Employment Eligibility Verification
Department of Homeland Security
U.S. Citizenship and Immigration Services
USCIS
Form I-9
OMB No. 1615-0047
Expires 08/31/2019
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.
  ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which document(s) an employee may present to establish employment authorization and identity. The refusal to hire or continue to employ 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 (Family Name) First Name (Given Name) Middle Initial Other Last Names Used (if any)
Address (Street Number and Name) Apt. Number City or Town State Zip Code
 
Date of Birth (mm/dd/yyyy) U.S. Social Security Number Employee's E-mail Address 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):
 
(See instructions)  
  (Alien Registration Number/USCIS Number):
If you are a J-1 student or exchange visitor who presented a foreign passport with a Form I-94 showing J-1 status, your work authorization expiration date can be found on your DS-2019 form ("Certificate of Eligibility for Exchange Visitor (J-1) Status").

If you are an F-1 student performing Curricular Practical Training (CPT), your work authorization expiration date--which is the same as your F-1 program end date-- can be found on page 3 of your Form I-20 endorsed by your school’s Designated School Official.

If you are an F-1 student performing Optional Practical Training (OPT), your work authorization expiration date can be found on your Employment Authorization Document (EAD, Form I-766).

If you are an F-1 student performing on-campus employment, your work authorization expiration date--which is the same as your F-1 program end date--can be found on page 3 of your Form I-20 endorsed by your school’s Designated School Official.

until (expiration date, if applicable, mm/dd/yyyy)   . 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 I-9: An Alien Registration Number/USCIS Number OR Form I-94 Admission Number OR Foreign Passport Number

1. Alien Registration Number/USCIS Number:
OR
2. Form I-94 Admission Number: 
OR
3. Foreign Passport Number: 
Country of Issuance: 
QR Code - Section 1
Do Not Write in This Space

Signature of Employee:
Press "Click to Sign" to go to the next step - If someone assisted you in completing this form, please have the preparer/translator(s) complete the information below. Date (mm/dd/yyyy): 
 
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.
Signature of Preparer or Translator: 
Date (mm/dd/yyyy): 
Last Name (Family Name)  First name (Given Name) 
Address (Street Number and Name)  City or Town  State  Zip Code 
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:  
Date (mm/dd/yyyy): 
Last Name (Family Name)  First name (Given Name) 
Address (Street Number and Name)  City or Town  State  Zip Code 
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:  
Date (mm/dd/yyyy): 
Last Name (Family Name)  First name (Given Name) 
Address (Street Number and Name)  City or Town  State  Zip Code 
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: 
Date (mm/dd/yyyy): 
Last Name (Family Name)  First name (Given Name) 
Address (Street Number and Name)  City or Town  State  Zip Code 
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:  
Date (mm/dd/yyyy): 
Last Name (Family Name)  First name (Given Name) 
Address (Street Number and Name)  City or Town  State  Zip Code   
Employer Completes Next Page

Form I-9 07/17/2017 N
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