EMPLOYMENT ELIGIBILITY VERIFICATION

EMPLOYMENT ELIGIBILITY VERIFICATION

USCIS FORM I-9 - DEPT OF HOMELAND SECURITY - US CITIZENSHIP & IMMIGRATION SERVICES
Read instructions carefully before completing this form. The instructions must be available during completion of this form. ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which document(s) they will accept from an employee. The refusal to hire an individual because the documentation presented has a future expiration date may also constitute illegal discrimination.

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)
Last Name
First Name
Middle Initial
Other Names Used (if any)
Address (Street Number and Name)
Apt Number
City or Town
State
Zip Code
Date of Birth mmddyyyy

MonthDayYear
Date
U.S. Social Security Number Date of Birth (mm/dd/yyyy)E-mail Address
Social Security Number
example@example.com
Email Address
example@example.com
Telephone Number
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:

A citizen of the United StatesA noncitizen national of the United States (See instructions)A lawful permanent resident (Alien Registration Number/USCIS Number)An alien authorized to work until (expiration date, if applicable, mm/dd/yyyy) (See instructions)
Additional Documentation

If you selected any option other than "A citizen of the United States," please continue with this form and provide accurate form and/or document numbers. If you selected "A citizen of the United States, please proceed to the signature portion of this document.
1 Alien Registration NumberUSCIS Number
Form I94 Admission Number
If you obtained your admission number from CBP in connection with your arrival in the United States, include the following:
Foreign Passport Number
Some aliens may write "N/A" on the Foreign Passport Number and Country of Issuance fields. (See instructions)
Country of Issuance
Signature of Employee

Clear
Date mmddyyyy

MonthDayYear
Date
Should be Empty:

EMPLOYMENT ELIGIBILITY VERIFICATION

Additional Documentation