Chapter $2$ Homework

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Department of Homeland Security

Form I$-9$

U S$.$ Citizenship and Immigration Services

OMB No$.1615-0047$

Expires $10/31/2022$

$40$

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

employ an individual because the docume present to establish employment authorization and identity. The refusal to hire or continue to

Section $1.$ Employee Information and Attestation

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$\backslash$table$[[$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$-,,$Employ,$],[,,,,,]]$

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$)$:

A citizen of the United States

A noncitizen national of the United States $($see instructions$)$

A lawiul permanent resident $($Alien Registration Number$/$USCIS Number$).$

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 $1-9$

An Alien Registration Number$/$USCIS Number OR Form I$-94$ Admission Number OR Foreign Passport Number.

Alien Registration Number$/$USCIS Number

OR

Form I$-94$ Admission Number

QR Code $-$ Section $1$

Do Not Write in This Space

OR

OR

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