Employment Representation Authority

EMPLOYMENT REPRESENTATION AUTHORITY

This Employment Representation Authority ("Agreement") is entered into between Client Name: and Representative Name: . The Client appoints the Representative to act on Client's behalf under the terms set forth below.

Personal Information (Client)

Position Information

Representative Authority and Scope

Representative is authorized to take the following actions on behalf of Client (initial applicable authorities and describe limits where required):

Submit resume, curriculum vitae, and employment application materials to prospective employers.

Negotiate employment terms, including compensation and start date, subject to Client's express instructions.

Accept an employment offer on Client's behalf (only if Client provides separate written, pre-authorized consent).

Other scope limitations or special instructions:

Representation Terms — Exclusivity and Term

Representative shall have exclusive representation rights during the term. If exclusive, the exclusive period (in months):

Agreement term begins on signing and continues until: or until earlier written termination by either party in accordance with this Agreement.

Fees and Commission

If Representative procures an employment offer accepted by Client, Client agrees to pay Representative a placement fee equal to of the first year base cash compensation, or as otherwise agreed in writing. Alternative fee arrangement:

Fee becomes due and payable within days of Client's start date or other agreed milestone.

Confidentiality and Data Use

Representative will treat Client's personal information, employment history, references, and confidential materials as confidential and may share such information only with prospective employers or third parties reasonably necessary to effectuate representation. Representative will not disclose sensitive personal identifiers other than as required for background checks and recruitment, except with Client's express written consent.

Authorizations and Consents

Client expressly authorizes Representative and its agents to contact current and former employers, educational institutions, references, and other entities to verify employment history, education, professional credentials, and to obtain background and reference information. Client further authorizes prospective employers to disclose verifiable employment and salary history to Representative for the purpose of recruitment and placement.

Client authorizes background screening, including criminal background checks, drug testing, credit checks where permitted by law, and authorization for Representative to receive the results. Client acknowledges that any offer of employment is subject to the employer's screening requirements.

Employment History (Provide at least two recent employers)

Dates Employed: From to

Dates Employed: From to

Education

Professional References (Provide three)

Legal Disclosures

At-Will Employment: Client acknowledges that Representative does not guarantee employment and that any employment relationship with a prospective employer may be at-will, unless a written contract states otherwise.

Equal Opportunity: Representative and prospective employers are equal opportunity organizations. Decisions regarding representation and placement will be made without regard to legally protected characteristics.

Representations, Warranties, and Indemnity

Client represents and warrants that all information provided to Representative is true, complete, and accurate to the best of Client's knowledge. Client agrees to promptly notify Representative of any material change to such information. Client agrees to indemnify and hold Representative harmless from claims arising from inaccuracies in Client-provided information or from Client's breach of this Agreement, except for claims arising from Representative's gross negligence or willful misconduct.

Termination

Either party may terminate this Agreement upon written notice to the other. Termination will not relieve Client of liability for fees that have become due under the Fee provisions for placements procured prior to termination in accordance with the agreed fee timing.

Governing Law and Notices

This Agreement will be governed by and construed in accordance with the laws of the state or jurisdiction stated in the parties' signatures below. Notices required under this Agreement shall be in writing and delivered to the addresses provided in this Agreement.

Applicant Certification and Authorization

I certify that all information provided in this document is true and complete. I authorize the Representative and prospective employers to verify any statements made herein, to obtain reference information, and to conduct background checks as permitted by applicable law. I understand that misrepresentation or omission of material facts may be grounds for immediate termination of representation.

I acknowledge receipt of a copy of this Agreement and consent to its terms.

I certify: Information is true and complete    |    I authorize background/reference checks:

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