VERIFICATION REPORT FORM
1. Report Information
- Report Number:
- Date of Report:
- Report Prepared By (Name & Title):
- Department/Organization:
2. Subject of Verification
- Full Name / Entity Name:
- Identification Number / Reference ID:
- Address / Location:
- Contact Details:
- Type of Verification:
[ ] Identity Verification
[ ] Document Verification
[ ] Employment
Verification [ ] Site Visit
[ ] Background Check
[ ] Other:
3. Documents/Information
Verified (Attach copies where
applicable)
Document/Item Presented Verified Remarks
4. Verification Method
- [ ] Physical Visit
- [ ] Phone Call
- [ ] Email/Online Communication
- [ ] Third-party Confirmation
- [ ] Other:
5. Verification Findings
(Describe the process and observations made. Be detailed and factual.)
6. Conclusion
- [ ] Verified - Information is accurate and authentic
- [ ] Partially Verified - Some discrepancies noted
- [ ] Not Verified - Information could not be confirmed
Remarks:
7. Signatures
- Verifier's Name & Signature:
- Designation:
- Date:
- Reviewed by (if applicable):
- Signature & Date: