I, (print full name)_______________________________________, request
Foundation Human Resource to provide a letter on Foundation
stationary for the following purpose:
Jury Duty (why I disqualify for wages during jury duty)
Sponsoring individual from another country
INS purpose (please specify)____________________________________________________
House/Apartment Rental requiring work verification
Other (please specify) _________________________________________________________
_________________________________________________________________________
Whom shall the letter be addressed to?
Letter needed by: ___________________________
(Date)
Letter should include:
Employee Name
Social Security Number
Employment Dates
Wage Earned
Job Classification
Employment Status
(part time or full time)
Eligibility for Health Benefits
__________________________________________
__________________
Employee Signature
Date
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
08/2001
Human Resource Date Stamp: