ࡱ> UWT{ g bjbjBrBr 4&  J\\\\\ppp8,<pqb(888$ @\\\88+F\8\88 42NFA0q   \Zm@4 q  ": Human Resource ServicesVerification Statement Seniority Date, Credential, Address, and Phone NumberEmployees on a Leave of Absence Please verify the information shown on Employee Information Report 298e regarding your seniority date, credential, address, and phone number, and make any corrections as needed. Attach a copy of your credential(s) to Employee Information Report 298e and this form to correct or update our records. If you feel that you may be NCLB Compliant outside of your teaching assignment, it is your responsibility to provide supporting documentation to your Human Resource Services Analyst for review no later than December 21, 2012. Please return the Employee Information Report 298e and this completed form no later than December 21, 2012: 鶹ԭ Human Resource Services Attention: Human Resource Services Analyst 5735 47th Avenue Sacramento, CA 95824 I certify the information shown on Employee Information Report 298e is true and correct. SignatureDate Print Name     11/30/12; Rev. 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