Job Applicant Employment Verification Form

A Job Applicant Employment Verification Form will get pertinent information and verification for any prospective employees your company is

wishing to hire.

The following sample form is intended for employers seeking proof and authentication of a considered applicant’s previous employment.

Although a relatively short form, this sample form requests a concise recollection of a prospective employees’ flaws and talents.

This sample form takes on from after applicants have provided you with an employment history.

Send this form to those businesses to request disclosure on the intended applicant’s employment history in further detail.

This form is a closer helper, giving you the tools to make the best decision for your business.


Dear ___________, 

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






Reason for leaving your employ________________________________



Eligible for rehire?  Yes_____No_____If not, why?_____________



Your further comments on any personal or professional strength and weaknesses will be appreciated.___________________________






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