Is an electronic signature legally valid?

Yes. Electronic signatures are generally enforceable under the federal ESIGN Act (15 U.S.C. §7001) and state UETA laws where adopted; exceptions include certain testamentary and court-filed documents. Verify whether any consumer-facing disclosure or industry-specific standard applies.

When is notarization required?

Notarization depends on state law and the recipient's requirements. Some licensing boards or background checks request notarized attestations; check the receiving authority or state notary rules before finalizing the method of execution.

Can I update a signed declaration?

You cannot alter a signed copy; instead, prepare a corrected or superseding declaration that references and replaces the prior version, have the appropriate parties sign and date the new document, and retain both records for audit purposes.

How should I authenticate signers for sensitive roles?

Use stronger identity proofing such as ID credential analysis, two-factor SMS authentication, or knowledge-based verification for regulated positions. Retain the audit trail showing method, timestamp, IP address, and steps taken.

How do I revoke or cancel a declaration?

To revoke, execute a dated, signed revocation statement that references the original declaration, notify interested parties in writing, and store revocation records with the original document. Some recipients may require a new attestation instead.

Where should executed declarations be stored?

Store signed copies in a secure document management system with access controls, encrypted storage, and an audit trail. For healthcare, follow HIPAA retention rules; for tax or regulatory matters, follow applicable federal or state retention statutes.

Electronic Signature
Templates
HR
Employment Declaration of Good Repute

Employment Declaration of Good Repute

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

EMPLOYMENT DECLARATION OF GOOD REPUTE

Employee Name: Preferred Name:

Personal Information

Residential Address Primary Phone Email Address

Position Information

Position Offered / Applied For Department / Unit Reporting Manager Proposed Start Date

Employment History (Most Recent First)

Employer 1 — Company Name Title / Position

Dates Employed: From to

Primary Responsibilities Reason for Leaving

Employer 2 — Company Name Title / Position

Dates Employed: From to

Primary Responsibilities Reason for Leaving

Education

Highest Degree or Credential Institution

Graduation / Completion Date:

References (Professional)

Reference 1 — Name

Reference 2 — Name

Reference 3 — Name

Declarations and Disclosures

The undersigned makes the following declarations under penalty of perjury. For each item, check the box that applies. If Yes, provide a complete written explanation in the space provided. Failure to disclose relevant information may result in denial of employment or later disciplinary action including termination.

1. Have you ever been convicted of a felony or any offense involving fraud, dishonesty, sexual misconduct, or violence?

Yes No

2. Have you ever been subject to professional disciplinary action, license suspension, or revocation by a licensing board or employer?

Yes No

3. Are you currently under investigation or subject to any pending charges, disciplinary proceedings, or administrative actions related to your professional conduct?

Yes No

4. Have you ever been terminated for cause, asked to resign, or resigned while under investigation?

Yes No

5. Have you ever falsified or materially misrepresented any information regarding your education, professional credentials, employment history, or other qualifications?

Yes No

6. Are you presently debarred, suspended, excluded, or otherwise ineligible to practice or be employed in any jurisdiction or by any public or private payer or regulatory authority?

Yes No

7. Are you legally authorized to work in the country of employment without sponsorship or any other restriction?

Yes No

Consent and Authorizations

I authorize the Company and its agents to investigate all statements contained in this declaration and to obtain any and all information concerning my education, employment history, licensing, disciplinary records, and criminal history. I further authorize former employers, educational institutions, licensing authorities, and references to provide such information to the Company.

I consent to background checks, reference checks, and verification of the information provided above.

I understand that any offer of employment is contingent upon satisfactory completion of any required background investigation, credential verification, and any required drug or medical screening. I further understand that falsification, omission, or misrepresentation of information on this declaration or in connection with my application may be cause for refusal to hire or for immediate termination of employment.

