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Request to Inspect Personnel File

1. Employee Name:
 
 
Social Security Number:
 
 
Date of This Request:
 
 
Department/Location:
 
 
Work Telephone or Extension:
 
 
I request an appointment with the HR Department to inspect my personnel file. The last date
I reviewed my file was _________________________.


Signature: _________________________________________________

2. Appointment Schedule:

_______________
Date

_______________
Time

__________________________
Place

File review completed (Date): _________________________
3. Employee comments regarding accuracy of information in this file. _______________________
______________________________________________________________________________

_______________________________________
Personnel Representative Signature

_______________________________________
Employee Signature