Form I-9 Preparer - Translator

REPLY
example@example.com
FROM
RAH Staff (Select One)*
Employee Name*

First NameLast Name
Employee ID#*
Enter DOB Numbers Only (MMDDYY)
CompanionHHAPCA
ST
Completed
Preparer and/or Translator
Employee Name*

First NameMiddle InitialLast Name
Instructions: This supplement must be completed by any preparer and/or translator who assists an employee in completing Section 1 of Form I-9. The preparer and/or translator must enter the employee's name in the spaces provided above. Each preparer or translator must complete, sign, and date a separate certification area. Employers must retain completed supplement sheets with the employee's completed Form I-9.
1) Preparer - Translator
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.
Signature*

Clear
Date*

MonthDayYear
Date
First Name*
Last Name*
Middle Initial (if any)*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
2) Preparer - Translator
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.
Signature

Clear
Date

MonthDayYear
Date
First Name
Last Name
Middle Initial (if any)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
3) Preparer - Translator
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.
Signature

Clear
Date

MonthDayYear
Date
First Name
Last Name
Middle Initial (if any)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
4) Preparer - Translator
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.
Signature

Clear
Date

MonthDayYear
Date
First Name
Last Name
Middle Initial (if any)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Preparer and/or Translator

Confirmation