Legal Notices

At-Will Employment: Unless otherwise provided in a written employment agreement signed by an authorized representative of the Company, employment is at will and may be terminated by either the employee or the Company at any time, with or without cause or notice.

Equal Employment Opportunity: The Company is an equal opportunity employer and prohibits unlawful discrimination or harassment of any kind. All employment decisions are based on business needs, job requirements, and individual qualifications without regard to protected characteristics.

Applicant Certification

I certify that all information provided in this Employment Declaration of Good Repute is true, complete, and correct to the best of my knowledge. I understand that this declaration becomes part of my personnel file if I am employed and that any false statement or omission may be grounds for denial of employment or discipline up to and including termination. By signing below I acknowledge that I have read, understand, and accept the terms of this declaration and the consents herein.

Applicant Printed Name:

Signature:

Date:

What the Employment Declaration of Good Repute Is

An Employment Declaration of Good Repute is a written attestation used by employers, licensing authorities, and regulators in the United States to document an individual's professional reputation, conduct, and suitability for a role. The declaration typically identifies the declarant and subject, summarizes relevant employment or disciplinary history, and states whether any incidents or convictions adversely affect fitness for the position. It serves as part of hiring, credentialing, security clearance, or licensing files where an official, signed statement about character or professional standing is required and must be retained for compliance or dispute resolution.

Why a Formal Declaration Matters

A clear Employment Declaration of Good Repute creates an auditable written record that supports hiring and licensing decisions, documents due diligence, and reduces ambiguity in disputes. It helps employers and regulators demonstrate consistent, documented assessments of suitability and conduct across applicants and incumbents.

Who Commonly Relies on This Declaration

Employers, licensing boards, and HR teams use this declaration when reputation and regulatory suitability are material to hiring or credentialing decisions.

Healthcare employers conducting credentialing checks and meeting HIPAA-related documentation requirements for clinical hires.
Educational institutions verifying prior employment, conduct, and suitability for positions involving minors or sensitive student data.
Financial services and government agencies screening candidates for fiduciary responsibility and regulatory fitness before onboarding.

Use the declaration to standardize evidence of reputation across files, reduce inconsistency in reference checks, and create records that can be retained for compliance and future audits.

Essential Sections to Include in the Declaration

A professional Employment Declaration of Good Repute organizes identity details, factual employment history, declarative statements about conduct, required disclosures, signature details, and any authentication elements.

Parties

Identify declarant and subject fully, including legal names, current employer or licensing body, and official contact information so the statement is attributable and auditable.

Employment History

Summarize positions, dates, employer names, and supervisory contacts. Include formal title and dates to verify chronology and link the declaration to background records.

Affirmations

Clear yes/no or narrative responses addressing professional conduct, disciplinary actions, suspensions, or misconduct relevant to the role; avoid vague or ambiguous language.

Required Disclosures

List convictions, pending charges, licensing sanctions, or investigations that legally must be disclosed for the role; cite applicable regulatory triggers if known.

Signature Block

Provide a dated signature area for the declarant and a witness or official countersignature if required; include printed name, title, and contact details for follow-up verification.

Authentication

Note whether notarization, witness statements, or electronic identity verification (KBA, SMS, ID scan) is required and include fields to record those authentication details.

Core Data Fields Required

Full Legal Name: Subject's legal name

Date of Birth: MM/DD/YYYY

Identifier: SSN last four or employee ID

Employer Details: Current/former employer name

Employment Dates: Start and end dates

Signature & Date: Signed, dated attestation

Step-by-Step: Completing the Declaration

Follow these sequential steps to prepare, execute, and retain a valid Employment Declaration of Good Repute.

01

Prepare Documentation: Gather IDs, employment records.
02

Complete Fields: Enter accurate, formatted data.
03

Authenticate Signer: Use required ID checks.
04

Store Record: Save signed copy securely.

Configure an Online Workflow for the Declaration

Set up a consistent digital workflow to collect attestations, authenticate signers, and retain executed copies in your records system.

