May 25, 2025

[Former employer name]

Address

Address2

City, State/Province

Zip/Postal Code

OBJECT:Reference Check for [Applicant name] – [Social security number]

Dear [former employer name],

A former employee of your company, [Applicant name], has applied for a position with our company. As part of interview process, we are hereby requesting background information from you on this employee. [He/she] has given us permission to request such information from you and a copy of such request is attached hereto.

Please provide us the following information concerning this former employee:

Dates of employment:Positions held:

Responsibilities:

Last total salary and bonus while employed:

Reason given for terminated/leaving:

How would you rate his/her overall competence? (Check one.)Outstanding
GoodAverageFairPoor

Please state briefly what you believe to be his/her greatest strengths and weaknesses (if any):

Strengths

Weaknesses

If you had an opening for which he/she is qualified, would you rehire him/her? YesNo

If no, please state why.

I assure that any information you supply about this applicant will be held in strict confidence. If there is ever an opportunity for me to reciprocate, I will be pleased to do so. We will need this information as soon as possible, and thus we would appreciate if you could fax the response to the undersigned at [fax number]. Thank you for your consideration.

Sincerely,

Your name

Your title

(800) 123-4567

youremail@yourcompany.com