Recipient's Details

• What is the full name of the Recipient (i.e. a person to whom this letter is being sent)?

• Indicate the Recipient's full business or residential address:

• Do you know the full name of a person, who will read this Letter?

  • Yes
  • No
  • This is the same name as the name of a recipient, indicated above

• Indicate the full name of a person to whom this letter is addressed:

Employee's Details

• What is Employee's full name?

• Indicate the date, when an Employee started their employment with Employer:

• Indicate the full name of an Employee's current job title/position:

• Indicate an Employee's annual salary (in USD) before taxes:

• Does Employee receive annual bonuses and commissions in addition to the salary?

  • Yes
  • No

• Indicate the amount of Employee's last annual bonus or commission in USD:

• Indicate Employee's average number of working hours per week:

• Does an Employee work remotely (full-time or part-time)?

  • No
  • Yes

• Indicate the date on which Employee started working remotely:

• Do you want to add a signature?

  • Yes
  • No

• Employer's signature:

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