Department of Homeland Security
U.S. Citizenship and Immigration Services
Form I-9, Employment
Eligibility Verification
Anti-Discrimination Notice. It is illegal to discriminate against
any individual (other than an alien not authorized to work in the
United States) in hiring, discharging, or recruiting or referring for a
fee because of that individual's national origin or citizenship status.
It is illegal to discriminate against work-authorized individuals.
Employers CANNOT specify which document(s) they will accept
from an employee. The refusal to hire an individual because the
documents presented have a future expiration date may also
constitute illegal discrimination. For more information, call the
Office of Special Counsel for Immigration Related Unfair
Employment Practices at 1-800-255-8155.
All employees (citizens and noncitizens) hired after November
6, 1986, and working in the United States must complete
Form I-9.
OMB No. 1615-0047; Expires 08/31/12
The Preparer/Translator Certification must be completed if
Section 1 is prepared by a person other than the employee. A
preparer/translator may be used only when the employee is
unable to complete Section 1 on his or her own. However, the
employee must still sign Section 1 personally.
Form I-9 (Rev. 08/07/09) Y
Read all instructions carefully before completing this form.
Instructions
When Should Form I-9 Be Used?
What Is the Purpose of This Form?
The purpose of this form is to document that each new
employee (both citizen and noncitizen) hired after November
6, 1986, is authorized to work in the United States.
For the purpose of completing this form, the term "employer"
means all employers including those recruiters and referrers
for a fee who are agricultural associations, agricultural
employers, or farm labor contractors. Employers must
complete Section 2 by examining evidence of identity and
employment authorization within three business days of the
date employment begins. However, if an employer hires an
individual for less than three business days, Section 2 must be
completed at the time employment begins. Employers cannot
specify which document(s) listed on the last page of Form I-9
employees present to establish identity and employment
authorization. Employees may present any List A document
OR a combination of a List B and a List C document.
Filling Out Form I-9
This part of the form must be completed no later than the time
of hire, which is the actual beginning of employment.
Providing the Social Security Number is voluntary, except for
employees hired by employers participating in the USCIS
Electronic Employment Eligibility Verification Program (E-
Verify). The employer is responsible for ensuring that
Section 1 is timely and properly completed.
1. Document title;
2. Issuing authority;
3. Document number;
4. Expiration date, if any; and
5. The date employment begins.
Employers must sign and date the certification in Section 2.
Employees must present original documents. Employers may,
but are not required to, photocopy the document(s) presented.
If photocopies are made, they must be made for all new hires.
Photocopies may only be used for the verification process and
must be retained with Form I-9. Employers are still
responsible for completing and retaining Form I-9.
Noncitizen nationals of the United States are persons born in
American Samoa, certain former citizens of the former Trust
Territory of the Pacific Islands, and certain children of
noncitizen nationals born abroad.
Employers should note the work authorization expiration
date (if any) shown in Section 1. For employees who indicate
an employment authorization expiration date in Section 1,
employers are required to reverify employment authorization
for employment on or before the date shown. Note that some
employees may leave the expiration date blank if they are
aliens whose work authorization does not expire (e.g., asylees,
refugees, certain citizens of the Federated States of Micronesia
or the Republic of the Marshall Islands). For such employees,
reverification does not apply unless they choose to present
If an employee is unable to present a required document (or
documents), the employee must present an acceptable receipt
in lieu of a document listed on the last page of this form.
Receipts showing that a person has applied for an initial grant
of employment authorization, or for renewal of employment
authorization, are not acceptable. Employees must present
receipts within three business days of the date employment
begins and must present valid replacement documents within
90 days or other specified time.
Employers must record in Section 2:
Preparer/Translator Certification
Section 2, Employer
Section 1, Employee
in Section 2 evidence of employment authorization that
contains an expiration date (e.g., Employment Authorization
Document (Form I-766)).
EMPLOYERS MUST RETAIN COMPLETED FORM I-9
DO NOT MAIL COMPLETED FORM I-9 TO ICE OR USCIS
To order USCIS forms, you can download them from our
website at www.uscis.gov/forms or call our toll-free number at
1-800-870-3676. You can obtain information about Form I-9
from our website at www.uscis.gov or by calling
1-888-464-4218.
