TO BE COMPLETED BY THE EMPLOYER
Zanesville Metropolitan Housing Authority
HOUSING CHOICE VOUCHER PROGRAM (Section 8)
407 Pershing Road, Zanesville, Ohio 43701 ● Phone: (740) 454∙6866 ● Fax: (740) 454∙8567
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EMPLOYMENT VERIFICATION
|HEAD OF HOUSEHOLD NAME (for HCVP filing purposes): | |
I, the employee, (print name) hereby request the release of my employment information.
|SIGNATURE OF PERSON EMPLOYED |DATE |
| | |
…………………………………………………………………………………………………………
EMPLOYEE’S SUPERVISOR: Please complete below information and return to ZMHA by mail or fax.
|Employee First & Last Name |Employees Social Security # |
| | |
|Title/Occupation of Employee |Date of Hire |
| | |
|Date of Termination/Last date worked (if applicable) |Number of Hours Per week |
| | |
| | |
|Date Present Pay Rate Effective: | |
|Present Base Pay Rate : |$ |per: |
|Present Overtime Rate: |$ |per: |
|Anticipated Overtime: |Hours: |per: |
|Amount of bonus, incentive pay, commission, tips or other compensation not included above: | | |
| |$ |per: |
|Total Base Pay Earnings for past 12 months: |$ |
|Total Overtime Earnings for past 12 months: |$ |
|I hereby certify that the information above is true. I understand I can be fined up to $10,000.00 or imprisoned up to five (5) years if I |
|furnished false or incomplete information. |
|SIGNATURE OF MANAGER/SUPERVISOR |DATE |
| | |
|( | |
|Business/Employer Name: | |
|Address: | |
| | |
|Phone: | |
|Fax: | |
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