Fillable Employment Verification THIS SECTION TO BE COMPLETED BY (California)

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Employment Verification THIS SECTION TO BE COMPLETED BY (California)

On average this form takes 14 minutes to complete

The Employment Verification THIS SECTION TO BE COMPLETED BY (California) form is 2 pages long and contains:

  • 2 signatures
  • 12 check-boxes
  • 41 other fields

Country of origin: US
File type: PDF

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Employment Verification
To: (Name and Address of Employer) Date:
RE:
Employee:
Presently Employed: Yes
No
Current Wages/Salary: (check one)
hourly weekly bi-weekly semi-monthly monthly other:
Average # of Regular hours per week:
From: To:
Overtime Rate (per hour) Average # of OT Hours:
Shift Differential Rate: Average # of SD Hours: $
THIS SECTION TO BE COMPLETED BY EMPLOYER
THIS SECTION TO BE COMPLETED BY MANAGEMENT AND EXECUTED BY TENANT
Date
SSN # Unit #
I hereby authorize the release of my employment information:
Applicant/Tenant Name
Signature of Applicant/Tenant
Job Title:
Date First Employed:
Last Day Employed:
(per week)
$
(per week)
The individual named directly above is an applicant/tenantof a housing program that requires
verification of income. The information provided will remain confidential to satisfaction of that
stated purpose only. Your prompt response is crucial and greatly appreciated.
YTD $
Project Owner/Management Agent
Return Form To:
Page1of2
CATaxCreditAllocationCommittee
VerificationofEmployment(April2022)
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Employment Verification
Commissions, bonuses, tips, other additional pay: (check one)
hourly weekly bi-weekly semi-monthly monthly other
List any anticipated change in the employees rate of pay within the next 12 months (raise):
Amount: Effective Date:
If the employee's work is seasonal or sporadic, please indicate the layoff period(s):
Additional Remarks:
NOTE: Section 1001 of Title 18 of the U.S. Code makes it a criminal offense to
make willful false statements or misrepresentations to any Department or Agency of
the United States as to any matter within its jurisdiction.
Employer [Company] Name and Address
E-mail Phone Fax
Employer's Signature Employer's Printed Name Date
$
Page2of2
CATaxCreditAllocationCommittee
VerificationofEmployment(April2022)
click to sign
signature
click to edit
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Employment Verification THIS SECTION TO BE COMPLETED BY (California)

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Completed 9 June 2022

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