USCIS Forms and Information
What Is the Filing Fee?
There is no associated filing fee for completing Form I-9. This
form is not filed with USCIS or any government agency. Form
I-9 must be retained by the employer and made available for
inspection by U.S. Government officials as specified in the
Privacy Act Notice below.
The authority for collecting this information is the
Immigration Reform and Control Act of 1986, Pub. L. 99-603
(8 USC 1324a).
Privacy Act Notice
This information is for employers to verify the eligibility of
individuals for employment to preclude the unlawful hiring, or
recruiting or referring for a fee, of aliens who are not
authorized to work in the United States.
A blank Form I-9 may be reproduced, provided both sides are
copied. The Instructions must be available to all employees
completing this form. Employers must retain completed Form
I-9s for three years after the date of hire or one year after the
date employment ends, whichever is later.
Photocopying and Retaining Form I-9
Form I-9 may be signed and retained electronically, as
authorized in Department of Homeland Security regulations
at 8 CFR 274a.2.
C. If an employee is rehired within three years of the date
this form was originally completed and the employee's
work authorization has expired or if a current
employee's work authorization is about to expire
(reverification), complete Block B; and:
1. Examine any document that reflects the employee
is authorized to work in the United States (see List
A or C);
2. Record the document title, document number, and
expiration date (if any) in Block C; and
3. Complete the signature block.
A. If an employee's name has changed at the time this form
is being updated/reverified, complete Block A.
B. If an employee is rehired within three years of the date
this form was originally completed and the employee is
still authorized to be employed on the same basis as
previously indicated on this form (updating), complete
Block B and the signature block.
Employers must complete Section 3 when updating and/or
reverifying Form I-9. Employers must reverify employment
authorization of their employees on or before the work
authorization expiration date recorded in Section 1 (if any).
Employers CANNOT specify which document(s) they will
accept from an employee.
For more detailed information, you may refer to the
USCIS Handbook for Employers (Form M-274). You may
obtain the handbook using the contact information found
under the header "USCIS Forms and Information."
Note that for reverification purposes, employers have the
option of completing a new Form I-9 instead of completing
Section 3.
Information about E-Verify, a free and voluntary program that
allows participating employers to electronically verify the
employment eligibility of their newly hired employees, can be
obtained from our website at www.uscis.gov/e-verify or by
calling 1-888-464-4218.
General information on immigration laws, regulations, and
procedures can be obtained by telephoning our National
Customer Service Center at 1-800-375-5283 or visiting our
Internet website at www.uscis.gov.
This information will be used by employers as a record of
their basis for determining eligibility of an employee to work
in the United States. The form will be kept by the employer
and made available for inspection by authorized officials of
the Department of Homeland Security, Department of Labor,
and Office of Special Counsel for Immigration-Related Unfair
Employment Practices.
Submission of the information required in this form is
voluntary. However, an individual may not begin employment
unless this form is completed, since employers are subject to
civil or criminal penalties if they do not comply with the
Immigration Reform and Control Act of 1986.
Section 3, Updating and Reverification
Form I-9 (Rev. 08/07/09) Y Page 2
Paperwork Reduction Act
An agency may not conduct or sponsor an information
collection and a person is not required to respond to a
collection of information unless it displays a currently valid
OMB control number. The public reporting burden for this
collection of information is estimated at 12 minutes per
response, including the time for reviewing instructions and
completing and submitting the form. Send comments
regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing
this burden, to: U.S. Citizenship and Immigration Services,
Regulatory Management Division, 111 Massachusetts
Avenue, N.W., 3rd Floor, Suite 3008, Washington, DC
20529-2210. OMB No. 1615-0047. Do not mail your
completed Form I-9 to this address.
Form I-9 (Rev. 08/07/09) Y Page 3
Department of Homeland Security
U.S. Citizenship and Immigration Services
Form I-9, Employment
Eligibility Verification
OMB No. 1615-0047; Expires 08/31/12
Read instructions carefully before completing this form. The instructions must be available during completion of this form.
ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOT
specify which document(s) they will accept from an employee. The refusal to hire an individual because the documents have a
future expiration date may also constitute illegal discrimination.
Section 1. Employee Information and Verification (To be completed and signed by employee at the time employment begins.)
