HR Annual Workforce Declaration

HR ANNUAL WORKFORCE DECLARATION

Employer Name:   Reporting Year:

Personal Information

Phone:   Email:   Date of Birth:

Position Information

Reporting Manager:   Official Work Location:

Official Start Date:   Current Annual Compensation: $

Full-time    Part-time    Temporary    Contractor    Intern

Exempt    Non-exempt    Union-represented

Workforce Demographics and Availability

Primary Work Arrangement:   FTE Allocation (decimal):

Veteran    Person with a disability    Decline to state

Employment History (Most Recent)

Title:   Dates Employed: From to

Employment History (Previous)

Title:   Dates Employed: From to

Education

Major/Field:   Graduation Date:

Professional References

Phone:   Email:   Relationship:

Phone:   Email:   Relationship:

Phone:   Email:   Relationship:

Legal Disclosures and Notices

At-Will Employment: I acknowledge that, unless otherwise expressly provided in a separate written agreement signed by an authorized company officer, my employment with the employer is at-will and may be terminated by either the employer or myself at any time, with or without cause or notice.

Equal Opportunity: The employer provides equal employment opportunity to all persons and prohibits discrimination and harassment of any type. This policy applies to all terms and conditions of employment.

Truthfulness and Consequences: I certify that the information provided in this declaration is true, complete, and accurate to the best of my knowledge. I understand that materially false statements or omissions may result in disciplinary action up to and including termination.

Authorization and Consent

Authorization to Verify: I authorize the employer and its agents to verify all information provided on this declaration, including contacting prior employers, educational institutions, references, and other third parties as necessary for verification or workforce planning purposes. I authorize the release of information requested by the employer.

Background Checks and Records: I consent to any background checks, employment verification, and records checks consistent with applicable law. I understand that any checks will be conducted in accordance with applicable laws and company policies.

Data Use: I understand that the information provided is used for employment administration, benefits eligibility, regulatory reporting, internal workforce planning, and other legitimate business purposes consistent with company policy and applicable law.

I consent to verification of education and prior employment.
I consent to employment-related background checks as permitted by law.
I acknowledge the employer's use of the data as described above.

Applicant Certification

I certify under penalty of perjury that the information provided in this HR Annual Workforce Declaration is true, complete, and correct. I understand that this declaration will be retained in my personnel file and used for internal reporting and compliance purposes.

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