Form I-9, Employment Eligibility Verification Instructions

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This form contains 130 fields organized into 24 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Additional Information
Additional Information Text
Please provide any additional information or comments related to the employment verification process.
Citizenship and Immigration Status
Ciudadano de Estados Unidos Checkbox
Check this box if you are a citizen of the United States.
Nacional no ciudadano de Estados Unidos Checkbox
Check this box if you are a noncitizen national of the United States.
Residente permanente legal Checkbox
Check this box if you are a lawful permanent resident.
Alien Registration or USCIS Number Text
Please provide your Alien Registration Number (A-Number) or USCIS Number. Fill only if 'Residente permanente legal' is selected.
Depends on: Residente permanente legal
Extranjero autorizado para trabajar Checkbox
Check this box if you are an alien authorized to work.
Work Authorization Expiration Date Date
Please provide the expiration date of your employment authorization. Fill only if 'Extranjero autorizado para trabajar' is selected.
Depends on: Extranjero autorizado para trabajar
Employee Address
Street Address Text
Please provide the building number and street name of the employee's address.
Apartment Number Text
Please enter the apartment number, if applicable.
City or Town Text
Please provide the city or town of the employee's address.
Postal Code Text
Please provide the postal code for the employee's address.
Max length: 6 characters
Employee Name
Apellido (Nombre de Familia) Text
Primer Nombre (Nombre de Pila) Text
Inicial de Segundo Nombre (si alguno) Text
Max length: 1 characters
Otros Apellidos Utilizados (si alguno) Text
Employee Last Name Text
Please provide the employee's last name, also known as family name, as it appears in Section 1. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Employee First Name Text
Please provide the employee's first name, also known as given name, as it appears in Section 1. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Employee Middle Initial Text
Please provide the employee's middle initial, if applicable, as it appears in Section 1. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Employee Name (As in Section 1)
Employee Last Name Text
Please enter the employee's last name exactly as it appears in Section 1.
Employee First Name Text
Please enter the employee's first name exactly as it appears in Section 1.
Employee Middle Initial Text
Please enter the employee's middle initial if they have one.
Employee Personal Information
Date of Birth Date
Please provide your date of birth.
Social Security Number Text
Please enter your U.S. Social Security Number.
Max length: 9 characters
Employee Email Address Text
Please provide your email address.
Employee Phone Number Text
Please enter your phone number.
Employee Signature
Employee Signature Text
Provide the employee's signature by typing their full legal name.
Todays Date mmddyyyy Text
Signature Date Date
Enter the date the employee signed this form.
Employee's First Day of Employment
Employee's First Day of Employment Date
Enter the employee's first day of employment.
Employer or Authorized Representative Signature Details
Employer or Representative Full Name and Title Text
Please enter the full name and title of the employer or authorized representative.
Employer or Representative Signature Text
Please enter the signature of the employer or authorized representative.
Employer's Business Information
Employer Business Name Text
Enter the full legal name of the employer's company or organization.
Employer Business Address Text
Provide the full street address, including street number, street name, city, state, and zip code, for the employer's company or organization.
First Preparer/Translator Certification
Preparer/Translator Name Text
Enter the full name of the preparer or translator in this signature field. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Date of Certification Date
Enter the date when this certification is completed. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator Last Name Text
Enter the last name of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator First Name Text
Enter the first name of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator Middle Initial Text
Enter the middle initial of the preparer or translator, if applicable. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Max length: 1 characters
Preparer/Translator Street Address Text
Enter the street number and name for the preparer's or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator City Text
Enter the city or town for the preparer's or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator State Combobox
Enter the state for the preparer's or translator's address.
MEX KY MS MT MD OK MP PR SD NH NC IA WY LA CO OH NV PA MN GA MA SC UT NM CA AR ID VA IN MI VI ND NE OR TN FL GU IL WA WV NY NJ DE AK VT TX AZ MO HI AL KS ME RI WI AS CT DC CAN
Preparer/Translator Postal Code Text
Enter the postal code for the preparer's or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Max length: 6 characters
First Reverification/Rehiring Record
Fecha de Hoy (mm/dd/aaaa) Text
New Last Name (if applicable) Text
Provide the employee's new last name, if applicable.
New First Name (if applicable) Text
Provide the employee's new first name, if applicable.