Field	Configuration
Upload Template	Use PDF or DOCX master
Add Fillable Fields	Name, date, disclosures, signature
Authentication	Email + SMS code or ID scan
Retention	Export to DMS with metadata

Where to Send or File the Completed Declaration

Routing depends on the recipient and regulatory requirements; document the final recipient and storage path when the form is executed.

Employer HR: Attach to employee file
Licensing Board: Include with application package
Regulator: File per agency instructions
Records Archive: Store in secure DMS

Delivery Options and Technical Requirements

Choose execution and delivery methods that match authentication needs, storage, and integration requirements for your organization.

File formats: PDF, DOCX, HTML supported
Integrations: Salesforce, NetSuite, Google Workspace
Authentication: Email, SMS, KBA, ID scan

For regulated workflows, require stronger signer authentication and retained audit trails. Integrate signed outputs with HRIS or document management systems to automate retention schedules and centralize compliance records.

Timing and Typical Submission Expectations

While there is no universal filing date, timing expectations depend on hiring, licensing, or regulatory schedules; document execution timing clearly.

At Hire or Application:

Execute when requested for onboarding

Prior to Clearance:

Provide before security or license approval

When Requested:

Respond promptly to regulator inquiries

After Incident:

Complete immediately following relevant events

Record Date:

Sign and record execution date

Common Mistakes to Avoid

Using informal or incomplete names that do not match government ID, which hinders verification and may invalidate the attestation.
Failing to disclose relevant disciplinary actions or convictions that are material to the role and could lead to regulatory penalties.
Omitting authentication details or relying on weak identity checks when stronger verification is required for regulated positions.
Storing signed copies in insecure locations or without a clear retention policy, complicating audits and legal responses.

Consequences of Incorrect or Incomplete Declarations

Employment Risk: Hiring decisions overturned

Licensing Sanctions: License suspension or denial

Regulatory Penalty: Fines or administrative action

Perjury Exposure: Criminal risk for false statements

Privacy Breach: Improper handling of personal data

Operational Delay: Slowed onboarding or approvals

eSignature Vendor Comparison for Executing This Declaration

Key vendor considerations for executing an Employment Declaration of Good Repute include starting price, trial availability, bulk send, audit trail, and HIPAA support; signNow is listed first for comparison.

	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 vendor	Varies by vendor	Varies by vendor	Varies by vendor
Bulk Send	Yes (Business Premium)	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Frequently Asked Questions

Answers to common questions about validity, e-signing, notarization, updating, and revocation of Employment Declarations of Good Repute.

Need help? Contact support

Is an electronic signature legally valid?
Yes. Electronic signatures are generally enforceable under the federal ESIGN Act (15 U.S.C. §7001) and state UETA laws where adopted; exceptions include certain testamentary and court-filed documents. Verify whether any consumer-facing disclosure or industry-specific standard applies.
When is notarization required?
Notarization depends on state law and the recipient's requirements. Some licensing boards or background checks request notarized attestations; check the receiving authority or state notary rules before finalizing the method of execution.
Can I update a signed declaration?
You cannot alter a signed copy; instead, prepare a corrected or superseding declaration that references and replaces the prior version, have the appropriate parties sign and date the new document, and retain both records for audit purposes.
How should I authenticate signers for sensitive roles?
Use stronger identity proofing such as ID credential analysis, two-factor SMS authentication, or knowledge-based verification for regulated positions. Retain the audit trail showing method, timestamp, IP address, and steps taken.
How do I revoke or cancel a declaration?
To revoke, execute a dated, signed revocation statement that references the original declaration, notify interested parties in writing, and store revocation records with the original document. Some recipients may require a new attestation instead.
Where should executed declarations be stored?
Store signed copies in a secure document management system with access controls, encrypted storage, and an audit trail. For healthcare, follow HIPAA retention rules; for tax or regulatory matters, follow applicable federal or state retention statutes.

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