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APPLICANT RELEASE OF EMPLOYMENT INFORMATION
READ THIS STATEMENT BEFORE SIGNING THIS APPLICATION:
Information provided on this application may be verified, including, but not limited to, contacting former
employers. Any false or substantive omission of information may be cause for rejection or dismissal if
employed by the State.
I authorize the release of any information from previous employers or references. If I am a current or former
employee of the State of Delaware, I acknowledge that my personnel records shall be subject to review by the
hiring agency.
By signing this application, I certify agreement with the terms given above for Applicant Release of
Employment Information.
By signing this application, I certify that I have read and understand the conditions of employment as stated
below. I also certify that this application was completed by me, that all entries on it are true, and that I seek
employment under these conditions.
• Child Support Compliance: State law requires that information on all hires (i.e. Name, Address, Social
Security Number, and Date of Hire) be reported to the State for the purpose of locating persons who owe
family support. The Division of Child Support Enforcement is authorized to request additional
employment and identifying information under special circumstances. Applicants will not be
disqualified from employment based on this information.
• Direct Deposit: As a condition of employment, direct deposit of paychecks is required for all new
employees.
• Immigration Law: At the time of hire, state employees must meet the documentation requirements of the
Immigration Reform and Control Act of 1986.
• Reference Check: Prior to appointment, your education and employment history are subject to
verification. At the time of a selection interview, candidates may be required to provide copies of
certificates, licenses, diplomas, and course transcripts.
Signature Date
An Equal Opportunity Employer
Accommodations are available for applicants with
disabilities in all phases of the application and
employment process. To request auxiliary aid or service, please call (302) 739-5458 for assistance. TDD
users should call the Delaware Relay Service Number 1-800-232-5460 for assistance.
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