Employee Onboarding Request

EMPLOYEE ONBOARDING REQUEST

Request Summary

Requesting Department:     Requester Name:

Requester Title:     Requester Phone:

New Hire — Personal Information

Phone:     Email:

Position and Compensation

Department:    Reporting Manager:

Proposed Start Date:    Employment Type: Full-Time Part-Time Temporary Contractor

Pay Frequency:    Exempt Status:

Equipment, Access & Security

Required equipment and access (check all that apply):

Laptop    Desktop    Monitor(s)    Desk Phone / Softphone    Mobile Stipend

Company Email Account    VPN / Remote Access    Elevated/Admin Access    Building Badge

Payroll, Benefits & Compliance

Benefits Enrollment Requested: Medical Dental Retirement

I authorize the HR and Payroll departments to establish payroll and benefits records for the individual named above and to request any documentation reasonably required for compliance with employment eligibility and tax withholding obligations.

Employment History (Most Recent)

Title:    Dates Employed: From To

Title:    Dates Employed: From To

Education

Professional References

Reference 1

Phone:    Email:

Reference 2

Phone:    Email:

Reference 3

Phone:    Email:

Legal Disclosures & Authorizations

At-Will Employment: Employment with the organization is at-will, which means either the employee or the employer may terminate the employment relationship at any time, with or without cause or notice, unless otherwise specifically provided in a written agreement signed by an authorized representative.

Equal Opportunity: The organization provides equal employment opportunities to all employees and applicants without regard to protected characteristics, consistent with applicable law. Employment decisions are based on legitimate business needs and the qualifications of the applicant.

Applicant Certification and Authorization: I certify that the information provided on this form is true and complete to the best of my knowledge. I authorize the organization and its agents to verify any information provided, to contact previous employers and listed references, and to perform background checks as permitted by law. I acknowledge that false statements, omissions, or misrepresentations may result in withdrawal of this request or termination of employment.

Consent to Background Check: I consent to a consumer background check and related verification processes.    I consent to a pre-employment drug screen if required.

HR Onboarding Checklist (For HR Use)

Items to complete prior to start date (check when complete):

I-9 Completed    Payroll Entered    Benefits Enrolled

Equipment Ordered    Badge Issued    Orientation Scheduled

Attachments & Additional Instructions

Attachments required with this request: Offer letter, signed acceptance, identification documents, and any role-specific agreements. Indicate additional instructions or special conditions below.

Applicant Certification (Signature Required)

By signing below, I certify that the information provided in this Employee Onboarding Request is accurate and complete. I authorize the organization to verify any information contained herein and to take the actions described in this form to facilitate employment and onboarding.

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