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Employer Affidavit of Employment Template
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Employer Affidavit of Employment Template
This Employer Affidavit of Employment (the “Affidavit”) is made on [Date] by:
Employer: [Company Legal Name]
Company Address: [Address]
Employer Phone/Email: [Contact]
Authorized Representative/Affiant: [Full Name], [Title/Department]
Work Address (If Different): [Address]
Phone/Email: [Contact]
Employee: [Employee Full Name]
Employee ID (Optional): [ID]
Employee DOB (Optional): [DOB]
Employee SSN/Tax ID (Last 4 Only) (Optional): [____]
1. Employment Verification
1.1 The employee listed above is employed by [Company Legal Name].
1.2 Job Title/Position: [Title]
1.3 Employment Status: ☐ Full-time ☐ Part-time ☐ Temporary ☐ Seasonal ☐ Contract (employee)
1.4 Start Date: [Date]
1.5 Current Employment (Select One): ☐ Active ☐ On leave (type: []) ☐ Terminated (date: [])
1.6 Work Location: ☐ On-site ☐ Remote ☐ Hybrid — Location/Office: [__]
2. Compensation (Optional — Include Only If Requested)
2.1 Pay Type: ☐ Hourly ☐ Salary ☐ Commission ☐ Mixed
2.2 Rate/Salary: $[Amount] per ☐ hour ☐ year (or base salary: $[])
2.3 Average Hours Per Week (If Hourly): []
2.4 Pay Frequency: ☐ Weekly ☐ Biweekly ☐ Semi-monthly ☐ Monthly
2.5 Additional Compensation (Optional): ☐ bonus ☐ commission ☐ tips ☐ other: []
2.6 Current Annualized Income (Optional): $[] (estimate).
3. Employment Details (Optional)
3.1 Supervisor Name/Title (Optional): []
3.2 Department (Optional): []
3.3 Good Standing (Optional): ☐ Yes ☐ No (if “No,” explain briefly): [__].
4. Purpose (Optional)
4.1 This Affidavit is provided for: ☐ loan/mortgage ☐ housing ☐ benefits ☐ court ☐ immigration ☐ other: [__].
5. Statement Under Oath
5.1 I declare under penalty of perjury that the statements in this Affidavit are true and correct based on the employer’s records and my knowledge as an authorized representative.
Signatures
Authorized Representative/Affiant: [Full Name]
Title: [Title]
Date: [Date]
Signature: ___________________________
Witnesses (If Required)
Witness Name: [Name]
Date: [Date]
Signature: ___________________________
Notary / Notarization (If Required)
State of [State]
County of [County]
On [Date], before me, [Notary Name], personally appeared [Authorized Representative Full Name], known to me (or satisfactorily proven) to be the person whose name is subscribed to this Affidavit, and acknowledged that they executed it for the purposes stated.
Notary Public Signature: _______________________
My Commission Expires: _______________________
Notary Seal (if applicable): ___________________
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Employer Affidavit of Employment Template
EMPLOYER AFFIDAVIT OF EMPLOYMENT TEMPLATE FAQ
What is an employer affidavit of employment?
An Employer Affidavit of Employment is a sworn statement from an employer confirming an employee’s job details (such as position, start date, status, and pay). It is sometimes requested for loans, housing, benefits, immigration, or court matters when an affidavit is required rather than a standard verification letter.
Who should sign it?
A company representative with authority and access to employment records typically signs it — often HR, payroll, or a manager. This template includes a role/title line to identify the signer.
What information is usually included?
Common fields include: employer name, employee name, job title, employment status (full-time/part-time), start date, work location, and compensation (if required). This template includes optional pay fields so you can include only what the receiving organization needs.
Does it need notarization?
Often yes. If the document is used as an affidavit, notarization is commonly required. This template includes a notarization block and an optional witness section.
What should you avoid including?
Avoid sensitive details not requested (full SSNs, bank info, medical details). This template uses “last 4 digits only” options and keeps the statement factual.
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