[{"id":"b761599a-e469-4886-b18c-a57b7a5e2564","order":10,"text":"FINAL PAYCHECK AND OFFBOARDING COMPLIANCE CHECKLIST","fontSize":"20","textAlign":"center","bold":true,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"bf7a431b-7dad-4bae-a76c-a740c43552c1","order":20,"text":"Employee Separation, Final Wage Reconciliation, and Statutory Compliance Record","fontSize":"14","textAlign":"center","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"39535a9e-b532-4a4a-81e1-6a4426ce194e","order":30,"text":"This Final Paycheck and Offboarding Compliance Checklist (the “Checklist”) is prepared by and for [Company legal name], having its principal place of business at [Company address] (the “Company” or “Employer”), in connection with the separation from employment of the individual identified below (the “Employee”).","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"14","cflou":false,"active":true},{"id":"ee07228f-2a8c-4b32-95d8-204a66d36587","order":40,"text":"Employee: [Employee full name], formerly employed as [Employee job title] (Employee ID [Employee ID]), whose address of record is [Employee mailing address].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"14","cflou":false,"active":true},{"id":"5ac129f7-b895-403d-858a-b5e061be52af","order":50,"text":"Date of hire: [Hire date]. Last day of work: [Last day worked]. Nature of separation: [Separation type]. Stated reason: [Reason for separation].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"29ed8a95-2a47-48b1-9ba4-67c889a5a0ba","order":60,"text":"SECTION 1 — PURPOSE AND SCOPE","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"10","cflou":false,"active":true,"marginTop":"14"},{"id":"d99775af-9a04-4120-9680-c100961f6082","order":70,"text":"This Checklist documents the steps the Company has taken to comply with applicable federal and state wage-payment law upon the Employee's separation, to reconcile and pay all final compensation owed, and to complete the administrative offboarding of the Employee. It is intended to create a contemporaneous record evidencing the Company's good-faith compliance and to reduce the risk of wage claims, statutory penalties, and litigation arising from an improperly handled separation.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"92aa7ae1-f764-402e-a2f5-d1266e7e18dc","order":80,"text":"Nothing in this Checklist waives, releases, or modifies any right or obligation of either party except as expressly stated. Where state law imposes a requirement more protective of the Employee than is described here, that state-law requirement controls.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"e027025b-719b-4c41-a72f-017b5990ef1f","order":90,"text":"SECTION 2 — CLASSIFICATION OF THE SEPARATION","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"10","cflou":false,"active":true,"marginTop":"14"},{"id":"16b9618f-c087-45f8-b4ee-a69c20a281e9","order":100,"text":"The parties acknowledge that the timing and content of the final wage payment are governed in significant part by whether the separation is voluntary or involuntary. The Company has classified this separation as set forth above and has applied the corresponding statutory deadline.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"d55abad3-e38f-4d6c-96e9-73a9d62f5e4c","order":110,"text":"Because the separation is involuntary (a discharge, termination, or layoff initiated by the Company), the Company recognizes that most jurisdictions require final wages to be paid on an accelerated timeline, in several states immediately upon separation.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"d110d8bf-1d8d-4657-91ff-153c25d8e033","value":"a voluntary separation (resignation initiated by the Employee)","type":"remove","operator":"="}]},{"id":"79a56d3b-bb6b-4539-9639-665dd7592d20","order":120,"text":"Because the separation is voluntary (a resignation initiated by the Employee), the Company recognizes that many jurisdictions permit final wages to be paid on the next regularly scheduled payday, subject to any shorter deadline triggered where the Employee gave advance notice of resignation.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"d110d8bf-1d8d-4657-91ff-153c25d8e033","value":"an involuntary separation (termination, layoff, or discharge initiated by the Company)","type":"remove","operator":"="}]},{"id":"e7419430-bc90-4a86-b1dc-a288b1a0f6d3","order":130,"text":"SECTION 3 — FINAL WAGES EARNED THROUGH THE LAST DAY OF WORK","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"10","cflou":false,"active":true,"marginTop":"14"},{"id":"53150eed-e9e1-4bf8-a213-7ee11f00f4ac","order":140,"text":"Federal law under the Fair Labor Standards Act requires that the final paycheck include payment for all hours worked through the last day of employment, including any overtime earned during the final pay period. No condition may be attached to the receipt of earned wages, and earned wages may not be withheld on the ground that the Employee owes the Company money, except by a deduction permitted by law as described in Section 7.