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Employer Statement Form Template

Streamline Employment Verification with Our Employer Statement Form

Struggling to provide clear and reliable employment verification? This Employer Statement Form Template is designed to help you easily confirm employment details for job applications, reference checks, loans, and more. By using this template, you can improve communication with applicants, maintain consistency in your documentation, and ensure legal compliance with WCAG-aligned labels. Make the process efficient and user-friendly-explore the live template to see how it works!

Organization name
Organization address
Main phone number
Employee full name
Job title/position
Employment start date
Is the employee currently employed?
Yes
No
Employment end date (if applicable)
Employment status
Full-time
Part-time
Temporary
Seasonal
Contractor
Intern
Per diem
Other
Please Specify:
Compensation basis
Hourly
Salary
Commission
Stipend
Contract
Other
Please Specify:
Regular pay rate (include currency and unit)
Pay frequency
Weekly
Biweekly
Semimonthly
Monthly
Other
Please Specify:
Name of requesting organization
Purpose(s) of this statement
Please Specify:
Employer statement (factual summary)
I affirm the information provided is true and accurate
Yes
No
I am authorized to release this information to the requesting party
Yes
No
Employer representative full name
Job title/role
Work email
Typed name as signature
Date signed
{"name":"Organization name", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Organization name, Organization address, Main phone number","img":"https://www.quiz-maker.com/3012/images/ogquiz.png"}
Paper art illustration representing an employer statement form template for FormCreatorAI article

When to use this form

Use this form when a bank, landlord, or agency asks you to confirm employment details in writing. HR teams and managers can complete it fast to support loan approvals, rental applications, visa processing, or benefit claims. Include job title, status, dates, hours, and pay so third parties can validate the record and make a decision. If a requester needs deeper proof of role, pair this with our Employment verification form. When pay amounts are required for underwriting or assistance programs, add a Wage verification form. The result is a clear, signed record that reduces back-and-forth, protects employee privacy, and speeds up processing.

Must Ask Employer Statement Questions

  1. What is the employee's full legal name, current job title, and employment status (full-time, part-time, or contractor)?

    This uniquely identifies the person and prevents mixing records for people with similar names. Role and status help the requester assess stability and eligibility.

  2. What is the employment start date and, if applicable, the end or separation date?

    Tenure confirms work history for mortgages, visas, and claims. An end date clarifies whether the employment is active or ended.

  3. How many hours does the employee work per week, and what is the typical schedule?

    Hours show consistency of work and expected income. Schedule details support childcare, leave, and shift-sensitive reviews.

  4. What is the employee's current base pay, pay frequency, and any variable pay (overtime, bonuses, tips)?

    Precise pay data lets lenders and agencies verify income without guessing. Listing variable pay signals whether earnings fluctuate across periods.

  5. Who is the authorized company representative completing this form (name, title, phone/email), and when did they sign?

    An authorized contact adds accountability and a path for follow-up. If the recipient requires proof of the signer's identity, attach a Signature verification form.

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