(USA) Managing I-9 Information

Other Last Names Used (if any)

Enter the maiden or other names, if applicable. When more than one name exists, separate the names by a semicolon (;).

Employee’s E-mail Address and Employee’s Telephone Number

Enter the appropriate contact information.

Citizenship or immigration status group box

Select the option for your eligibility type. You must select one of the options and provide any additional data that is associated with the selected option. Options are:

1. A citizen of the United States: Select this option if you are a citizen of the United States.

2. A noncitizen national of the United States (See Instructions): Select this option if you are a noncitizen national of the United States.

3. A lawful permanent resident: Select this option if you are a conditional resident and have received legal permanent residency in the United States.

   By selecting this option, the (Enter USCIS or A- Number.) field within this group box becomes available for entry.

4. A noncitizen (other than item Numbers 2. and 3. above) authorized to work until (exp. date, if any): Select this option when you are noncitizen but have been granted authorization to work in the United States and enter the date that your employment authorization expires, if any.

   By selecting this option, the remaining fields within this group box become available for entry.

   Note: Noncitizens authorized to work must enter one of the following to complete Section 1:

   1. USCIS A-Number

   2. Form I-94 Admission Number

   3. Foreign Passport Number and the Country of Issuance

(Enter USCIS or A-Number.)

Enter your lawful permanent resident number or USCIS number. This field is mandatory if you select the option stating that you are a lawful permanent resident.

until (expiration date, if applicable, mm/dd/yyyy) (month/day/year)

This field is available when you select that you are an noncitizen authorized to work.

Enter the date until which you are authorized to work. There are certain types of work authorizations that do not expire - e.g. refugees or asylees. Therefore, if the expiration date does not apply, leave this field blank.

Signature of Employee

Select a signature type. Options include:

• <employee’s name>: The name is derived from the values entered in the Last Name, First Name, and Middle Initial fields.

• Minor Under Age 18

• Special Placement

Signature of Preparer of Translator

Enter the preparer's signature.

Last Name (Family Name) and First Name (Given Name)

Enter the preparer's first and last name in these fields. These fields are required.

Address (Street Number and Name), City or Town, State, and Zip Code

Enter the preparer's address information in these fields. These fields are required.

Submit button

Select this button to save and submit this form, trigger appropriate workflow notifications to the administrator, and generate the confirmation page.

When you select this button, the system will prompt you to perform a check. Select Yes to perform the check.

Document Title

Record the type of documentation provided by the employee. There are separate fields for each document type (A, B and C).

Issuing Authority

Enter the name of the agency that issued the document.

Document Number (if any)

Enter the number of the actual document.

Expiration Date (if any) (mm/dd/yyyy)

(Optional) Record the expiration date, if any, of the document.

Additional Information

Record any additional information required to complete Section 2, or any updates that are necessary once Section 2 is complete.

Check here if you used an alternative procedure authorized by DHS to examine documents.

Select this check box if you used an alternative procedure authorized by DHS to examine the documents.

Signature of Employer or Authorized Representative

Select the name of the employer representative who is submitting the data. The drop-down value displays the name of the person logged into the system.

Last Name, First Name and Title of Employer or Authorized Representative

Displays the name and job title of the employer representative who is submitting the data.

Employer’s Business or Organization Name

Displays the organization’s name.

Employer’s Business or Organization Address, City or Town, State, Zip Code

Displays the current organization’s address.

Submit button

Select this button to save and submit the information you entered.

When you select this button, the system will prompt you to perform a validation check. Select Yes to perform the check.

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

Displays the most current rehire date by default in this field.

New Name (if applicable)

Displays the employee's current name if it is different from the name initially saved on the form.

Document Title

Enter the type of documentation being reverified or for the employee being rehired.

Document Number (if any)

Enter the number of the actual document.

Expiration Date (if any) (mm/dd/yyyy)

(Optional) Record the document expiration date, if any.

Signature of Employer or Authorized Representative

Select the signature of the employer or representative to confirm that the employee is authorized to work. The drop-down menu value displays the name of the person logged into the system.

Check here if you used an alternative procedure authorized by DHS to examine documents.

Select this check box if you used an alternative procedure authorized by DHS to examine the documents.

Submit

Select this button to save and submit the form.

Select

Select this button to send an email notification to the employee to request a new Form I-9.