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"d93e6a6a-3176-4bc1-bba2-3cdb51c3b7ab","order":150,"text":"Final pay period: [Pay period start] through [Pay period end]. Compensation rate: $[Pay rate] [Pay basis]. Regular hours in the final period: [Regular hours]. Overtime hours in the final period: [Overtime hours], payable at the applicable overtime premium.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"936dd5d3-bd2b-4aa9-9629-8b68f5b148ac","order":160,"text":"Estimated gross final wages earned through the last day worked (regular and overtime, before lawful withholdings and deductions): $[Estimated gross final wages]. This figure is subject to ordinary tax withholding and to the adjustments described in the following sections.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"c284f0a3-82c3-44b9-86ae-eca57e447001","order":170,"text":"In addition, the Company acknowledges that earned but unpaid [commissions] in the amount of $[Commission amount owed] are due to the Employee and shall be included in or paid alongside the final wages in accordance with the terms of the applicable commission agreement and state law.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"cf03ee4d-89a8-4e63-b099-ee04b1b3c562","value":"1","type":"add","operator":"="}]},{"id":"fd6d0115-eb98-463b-95da-101b2d699392","order":180,"text":"The Company further acknowledges that an earned [bonus] in the amount of $[Bonus amount owed] is due to the Employee. Earned, non-discretionary incentive compensation that has vested under the governing plan is treated as wages and is paid with or promptly after the final wages.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"9debfcb0-5aad-41ae-8b92-e9cb7ac20181","value":"1","type":"add","operator":"="}]},{"id":"cccea592-84fe-4b0c-aa01-47258d97a44c","order":190,"text":"SECTION 4 — STATUTORY DEADLINE FOR PAYMENT OF FINAL WAGES","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"10","cflou":false,"active":true,"marginTop":"14"},{"id":"98b92648-fd3d-4234-a685-7474c6e0c309","order":200,"text":"The Company operates and the Employee primarily worked in [State], and the final wage payment is governed by that state's wage-payment law. The applicable deadline category for this separation is: [Selected deadline rule].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"f2f98bfd-2512-4f63-97d1-62bdedce43a9","order":210,"text":"Accordingly, the entire amount of final wages was made available to the Employee immediately upon separation on the last day of work, [Last day worked], at the place of separation or as otherwise directed by the Employee. The Company recognizes that states applying the immediate-payment rule (including, for example, California, Colorado, Massachusetts, Montana, and Nevada) impose this obligation on involuntary separations and that delay exposes the Company to waiting-time penalties.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"aed62e8c-948d-4547-97e7-7860b6f05394","value":"immediate payment on the last day of work","type":"add","operator":"="}]},{"id":"f5c9d497-cd61-4aa2-ae13-07959d66eb87","order":220,"text":"Accordingly, the Company shall pay the entire amount of final wages no later than [Number of days] calendar days following the separation, or on the next regularly scheduled payday, whichever occurs first, consistent with the fixed-period rule applicable in this state (for example, Arizona requires payment within seven working days of an involuntary separation).","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"aed62e8c-948d-4547-97e7-7860b6f05394","value":"payment within a fixed number of days after separation","type":"add","operator":"="}]},{"id":"298402fe-eb5b-4bf2-8d8c-e764680e5ec4","order":230,"text":"Accordingly, the Company shall pay the entire amount of final wages on the next regularly scheduled payday, which is [Next scheduled payday]. Where this state imposes a shorter deadline for involuntary separations or where the Employee provided advance notice of resignation, the Company has applied that shorter deadline.