New Middle Initial (if applicable) Text
Provide the employee's new middle initial, if applicable.
Max length: 1 characters
Document Title Text
Enter the title of the document presented for reverification.
Document Number Text
Enter the document number, if any.
Document Expiration Date Date
Enter the document's expiration date, if any.
Employer or Authorized Representative Name Text
Enter the name of the employer or authorized representative.
Employer or Authorized Representative Signature Text
Provide the signature of the employer or authorized representative.
Employer/Representative Signature Date Date
Enter today's date for the employer or authorized representative's signature.
Additional Information Text
Provide any additional information, including initials and date for each annotation.
DHS Alternate Procedure Checkbox
Check this box if you used an alternate procedure authorized by DHS to examine documents.
Fourth Preparer/Translator Certification
Preparer/Translator Name (Signature) Text
Enter the full name of the preparer or translator as their signature. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Certification Date Date
Enter the date the preparer or translator completed this certification. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator Last Name Text
Enter the last name of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator First Name Text
Enter the first name of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator Middle Initial Text
Enter the middle initial of the preparer or translator, if applicable. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Max length: 1 characters
Preparer/Translator Street Address Text
Enter the street number and name of the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator City Text
Enter the city or town of the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator State Combobox
Enter the state of the preparer or translator's address.
MEX KY MS MT MD OK MP PR SD NH NC IA WY LA CO OH NV PA MN GA MA SC UT NM CA AR ID VA IN MI VI ND NE OR TN FL GU IL WA WV NY NJ DE AK VT TX AZ MO HI AL KS ME RI WI AS CT DC CAN
Preparer/Translator Postal Code Text
Enter the postal code of the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Max length: 6 characters
General
State Combobox
Please enter the state of the employee's residence.
MEX KY MS MT MD OK MP PR SD NH NC IA WY LA CO OH NV PA MN GA MA SC UT NM CA AR ID VA IN MI VI ND NE OR TN FL GU IL WA WV NY NJ DE AK VT TX AZ MO HI AL KS ME RI WI AS CT DC CAN
Marque aquí si usó un procedimiento alterno autorizado por DHS para examinar documentos. Checkbox
Check this box if an alternative procedure authorized by DHS was used to examine the documents.
Immigration Document Number
USCIS Number A Text
Please provide your USCIS Alien Registration Number (A-Number). Fill only if 'Extranjero autorizado para trabajar' is selected.
Depends on: Extranjero autorizado para trabajar
Form I-94 Admission Number Text
Please provide your Form I-94 Admission Number. Fill only if 'Extranjero autorizado para trabajar' is selected.
Depends on: Extranjero autorizado para trabajar
Foreign Passport Number and Issuing Country Text
Please provide your foreign passport number and the country that issued it. Fill only if 'Extranjero autorizado para trabajar' is selected.
Depends on: Extranjero autorizado para trabajar
List A Document 1
Document 1 Title Text
Please enter the title of the first document presented from List A.
Document 1 Issuing Authority Text
Please enter the name of the authority that issued the first document from List A.
Document 1 Number Text
Please enter the document number for the first document from List A, if applicable.
Document 1 Expiration Date Date
Please enter the expiration date of the first document from List A, if applicable.
List A Document 2
Document Title 2 Text
Provide the title of the List A Document 2.
Issuing Authority 2 Text
Provide the name of the authority that issued the List A Document 2.
Document Number if any_2 Text
Expiration Date 2 Date
Provide the expiration date of the List A Document 2.
Document Number 2 Text
Provide the document number of the List A Document 2.
List A Document 3
Document 3 Title Text
Please provide the title of the third document presented for List A.
Document 3 Issuing Authority Text
Please provide the name of the authority that issued the third document for List A.
Document Number if any_3 Text
Document 3 Expiration Date Date
Please provide the expiration date of the third document presented for List A.
Document 3 Number Text
Please provide the document number for the third document presented for List A, if applicable.
List B Document
Document Title Text
Enter the title of the List B document.
Issuing Authority Text
Enter the name of the authority that issued the List B document.
Document Number Text
Enter the document number of the List B document, if applicable.
Expiration Date Date
Enter the expiration date of the List B document, if any.
List C Document
List C Document Title 1 Text
Provide the title of the document presented from List C.
