Establishing secure connection…Loading editor…Preparing document…

Employee Statement of Values

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

EMPLOYEE STATEMENT OF VALUES

This Employee Statement of Values records the employee's acknowledgement of the organization's core values, responsibilities to act consistently with those values, obligations to report conflicts or misconduct, and consent to employer inquiries necessary to enforce these standards. Employee Name: Employee ID:

Personal Information

Position Information

Start Date: Annual Salary:

Core Values Acknowledgement

The organization maintains the following core values which guide expected conduct: Integrity, Respect, Accountability, Service, and Continuous Improvement. By checking and signing below, the employee confirms understanding of these values and commits to acting consistently with them in all workplace activities.

Integrity — Act with honesty and adhere to ethical standards.

Respect — Treat colleagues, clients, and partners with dignity.

Accountability — Take responsibility for actions and outcomes.

Service — Prioritize service to stakeholders and community.

Continuous Improvement — Seek learning and better ways of working.

Conflict of Interest and Reporting

Employees must disclose any actual or potential conflicts of interest that could impair impartial performance of duties. Failure to disclose a conflict may result in disciplinary action, up to and including termination.

Do you have any current conflicts of interest to disclose? None Yes

Training, Compliance, and Reporting Misconduct

The employee agrees to complete values and compliance training as required and to promptly report suspected violations of law, policy, or these values. Reports may be made through designated internal channels and will be handled in accordance with policy; retaliation for good-faith reporting is prohibited.

I confirm completion/readiness for values training: Completed Pending Completion Date:

Employment History

Education

Professional References

Legal Disclosures and Authorizations

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

Equal Opportunity: The organization is an equal opportunity employer. Employment decisions are made without regard to protected characteristics, and the organization prohibits unlawful discrimination and harassment.

Authorization to Contact and Background Checks: I authorize the organization to contact previous employers, references, and other third parties to verify information provided here and to perform background checks as permitted by applicable law. I understand that certain checks may be required and that information obtained may be used in employment decisions.

I expressly authorize contact with prior employers and references and consent to background checks as necessary to verify my qualifications and compliance with organizational policies.

Employee Certification

I certify that the information provided in this Statement of Values and in the attached employment history, education, and reference information is true, complete, and accurate to the best of my knowledge. I understand that materially false, misleading, or omitted information may be grounds for disciplinary action, including termination. I acknowledge my duty to comply with the organization's values and policies and to timely report any violations or conflicts of interest.

Printed Name:

Signature:

Date:

Enter text✕
Prepare your document for signing right on this page
  • 01 Edit the text and complete the fields
  • 02 Click Sign Now and on the next screen add recipients and signature fields in SignNow
  • 03 Start your free trial to sign and send your doc
Sign Now

What an Employee Statement of Values Is and Why It Exists

An Employee Statement of Values is an internal HR document that records an employee's acknowledgement of an employer's core values, ethical expectations, and workplace standards. It typically defines behavioral expectations, confidentiality obligations where applicable, and the employee's commitment to abide by those principles during employment. The document is used for onboarding, performance discussions, and to support disciplinary processes; it is not generally a government filing but can be attached to personnel files and retained for legal or regulatory purposes.

Why documenting values matters for employers and staff

A clear, signed statement aligns expectations, supports consistent enforcement of workplace policies, and creates a dated record that can be referenced during reviews or disputes.

Why documenting values matters for employers and staff

Who typically completes an Employee Statement of Values

Employers provide the form; individual employees sign and return it as part of onboarding or periodic policy reaffirmation.

  • New hires — sign during onboarding to confirm understanding of company values and conduct expectations.
  • Existing employees — update or reaffirm annually or after significant policy changes.
  • HR and managers — collect and retain the signed form in the personnel file.

Maintain a copy in the employee record and use consistent distribution and retention practices for defensibility and HR governance.

Typical signatories and approvers

HR Manager

HR Managers distribute the document, track completions, and retain signed copies in the personnel file. They coordinate any necessary follow-up training or corrective action tied to the statement.

Employee

Employees sign to acknowledge receipt, understanding, and agreement to follow the stated values. The signature is a dated record that documents notice of expectations and can be used in evaluations.

Core components every professional statement should include

A concise Employee Statement of Values typically contains identifiable sections to ensure clarity, enforceability, and consistent recordkeeping across the organization.

Company Values

A short list of the employer's core principles—ethical standards, respect, safety, confidentiality—with clear, plain-language descriptions so employees understand expectations.

Employee Acknowledgment

A declarative clause where the employee affirms receipt, review, and acceptance of the values and related policies, creating an evidentiary record of notice.

Related Policies

References to linked policies such as the code of conduct, anti-harassment policy, confidentiality and data protection rules, and disciplinary procedures.

Signatures

Clear signature block with printed name, signature, job title, and date; include manager or witness signature if your workflow requires it.

Effective Date

The date the employee acknowledges the values; this governs the period for which the acknowledgement applies and helps establish timeline for compliance.

