Employee Loan Agreement Form

EMPLOYEE LOAN AGREEMENT FORM

Parties and Identification

Employer Name:    Employer Contact Phone:

Employee Name:    Employee ID #:

Position and Compensation

Department:    Reporting Manager:

Employment Start Date:    Annual Salary/Base Pay: $

Employment History

Title:    Dates Employed: From To

Title:    Dates Employed: From To

Education

Graduation Date:

References

Phone:    Email:    Relationship:

Phone:    Email:    Relationship:

Phone:    Email:    Relationship:

Loan Terms and Repayment

Principal Amount: $    Loan Date:

Interest Rate (annual, if any):    Term: months

Installment Amount: $    Frequency:    First Payment Date:

Payment Method (select all that apply): Payroll deduction Direct payment Other

I authorize payroll deduction for repayment: Yes No

Legal Terms and Conditions

Promissory Note: Employee promises to repay the Principal Amount, together with accrued interest at the stated rate, in accordance with the Repayment Schedule. Employee acknowledges that this Agreement constitutes a binding obligation and a promissory note for all legal purposes.

Payroll Setoff and Withholding: To secure repayment, Employee authorizes Employer to deduct from Employee’s wages or other compensation any unpaid amounts due under this Agreement to the extent permitted by law. Such deductions may be made without further notice where permitted by law or by a separate written authorization.

Default and Remedies: Employee will be in default upon failure to make any required payment when due, termination of employment, or material breach of any representation herein. Upon default Employer may accelerate the balance, declare the entire unpaid principal and accrued interest immediately due, pursue collection remedies, and set off against wages and other amounts owed to Employee to the maximum extent permitted by law.

Prepayment: Employee may prepay all or any part of the loan at any time without penalty unless otherwise noted in this Agreement.

Representations and Warranties: Employee represents that all information provided to Employer in connection with this Agreement is true and complete. Employee agrees to notify Employer promptly of any change in address or employment status.

Governing Law: This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to conflict-of-law principles.

Authorizations, Disclosures, and Certifications

Background and References: Employee authorizes Employer to contact prior employers, references, and educational institutions to verify information provided. Employee further authorizes background checks to the extent permitted by law and consistent with Employer policy.

Equal Employment Opportunity: Employer is an equal opportunity employer. Nothing in this Agreement modifies the Employer’s policy of nondiscrimination with respect to employment decisions.

At-Will Employment: Nothing in this Agreement shall be construed to alter the at-will employment relationship between Employer and Employee, unless separate written employment terms signed by both parties expressly state otherwise.

Applicant/Employee Certification: I certify that all information provided in this form is true, accurate, and complete to the best of my knowledge. I understand that any misrepresentation may be grounds for termination and may subject me to other legal remedies. I authorize Employer to make inquiries necessary to verify statements made herein.

Consent to Contact: Employee authorizes contact of the references listed above and prior employers for employment verification and related purposes: Yes No

Acknowledgment and Agreement

By signing below, Employee acknowledges receipt of the funds described in this Agreement (if disbursed), agrees to the repayment terms and payroll deduction authorization (if elected), and covenants to repay as provided herein. Employer and Employee agree that this Agreement may be enforced by either party and their successors.

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