HR CA Notices Packet

HR CA NOTICES PACKET

Personal Information

Position Information

Proposed Start Date:    Annual Salary/Rate: $

Employment History (Most Recent)

Dates Employed: From to

Employment History (Prior)

Dates Employed: From to

Education

References (Professional)

California Employer Notices (Acknowledgment)

The following are brief summaries of legally required California notices provided to you. By checking each box you acknowledge receipt of the corresponding notice and understand that complete policy texts and detailed explanations are maintained by the employer and are available upon request.

 Minimum Wage Notice: Information about current minimum wage and wage statement rights, including itemized pay statements and deductions.

 Meal and Rest Breaks: Employees are entitled to unpaid meal periods and paid rest breaks under California law; employer policy on timing and compensation for missed breaks is provided.

 Paid Sick Leave: Accrual, carryover, allowable uses, and required notice when using paid sick leave.

 Workers' Compensation: Procedures for reporting work-related injuries or illnesses and rights to medical treatment and benefits.

 Family and Medical Leave (CFRA/FMLA): Eligibility, leave duration, job protection, and certification requirements for family and medical leave.

 Sexual Harassment & Discrimination: Employer policy prohibiting harassment and discrimination, complaint procedures, and anti-retaliation protections.

 Lactation Accommodation: Right to breaks and a private space for lactation; process to request accommodations.

 Unemployment Insurance: Notice of potential eligibility for state unemployment benefits if employment terminates through no fault of the employee.

Legal Disclosures

At-Will Employment: Unless otherwise set forth in a separate signed written agreement, employment with the employer is at-will. This means either the employee or the employer may terminate the employment relationship at any time, with or without cause or advance notice. Nothing in this packet, nor any policy provided herein, creates a contract guaranteeing employment for any specific period.

Equal Employment Opportunity: The employer maintains a policy of equal employment opportunity. Hiring, promotion, discipline, and termination decisions are made without regard to protected characteristics and in accordance with federal and California law. Harassment and retaliation are prohibited.

Authorization to Verify and Conduct Background Checks

I authorize the employer and its agents to contact current and former employers, educational institutions, personal references, and other third parties to verify information provided in this packet and to obtain information regarding my background relevant to employment. I further authorize the employer to obtain consumer reports, criminal background checks, and other investigative reports as permitted by law. I understand that any adverse action based wholly or in part on a consumer report will follow applicable disclosure and consent requirements.

 I authorize the background, reference, and education checks described above and consent to release of records.

Applicant Certification

I certify under penalty of perjury under the laws of the State of California that all information I have provided on this form and in any supporting documents is true, correct, and complete. I understand that falsification, misrepresentation, or omission of facts may result in denial of employment or, if employed, disciplinary action up to and including termination. I understand that any employment offer is contingent upon satisfactory completion of all background checks, verification of credentials, and, where applicable, completion of required employment paperwork.

 I certify that the information provided is complete and accurate and I consent to the terms stated in this packet.

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