Verification of Employment Form
This file provides a structured format for applicants to verify their employment history for board evaluations. Employers are required to fill out specific sections to attest to the applicant's work experience. This process is crucial for individuals seeking certification or licensing.
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How do I fill this out?
To fill out this form, start by entering your personal details in Section 1. Next, provide the completed form to your employer for verification. Ensure that your employer submits it directly to the board as instructed.

How to fill out the Verification of Employment Form?
1
Complete your personal information in Section 1.
2
Forward the form to your employer for completion.
3
Ensure your employer confirms your employment details.
4
Submit the form directly to the board via email.
5
Keep a copy for your records.
Who needs the Verification of Employment Form?
1
Job applicants who need to validate their employment history.
2
Employers submitting proof of employment.
3
Licensure boards requiring verification for credentialing.
4
Human resources departments needing to confirm past employment.
5
Education professionals seeking to verify work experience.
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What are the instructions for submitting this form?
To submit this form, ensure that it is completed accurately by both the applicant and the employer. The completed form should then be sent directly to the respective licensing board at the email address st-landscape@pa.gov. It is advisable to keep a copy of the submission for your own records.
What are the important dates for this form in 2024 and 2025?
For 2024 and 2025, applicants should note that submissions for licensure applications will typically open in January and close by March 31st. Ensure to submit your verification forms well in advance to meet deadlines.

What is the purpose of this form?
The purpose of this form is to verify an applicant's employment experience required for licensing or certification. It serves as a formal declaration by employers regarding the applicant's work history. The accurate completion of this form is essential for the review process by licensing boards.

Tell me about this form and its components and fields line-by-line.

- 1. Applicant's Name: Full name of the applicant as it appears legally.
- 2. Employer's Name: Name of the employer completing the verification.
- 3. Employment Dates: Start and end dates of the applicant's employment.
- 4. Specific Duties Performed: A detailed description of the applicant's job responsibilities.
- 5. Signature: Legal signature of the employer verifying the information.
What happens if I fail to submit this form?
If the form is not submitted correctly, the applicant may face delays in the licensure process. It is crucial to ensure all sections are completed accurately to avoid complications. Incomplete forms can lead to additional follow-up requests from the board.
- Delays in Processing: Incomplete or incorrectly submitted forms can prolong the licensing process.
- Denial of Application: Failure to provide accurate verification may lead to application denial.
- Need for Resubmission: Incorrect submissions may require the form to be filled out again, causing further delays.
How do I know when to use this form?

- 1. Licensure Applications: To validate your professional experience for licensure.
- 2. Job Applications: When prospective employers request proof of previous employment.
- 3. Educational Verification: For educational institutions requiring work experience confirmation.
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