Is an electronic signature valid for this declaration

Yes. Electronic signatures are generally enforceable under the federal ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided the signing meets intent, consent, attribution, and retention tests. Confirm any state board or contract-specific requirements before relying on an e-signed declaration.

What if the name on the declaration differs from the license

Name mismatches can hinder verification. If names differ due to marriage or legal change, attach supporting documentation (court order or updated license) and note the variation in the declaration.

When is notarization or a PE seal required

Notarization and seal requirements vary by state and by the permit or contract. Check the relevant state licensing board and project owner requirements; do not presume a signed declaration substitutes for a required seal on technical documents.

How do I update a previously submitted declaration

Execute a new declaration or an amendment noting the effective date. Retain both versions for audit trails and clearly mark superseded records to avoid confusion.

Can I revoke or cancel a declaration

Yes. An employee or employer may revoke or supersede a declaration in writing; retain revocation records and ensure project teams are notified to prevent misapplication of seal authority.

How long should signed declarations be kept

Retain declarations for the life of the project plus an appropriate statutory period. Federal standards like the IRS three-year rule apply to financial records and HIPAA six-year rules may apply to health-related records; consult counsel for industry-specific retention.

Electronic Signature
Templates
HR
Employee PE Declaration

Employee PE Declaration

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

EMPLOYEE PE DECLARATION

This Employee PE Declaration ("Declaration") is completed by the applicant or employee to disclose information relevant to pre-employment screening, physical evaluation requirements, and authorizations necessary to determine fitness for duty. The information provided will be used for employment eligibility, placement, reasonable accommodation assessments, and safety determinations. Providing false information may result in withdrawal of an offer or termination of employment.

Personal Information

Full Legal Name Current Address

Phone:

Email:

Date of Birth:

Position Information

Position Applied / Position Department

Reporting Manager:

Proposed Start Date:

Salary / Compensation (if applicable)

Employment History (Most Recent First)

Employer 1 — Company Name

Title:

Dates Employed: From To

Primary Responsibilities Reason for Leaving Employer 2 — Company Name

Title:

Dates Employed: From To

Primary Responsibilities Reason for Leaving

Education

Highest Degree or Credential Institution

Graduation Date:

Additional Education / Certifications

References

Reference 1 - Name

Phone:

Email:

Relationship Reference 2 - Name

Phone:

Email:

Relationship Reference 3 - Name

Phone:

Email:

Relationship

Medical / Physical Evaluation Declarations

The following declarations are required to determine physical fitness for the duties of the position. Responses are subject to verification by a company-authorized medical professional where permitted by law.

I have a current medical condition or physical limitation that may affect my ability to perform essential job functions.

If yes, provide details and any required accommodation

I consent to a job-related physical examination if required as a condition of hire.

Authorizations and Background Screening

By checking the boxes below and signing this Declaration, I authorize the employer to obtain information relating to my background, including but not limited to employment verification, reference checks, criminal history, and drug and alcohol screening where Job-related and permitted by law. I authorize past employers, educational institutions, and references to release information about my employment, education, performance, and fitness for duty.

I authorize a background check and verifications.

I consent to a pre-employment drug and substance test if required.

I authorize release of medical information to assess fitness for duty and reasonable accommodation.

Legal Disclosures

At-Will Employment: If employed, I understand that employment is at-will unless a written agreement signed by an authorized company representative states otherwise. Either I or the employer may terminate employment at any time, for any lawful reason, with or without cause or notice.

Equal Opportunity: The employer provides equal employment opportunity to all employees and applicants without regard to race, color, religion, sex, national origin, age, disability, veteran status, or other protected characteristics, consistent with applicable law.

Applicant Certification and Acknowledgment

I certify that the information I have provided on this Declaration is true, complete, and correct to the best of my knowledge. I acknowledge that omission of material facts, misstatements, or fraudulent information may disqualify me from employment or lead to termination. I understand that any offer of employment may be conditional on the satisfactory completion of required screenings, verifications, and/or medical examinations.

I certify the statements above are true and complete.

I further authorize the release of any information necessary to complete background, reference, and medical verifications in connection with my application for employment. I release all persons and entities from liability arising from the release of such information to the employer.

Additional Comments (Applicant may use this space to provide clarifying information)

Signature

Printed Name:

Signature:

Date:

What the Employee PE Declaration Is

An Employee PE Declaration is a signed statement used by employers to record an employee's Professional Engineer (PE) credential, jurisdiction of licensure, license number, discipline, and any attestations about current standing or restrictions. The form documents the employee's authority to sign or seal technical documents, confirms compliance with employer policy and state licensing rules, and creates an auditable record for contract, permitting, and project files. Employers commonly use it during onboarding, annual compliance checks, project assignments, and when engineering deliverables require a licensed professional's seal. The declaration can be executed electronically consistent with U.S. e-signature law.

Why this declaration matters for compliance and project risk

A completed Employee PE Declaration protects firms and public clients by confirming licensure, exposing disciplinary or restriction status, and establishing who can legally seal work products under state rules. Under federal and state e-signature law, an electronically signed declaration may be enforceable when executed properly.

Who typically completes an Employee PE Declaration

The declaration is used by a mix of individual engineers, hiring managers, and compliance teams before technical work is authorized.

Licensed engineers and registrants who perform sealing or certifying work for the employer
Human resources and credentialing teams responsible for onboarding and annual verifications
Project managers and contract administrators who must confirm signatory authority for deliverables

Employers retain the signed declaration for audits, contract compliance, and to verify that sealed documents were prepared by a licensed professional.

