Pre-Employment Reference Check

Pre-Employment Reference Check Via Letter From: Date To: We would appreciate your assistance in verifying the information listed below regarding an employment application. It is to be understood that all information is confidential and will be treated as such in our company personnel files. Attached, please find an authorization to release information signed by the applicant. A self addressed, stamped envelope is enclosed for your convenience in replying. We appreciate your assistance in this matter. Thank You. Sincerely, Human Resource Manager The Following information was provided to us by the applicant. Please make any appropriate corrections Name Job Title Dates of Employment Reason for Termination SSN Final Salary OUTSTANDING GOOD AVERAGE POOR Attendance Quality of Work Quantity of Work Cooperation Responsibility 1 1 1 1 1 2 2 2 2 2 3 3 3 3 3 4 4 4 4 4 Signed Title Date American LegalNet, Inc. www.FormsWorkFlow.com 2001 © American LegalNet, Inc.