Homepage USCIS I-9 Form

USCIS I-9 Sample

Employment Eligibility Verification

USCIS

Department of Homeland Security

Form I-9

OMB No. 1615-0047

U.S. Citizenship and Immigration Services

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.

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 boxes):

1.

A citizen of the United States

 

 

 

 

 

 

 

2.

A noncitizen national of the United States (See instructions)

 

 

 

 

 

3.

A lawful permanent resident

(Alien Registration Number/USCIS Number):

 

 

 

 

 

 

 

 

 

 

4.

An alien authorized to work

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

Today's Date (mm/dd/yyyy)

 

 

Preparer and/or Translator Certification (check one):

I did not use a preparer or translator.

 

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

 

 

Today's 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 10/21/2019

PagePage1 ofof4

Employment Eligibility Verification

USCIS

Department of Homeland Security

Form I-9

OMB No. 1615-0047

U.S. Citizenship and Immigration Services

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

 

List B

AND

List C

Identity and Employment Authorization

 

 

 

 

 

Identity

 

 

 

 

Employment Authorization

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Document Title

 

 

 

 

Document Title

 

 

Document Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Issuing Authority

 

 

 

 

Issuing Authority

 

 

Issuing Authority

 

 

 

 

 

 

 

 

 

 

 

Document Number

 

 

 

 

Document Number

 

 

Document Number

 

 

 

 

 

 

 

 

 

Expiration Date (if any) (mm/dd/yyyy)

 

 

 

 

Expiration Date (if any) (mm/dd/yyyy)

 

 

Expiration Date (if any) (mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Document Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Issuing Authority

 

 

 

 

 

Additional Information

 

 

 

 

 

QR Code - Sections 2 & 3

 

 

 

 

 

 

 

 

 

 

 

Do Not Write In This Space

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Document Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Expiration Date (if any) (mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Document Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Issuing Authority

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Document Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Expiration Date (if any) (mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Certification: I attest, under penalty of perjury, that (1) I have examined the document(s) presented by the above-named employee,

(2)the above-listed document(s) appear 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.

The employee's first day of employment (mm/dd/yyyy):

 

(See instructions for exemptions)

 

 

 

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

 

 

Employer's Business or Organization Name

Employer's Business or Organization Address (Street Number and Name) City or Town

State

ZIP Code

Form I-9 10/21/2019

PagePage2 ofof4

Employment Eligibility Verification

USCIS

Department of Homeland Security

Form I-9

OMB No. 1615-0047

U.S. Citizenship and Immigration Services

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)

 

 

B. Date of Rehire (if applicable)

Last Name (Family Name)

First Name (Given Name)

Middle Initial

Date (mm/dd/yyyy)

 

 

 

 

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

 

 

 

Form I-9 10/21/2019

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 I-551)

3.Foreign passport that contains a temporary I-551 stamp or temporary I-551 printed notation on a machine- readable immigrant visa

4.Employment Authorization Document that contains a photograph (Form I-766)

5.For a nonimmigrant alien authorized to work for a specific employer because of his or her status:

a.Foreign passport; and

b.Form I-94 or Form I-94A that has the following:

(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 I-94 or Form I-94A indicating nonimmigrant admission under the Compact of Free Association Between the United States and the FSM or RMI

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.Day-care or nursery school record

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 DS-1350, FS-545, FS-240)

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 I-197)

6.Identification Card for Use of Resident Citizen in the United States (Form I-179)

7.Employment authorization document issued by the Department of Homeland Security

Examples of many of these documents appear in the Handbook for Employers (M-274).

Refer to the instructions for more information about acceptable receipts.

Form I-9 10/21/2019

Page 4 of 4

Instructions on Utilizing USCIS I-9

Completing the USCIS I-9 form is an important step for employers and employees in the United States. After filling out the form, ensure that all necessary documents are provided to verify identity and employment eligibility. Follow these steps to accurately fill out the I-9 form.

