Can this form be signed electronically?

Yes. Electronic signatures are legally valid for most employment verification requests under the ESIGN Act and UETA when intent, consent, attribution, and retention can be demonstrated.

Is explicit consent required?

Yes. A signed release authorizing prior employers to disclose employment details prevents privacy refusals and documents applicant permission to proceed.

Do I need a notary or witness?

Not usually. Notarization or witnesses are only required when state law or company policy specifically mandates them for a verification or release form.

What if employer refuses to confirm details?

Document the refusal, attempt a secondary contact, and record the steps taken. Use the refusal record in hiring decisions consistent with policy and legal requirements.

How should sensitive data be protected?

Transmit and store completed forms using encrypted channels and access controls. Limit disclosure to authorized personnel and retain audit logs for compliance.

How long must I keep the completed form?

Retention depends on record type and regulations; follow federal minimums and applicable state or industry rules, and document your retention schedule.

Electronic Signature
Templates
HR
Employment History Request Form

Employment History Request Form

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

EMPLOYMENT HISTORY REQUEST FORM

Use this form to provide a complete employment history and to authorize prior employers and third parties to release employment-related information for the purpose of evaluating employment eligibility. Completion of this form authorizes the release of records and verifies the accuracy of the information provided. Fraudulent statements may result in denial of employment or termination.

Personal Information

Applicant Full Legal Name Current Address

Phone:

Email:

Position Information

Position Applied For Department

Reporting Manager:

Proposed Start Date:

Proposed Salary

Employment History — Employer 1

Employer Name Employer Address

Supervisor:

Supervisor Phone:

Job Title:

Start Date:

End Date:

Duties and Responsibilities Reason for Leaving

Employment History — Employer 2

Employer Name Employer Address

Supervisor:

Supervisor Phone:

Job Title:

Start Date:

End Date:

Duties and Responsibilities Reason for Leaving

Additional Employment (Optional)

Employer Name Employer Address

Education

Highest Degree or Certificate Institution Graduation Date

References

Reference 1 — Name

Phone:

Email:

Relationship Reference 2 — Name

Phone:

Email:

Relationship Reference 3 — Name

Phone:

Email:

Relationship

Legal Disclosures and Authorizations

At-Will Employment: I understand that submission of this form does not constitute an offer or guarantee of employment. If employed, my employment will be at-will and may be terminated by either party at any time, with or without cause or notice, unless otherwise agreed in writing by an authorized representative.

Equal Opportunity: The employer is an equal opportunity employer. Employment decisions are made without unlawful consideration of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status, consistent with applicable law.

Authorization to Contact and Release: I authorize the organizations and persons named in this form to release employment-related information, including dates of employment, job title, duties, performance, disciplinary actions, and reason for separation, to representatives of the prospective employer. I release such organizations and persons from any liability for damages that may result from the release of such information.

Applicant Consent (check all that apply)

I consent to allow contact with my previous employers for employment verification.

I consent to a background check, which may include criminal history, education verification, and employment verification.

I consent to a credit check when required for the position. (If applicable by law.)

Applicant Certification and Release

I certify that all statements on this form are true, complete and made in good faith. I understand that omission or misrepresentation of facts is cause for rejection of my application or, if employed, termination. I expressly authorize the release of employment-related information by prior employers and other third parties to the prospective employer, and I waive any claims against such parties for providing truthful information. I also agree to indemnify and hold harmless any party who provides or receives information in good faith pursuant to this authorization.

Applicant Additional Comments (optional)

For Prior Employer / Verifier Use (to be completed by verifier)

Please complete the verification below and return a signed copy to the requestor. Provide factual confirmation only. Do not provide opinions beyond employment facts.

Verified By — Name Verifier Title and Company

Date Completed:

Verification Notes

Acknowledgment and Signature

By signing below I acknowledge that I have read and understand the certification, disclosures, and authorizations above and that I am the person identified on this form.

Applicant Printed Name:

Signature:

Date:

What the Employment History Request Form Is

The Employment History Request Form is a standardized document used to collect a job candidate's prior employment details and obtain authorization to verify those records. It typically requests employer names, job titles, dates of employment, reason for leaving, and contact information for verification. Organizations use the form to confirm experience, dates, and eligibility for positions while documenting the candidate's consent to contact prior employers and release employment information for hiring decisions.

Why an Employment History Request Form Matters

A consistent request form reduces verification errors, documents candidate consent, and creates an auditable record for hiring decisions. It supports background checks, reduces liability, and provides a defensible process when verification results influence employment actions.

Who Completes and Responds to This Form

Proper routing and consistent completion help maintain compliance with company policy, reduce follow-up requests, and accelerate hiring timelines.

Hiring managers and recruiters who need confirmed employment histories for selection decisions.
Human resources professionals processing background checks and onboarding documentation.
Third-party verification services or background screening firms performing employer checks.

Core Sections to Include in a Professional Form

A well-structured Employment History Request Form groups identity, employment entries, release language, and signature details for clarity and legal defensibility.

Requestor Info

Name, department, and contact details of the person or organization requesting verification, so responses are directed correctly and logged.

Employee Identity

Full legal name, other names used, date of birth, and applicant ID to ensure the verification matches the correct individual.

