HR Signature Request Form

HR Signature Request Form

Request Details

Requestor Name:

Date Requested:   Priority:

Employee / Applicant Information

Phone:   Email:   Employee ID:

Position Information

Proposed Start Date:   Salary / Rate:

Full-Time    Part-Time    Temporary    Contractor

Documents Requested for Signature

Please select each document to be presented for signature and provide any distribution instructions below.

Offer Letter    Employment Agreement    Non-Disclosure Agreement (NDA)    Employee Handbook Acknowledgment

Direct Deposit Form    Policy Acknowledgment(s)    Other (specify below)

Delivery Method & Deadline

Delivery Method: Electronic Signature (email)    In‑Person    Mail

Signature Deadline:   Requested Signer:

Special Instructions / Comments

Employment History (Most Recent First)

Title:   Start Date:   End Date:

Title:   Start Date:   End Date:

Education

Graduation Date:

References (Professional)

Legal Disclosures and Authorizations

At-Will Employment Statement: The submission of this form and any subsequent offer shall not constitute a guarantee of employment for any specified duration. Employment, if offered, is on an at-will basis, which means either the employee or the employer may terminate the employment relationship at any time, with or without cause or advance notice, except where contrary to applicable law or a written agreement signed by an authorized representative.

Equal Opportunity: The employer is an equal opportunity employer. Employment decisions are made without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, veteran status, or any other protected characteristic under applicable law.

Authorization to Verify and Background Check: By checking the box below and signing this form, I authorize the employer, its agents, and service providers to contact current and former employers, educational institutions, references, licensing authorities and other specified sources to verify the statements on this form and to obtain consumer reports, background checks, and other information necessary for employment decisions. I understand such checks may include verification of education, employment history, criminal record where permitted by law, and professional references. I further authorize release of records and waive any right to bring action against any person or entity who provides information in good faith.

I authorize verification of the information provided and consent to background and reference checks as described above.

Applicant Certification

I certify that all information submitted on and with this form is true, complete and correct to the best of my knowledge. I understand that any misrepresentation or omission may result in denial of the requested signature process or, if employment has commenced, disciplinary action up to and including termination. I authorize the employer to rely on this certification for purposes of executing or presenting documents for signature. I understand that execution of requested documents by me does not alter the at-will nature of employment unless expressly stated in a separate written agreement signed by an authorized representative.

I certify the foregoing and consent to the terms above.

Acknowledgment and Release

I acknowledge receipt of this request and understand that signature routing and execution will proceed in accordance with the employer's internal signature and records procedures. I release the employer and any third parties providing background or reference information from liability for providing truthful information in response to verification inquiries.

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