  1. Obtain a copy of the USCIS I-9 form. You can download it from the USCIS website.
  2. Complete Section 1 of the form. This section requires personal information such as your name, address, date of birth, and Social Security number.
  3. Indicate your citizenship or immigration status by checking the appropriate box in Section 1.
  4. Sign and date Section 1 to certify that the information provided is true and correct.
  5. In Section 2, your employer will need to complete the employer's review of documents. Provide the required identification documents to your employer.
  6. Your employer will fill out the details of the documents you presented in Section 2, including document title, issuing authority, document number, and expiration date if applicable.
  7. Your employer must sign and date Section 2 to confirm the review of your documents.
  8. Ensure that both you and your employer keep copies of the completed I-9 form for your records.

Misconceptions

The USCIS I-9 form is an important document for employers and employees in the United States. However, there are several misconceptions surrounding it. Here are six common misunderstandings:

  1. The I-9 form is only for new hires.

    This is not entirely accurate. While the I-9 form must be completed for new employees, it also applies to employees who are rehired or who change their job duties. Employers need to ensure that the I-9 is updated as necessary.

  2. Employers can keep the I-9 form indefinitely.

    Employers must retain the I-9 form for a specific period. Generally, they must keep it for three years after the employee's hire date or one year after the employee's termination, whichever is longer.

  3. Only U.S. citizens can fill out an I-9 form.

    This is incorrect. The I-9 form is for all employees, regardless of citizenship status. Non-citizens must provide documentation proving their eligibility to work in the U.S.

  4. Employers are responsible for verifying the authenticity of the documents provided.

    While employers must review the documents for authenticity, they are not expected to be experts in identifying fraudulent documents. They should, however, ensure that the documents appear valid and belong to the employee.

  5. Once the I-9 is completed, it doesn’t need to be updated.

    This is a misconception. If an employee's work authorization expires, the employer must complete a new I-9 form and verify the new documentation. Regular updates are crucial to remain compliant.

  6. The I-9 form is optional for employers.

    This is false. Completing the I-9 form is a legal requirement for employers. Failure to do so can result in penalties and fines from the government.

Documents used along the form

When hiring new employees, the USCIS I-9 form is a critical document that verifies an individual's eligibility to work in the United States. However, several other forms and documents are often used in conjunction with the I-9 to ensure compliance with employment laws and regulations. Here is a list of these documents, along with a brief description of each.

  • W-4 Form: This form is used by employees to indicate their tax situation to their employer. It helps determine the amount of federal income tax to withhold from their paychecks.
  • State Tax Withholding Form: Similar to the W-4, this form is specific to state taxes. Employees fill it out to inform their employer about state tax withholding preferences.
  • Form 1099: This form is utilized for reporting income received by independent contractors or freelancers. It details the amount paid and is essential for tax reporting purposes.
  • Form I-765: Known as the Application for Employment Authorization, this form is used by individuals who are not U.S. citizens but wish to apply for permission to work in the country.
  • Form I-131: This document is used to apply for a travel document, such as a re-entry permit or refugee travel document, which may be necessary for certain employees with specific immigration statuses.
  • Form I-140: This is a petition for an immigrant worker. Employers use it to sponsor foreign nationals for permanent residency based on employment.
  • Form I-485: This is the Application to Register Permanent Residence or Adjust Status. It is often filed by individuals already in the U.S. seeking to become permanent residents.
  • Durable Power of Attorney: This essential document allows individuals to appoint someone to handle their financial affairs when they are unable to do so themselves. For more information, visit the Durable Power of Attorney page.
  • Job Offer Letter: This document outlines the terms of employment, including job title, salary, and start date. It serves as a formal agreement between the employer and the employee.

Each of these forms plays a vital role in the employment process. Understanding their purpose can help both employers and employees navigate the complexities of hiring and compliance with U.S. immigration and tax laws. Keeping these documents organized and accessible can ensure a smoother onboarding experience for everyone involved.