Employment Records

Structured rows for each employer: company name, job title, start and end dates, primary duties, and reason for leaving.

Verification Contacts

Employer HR contact or supervisor name, phone, email, and best contact hours to minimize delays when verifiers reach out.

Release Authorization

Clear consent text authorizing prior employers to disclose specified employment information to the requester.

Signature Block

Signature, printed name, title (if organization signatory), and date; include witness or notary fields when required.

Required Fields at a Glance

Employee Name: Full legal name

Date of Birth: MM/DD/YYYY

Employer List: Company names

Employment Dates: MM/YYYY–MM/YYYY

Release Consent: Signed authorization

Verifier Contact: Name and phone

Step-by-Step: Completing the Employment History Request Form

Follow a clear sequence to collect consent, fill required fields, send the request, and preserve the signed record for compliance.

01

Prepare the Form: Populate requester fields and add employee identity information before sending.
02

Obtain Applicant Consent: Have the candidate sign the release language to authorize employer verification.
03

Send to Verifier: Deliver the form to the prior employer or verification vendor using a secure channel.
04

Retain the Record: Store the signed copy and audit trail in the employee file for the required retention period.

How to Configure an Online Verification Workflow

Set up fields, authentication, routing, and retention in your document platform to standardize verification requests and audit trails.

Field \| Configuration	Field Name \| Platform Setting
Authentication	Email link with optional SMS code
Signature Type	Electronic signature with full audit trail
Conditional Logic	Show employer contact when consent is affirmative
Retention Policy	Save signed PDF with timestamped audit log

Where to Send Completed Requests and Responses

Choose secure, auditable destinations for requests and returned verifications to maintain chain-of-custody and confidentiality.

Former Employer HR: Direct address to HR or records department for official responses.
Verification Vendor: Send to accredited third-party screeners under engagement terms.
Secure Portal: Use a controlled portal or encrypted email for returned documents.
Applicant File: Store signed verification with candidate record in HRIS or personnel file.

Delivery Options and Technical Considerations

Ensure the platform records timestamps, IP addresses, and a tamper-evident audit trail, and supports export of signed PDFs for retention and compliance.

File Types: PDF or DOCX with preserved formatting
Integrations: Connectors to HRIS and cloud storage
Authentication: Email, SMS code, or knowledge-based checks

Typical Timelines and Processing Expectations

Understand common response windows and retention triggers so you can set realistic SLAs and reminders.

Employer Response Window:

Expect replies within 7–14 calendar days for routine verifications.

Follow-up Reminder:

Send a single reminder after 7 days; follow additional steps if no reply.

I-9 Retention Rule:

Retain I-9 documents for three years after hire or one year after termination, whichever is later.

Record Availability:

Store signed records so they can be produced within regulatory timelines.

Background Check Timing:

Adverse or complex verifications may add 3–10 business days.

Common Preparation and Submission Errors to Avoid

Incomplete dates or vague timelines that prevent accurate verification and trigger follow-up requests.
Missing applicant consent language that makes employers refuse disclosure for privacy reasons.
Incorrect verifier contacts or generic HR addresses that delay responses by several business days.
Using unsecured email for return documents, risking unauthorized disclosure of personal data.

Key Risks and Consequences of Faulty Requests

Incorrect Identity: Mismatched records

Missing Consent: Refused disclosure

TIN Mismatch: Tax or payroll issues

Late Verification: Hiring delays

Incomplete Dates: Ambiguous tenure

Unauthorized Disclosure: Privacy breach risk

eSignature Pricing and Feature Comparison

Selected vendors and typical starting prices for eSignature plans. Confirm vendor plan details before purchase or procurement.

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

Real-World Examples of Use

These brief examples show how organizations structure verification requests and benefit from consistent processes.

Optica Ventures

The interface is simple and easy-to-use for our team; more importantly, it is just as easy for our customers.

Faster turnaround on employment confirmations.
Optica centralized requests to reduce phone follow-ups and built an auditable verification log to support hiring and investor diligence.

Fertility Centers

The airSlate SignNow team has been exceptional, responsive, the API has been great, and we're extremely happy that we chose airSlate SignNow as a company.

Integration with HR systems reduced manual filing.
The organization automated storage of signed verifications and reduced processing time for credential checks.

Frequently Asked Questions About Employment History Requests

Answers to common questions about signing, consent, legal validity, and handling of completed verification forms.

Need help? Contact support

Can this form be signed electronically?
Yes. Electronic signatures are legally valid for most employment verification requests under the ESIGN Act and UETA when intent, consent, attribution, and retention can be demonstrated.
Is explicit consent required?
Yes. A signed release authorizing prior employers to disclose employment details prevents privacy refusals and documents applicant permission to proceed.
Do I need a notary or witness?
Not usually. Notarization or witnesses are only required when state law or company policy specifically mandates them for a verification or release form.
What if employer refuses to confirm details?
Document the refusal, attempt a secondary contact, and record the steps taken. Use the refusal record in hiring decisions consistent with policy and legal requirements.
How should sensitive data be protected?
Transmit and store completed forms using encrypted channels and access controls. Limit disclosure to authorized personnel and retain audit logs for compliance.
How long must I keep the completed form?
Retention depends on record type and regulations; follow federal minimums and applicable state or industry rules, and document your retention schedule.

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