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"aed62e8c-948d-4547-97e7-7860b6f05394","value":"payment on the next regularly scheduled payday","type":"add","operator":"="}]},{"id":"21adfeeb-810a-4c20-99da-c5e1c8a6043c","order":240,"text":"Because this state has not enacted a specific final-paycheck statute, the federal Fair Labor Standards Act baseline applies, and the Company shall pay all final wages on the next regularly scheduled payday, which is [Next regular payday].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"aed62e8c-948d-4547-97e7-7860b6f05394","value":"payment on the next regularly scheduled payday under the federal FLSA default","type":"add","operator":"="}]},{"id":"1ae1e5f8-5329-4622-a632-95a5d75541b0","order":250,"text":"Method of delivery of the final paycheck: [Delivery method]. The Company shall retain proof of payment and of the date and manner of delivery as part of its compliance record.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"1774ddc4-ba8b-4959-9d17-fd0d41eba719","order":260,"text":"SECTION 5 — ACCRUED PAID TIME OFF AND VACATION","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"10","cflou":false,"active":true,"marginTop":"14"},{"id":"b74ea78b-b340-466c-b6dc-99b7f5415bb1","order":270,"text":"Whether accrued but unused vacation or paid time off must be paid out at separation depends on state law and on the Company's written policy. In states that treat accrued vacation as earned wages, it must be paid out regardless of policy; in most states the obligation is governed by the employer's written policy, contract, or collective bargaining agreement, and a policy promising payout binds the employer even where no statute requires it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"9472d16a-fcbc-44ca-9da6-55b6ba533d7d","order":280,"text":"The Employee's accrued, unused balance at separation is [Accrued unused PTO hours] hours. Because applicable state law treats accrued vacation as earned wages that must be paid out upon separation, the Company shall include a PTO payout of $[PTO payout amount] with the final wages.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"5591dd6d-715a-446e-88bf-ff30e6c5c04e","value":"statutory","type":"add","operator":"="}]},{"id":"2bf47f0a-13e2-4e53-bc46-bf55d44f1e34","order":290,"text":"The Employee's accrued, unused balance at separation is [Accrued unused PTO hours] hours. In accordance with the Company's written paid-time-off policy, the Company shall pay out this balance in the amount of $[PTO payout amount] with the final wages.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"5591dd6d-715a-446e-88bf-ff30e6c5c04e","value":"policy","type":"add","operator":"="}]},{"id":"189ca83a-4840-4d38-aa18-26a8d76fc2f8","order":300,"text":"The Company confirms that, consistent with applicable state law and its written policy, no accrued but unused paid time off is owed to the Employee at separation.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"5591dd6d-715a-446e-88bf-ff30e6c5c04e","value":"none","type":"add","operator":"="}]},{"id":"a9730c26-a688-417b-9263-3c9d6c2fb50e","order":310,"text":"SECTION 6 — OUTSTANDING EXPENSE REIMBURSEMENT","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"10","cflou":false,"active":true,"marginTop":"14"},{"id":"e34e410e-f7ee-4de5-b2f0-8946f6115a4f","order":320,"text":"The Company shall reimburse the Employee for all reasonable, documented, and previously approved business expenses outstanding as of the separation date. Outstanding reimbursable expenses are estimated at $[Outstanding expense reimbursement] and shall be paid no later than the next regular expense-reimbursement cycle. Business expense reimbursement is separate from, and shall not be offset against, earned wages except as permitted by law.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"5bb3811c-31f8-4db5-a017-891db7994860","order":330,"text":"SECTION 7 — PERMISSIBLE DEDUCTIONS FROM THE FINAL PAYCHECK","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"10","cflou":false,"active":true,"marginTop":"14"},{"id":"2d01203a-d167-43ef-b48e-06695b1adfec","order":340,"text":"The Company may deduct from the final paycheck only those amounts authorized by law (such as taxes and court-ordered garnishments) or by the Employee's prior written consent. The Company shall not deduct the cost of uniforms, tools, damaged or unreturned equipment, cash shortages, or business losses from the final paycheck without specific written authorization where required, and shall not reduce final wages below any applicable minimum-wage or overtime floor.