Fill in a Valid USCIS I-9 Form
Document Sample
Employment Eligibility Verification |
USCIS |
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Department of Homeland Security |
Form |
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OMB No. |
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U.S. Citizenship and Immigration Services |
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Expires 10/31/2022 |
►START HERE: Read instructions carefully before completing this form. The instructions must be available, either in paper or electronically, during completion of this form. Employers are liable for errors in the completion of this form.
Section 1. Employee Information and Attestation (Employees must complete and sign Section 1 of Form
Last Name (Family Name)
First Name (Given Name)
Middle Initial |
Other Last Names Used (if any) |
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Address (Street Number and Name)
Apt. Number |
City or Town |
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State |
ZIP Code |
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Date of Birth (mm/dd/yyyy) |
U.S. Social Security Number |
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Employee's |
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Employee's 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 (check one of the following boxes):
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A citizen of the United States |
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A noncitizen national of the United States (See instructions) |
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A lawful permanent resident |
(Alien Registration Number/USCIS Number): |
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An alien authorized to work |
until (expiration date, if applicable, mm/dd/yyyy): |
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Some aliens may write "N/A" in the expiration date field. (See instructions)
Aliens authorized to work must provide only one of the following document numbers to complete Form
An Alien Registration Number/USCIS Number OR Form
1.Alien Registration Number/USCIS Number:
OR
2.Form
OR
3.Foreign Passport Number: Country of Issuance:
QR Code - Section 1
Do Not Write In This Space
Signature of Employee |
Today's Date (mm/dd/yyyy) |
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Preparer and/or Translator Certification (check one):
I did not use a preparer or translator. |
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A preparer(s) and/or translator(s) assisted the employee in completing Section 1. |
(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.
Signature of Preparer or Translator |
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Today's Date (mm/dd/yyyy) |
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Last Name (Family Name) |
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First Name (Given Name) |
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Address (Street Number and Name) |
City or Town |
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State |
ZIP Code |
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Employer Completes Next Page
Form |
PagePage1 ofof4 |
Employment Eligibility Verification |
USCIS |
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Department of Homeland Security |
Form |
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OMB No. |
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U.S. Citizenship and Immigration Services |
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Expires 10/31/2022 |
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
Last Name (Family Name)
First Name (Given Name)
M.I.
Citizenship/Immigration Status
List A |
OR |
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List B |
AND |
List C |
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Identity and Employment Authorization |
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Identity |
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Employment Authorization |
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Document Title |
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Document Title |
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Document Title |
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Issuing Authority |
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Issuing Authority |
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Issuing Authority |
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Document Number |
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Document Number |
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Document Number |
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Expiration Date (if any) (mm/dd/yyyy) |
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Expiration Date (if any) (mm/dd/yyyy) |
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Expiration Date (if any) (mm/dd/yyyy) |
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Document Title |
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Issuing Authority |
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Additional Information |
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QR Code - Sections 2 & 3 |
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Do Not Write In This Space |
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Document Number |
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Expiration Date (if any) (mm/dd/yyyy) |
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Document Title |
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Issuing Authority |
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Document Number |
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Expiration Date (if any) (mm/dd/yyyy) |
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Certification: I attest, under penalty of perjury, that (1) I have examined the document(s) presented by the
(2)the
The employee's first day of employment (mm/dd/yyyy): |
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(See instructions for exemptions) |
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Signature of Employer or Authorized Representative
Today's Date (mm/dd/yyyy)
Title of Employer or Authorized Representative
Last Name of Employer or Authorized Representative |
First Name of Employer or Authorized Representative |
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Employer's Business or Organization Name
Employer's Business or Organization Address (Street Number and Name) City or Town
State
ZIP Code
Form |
PagePage2 ofof4 |
Employment Eligibility Verification |
USCIS |
|
Department of Homeland Security |
Form |
|
OMB No. |
||
U.S. Citizenship and Immigration Services |
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Expires 10/31/2022 |
Employee Name from Section 1:
Last Name (Family Name)
First Name (Given Name)
Middle Initial
Section 3. Reverification and Rehires (To be completed and signed by employer or authorized representative.)
A. New Name (if applicable) |
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B. Date of Rehire (if applicable) |
Last Name (Family Name) |
First Name (Given Name) |
Middle Initial |
Date (mm/dd/yyyy) |
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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.
Document Title
Document Number
Expiration Date (if any) (mm/dd/yyyy)
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.
Signature of Employer or Authorized Representative |
Today's Date (mm/dd/yyyy) |
Name of Employer or Authorized Representative |
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Form |
PagePage3 ofof4 |
LISTS OF ACCEPTABLE DOCUMENTS
All documents must be UNEXPIRED
Employees may present one selection from List A
or a combination of one selection from List B and one selection from List C.
LIST A |
LIST B |
LIST C |
Documents that Establish |
Documents that Establish |
Documents that Establish |
Both Identity and |
Identity |
Employment Authorization |
Employment Authorization |
OR |
AND |
1.U.S. Passport or U.S. Passport Card
2.Permanent Resident Card or Alien Registration Receipt Card (Form
3.Foreign passport that contains a temporary
4.Employment Authorization Document that contains a photograph (Form
5.For a nonimmigrant alien authorized to work for a specific employer because of his or her status:
a.Foreign passport; and
b.Form
(1)The same name as the passport; and
(2)An endorsement of the alien's nonimmigrant status as long as that period of endorsement has not yet expired and the proposed employment is not in conflict with any restrictions or limitations identified on the form.