Amendment Clause

A short statement describing how and when the employer may update values or policies and how employees will be notified and required to re-acknowledge.

Step-by-step: issuing, signing, and filing the statement

Follow this sequence to distribute the statement, collect acknowledgements, and store them correctly in personnel records.

  • 01
    Prepare the Template: Customize values, effective date, and related policy references.
  • 02
    Distribute to Employee: Send via HR system, email, or secure eSignature link.
  • 03
    Collect Signature: Employee signs, dates, and returns the form.
  • 04
    File and Record: Store signed copy in the employee personnel file with access controls.

Typical electronic acknowledgement workflow

An electronic process reduces manual handling and creates an audit trail; below are the operational steps most organizations use.

  • Upload Document: Upload the statement template to your e-signature platform or HRIS.
  • Add Fields: Place name, date, signature, and manager fields where needed.
  • Send to Signer: Invite employee by email or secure link for signature.
  • Archive with Audit Trail: Save signed PDF and capture timestamp, IP, and completion certificate.

Distribution and platform considerations

Choose a secure delivery method that preserves intent, attribution, and an audit trail for each signed acknowledgement.

  • Document Formats: PDF | Word | DOCX supported
  • Authentication Options: Email link | SMS code | SSO
  • Integrations: HRIS and cloud storage integrations

Ensure the chosen platform supports ESIGN/UETA compliance, record retention, and access controls appropriate for employee records.

Key security and compliance elements to document

Encryption: TLS 1.2/1.3 and AES-256 at rest
Audit Trail: Timestamps, IP, and signer events
Access Controls: Role-based permissions for personnel files
HIPAA Support: BAA available where required
Retention: Configurable retention policies
Certifications: SOC 2 Type II, ISO 27001

Typical timing and deadlines for acknowledgements

Set clear deadlines for acknowledgement to ensure compliance and consistent enforcement across the workforce.

Onboarding Deadline:

Complete acknowledgement within 7 days of hire

Policy Reaffirmation:

Re-acknowledge annually or after substantive policy updates

Manager Review:

Manager verifies completion within 14 days

Escalation Window:

Non-compliance flagged after 30 days

Records Audit:

Periodic audits scheduled yearly

Common mistakes to avoid when preparing the statement

  • Using vague or aspirational language that lacks actionable obligations and review triggers.
  • Failing to record the effective date or retaining undated acknowledgements in personnel files.
  • Not capturing an auditable signature event or relying on informal email confirmations.
  • Inconsistent distribution practices across departments causing gaps in compliance.

Risks and legal consequences to be aware of

Employment Disputes: Weakened employer position without dated acknowledgement
Privacy Violations: HIPAA exposure if health data mishandled
Recordkeeping Failures: Noncompliance with retention laws
I-9 Related Risk: Document errors can trigger fines
Discrimination Claims: Inconsistent enforcement increases liability
Regulatory Scrutiny: Industry regulators may request records

Real-world examples of how organizations use a values acknowledgement

These examples show documented, practical uses of an Employee Statement of Values in operational settings.

Optica Ventures LLC — Onboarding

Optica integrated a short values acknowledgement into new hire packets to reinforce culture during onboarding.

  • The team used a single-page statement tied to HRIS records.
  • This provided a dated record for managers and reduced follow-up questions during the first 90 days by creating a consistent reference point for expected conduct.

Fertility Centers of Illinois — Compliance

The center attached privacy reminders to staff values statements to reinforce patient confidentiality.

  • It combined the acknowledgement with privacy training completion.
  • The approach linked the values statement to HIPAA training records, improving audit readiness and clarifying staff responsibilities around protected health information.

eSignature pricing snapshot for Employee Statement of Values workflows

Compare core price points and capability signals for common eSignature vendors. signNow is listed first per platform comparison conventions.

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 Varies by plan Varies by plan Varies by plan Varies by plan
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
Envelope Cap No envelope cap 100 envelopes/user/year Varies by plan Varies by plan Varies by plan

Practical tips for accurate and efficient completion

Follow these best practices to minimize errors and ensure your acknowledgements serve as reliable records.

Use a single authoritative template
Maintain one template required across the organization to avoid conflicting language and ensure consistent enforcement and recordkeeping.
Require dated signatures
Always capture the date with the signature to establish when the employee agreed and to control the applicable policy period.
Preserve audit trails
Store signed PDFs with timestamps, signer identity, and event logs to demonstrate intent and attribution if needed.
Coordinate with compliance
Work with legal or compliance teams when adding sector-specific clauses, such as HIPAA, FERPA, or financial confidentiality language.

Frequently asked questions about Employee Statement of Values

Answers below address common legal, procedural, and technical questions about issuing and storing signed acknowledgements.


Need help? Contact support

be ready to get more
Join over 28 million airSlate SignNow users
Sign Now
Company
Forms
Pricing
Resources
Knowledge base
Other Products
© 2026 airSlate Inc. All rights reserved.