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"45517c03-a680-43cf-baab-bab7f89f2ecc","order":350,"text":"The Company will apply the following [deductions] to the final paycheck: [Deduction description], in the amount of $[Deduction amount], on the basis of [Authorization basis]. The Company has confirmed that this deduction is legally permissible and properly authorized.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"9df6daeb-277a-4a23-9328-2fa132e425b2","value":"1","type":"add","operator":"="}]},{"id":"abb58fb3-9b6d-4eaf-beb1-295cd43ee85d","order":360,"text":"SECTION 8 — SEVERANCE","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"10","cflou":false,"active":true,"marginTop":"14"},{"id":"ad88a62f-0310-4b50-9a99-51c197221cdb","order":370,"text":"Severance is not earned wages and is owed only where the Company elects to offer it or where a severance plan, policy, or agreement applies. Where severance is offered, it is paid separately from, and does not delay, the statutory payment of final wages described in Section 4. Where severance is conditioned on a release of claims, the Company shall provide the Employee any consideration and review and revocation period required by law, including under the Older Workers Benefit Protection Act where applicable.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"02a2e95e-6a9a-4a31-ab60-d19aef95a52f","order":380,"text":"In this case, the Company is offering the Employee [severance] in the gross amount of $[Severance amount], subject to the following conditions: [Severance conditions].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"00dfbcbf-38ee-4099-9150-216ad7f9e6ff","value":"1","type":"add","operator":"="}]},{"id":"cd1bcb4a-0324-4e2c-a062-450e010110a7","order":390,"text":"SECTION 9 — CONTINUATION OF GROUP HEALTH BENEFITS","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"10","cflou":false,"active":true,"marginTop":"14"},{"id":"d97a23fb-e77d-4edf-80ff-3f49b49c54db","order":400,"text":"Where the Company maintains a group health plan subject to federal COBRA continuation requirements (generally employers with twenty or more employees) or to an applicable state continuation law, the Employee and any covered dependents are entitled to elect continuation coverage following the loss of coverage caused by this separation. The Company shall inform the Employee of the date on which active coverage ends and of the continuation and marketplace options available.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"8ef07872-3498-4157-8f9e-501490ee3400","order":410,"text":"In this case, because the Company maintains a group health plan subject to [cobra] continuation requirements, the Company shall ensure that the plan administrator, [Plan administrator], furnishes the required election notice within the time prescribed by law, and the Employee shall have the statutory period to elect coverage.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"93a56e08-8c12-4681-90b0-f73b986ebf39","value":"1","type":"add","operator":"="}]},{"id":"927a34d4-c584-4695-9c80-f0a4b567ac91","order":420,"text":"SECTION 10 — RETURN OF COMPANY PROPERTY AND TERMINATION OF ACCESS","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"10","cflou":false,"active":true,"marginTop":"14"},{"id":"7276e884-c6b1-4261-a283-53eec21d25c0","order":430,"text":"As part of offboarding, the Employee shall return all Company property in the Employee's possession or control, including keys, access cards, identification badges, laptops and mobile devices, credit and purchasing cards, documents, and any other tangible or intangible Company property. The Company shall disable the Employee's physical and electronic access, including email, network, and application credentials, no later than the end of the last day of work, and shall recover or remotely wipe Company data on personal devices to the extent permitted by law.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"27191915-e854-4b6f-9f8b-6feaeef489c5","order":440,"text":"The Company's recovery of its property shall be pursued separately and shall not be effected by an unauthorized deduction from earned wages.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"7ff04249-8068-4b9b-b193-d555bc5a71df","order":450,"text":"SECTION 11 — CONTINUING OBLIGATIONS AND RESTRICTIVE COVENANTS","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"10","cflou":false,"active":true,"marginTop":"14"},{"id":"2e904a30-bc00-4739-b4a0-ac68d2f1530d","order":460,"text":"The Employee's obligations that by their nature survive separation remain in full force, including any duty of confidentiality, the obligation to return and not to use or disclose the Company's trade secrets and proprietary information, and the assignment of inventions, in each case to the extent enforceable under applicable law.