6.Passport from the Federated States of Micronesia (FSM) or the Republic of the Marshall Islands (RMI) with Form
1.Driver's license or ID card issued by a State or outlying possession of the United States provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address
2.ID card issued by federal, state or local government agencies or entities, provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address
3.School ID card with a photograph
4.Voter's registration card
5.U.S. Military card or draft record
6.Military dependent's ID card
7.U.S. Coast Guard Merchant Mariner Card
8.Native American tribal document
9.Driver's license issued by a Canadian government authority
For persons under age 18 who are
unable to present a document
listed above:
10.School record or report card
11.Clinic, doctor, or hospital record
12.
1.A Social Security Account Number card, unless the card includes one of the following restrictions:
(1)NOT VALID FOR EMPLOYMENT
(2)VALID FOR WORK ONLY WITH INS AUTHORIZATION
(3)VALID FOR WORK ONLY WITH DHS AUTHORIZATION
2.Certification of report of birth issued by the Department of State (Forms
3.Original or certified copy of birth certificate issued by a State, county, municipal authority, or territory of the United States bearing an official seal
4.Native American tribal document
5.U.S. Citizen ID Card (Form
6.Identification Card for Use of Resident Citizen in the United States (Form
7.Employment authorization document issued by the Department of Homeland Security
Examples of many of these documents appear in the Handbook for Employers
Refer to the instructions for more information about acceptable receipts.
Form |
Page 4 of 4 |
Document Information
| Fact Name | Description |
|---|---|
| Purpose | The I-9 form verifies the identity and employment authorization of individuals hired for employment in the United States. |
| Who Must Complete | All employers must have new hires complete the I-9 form, regardless of citizenship status. |
| Completion Deadline | Employees must complete Section 1 of the I-9 form on or before their first day of work. |
| Employer Responsibilities | Employers must complete Section 2 within three business days of the employee's start date. |
| Retention Period | Employers must retain the I-9 form for three years after the employee's hire date or one year after termination, whichever is longer. |
| State-Specific Forms | Some states may have additional forms or requirements; for example, California requires the I-9 along with state-specific employment forms. |
| Penalties for Noncompliance | Failure to properly complete and retain the I-9 form can result in fines and penalties for employers. |
USCIS I-9 - Usage Guidelines
After obtaining the USCIS I-9 form, it is important to fill it out accurately to ensure compliance with employment verification requirements. The following steps will guide you through the process of completing the form correctly.
- Begin by entering your full name in the designated fields. This includes your last name, first name, and middle initial, if applicable.
- Provide your address, including street number and name, city or town, state, and ZIP code.
- Input your date of birth in the format requested, typically month, day, and year.
- Indicate your Social Security number. If you do not have one, leave this section blank, as it is not required for certain individuals.
- Mark the appropriate box to indicate your citizenship or immigration status. Options may include being a U.S. citizen, a noncitizen national, or a lawful permanent resident.
- In Section 2, your employer or authorized representative will need to fill out information regarding the documents you present for verification. This includes the document title, issuing authority, document number, and expiration date, if applicable.
- Both you and your employer must sign and date the form in the appropriate sections. Ensure that the dates reflect when the form is completed.
Once the form is filled out, it should be submitted to your employer for their records. Keep a copy for your own reference, as it may be needed for future employment verification processes.
Common PDF Forms
Copy of Birth Certificate - This government document is integral to many legal and administrative processes.
When engaging in the sale or purchase of a vehicle, it is crucial to utilize the appropriate documentation, such as the Colorado Motor Vehicle Bill of Sale. This legal form not only validates the transaction but also aids in the proper transfer of ownership. For those looking for reliable resources, the Colorado PDF Templates can provide essential templates that meet state requirements, making the process even more seamless.
What Is an I9 Form - Some forms may also require additional information like the employee's start date and job duties.
Streamlined Foreign Offshore Procedures - It must include details about foreign financial accounts and their sources of funds.
Dos and Don'ts
When filling out the USCIS I-9 form, it’s important to follow specific guidelines to ensure accuracy and compliance. Here’s a list of what you should and shouldn’t do:
- Do: Read the instructions carefully before starting.
- Do: Use black or blue ink to fill out the form.
- Do: Provide accurate information about your identity and employment eligibility.
- Do: Sign and date the form after completing it.
- Do: Keep a copy of the completed form for your records.
- Don't: Leave any required fields blank.
- Don't: Use correction fluid or tape on the form.
- Don't: Provide false information or documents.
- Don't: Submit the form after the deadline.
- Don't: Forget to check for any updates to the form or instructions.
Common mistakes
When completing the USCIS I-9 form, individuals often encounter several common pitfalls. Understanding these mistakes can help ensure that the form is filled out correctly and efficiently. Here’s a list of seven frequent errors:
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Incorrect Dates: Failing to enter the correct date of hire or the date of birth can lead to complications. It is essential to double-check these dates for accuracy.
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Missing Signatures: Both the employee and employer must sign the form. Omitting signatures can result in the form being deemed incomplete.
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Wrong Document Selection: Employees must provide the correct documents to verify their identity and eligibility to work. Choosing documents that do not meet the I-9 requirements can cause delays.
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Inconsistent Information: Providing information that does not match the documents presented can raise red flags. Always ensure that names and details are consistent.
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Failure to Complete Sections: Each section of the I-9 must be filled out completely. Leaving sections blank can lead to rejection or requests for additional information.
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Not Using the Latest Version: The USCIS periodically updates the I-9 form. Using an outdated version can result in compliance issues.
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Ignoring Deadlines: There are specific timelines for completing the I-9 form. Failing to meet these deadlines can lead to penalties for employers.
By being aware of these common mistakes, individuals can navigate the I-9 form process more smoothly and ensure compliance with USCIS regulations.