Sample of employment verification

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Date Prepared: September 5, 20xx
ID #: xxxx

Stated Name: TORU YAMADA
Actual Name: Same
Maiden Name: NA
Date of Birth: August 2, 19xx
Sex: Male
Country: Japan

Employer Name: ALL JAPAN xxxx CORP.
Department: Accounting
Address: xxxxx CHIYODA CHIYODA-KU
City/Province: TOKYO
Postal Code: xxxxxxxx
Country: JAPAN

Summary: Subject’s information was verified with discrepancies.

Verified by: JIRO KIMURA
Title: Human Resources Senior Administrator
Actual Date of Employment: August 19xx to January 20xx
Stated Date of Employment: Same
Stated Title of Subject: Senior Accountant
Actual Title of Subject: Assistant Senior Accountant
Disciplinary Action: Yes, see comments
Willing to re-hire: No
Displayed advanced skills: No
Stated Supervisor’s Name: KEN SUZUKI
Actual Supervisor’s Name: KEN NAKAMURA
Stated Supervisor’s Title: Senior Vice President
Actual Supervisor’s Title: Senior Accountant

Supervisor indicates that subject “is wanted on charges of embezzling over US$120,000 from our firm”.