Employee WVOE Document

EMPLOYEE WRITTEN VERIFICATION OF EMPLOYMENT (WVOE)

Purpose: This form documents the employee's information and provides the Employee's written authorization for release of employment and compensation data to the named requesting party. Information provided on this form is furnished for the limited purpose stated below; the Employer's response is certified by Employer only to the extent indicated in the Employer Verification section.

Personal Information

Position Information

Employment Status: Active Terminated On Leave

Full-Time Part-Time Temporary Contractor

Weekly Biweekly Semi-Monthly Monthly Hourly

Employment History

Employer 1

From To

Employer 2

From To

Education

Professional References

Reference 1

Reference 2

Reference 3

Legal Disclosures & Authorizations

At-Will Employment: If applicable, employment with the Employer is at-will and may be terminated by either the Employee or the Employer at any time, with or without cause or notice, unless modified by a written agreement signed by an authorized representative of the Employer.

Equal Opportunity Statement: Employer maintains a policy of nondiscrimination and provides equal employment opportunity to all employees and applicants without regard to protected characteristics as required by law.

Authorization to Release Information: I authorize Employer to release information about my employment, including dates of employment, title(s), compensation, hours, and termination details, to the Requesting Party named below for the purpose stated. I understand that the information released will be limited to employment facts and will be provided in good faith based on Employer records.

Background Check Authorization: I authorize Employer to release information to permitted background screening providers as necessary for the stated purpose.

Applicant Certification & Consent

I certify that all information that I have provided on this form is true, complete, and correct to the best of my knowledge. I understand that knowingly providing false information may result in disciplinary action or other penalties. By signing below, I grant my consent for Employer to disclose the specified employment information to the Requesting Party for the stated purpose.

I further authorize Employer and my prior employers to provide verification of my employment and compensation to the Requesting Party. This authorization is voluntary and may be revoked in writing; however, revocation will not affect disclosures made prior to receipt of the revocation.

I certify the above statements and authorize release of my employment information as described.

Employer Verification (For HR Use Only)

To be completed by Employer representative. This section documents Employer's factual verification only.

Verified Employment Data:

Employer verifies that the information above is true and accurate to the best of the Employer's knowledge based on company records as of the date indicated below. Employer does not warrant future employment or continued compensation.

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