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Attestation and Agreement to Notify Employer 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by filling in your employer's name in the designated field. This is crucial as it identifies who you will notify regarding any disqualifying offenses.
- Review the list of disqualifying offenses carefully. Ensure that you have not been convicted, pleaded guilty, or found eligible for intervention concerning any of these offenses.
- Sign the document in the provided signature field. This confirms your attestation and agreement to notify your employer within 14 calendar days if necessary.
- Finally, print your name clearly in the designated area and date the form to complete it.
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