Required Complete the l-9 for employment at Erma Jane Grant. Erma Jane Grant 441 West Hill Road Montrose, Colorado 81401 SSN: 432-55-6792 Maiden name: Grant Date of Birth: June 12, 1986 U.S. Citizen Erma presented her passport for her employer to review Passport number 3890493, issued by the United States State Department, expires April 1, 2020 (NOTE): Further instructions on format can be found on certain cells within the forms. Employer 19 PG 2 Section should also be completed The following file provides the lists of acceptable documents. Complete this question by entering your answers in the tabs below I9 PG 1 I9 PG 2 Complete Page 1 of Form I-9 Employment Eligibility Verification USCIS Form I-9 OMB No. 1615-0047 Expires 08/31/2019 Department of Homeland Security U.S. Citizenship and Immigration Services START HERE. Read instructions carefully before completing this form. The instructions must be available during completion of this form. ANTI-DISCRIMINATION NOTICE: accept from an employee. The refusal to hire 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.) It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which document s) they will Complete Page 1 of Form I-9 Employment Eligibility Verification USCIS Form I-9 OMB No. 1615-0047 Expires 08/31/2019 Department of Homeland Security U.S. Citizenship and Immigration Services START HERE. Read instructions carefully before completing this form. The instructions must be available during completion of this form. ANTI-DISCRIMINATION NOTICE accept from an employee. The refusal to hire 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 1-9 no later than the first day of employment, but not before accepting a job offer.) Last name (Family Name) It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which document s) they will First Name (Given Name) Erma Middle Initial Other Names Used (if any) rant Address (Street Number and Name) 441 West Hill Road Date of Birth (mm/ddlyyyy) 06/12/1986 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): rant Apt Number City or Town ontrose E-mail Address State Zip Code 1401 0 U.S. Social Security Number 432-55-6792 Telephone Number A citizen of the United States COA noncitizen national of the United States (see nstructions) A lawful permanent resident (Alien Registration Number USCIS Number): An alien authorized to work until (expiration date,if applicable, mm/dd)yyy). Some aliens may write "N/A" in this field. (See instructions) For aliens authorized to work, provide your Alien Registration Number/USCIS Number OR Form 1-94 Admission Number 1. Alien Registration NumberUSCIS Number OR 3-D Barcode 2. Form 1-94 Admission Number: Do Not Write in This Space If you obtained your admission number from CBP in connection with your arrival in the United States, include the folllowing: Foreign Passport Number: Country of Issuance: Some aliens may write 'N/A" on the Foreign Passport Number and Country of Issuance fields. (See instructions) Signature of Employee 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. Signature of Preparer or Translator: Date (mm/ddlyyyy) Date (mm/ddlyyyy) Last Name (Family Name) First Name (Given Name) I9 PG 1 I9 PG 2 Complete Page 2 of Form I-9 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 examine a combination of one document from List B and one document from List C as listed on the "Lists of Acceptable Documents First NameGiven Name) M.I Status Employee Info from Last Name (Family Name) Section 1 List A OR List B AND List C Employment Authorization Ide Document Title: Identity and Em ent Authorization Document Title: Issuing Authority Issuing Authority: Issuing Authority: Document Number: Document Number Expiration Date (if any) (mm/ddlyyyy) Expiration Date (if any) (mm/ddlyyyy)- Expiraton Datef any) (mm/ddlyyyy): Issuing Authority Expiration Date (if any) (mm/ddlyyyy) 3-D Barcode Do Not Write in This Space Issuing Authority Expiration Date (if any) (mm/ddlyyyy) 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