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IRS i9 Form
RS Consulting
2023-03-10T01:05:41-05:00
CCS Online Application including IRS Form I-9, Form W-4, TRION
IRS Form I-9 | Employment Eligibility Verification
Please read the IRS Form I-9 Employment Eligibility Verification instructions carefully before completing this form. Click here to download the
IRS Form 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 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.)
Name
*
First
Last
Middle Initial
Other Names Used (if any)
Address
Street Address
Apt #
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Date of Birth
*
MM slash DD slash YYYY
U.S. Social Security Number
*
Email 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
An alien authorized to work until
Alien Registration Number/USCIS Number
*
Expiration date, if applicable
MM slash DD slash YYYY
Some aliens may write "N/A" in this field. If so, leave this field blank. (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:
*
I will provide Alien Registration Number/USCIS Number
I will provide Form I-94 Admission Number
I will provide a Foreign Passport Number
Alien Registration Number/USCIS Number
*
Form I-94 Admission Number
*
Did you obtain your admission number from CBP in connection with your arrival in the United States
Yes
No
Please enter your 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
*
If you are on a mobile device, turn your device to display a larger signature area.
Date
*
MM slash DD slash YYYY
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
If you are on a mobile device, turn your device to display a larger signature area.
Date
MM slash DD slash YYYY
Name
First
Middle
Last
Address
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
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