HR Duplicate Document Template

HR Duplicate Document Template

Document Title:    Duplicate ID:

Personal Information

Position Information

Reporting Manager:    Agreed Start Date:

Employment Type: Full-time Part-time Contractor

Employment History (Most Recent First)

Education

Graduation Date:

References (Professional)

Legal Disclosures

At-Will Employment: I acknowledge that, unless otherwise provided in a separate written agreement signed by an authorized representative of the Employer, my employment is at-will and may be terminated by either party with or without cause and with or without notice.

Equal Employment Opportunity: The Employer prohibits discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to protected characteristics as defined by applicable law.

I acknowledge the At-Will Employment statement above.
I acknowledge the Equal Employment Opportunity statement above.

Applicant Certification & Authorization

I certify that all information provided in this form is true, complete, and correct to the best of my knowledge. I understand that any misrepresentation or omission may result in withdrawal of an offer or termination of employment.

Authorization: I authorize the Employer to contact my previous employers, educational institutions, references, and other entities identified herein to verify the information provided. I further authorize the Employer to obtain background checks, employment verification, and where required, drug screening in accordance with applicable law.

I certify that the information is true and grant the authorizations above.

Have you ever been convicted of a crime that has not been annulled, expunged, or sealed?    Yes    No

Duplicate Document Record (For HR Use)

Number of Copies Issued:    Date Issued:    Recipient Copy #:

Employer Acknowledgment (HR)

HR Acknowledgment Date:

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