I-9 Form

The I-9 form, also known as the Employment Eligibility Verification form, is used by employers in the United States to verify the identity and employment authorization of individuals hired for employment. Here is an example of the I-9 form:

Form I-9

Employment Eligibility Verification

Section 1: Employee Information and Attestation

- Employee's Last Name (Family Name): ________________________

- Employee's First Name (Given Name): ________________________

- Employee's Middle Initial: _________________________________

- Other Last Names Used (if any): ___________________________

- Address (Street Number and Name): _________________________

- City or Town: _________________________________________

- State: ___________________ ZIP Code: ___________________

- Date of Birth (mm/dd/yyyy): ______________________________

- Social Security Number: _________________________________

- Email Address: _______________________________________

- Phone Number: _________________________________________

Alien Registration Number/USCIS Number (if applicable): _______________________

1. Are you a citizen of the United States?

[ ] Yes

[ ] No

If "No," complete the following:

Alien Authorized to Work:

[ ] Yes (Attach documentation of your immigration status)

[ ] No

2. The employee's attestation:

I attest, under penalty of perjury, that I am:

• A citizen of the United States
• An alien authorized to work in the United States

Employee's Signature: _______________________________

Date: ____________________________

Section 2: Employer or Authorized Representative Review and Verification

Employers or their authorized representatives must complete this section by reviewing the employee's original documents and verifying their identity and employment eligibility.

List of Acceptable Documents:

(Choose and record the document(s) presented by the employee)

Document Title Document Number Expiration Date

Certification:

I attest, under penalty of perjury, that I have examined the document(s) presented by the above-named employee, that the above-listed document(s) appear to be genuine and to relate to the employee named, that the employee began employment on (mm/dd/yyyy), and that to the best of my knowledge, the employee is authorized to work in the United States.

Employer's or Authorized Representative's Signature: ________________________________

Date: _____________________________

Section 3: Reverification and Rehires (if applicable)

To be completed and signed by the employer or authorized representative if the employee's work authorization has expired or if the employee is rehired within three years of the date the I-9 form was originally completed.

Signature of Employer or Authorized Representative: ____________________________

Date: ___________________________

Please note that this is a simplified example of the I-9 form. The actual form contains detailed instructions and additional sections that must be completed as per the guidelines provided by the U.S. Citizenship and Immigration Services (USCIS). It is important to refer to the official USCIS Form I-9 and follow the instructions or seek guidance from legal professionals to ensure compliance with immigration and employment eligibility verification requirements.