Employment Verification Form - Mass 2025

1. Click ‘Get Form’ to open the Employment Verification Form - Mass in the editor.
2. Begin by entering the applicant's name and the last four digits of their Social Security number in the designated fields.
3. In Section I, provide the date of original permanent appointment and title. If there are any breaks in service, list those dates and reasons clearly.
4. For Section II, document any promotions within the department by listing the rank and date of promotion for each instance.
5. In Section III, detail any reserve, intermittent, temporary, or provisional service. Specify ranks, total hours worked (indicating full-time or part-time), and service timeframes.
6. Finally, ensure that the Appointing Authority or designee prints their name, title, signs, and dates the form at the bottom before submission.

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