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200109053 <br />EXHIBIT B -2 <br />REQUEST FOR VERIFICATION OF EMPLOYMENT <br />THIS SECTION TO BE COMPLETED BY MANAGEMENT AND EXECUTED BY TENANT <br />TO: (Name & address of employer) Date: <br />RE: <br />Applicant/Tenant Name <br />I hereby authorize release of my employment information. <br />Social Security Number Unit # (if assigned) <br />Signature of Applicant/Tenant Date <br />The individual named directly above is an applicant/tenant of a housing program that requires verification of income. The information provided will <br />remain confidential to satisfaction of that stated purpose only. Your prompt response is crucial and greatly appreciated. <br />Project/Owner /Management Agent <br />Return Form To: <br />THIS SECTION TO BE COMPLETED BY EMPLOYER <br />Employee Name: Job Title: <br />Presently Employed: Yes _ Date First Employed No Last Day of Employment <br />Current Wages/Salary: $ (circle one) hourly weekly bi- weekly semi - monthly monthly yearly other <br />Average # of regular hours per week: Year -to -date earnings: $ through <br />Overtime Rate: $ per hour Average # of overtime hours per week: <br />Shift Differential Rate: $ per hour Average # of shift differential hours per week: <br />Commissions, bonuses, tips, other: $ (circle one) hourly weekly bi- weekly semi - monthly monthly yearly other <br />List any anticipated change in the employee's rate of pay within the next 12 months: ; Effective date: _ <br />If the employee's work is seasonal or sporadic, please indicate the layoff period(s): <br />Additional remarks: <br />Employer's Signature <br />Phone # <br />01- 351904.01 <br />Employer's Printed Name <br />Employer [Company] Name and Address <br />Fax # <br />Date <br />E -mail <br />