Employment Verification Form

Middle Name

Company name

Manager name

Manager job title

Manager phone number

Manager email

Employee name

Please enter employee's legal first and last name

What position does this employee hold?

When did employment start?

Full time/part time?

How many work hours a week?

What is their wage?

Please put hourly rate or salary rate

How often paid?

Weekly / bi-weekly / monthly / yearly

Likelihood of employment continuing?

Digital Signature (Type your name)

I certify that the information I have given on this form is true and correct.

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Employment Verification Form