Employee Performance Certificate

EMPLOYEE PERFORMANCE CERTIFICATE

Personal Information

Position Information & Review Period

Job Title:    Department:

Reporting Manager:    Date Hired:

Review Period From:    To:    Current Salary:

Employment History (Most Recent)

Employer 1 — Company Name:

Title:    From:    To:

Employer 2 — Company Name:

Title:    From:    To:

Education

Professional References

Reference 1 — Name:   Phone:   Email:

Relationship:

Reference 2 — Name:   Phone:   Email:

Relationship:

Reference 3 — Name:   Phone:   Email:

Relationship:

Performance Evaluation

Instructions: For each competency provide a rating (1 = Unsatisfactory, 3 = Meets Expectations, 5 = Outstanding) and supporting comments.

Goals, Training and Development

Goals for Next Review Period (list objectives and success metrics)

Reviewer Recommendation

Recommended Action: No change Promotion Salary increase Performance improvement plan

If promotion or salary change, specify title/amount/effective date:

Legal Notices and Authorizations

At-Will Employment: This certificate does not alter the at-will nature of employment where applicable. Either the employee or the employer may terminate the employment relationship at any time, with or without cause or notice, unless a written agreement signed by authorized representatives explicitly provides otherwise.

Equal Opportunity: The employer affirms that employment decisions are made without regard to protected characteristics in compliance with applicable law. This performance assessment is conducted in accordance with the employer's equal employment opportunity policies.

Authorization to Contact: By signing below, the employee authorizes the employer to contact previous employers and references listed in this document for purposes of verification and personnel action. Consent to periodic background checks and verification is granted as required for employment and continued employment evaluation.

Consent: Employee authorizes background checks and contact with prior employers as described above.

Employee Certification and Acknowledgment

I certify that the information provided in this Employee Performance Certificate is accurate to the best of my knowledge. I acknowledge receipt of this performance evaluation and understand that my signature indicates only that I have read and received the document, not that I necessarily agree with all statements contained herein.

Acknowledgment: I acknowledge receipt of this performance certificate.

Reviewer Comments

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