____________________________________________________________________
, a Division of Gesa Credit Union
Authorization for Release of
Employment Verification Information
I authorize you to release to Inspirus Credit Union
verification of my employment at
A copy of this authorization may be accepted as an original.
Employee _________________________________________
Signature _________________________________________
Date _____________________________________________
Employer, please complete the information below and mail or fax to:
Inspirus Credit Union
P.O. Box 576
Seattle, WA 98111-0576
Fax: (206) 676-1007
Phone: (206) 628-4085
Date _____________________
Time ________________________________
________________________________ is employed at ________________________________
(employee name) (company name)
full time / part time (please check one) as a/an _____________________________________
(position)
Completed by ____________________________ _______________________________
(printed name) (signature)
Title ____________________________________
055_v08/2019
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