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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICESForm Approved OMB No. 09380787REQUEST FOR EMPLOYMENT INFORMATION WHAT IS THE PURPOSE OF THIS FORM?WHAT DO I DO WITH
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How to fill out and dates of employment

01
To fill out the dates of employment, follow these steps:
02
Start with your most recent employment and work backwards.
03
Write the name of the company you worked for.
04
Indicate the dates of your employment, including the month and year you started and finished.
05
If you are still currently employed, write 'Present' or 'Currently employed' as the end date.
06
Repeat the process for each previous employment experience, providing accurate dates for each.
07
Double-check your dates and make sure they are correct before submitting.
08
Note: If you have gaps in employment, it may be helpful to provide an explanation or reason for those gaps.

Who needs and dates of employment?

01
Dates of employment are typically needed by employers, recruiters, and background check agencies.
02
Employers use dates of employment to verify your work history and assess your suitability for a job.
03
Recruiters may need this information to evaluate your career progression and match your skills to job requirements.
04
Background check agencies use dates of employment to verify your employment history and ensure accuracy of your background report.
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Dates of employment refer to the specific period during which an employee worked for an employer, usually indicated by the start date and end date of employment.
Employers are required to file dates of employment for their employees as part of their tax reporting responsibilities.
To fill out dates of employment, employers need to provide the employee's start date and end date on the relevant employment forms or tax documents.
The purpose of recording dates of employment is to maintain accurate employment records for tax, benefits, and legal compliance.
The information that must be reported includes the employee's full name, Social Security number, start date, and any termination dates if applicable.
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