JOB VERIFICATION REQUEST FORM 
 
Please complete all sections below 
NOTE: There is a 24 hour processing period on all job verification * ID must be presented when picking up  
 
EMPLOYEE INFORMATION 
 
Name: ___________________________________  
Employee Number: ____________________ 
 
Telephone Number: ______________________ 
Address: _________________________ 
 
Email Address: _________________________ _ 
Job Title: __________________________ 
 
Activity Site: ___________________________________________________________________ 
 
 
THIS LETTER IS BEING DONE FOR: 
 
 Federal Credit Union (Circle one): Mid-Island Christiansted    Frederiksted 
 
 G.E.R.S 
 
 SNAP 
 
 V.I. Housing Authority  
 
 
 
 Other: _____________________________ 
 
FOR HR OFFICE USE ONLY 
Prepared By: ________________________ 
Date Issued: ________________________ 
Comments: ___________________________________________________________________________ 
_____________________________________________________________________________________ 
_____________________________________________________________________________________ 
 
Knud Hansen Complex Bldg. A • 1303 Hospital Ground, Suite 1 • St. Thomas, Virgin Islands 00802-6472 • (340) 774-0930  
3011 Golden Rock • Christiansted, St. Croix, Virgin Islands 00820 • (340) 718-2980  
 OTHER INFORMATION: 
 
How would you like to get your verification letter? (Circle one): In-Person pick up  
Email 
Pick up Person (if other than the employee): ______________________________ 
Is a NOPA needed? 
 Yes 
 
 No 
 
Employee Signature: ____________________________________ 
 
Date: _______________