Can the Employment Disclosure Form be e-signed?

Yes. Electronic signatures are valid under the federal ESIGN Act (15 U.S.C. ch. 96) and in most states under UETA; confirm exceptions such as wills or certain court filings.

When does the ESIGN consumer disclosure apply?

Provide consumer-facing disclosure and obtain consent when the transaction is consumer-oriented; follow 15 U.S.C. §7001(c) requirements to show the signer can access electronic records.

Is notarization ever required?

Not typically for standard employment disclosures, but specific attestations or state rules may require notarization or witnesses; verify state requirements before sending for notarization.

What identity verification should I use?

Match verification strength to risk: email only for low risk, add SMS or KBA for moderate risk, and use government ID checks for high-risk screening.

How long should completed forms be kept?

Follow federal minimums (IRS: 3 years; HIPAA: 6 years where applicable) and retain longer if industry rules or state law require it.

How do I correct a returned form with errors?

Request a corrected form and re-sign electronically; retain the original audit trail and a note describing the correction for audit purposes.

Electronic Signature
Templates
HR
Employment Disclosure Form

Employment Disclosure Form

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

EMPLOYMENT DISCLOSURE FORM

Personal Information

Full Legal Name Current Address

Phone Number

Email Address

Date of Birth

Position Information

Position Title:

Department

Reporting Manager:

Anticipated Start Date: Annual Salary/Rate:

Employment History (Most Recent First)

Employer 1 — Company Name

Primary Responsibilities Reason for Leaving

Employer 2 — Company Name

Primary Responsibilities Reason for Leaving

Education

Highest Degree Earned Institution

Graduation Date:

References (Professional)

Reference 1 — Name

Reference 2 — Name

Reference 3 — Name

Legal Disclosures and Authorizations

At-Will Employment: I understand and acknowledge that, unless otherwise provided in a separate written agreement signed by an authorized representative, employment with the company is on an at-will basis. Either the company or I may terminate the employment relationship at any time, with or without cause or notice.

Equal Opportunity: The company is an equal opportunity employer. Employment decisions are made without regard to race, color, religion, sex, national origin, age, disability, genetic information, veteran status, or any other protected characteristic under applicable law.

Authorization to Verify Information and Conduct Background Checks:

I authorize the company to verify the accuracy of the information provided in this form and to obtain information regarding my previous employment, education, criminal history, and other public records as permitted by law.

Criminal Convictions Disclosure: Conviction of a crime does not automatically disqualify an applicant. Failure to disclose convictions when requested is grounds for adverse action.

I have no convictions to disclose
I have the following conviction(s) to disclose:

Prior Termination or Resignation Under Investigation: Have you ever been terminated, asked to resign, or resigned while under investigation? If yes, provide details.

Yes No

Drug and Alcohol Testing: I acknowledge that the employer may require drug and alcohol testing consistent with company policy and applicable law. Refusal to submit to testing may result in withdrawal of an offer or disciplinary action.

I acknowledge and consent

Conflict of Interest and Confidentiality: I certify that I will disclose any potential conflicts of interest and that I understand my obligation to protect confidential company information both during and after employment.

I acknowledge and agree

Applicant Certification and Consent

I certify under penalty of law that the information provided in this Employment Disclosure Form is true, correct, and complete to the best of my knowledge. I understand that any false statements, omissions, or misrepresentations may result in the withdrawal of an offer of employment or termination of employment. I authorize the company and its agents to contact former employers, educational institutions, references, and other listed entities to verify the information provided and to obtain background information as permitted by law. I further release such persons and entities from liability for providing truthful information in good faith.

I certify that the above statements are true and authorize the disclosures and verifications described above.

Optional Identifying Information for Background Check

Providing the information below can assist in accurately matching records. Providing these details is voluntary and will be used only for background screening if consent is given above.

Signature

Printed Name:

Signature:

Date:

What the Employment Disclosure Form Is and when it’s used

An Employment Disclosure Form is a standardized document employers use to collect factual information from job applicants or current employees that may affect hiring, placement, or workplace compliance. Typical disclosures cover prior employment, criminal history, conflicts of interest, outside work, professional licenses, and authorizations for background checks. Employers use the form to assess suitability, satisfy regulatory screening requirements, and document informed consent. When completed electronically, the form must meet federal and state e-signature requirements such as the ESIGN Act and state UETA or ESRA statutes to be legally effective.

Why accurate disclosures matter for employers and employees

Clear, accurate disclosures reduce hiring risk, support regulatory compliance, and create an auditable record for background checks and internal decisions. They help employers make consistent hiring decisions and enable employees to disclose material facts while preserving privacy controls.

Who typically completes or requests an Employment Disclosure Form

Role clarity helps assign responsibility for distribution, verification, and secure storage across the organization.

HR and Recruiting Teams — Prepare forms, manage distribution, and evaluate disclosures for hiring and onboarding compliance.
Job Applicants and Employees — Provide truthful, complete responses and sign to authorize checks and attestations.
Legal and Compliance Departments — Review disclosures for regulatory obligations and retain records for audits and litigation support.

Step-by-step: How to complete and process the Employment Disclosure Form

Follow these sequential steps to collect, verify, and store completed disclosure forms with minimal friction and proper controls.

