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Form: Confirmation of employment status
Name and surname of employee:
Current position:
Current salary & benefits:
Date of employment:
Identification Number:
PAYE number:
Social Security Number:
Date of birth:
Marital status:
Gender:
Contact telephone number:
Cell phone number:
P O Box; Town:
Residential address:
Accumulated annual leave available on dd/mm/yyyy
________________:
Compassionate leave entitlement left for yyyy
______________:
Accumulated sick leave available on dd/mm/yyyy
______________:
Date of next sick leave cycle entitlement: (linked to
employment date):
________days
________days
________days
_____________________dd/mm/yyyy
Next of kin & contact number:
Employee signature in confirmation and voluntary agreement
that the submitted information in this form is true and correct with
specific reference to accumulated leave balances as on
dd/mm/yyyy ____________. The employee further agree that
he/she is not entitled to any benefits or arrears back pay amounts
( prior to date of signing this form) other than specified in the
attached contract of employment and or this form. (include date):
Employer signature & date:
Sample
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