Employment Eligibility Verification Department of Homeland Security
U.S. Citizenship and Immigration Services
USC1S Form 1-9 OMB No. 1615-0047 Expires 08/31/2019
Section 2 Employer or Authorized Representative Review and Verification
(Employers or their authorized representative must complete and sign Section 2 within 3 business day of the employees first day of employment. You must physically examine one document form List A or a combination of one document from B and one document from C as listed on the Lists of Acceptable Documents).
Complete the list A or complete list B and C
Identity and Employment Authorization
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)
Section 3 Reverification and Rehires
(To be completed and signed by employer or authorized representative)
A. New Name (if applicable)
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 below
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.