Form I-9
Department of Homeland Security
U.S. Citizenship and Immigration Services
USCIS
Form I-9
OMB No. 1615-0047
Expires 10/31/2022
FORM I-9

Section 1. Employee Information and Attestation

(Employees must complete and sign Section 1 of Form I-9 no later than the first day of employment, but not before accepting a job offer.)
Address
Address
City
State/Province
Zip/Postal
I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in connection with the completion of this form.
I attest, under penalty of perjury, that I am (check one of the following boxes) *

Aliens authorized to work must provide only one of the following document numbers to complete Form I-9: An Alien Registration Number/USCIS Number OR Form I-94 Admission Number OR Foreign Passport Number. Please enter in appropriate field below:

Signature Required

Preparer and/or Translator Certification

Check One
(Fields below must be completed and signed when preparers and/or translators assist an employee in completing Section 1.)

I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct.

Address of Prep/Trans
Address of Prep/Trans
City
State/Province
Zip/Postal

ATTENTION:

Your employer is required to verify your documents and complete section 2 of this form. Is your employer present?

Section 2. Employer or Authorized Representative Review and Verification

(Employers or their authorized representative must complete and sign Section 2 within 3 business days of the employee's first day of employment. You must physically examine one document from List A OR a combination of one document from List B and one document from List C as listed on the "Lists of Acceptable Documents.")
Employee Info from Section 1
Lists of Acceptable Documents Click Here
Please Select the Appropriate Document List(s)

LIST A - IDENTITY AND EMPLOYMENT AUTHORIZATION




LIST B - IDENTITY

LIST C - EMPLOYMENT AUTHORIZATION

Certification: I attest, under penalty of perjury, that (1) I have examined the document(s) presented by the above-named employee,
(2) the above-listed document(s) appear to be genuine and to relate to the employee named, and (3) to the best of my knowledge the
employee is authorized to work in the United States.
(See instructions for exemptions)

Employer's Business Address

Section 3. Reverification and Rehires

This section only applies to rehired employees. (To be completed and signed by employer or authorized representative.)
A. New Name (if applicable)
B. Date of Rehire (if applicable)
C. If the employee's previous grant of employment authorization has expired, provide the information for the document or receipt that establishes continuing employment authorization in the space provided below.
I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if
the employee presented document(s), the document(s) I have examined appear to be genuine and to relate to the individual.
only needed if Section 3 was completed

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