A wage verification form is a document utilized by private or public organizations to confirm an individual’s income and employment status. It is sent to the individual’s employer, requesting information such as the employee’s position, average pay (salary or hourly rate), work schedule, hours worked, and duration of employment.
The form also includes the employee’s signed authorization, removing any liability from the employer for releasing information. Upon completion, the employer returns the form solely to the requester, excluding the employee.
Main Usage
Primarily used by child support services (DHS) to determine spousal child care payments, this form can also serve various other wage verification purposes including:
- Disability compensation.
- Financial assistance.
- Rental applications.
How to Fill Out a Wage Verification Form
Step 1 – Download the Wage Verification Form
Begin by downloading the wage verification form in either PDF or MS Word.
Step 2 – Provide Personal Contact Information
The requesting party should start filling in the form by providing their name, phone number, email address, and fax number.
Step 3 – Obtain Employee Consent
The form is then sent to the employee to consent to the verification form. It is required from the employee in this section. Enter your name in the first field and provide your signature, date of signing, and printed name below. After this step, the form should be sent to the employer.
Step 4 – Input Employment Details
The employer must specify the employee’s job title and start date. If the employee is on leave, indicate the type of leave and the return date.
Step 5 – Specify Employee Earnings
Enter the employee’s average monthly earnings, including hourly pay, commission, and tips. Specify the payment frequency and whether the employee is paid in cash.
Step 6 – Record Work Schedule
Detail the employee’s work schedule by entering the start time (From) and finish time (To) for each day of the week worked.
Step 7 – Explain Variance in Hours
Specify whether the employee’s hours vary, and if so, explain the variance.
Step 8 – Enter Business Information
Enter the employer’s name or company name, followed by the business address (street, city, state), phone number, and email address.
Step 9 – Finalize Employer Certification
Complete the form by providing the employer’s signature and business title, dating the document, and printing the employer’s name then send it back to the requesting party.
Wage Verification Form Sample
Download a template below in PDF or Word format:
