Job Applicant Employment Verification Form

Dear xxxxxxxxxxx

The person identified below is being considered for employment and has signed a statement authorizing this verification and investigation.  We shall appreciate a statement of your opinions and experiences as outlined below.  Your reply will be considered confidential.

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Name of Applicant

 

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Social Security Number

 

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Dates of Claimed Employment

 

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Position Last Held

 

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Final Rate of Pay

 

Is the above information correct?  Yes______ No________

 

If not please make corrections.

 

What is your opinion as to this person’s?

 

Ability________________________Effort_________________________

 

Conduct________________________Attendance_____________________

 

Reason for leaving your employ________________________________

______________________________________________________________

 

Eligible for rehire?  Yes_____No_____If not, why?_____________

______________________________________________________________

 

Your further comments on any personal or professional strength and weaknesses will be appreciated.___________________________

______________________________________________________________

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Date__________Signed_____________________Title_____________

Click Here To Download Job Applicant Employment Verification Form