List C Issuing Authority Text
Enter the name of the authority that issued the List C document.
List C Document Number Text
Provide the document number for the List C document, if applicable.
List C Expiration Date Date
Enter the expiration date of the List C document, if any.
Second Preparer/Translator Certification
Preparer/Translator Signature Text
Provide the signature of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Certification Date Date
Enter the date this certification is being completed. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator Last Name Text
Enter the last name (apellido) of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator First Name Text
Enter the first name (nombre de pila) of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator Middle Initial Text
Enter the middle initial of the preparer or translator, if applicable. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Max length: 1 characters
Preparer/Translator Street Address Text
Enter the street number and name of the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator City or Town Text
Enter the city or town of the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator State Combobox
Enter the state of the preparer or translator's address.
MEX KY MS MT MD OK MP PR SD NH NC IA WY LA CO OH NV PA MN GA MA SC UT NM CA AR ID VA IN MI VI ND NE OR TN FL GU IL WA WV NY NJ DE AK VT TX AZ MO HI AL KS ME RI WI AS CT DC CAN
Preparer/Translator Zip Code Text
Enter the zip code (código postal) of the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Max length: 6 characters
Second Reverification/Rehiring Record
Rehiring Date Date
Provide the date of rehiring, if applicable.
New Last Name Text
Enter the new last name of the employee, if applicable.
New First Name Text
Enter the new first name of the employee, if applicable.
New Middle Initial Text
Enter the new middle initial of the employee, if applicable.
Max length: 1 characters
Document Title Text
Provide the title of the document presented for reverification.
Document Expiration Date Date
Provide the expiration date of the document, if any.
Employer or Authorized Representative Name Text
Enter the full name of the employer or authorized representative.
Employer or Authorized Representative Signature Text
Enter the signature of the employer or authorized representative.
Signature Date Date
Provide the date the employer or authorized representative signed.
Additional Information Text
Provide any additional information, including initials and date for each annotation.
Alternative DHS Procedure Checkbox
Check this box if an alternative procedure authorized by DHS was used to examine documents for this second reverification/rehiring record.
Third Preparer/Translator Certification
Preparer/Translator Printed Name Text
Enter the preparer's or translator's printed name as their certification signature. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Today's Date Date
Provide the current date. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator Last Name Text
Enter the preparer's or translator's last name. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator First Name Text
Enter the preparer's or translator's first name. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator Middle Initial Text
Enter the preparer's or translator's middle initial, if applicable. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Max length: 1 characters
Preparer/Translator Street Address Text
Enter the preparer's or translator's street name and number. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator City/Town Text
Enter the preparer's or translator's city or town. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator State Combobox
Enter the preparer's or translator's state.
MEX KY MS MT MD OK MP PR SD NH NC IA WY LA CO OH NV PA MN GA MA SC UT NM CA AR ID VA IN MI VI ND NE OR TN FL GU IL WA WV NY NJ DE AK VT TX AZ MO HI AL KS ME RI WI AS CT DC CAN
Preparer/Translator Zip Code Text
Enter the preparer's or translator's postal code. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Max length: 6 characters
Third Reverification/Rehiring Record
Rehire Date (if applicable) Date
Provide the date the employee was rehired, if applicable.
New Last Name (if applicable) Text
Enter the employee's new last name, if applicable due to a legal name change.
New First Name (if applicable) Text
Enter the employee's new first name, if applicable due to a legal name change.
New Middle Initial (if applicable) Text
Enter the employee's new middle initial, if applicable due to a legal name change.
Max length: 1 characters
Document Title Text
Provide the title of the document presented for reverification of employment authorization.
Document Expiration Date Date
Provide the expiration date of the document presented for reverification of employment authorization.
Employer/Representative Name Text
Enter the full name of the employer or authorized representative completing this section.
Employer/Representative Signature (Typed) Text
Type the name of the employer or authorized representative to signify their signature.
Signature Date Date
Provide the date the employer or authorized representative signed this section.
Additional Information Text
Provide any additional information, including initials and dates for each annotation, relevant to this reverification or rehire record.
Usó procedimiento alterno autorizado por DHS Checkbox
Check this box if an alternative procedure authorized by DHS was used to examine documents for this third reverification or rehiring record.