

SIGNATURE

DATE

NOTE: PROCESS TAKES APPROXIMATELY ONE TO TWO BUSINESS DAYS.

FOR PICK UP ONLY:

ACKNOWLEDGE RECEIPT OF VERIFICATION LETTER.

EMPLOYEE'S

SIGNATURE

IDENTIFICATION VERIFIED BY:

HR STAFF'S

SIGNATURE

DATE

This form and a copy of the verification letter will be filed in the personnel file.

HRD 05/23/12

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Parent category: Legal