Job Applicant Employment Verification Form



Job Applicant Employment Verification Form :



The person identified below is being considered for employment and has signed a statement authorizing this verification and investigation. We shall appreciate a statement of your opinions and experiences as outlined below. Your reply will be considered confidential.


Name of Applicant :


Social Security Number :


Dates of Claimed Employment :


Position Last Held :


Final Rate of Pay :


Is the above information correct? Yes No


If not please make corrections. :


What is your opinion as to this person's :


Ability :


Effort :


Conduct :


Attendance :


Reason for leaving your employ :


Eligible for rehire? Yes / NoIf not, why? :


Your further comments on any personal or professional strengthand weaknesses will be appreciated.:


Date :


Signed :


Title :




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Job Applicant Employment Verification Form
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