316 Federal I-9 Form WEBSITE from Itasca Area Schools Collaborative

316 Federal I-9 Form WEBSITE

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Department of Homeland Security
U.S. Citizenship and Immigration Services

USCIS
Form I-9, Employment
Eligibility Verification
OMB No. 1615-0047
Expires 10/31/2022

You will need to submit proper I-9 documentation. This can include a driver's license AND social security card OR passport.
Read instructions carefully before completing this form. The instructions relevant to this document are:

I-9 Instructions

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

Last Name:

First Name:

Middle Initial:

Other Name 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 (xxx-xx-xxxx):

E-mail Address:

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):

A citizen of the United States

A noncitizen national of the United States (See instructions)

A lawful permanent resident (Provide Alien Registration Number/USCIS Number below)

An alien authorized to work until (Provide expiration date below)

1. Alien Registration Number/USCIS Number:

Expiration date. Some aliens may write "N/A" in this 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:

2. Form I-94 Admission Number:

If you obtained your admission number from CBP in connection with your arrival in the United States, include the following:

3.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:

By typing in your name (your “eSignature”), you accept and consent to be legally bound by this document’s statements, terms and conditions as if this document was signed by you in writing with pen on paper. You agree that no third party or other means of verification is necessary to validate your eSignature and that the lack of such third party or other means of verification will not in any way affect the enforceability of this document.

Preparer and/or Translator Certification (check one) (To be completed and signed when preparers and/or translators assist an employee in completing Section 1.)

I did not use a preparer or translator.

A preparer(s) and/or translator(s) assisted the employee in completing section 1.

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.

Last Name (Family Name):

First Name (Given Name):

Address (Street Number and Name):

City or Town:

State:

Zip Code:

ADocTitle1

AExpDate1

BExpDate

Additional Information

Date of Rehire (if applicable)(mm/dd/yyyy):

Signature of Employer or Authorized Representative:

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History

Step: Fill out the form
Sent To: Public User, On: 4/5/2025 7:26:43 PM Central Standard Time

Itasca Area Schools Collaborative - 316 Federal I-9 Form WEBSITE