Core elements included in a professional PE declaration

Well-designed declarations collect license identifiers, attestations, scope limits, employer verification, and attachments while preserving an auditable signature trail for compliance and project records.

License Details

State, license number, and issuing board so reviewers can verify current licensure and any disciplinary history with the state board.

Attestation

A concise statement where the employee affirms license status, whether the license is active, and whether any restrictions or disciplinary actions exist.

Scope of Work

Clarifies which types of documents or projects the engineer is authorized to sign or seal under employer policy and state rules.

Expiration & Renewal

Fields for issue and expiration dates plus a renewal reminder mechanism to reduce the risk of expired seals on deliverables.

Employer Verification

Area for a company official to confirm review, add verification date, and note any registration or project-specific limits.

Attachments

Placeholders for attaching a license copy, proof of continuing education, or board correspondence that supports the attestation.

Step-by-step: complete and record the declaration

A concise workflow from form completion to employer verification and archival keeps seal authority current and auditable.

01

Prepare form: Select correct template and attach license copy.
02

Fill fields: Complete all required fields using specified formats.
03

Sign: Employee signs electronically or in ink as allowed.
04

Verify & store: Employer validates license and archives the signed record.

Typical online workflow settings for PE declarations

Configure the digital form to require required fields, enable verification steps, and capture an auditable trail for each signer.

Field	Configuration
Required fields	Enforce name, license number, state, dates.
Conditional fields	Show discipline and attachment fields only when applicable.
Verification step	Assign reviewer role to compliance or HR team.
Archive location	Save signed PDFs to project folder or records system.

How electronic submission and signing typically flow

Electronic workflows streamline verification while keeping a detailed audit trail of each action and signer identity.

Upload document: Sender uploads template and attachments.
Assign signer: Add employee email and role.
Authenticate signer: Use email link, SMS code, or stronger methods.
Finalize record: Signed PDF with audit trail is produced.

Technical and platform considerations for e-submission

Ensure the eSignature platform supports legal compliance, required file formats, and the authentication level your organization needs.

File formats: PDF, DOCX supported
Authentication: Email, SMS, KBA optional
Integrations: Connects to document management

Timing and reporting expectations to track

Keep a schedule for initial declarations, renewals, and updates so sealed work is always supported by an active license.

Initial submission timing:

Submit upon hire or before assigned sealing duties.

Renewal tracking:

Record renewal dates and trigger reminders before expiration.

Status change reporting:

Report suspensions or disciplinary actions promptly to stakeholders.

Periodic attestations:

Perform annual re-attestation to confirm unchanged status.

Audit readiness:

Have current declarations indexed for project audits.

Key milestones from onboarding to archival

Track milestones sequentially to ensure declarations are current at each project stage and retained after project close.

01

Onboarding declaration

Employee completes declaration before technical assignment.

02

License verification

Employer confirms licensure with state board records.

03

Project assignment

Assign sealing authority for specific deliverables.

04

Archival and review

Archive signed declaration and schedule periodic review.

Security, privacy, and compliance features to expect

Encryption: TLS 1.2/1.3 in transit; AES-256 at rest

Audit trail: Comprehensive timestamps and IP logs

HIPAA: BAA available for protected health data

21 CFR Part 11: Support for FDA-regulated record controls

SOC 2: SOC 2 Type II compliance available

Accessibility: WCAG 2.0 AA support for accessibility

Consequences of an incorrect or incomplete declaration

Misstated licensure: Civil fines or contract rescission

Unlicensed practice: Disciplinary sanctions or injunctions

Invalid seals: Project delays and rework costs

Contractual liability: Indemnity claims against employer

Regulatory exposure: Permitting or compliance failures

Data breaches: Confidential information exposure risk

eSignature platform pricing and feature comparison

Pricing and core features for common eSignature vendors. signNow is listed first per vendor comparison conventions; verify specific plan details with each provider.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	No	No	Yes, limited	Yes, limited
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No cap	100 envelopes/user/year	Varies	Varies	Varies

Frequently asked questions about executing and managing the declaration

Answers to common questions about validity, e-signing, updates, notarization, and record retention for Employee PE Declarations.

Need help? Contact support

Is an electronic signature valid for this declaration
Yes. Electronic signatures are generally enforceable under the federal ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided the signing meets intent, consent, attribution, and retention tests. Confirm any state board or contract-specific requirements before relying on an e-signed declaration.
What if the name on the declaration differs from the license
Name mismatches can hinder verification. If names differ due to marriage or legal change, attach supporting documentation (court order or updated license) and note the variation in the declaration.
When is notarization or a PE seal required
Notarization and seal requirements vary by state and by the permit or contract. Check the relevant state licensing board and project owner requirements; do not presume a signed declaration substitutes for a required seal on technical documents.
How do I update a previously submitted declaration
Execute a new declaration or an amendment noting the effective date. Retain both versions for audit trails and clearly mark superseded records to avoid confusion.
Can I revoke or cancel a declaration
Yes. An employee or employer may revoke or supersede a declaration in writing; retain revocation records and ensure project teams are notified to prevent misapplication of seal authority.
How long should signed declarations be kept
Retain declarations for the life of the project plus an appropriate statutory period. Federal standards like the IRS three-year rule apply to financial records and HIPAA six-year rules may apply to health-related records; consult counsel for industry-specific retention.

be ready to get more

Join over 28 million airSlate SignNow users

Sign Now