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Employment Verification for External Agencies

  1. Requestor Information
    Please enter the information the name and contact information for the individual requesting the information.
  2. Enter the name of the employee for whom you are requesting verification
  3. Which of the following best describes your verification type?
  4. Verification Type
  5. If you are requesting expanded employment details, please submit a copy of the employee's signed waiver/release. If you request expanded details and you fail to submit a release, your request will not be responded to.
  6. Certification*
    By submitting this form, I certify that the information I have provided is true and accurate to the best of my knowledge and that it is my responsibility to contact the City of Winston-Salem Human Resources Department as soon as I become aware of any changes. Submitting false information may result in legal action being taken against me.
  7. Leave This Blank:

  8. This field is not part of the form submission.