I-9

Employment Eligibility Verification

USCIS Form I-9
Department of Homeland Security

U.S Citizenship and Immigration Services
Form I-9
U.S. Citizenship and Immigration Services

OMB No.1615-0047 Expires 07 /31/2026

START HERE: Employers must ensure the form instructions are available to employees when completing this form. Employers are liable for failing to comply with the requirements for completing this form. See below and the Instructions.

ANTI-DISCRIMINATION NOTICE: All employees can choose which acceptable documentation to present for Form I-9. Employers cannot ask employees for documentation to verify information in Section 1, or specify which acceptable documentation employees must present for Section 2 or Supplement B, Reverification and Rehire. Treating employees differently based on their citizenship, immigration status, or national origin may be illegal.

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.
Full Name

First Name (Given Name)Middle Initial (if any)Last Name (family name)
Other Last Name (If any)
Address (Street Number and Name)*
Apt. Number (if any)
City or Town*
State*
ZIP Code*
Date of Birth (mm/dd/yyyy)*

MonthDayYear
Date
U.S. Social Security Number*
Employee's Email Address*
example@example.com
Employee's Telephone Number*
I am aware that federal law provides for imprisonment and/or fines for false statements, or the use of false documents, in connection with the completion of this form. I attest, under penalty of perjury, that this information, including my selection of the box attesting to my citizenship or immigration status, is true and correct.
Check one of the following boxes to attest to your citizenship or immigration status (Ask employer if instructions are needed)*

1. A Citizen of the United States2. A noncitizen national of the United States (See instructions)3. A lawful permanent resident (Alien Registration Number/USCIS Number)4. An noncitizen (other than Item Number 2 and 3 above) authorized to work until
If you selected option 3, please enter one of the following numbers: USCIS A-Number, Form I-94 Admission number, OR Foreign Passport Number and Country of Issuance.
If you have selected option 4 from the question above, please enter the alien work expiration date and one of the following numbers: USCIS A-Number, Form I-94 Admission number, OR Foreign Passport Number and Country of Issuance.
Date of expiration for alien work authorization

MonthDayYear
Date
USCIS A-Number
Form I-94 Admission Number
Foreign Passport Number and Country of Issuance
If a preparer and/or translator assisted you in completing Section 1, that person MUST complete the Preparer and/or Translator Certification on Page 3. Please request page 3 from your employer if needed.
Signature

Clear
Date*

MonthDayYear
Date
Certification: I attest, under penalty of perjury, that (1) I have examined the documentation presented by the above-named employee, (2) the above-listed documentation appears 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.
First Day of Employment (mm/dd/yyyy)

MonthDayYear
Date
Last Name, First Name and Title of Employer or Authorized Representative
Today's Date (mm/dd/yyyy)

MonthDayYear
Date
Employer Signature

Clear
Employer's Business or Organization Name
Employer's Business or Organization Address, City or Town, State, ZIP Code
List A: Document Title
List A: Issuing Authority
List A: Document Number (if any)
List A: Expiration Date (if any)
List B Item 1
List B: Issuing Authority
List B: Document Number (if any)
List B: Expiration Date (if any)
List C Item 1
List C: Issuing Authority
List C: Document Number (if any)
List C: Expiration Date (if any)
Additional Information
Check here if you used an alternative procedure authorized by DHS to examine documents

Check
User_ID
Should be Empty:

Employment Eligibility Verification

Department of Homeland Security

Form I-9