California Employment Verification Template
This document is designed to assist in the verification of employment for individuals working within the state of California. It adheres to the regulations set forth by the California Labor Code and the federal Fair Credit Reporting Act (FCRA), ensuring that all employment verification processes respect the privacy and rights of the employee.
Please complete all sections of this template accurately. Providing false or misleading information can lead to legal consequences.
Section 1: Employer Information
Employer Name: ___________________________
Employer Address: _________________________
City: ___________________, State: CA, Zip Code: _________
Employer Contact Number: __________________
Employer Email: ___________________________
Section 2: Employee Information
Employee Name: ____________________________
Employee Job Title: _______________________
Employee Department: _____________________
Employee Start Date: _____________________
Employee End Date (if applicable): ________
Section 3: Verification Requester Information
Requester Name: ___________________________
Requester Company: ________________________
Requester Contact Number: _________________
Requester Email: __________________________
Relation to Employee: ____________________________
Purpose of Verification: _________________________
Section 4: Declaration and Authorization
By signing below, I, _____________ (name of the requester), hereby affirm that all the information provided in this form is true and accurate to the best of my knowledge. I understand that the verification process will be conducted in accordance with California state-specific laws and regulations, including California Labor Code provisions relevant to employment verification. I authorize the release and sharing of the employee's employment information as requested above and understand that the employee may have the right to request a copy of this verification under state law.
Signature of Requester: _____________________ Date: ____________
Section 5: Employer's Verification
This section is to be completed by the employer or authorized representative only.
We, __________ (name of the company), verify that the above-named employee has been (or was) employed with us as stated. We declare that all information provided here is accurate and true, and we acknowledge that providing false information can have legal implications.
Signature of Employer/Authorized Representative: ______________ Date: ____________
Instructions for Completing the Verification
- Ensure all information is complete and accurate.
- Both the requester and the employer/authorized representative must sign the document.
- Keep a copy of the completed form for your records.
- Be aware of the employee’s rights under California law and respect their privacy throughout the process.
- Contact legal counsel if you have questions regarding this verification process or the applicable laws.