EMPLOYEE INCOME CONFIRMATION BY THE EMPLOYER

PERSONAL DATA OF EMPLOYEE (to be filled in by the Employee)

Employee (surname, name, title):	Birth certificate no:
This confirmation is requested for purposes of loan application negotiation. I hereby agree that the information stated here shall be made available to Česká spořitelna, a.s. („Banka“), and/or to Stavební spořitelna České spořitelny, a.s. („SSČS“) for purposes of loan application management purposes and/or to s Autoleasing, a.s. („sAutoleasing“) for purposes of leasing or credit contract negotiations. Furthermore, I agree to the phone verification of information contained in this document conducted by the Bank, or by SSČS, or by sAutoleasing.
Date:	Signature of the Employee:

EMPLOYEE DATA (to be filled in by the Employer’s payroll department)

Employer name:
Job title:	Employed from (date):
Notice period applies?	no	yes	Fixed-term employment contract:	no	yes, until:
Gross monthly wage ( as per the work contract) – currency:
Average net monthly wage (for the last 12 months) – currency:
In words:
Salary deductions based on court decision (execution etc.)	yes	no – Currency:
Wage is paid in	cash	credited to account
Account no. from which the salary is paid to the Employee

Confirmation issued by:
Contact phone no:	E-mail:
Code for verification:	In/at:	Date:
The employer acknowledges that: in order to comlpy with the obligation of "due professional care" pursuant to the Banking Act and the Consumer Credit Act and in accordance with the relevant employee consent, the Bank and/or SSČS and/or sAutoleasing are obligedto verify the accuracy and completeness of data regarding the emloyment relation, its existence and the level of emloee's income.e correctness of the data has been confirmed by you as the employer.
Employer stamp:	Employer signature:

This confirmation is valid for 30 calendar days after its issue date.