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 Page 1 of 1 This document is informational only and for personal use only. No representation is made or warranty given as to its content. The user assumes all risk of use. Contact [email protected] for more information. Visit www.namhr.com.
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