Print Name: Last First Middle Initial
Maiden Name
Address (Street Name and Number)
Apt. # Date of Birth (month/day/year)
StateCity Zip Code Social Security #
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.
Employee's Signature
Date (month/day/year)
Preparer and/or Translator Certification (To be completed and signed if Section 1 is prepared by a person other than the employee.) I attest, under
penalty of perjury, that I have assisted in the completion of this form and that to the best of my knowledge the information is true and correct.
Address (Street Name and Number, City, State, Zip Code)
Print NamePreparer's/Translator's Signature
Date (month/day/year)
Section 2. Employer Review and Verification (To be completed and signed by employer. Examine one document from List A OR
examine one document from List B and one from List C, as listed on the reverse of this form, and record the title, number, and
expiration date, if any, of the document(s).)
ANDList B List CORList A
Document title:
Issuing authority:
Document #:
Expiration Date (if any):
Document #:
Expiration Date (if any):
and that to the best of my knowledge the employee is authorized to work in the United States. (State
(month/day/year)
employment agencies may omit the date the employee began employment.)
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
Print Name TitleSignature of Employer or Authorized Representative
Date (month/day/year)Business or Organization Name and Address (Street Name and Number, City, State, Zip Code)
B. Date of Rehire (month/day/year) (if applicable)A. New Name (if applicable)
C. If employee's previous grant of work authorization has expired, provide the information below for the document that establishes current employment authorization.
Document #: Expiration Date (if any):Document Title:
Section 3. Updating and Reverification (To be completed and signed by employer.)
l 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) l have examined appear to be genuine and to relate to the individual.
Date (month/day/year)Signature of Employer or Authorized Representative
I attest, under penalty of perjury, that I am (check one of the following):
A lawful permanent resident (Alien #)
A citizen of the United States
An alien authorized to work (Alien # or Admission #)
A noncitizen national of the United States (see instructions)
until (expiration date, if applicable - month/day/year)
Form I-9 (Rev. 08/07/09) Y Page 4
Smith
Doe
Jane
A
123 Main Street
Apt. 22
NC
27604
01/01/1975
000-00-0000
NC Driver's License
NC DMV
33344555
08/10/2016
Social Security Card
SSA
000-00-0000
HR Specialist
Shannon Doah
07/19/2010
07/19/2010
click to sign
signature
click to edit
click to sign
signature
click to edit
For persons under age 18 who
are unable to present a
document listed above:
LISTS OF ACCEPTABLE DOCUMENTS
LIST A LIST B LIST C
2. Permanent Resident Card or Alien
Registration Receipt Card (Form
I-551)
8. Employment authorization
document issued by the
Department of Homeland Security
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
1. Social Security Account Number
card other than one that specifies
on the face that the issuance of the
card does not authorize
employment in the United States
9. Driver's license issued by a Canadian
government authority
1. U.S. Passport or U.S. Passport Card
2. Certification of Birth Abroad
issued by the Department of State
(Form FS-545)
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)
3. Certification of Report of Birth
issued by the Department of State
(Form DS-1350)
3. School ID card with a photograph
5. In the case of a nonimmigrant alien
authorized to work for a specific
employer incident to status, a foreign
passport with Form I-94 or Form
I-94A bearing the same name as the
passport and containing an
endorsement of the alien's
nonimmigrant status, as long as the
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. Military dependent's ID card
4. Original or certified copy of birth
certificate issued by a State,
county, municipal authority, or
territory of the United States
bearing an official seal
7. U.S. Coast Guard Merchant Mariner
Card
5. Native American tribal document
8. Native American tribal document
7. Identification Card for Use of
Resident Citizen in the United
States (Form I-179)
10. School record or report card
11. Clinic, doctor, or hospital record
12. Day-care or nursery school record
Illustrations of many of these documents appear in Part 8 of the Handbook for Employers (M-274)
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
4. Voter's registration card
5. U.S. Military card or draft record
Documents that Establish Both
Identity and Employment
Authorization
Documents that Establish
Identity
Documents that Establish
Employment Authorization
OR
AND
All documents must be unexpired
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
6. U.S. Citizen ID Card (Form I-197)
Form I-9 (Rev. 08/07/09) Y Page 5