Financial WVOE Document

FINANCIAL WRITTEN VERIFICATION OF EMPLOYMENT (WVOE)

Requesting Party Information (Complete by Requesting Financial Institution)

Company Name:

Request Date:

Applicant / Employee Information

Employee Identification (last four digits of SSN or Employee ID):

Date of Birth:

Employer Information (To be completed by Employer)

Employer Telephone:     Employer Email:

Employment and Compensation Details (Employer to Complete)

Employment Status: Full-time Part-time Contract Temporary

Hire Date:     Most Recent Status Change (if applicable):

Pay Frequency: Weekly Bi-weekly Semi-monthly Monthly

Date of Last Pay Period Ending:

Separation, Leave or Reduction in Hours

Yes No

Certification and Legal Authorization

Applicant Authorization: I authorize my employer and its agents to provide the requesting financial institution the information requested on this form. I understand that this information will be relied upon in connection with a credit or underwriting decision. I certify that the information I have provided to the requesting party is true and correct. I understand that knowingly providing false information may subject me to civil or criminal penalties under applicable law.

Employer Verification Statement: By completing this form the undersigned employer representative certifies, under penalty of perjury, that the facts contained herein are true and accurate to the best of their knowledge. The employer consents to release of the requested information to the requesting financial institution for legitimate business purposes related to the applicant's financial transaction.

Verification Completed Date:

Employer certifies under penalty of perjury: I certify the above information is accurate

Applicant Authorization — Signature

Applicant: By signing below I authorize release of employment and earnings information to the requesting financial institution for the specific purpose of evaluating my application for credit, mortgage or other financial product. I understand this authorization remains valid for a reasonable period to complete the verification process.

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