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"783b9829-e1ce-4239-98c6-0c05f026dc51","order":470,"text":"The Employee remains subject to the following [covenants]: [Restrictive covenant summary]. The Company acknowledges that the enforceability of non-competition and non-solicitation covenants is limited or prohibited in a number of states and that such covenants will be enforced only to the extent permitted by the law of the governing state.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"37989dfa-b377-488e-b18f-f2106f31a0ae","value":"1","type":"add","operator":"="}]},{"id":"971a8a27-75b6-4b75-90e0-71b1f882840d","order":480,"text":"SECTION 12 — CONSEQUENCES OF NON-COMPLIANCE","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"10","cflou":false,"active":true,"marginTop":"14"},{"id":"360053de-7bb1-466c-b499-9293da1724b5","order":490,"text":"The Company acknowledges that the failure to pay final wages in full and on time may expose it to significant liability, including statutory waiting-time penalties (in some states, the Employee's daily wage for each day the payment is late, up to a statutory cap), liquidated damages, interest, the Employee's attorneys' fees and costs, and administrative or civil enforcement by the state labor agency or the U.S. Department of Labor. This Checklist is maintained to evidence the Company's timely and complete compliance.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"cabc8347-4e94-4cf9-9f38-02076e93ab04","order":500,"text":"SECTION 13 — GOVERNING LAW AND CHARACTER OF THIS RECORD","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"10","cflou":false,"active":true,"marginTop":"14"},{"id":"fdb183d2-35bc-4756-a7b7-2d24a243eb16","order":510,"text":"This Checklist and the separation it documents are governed by the wage-payment and employment laws of [State] and by applicable federal law. This Checklist is an internal compliance record and the Employee's acknowledgment of receipt of final pay information; it is not a contract of employment, does not alter the at-will character of the employment relationship where applicable, and does not constitute a release of claims unless a separate release is executed.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"6ec29322-0acd-4044-b55e-74f64c7d02c3","order":520,"text":"ACKNOWLEDGMENT","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"10","cflou":false,"active":true,"marginTop":"18"},{"id":"39d0f34f-7fbc-4cbf-bcea-b9a0d55c282a","order":530,"text":"The undersigned representative of [Company legal name] certifies that the Company has reconciled and arranged payment of all final wages and other amounts owed to [Employee full name] as described above, in accordance with applicable federal and state law. The Employee acknowledges receipt of this information and of the final wage payment described herein. Acknowledgment does not waive any right to wages or other amounts not yet paid.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"7dd2212d-630a-42d0-aaca-a72be486626b","order":540,"text":"Executed in the State of [State of execution] on [Date of completion].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"30","cflou":false,"active":true},{"id":"d3c7bc2c-8cad-44d8-82b8-f4ae5b47795d","order":550,"text":"For the Company:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"68f58b13-dbf6-4312-802c-ee529a47ca8d","order":560,"text":"_______________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"cbccd298-f11f-4726-930e-f71de5583954","order":570,"text":"[Authorized representative], [Representative title]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"2","cflou":false,"active":true},{"id":"575ddb3a-a452-461a-8c28-28537b0591ab","order":580,"text":"On behalf of [Company legal name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"2","cflou":false,"active":true},{"id":"318abb30-119b-4699-89f0-0e0e8882f45d","order":590,"text":"Date: _______________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"28","cflou":false,"active":true},{"id":"5d8b7479-58a5-4e2e-bcf9-4310fca30fc6","order":600,"text":"Employee acknowledgment:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"5b24e2c4-786b-4c29-a92e-714a5ad8877c","order":610,"text":"_______________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"f09d2522-e9c1-430d-bad0-e39d9304dab2","order":620,"text":"[Employee full name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"2","cflou":false,"active":true},{"id":"96aecca9-d898-44bb-b34c-e44029693f69","order":630,"text":"Date: _______________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"0","cflou":false,"active":true}]