(Name of Past Employer):
Mr./Ms. (Name of Past Employee) has made application to this company for a position as (position) and states that he/she was employed by you as (position) from (start date) to (end date).
Will you kindly reply to the inquiry below respecting this applicant. Your reply will be held in strict confidence and will in no way involve you in any responsibility.
For your convenience in replying by return mail, we have enclosed a stamped, self-addressed envelope.
Very truly yours,
(Your name, title or position)