01

Prepare Form: Customize fields and required attachments before sending.
02

Send to Signer: Provide clear instructions and expected deadlines for return.
03

Verify Identity: Use ID check, SMS or KBA as required by policy.
04

Store and Audit: Archive completed form and audit trail in secure records.

Essential sections to include in a professional Employment Disclosure Form

A well-structured form balances thoroughness with clarity. Include standard components that support legal review, background checks, and retention.

Identification

Fields for full legal name, DOB, SSN or alternative ID, and current address to facilitate identity verification and background matching.

Disclosure Statements

Clear yes/no prompts and short free-text areas for criminal history, licensing issues, conflicts of interest, and outside employment disclosures.

Consent for Checks

Explicit authorization language for background checks, reference checks, and drug testing where applicable; specify scope and recipients.

Employment History

Structured fields for prior employers, positions, responsibilities, and dates to support verification and eligibility assessment.

Privacy Notice

Statement describing how information will be used, stored, and shared; include HIPAA or other data-handling notices when applicable.

Signature Block

Signature, printed name, and date with space for witness or notary if state law or employer policy requires authentication.

Required data elements commonly collected

Full name: Legal name as ID

Date of birth: MM/DD/YYYY

SSN or ID: Nine digits or alternate

Contact address: Street, city, state, ZIP

Employment dates: MM/YYYY ranges

Signed authorization: Signature and date

How to configure an online workflow for the Employment Disclosure Form

Configure fields, authentication, and routing before sending. The table below outlines typical workflow settings and recommended values.

Workflow Field and Configuration Guide	Field \| Configuration
Signer Authentication Method Required Option	Email link \| SMS code or KBA for higher risk
Signature Field Placement and Required	Signature block \| Required before submission
Conditional Fields and Visibility Rules	Show criminal-history details only if 'Yes' selected
Document Retention and Export Settings	Export PDF \| Store audit trail and attachments

Digital signing, format support, and integrations to consider

Confirm vendor compliance (ESIGN, UETA, HIPAA if applicable) and ensure secure export to HRIS or document storage.

File formats: PDF, DOCX, and HTML supported
Integrations: Salesforce, NetSuite, Google Workspace
Authentication: Email link, SMS code, KBA

Typical routing for completed Employment Disclosure Forms

Most organizations follow a short routing path: collect, verify, review, and store. Below are the common handoffs in that flow.

Upload: Sender uploads form and attachments to platform
Place fields: Add signature, initials, date, and conditional questions
Send to signer: Deliver via authenticated email or secure link
Review and archive: Verifier checks responses and stores PDF with audit trail

Important timelines and deadlines to track

Track key deadlines for distribution, retention, and tax or regulatory filings that relate to employment records.

Provide W-9 or similar upon request:

No statutory deadline; supply when a payer requests

W-2 distribution to employee:

Employee copy due by January 31

1099-NEC recipient and IRS deadline:

Forms due January 31 for nonemployee compensation

I-9 retention timeframe:

Retain 3 years after hire or 1 year after termination, whichever is later

Individual tax filing deadline:

Form 1040 due April 15 unless extended

Common mistakes to avoid when preparing the Employment Disclosure Form

Asking for unnecessary data without legal basis increases privacy risk and may violate state privacy laws.
Failing to use consistent date formats or official name spellings causes mismatches in background checks and delays.
Sending forms without consumer-facing ESIGN disclosures where required can render electronic consent unenforceable.
Storing completed forms in unsecured email or shared drives risks data breaches and regulatory penalties.

Consequences of incorrect or missing disclosures

Information return penalties: IRC §6721 penalties for incorrect filings

I-9 violations: 8 CFR §274a.2 penalties $281–$2,789 per violation

Background screening risk: Adverse decisions without proper notice risk claims

HIPAA exposure: PHI mishandling requires BAA and controls

State-law claims: Wrongful termination or discrimination suits

Recordkeeping failures: Regulatory fines and evidentiary problems

Common eSignature vendor pricing and feature snapshot for Employment Disclosure workflows

Compare baseline costs and key capabilities that affect high-volume HR workflows. signNow appears first for direct feature mapping and pricing context.

	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	Yes, 7-day	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Bulk Send	Yes (Premium)	Yes	Yes	Yes	Limited
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Frequently asked questions about the Employment Disclosure Form

Practical answers to common implementation, execution, and retention questions for HR and legal teams.

Need help? Contact support

Can the Employment Disclosure Form be e-signed?
Yes. Electronic signatures are valid under the federal ESIGN Act (15 U.S.C. ch. 96) and in most states under UETA; confirm exceptions such as wills or certain court filings.
When does the ESIGN consumer disclosure apply?
Provide consumer-facing disclosure and obtain consent when the transaction is consumer-oriented; follow 15 U.S.C. §7001(c) requirements to show the signer can access electronic records.
Is notarization ever required?
Not typically for standard employment disclosures, but specific attestations or state rules may require notarization or witnesses; verify state requirements before sending for notarization.
What identity verification should I use?
Match verification strength to risk: email only for low risk, add SMS or KBA for moderate risk, and use government ID checks for high-risk screening.
How long should completed forms be kept?
Follow federal minimums (IRS: 3 years; HIPAA: 6 years where applicable) and retain longer if industry rules or state law require it.
How do I correct a returned form with errors?
Request a corrected form and re-sign electronically; retain the original audit trail and a note describing the correction for audit purposes.

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