Section 1

The employee must complete Section 1 any time after accepting the position, and no later than the first day of employment.
The employer must check over Section 1 to ensure that all required information is completed.
The employee must fill out the following info:
Full legal name, Maiden or other last names (if any), Current Address, and Date of Birth

The employee does not need to provide the following information unless the employer uses E-Verify:

  • Social Security Number (SSN)
  • Email Address
  • Phone Number

The employee must attest to their citizenship status:

The employee must sign and date Section 1.
Reminder: Section 1 must be completed and signed no later than the first day of employment.

The employee has the right to use a preparer and/or translator if needed. If a preparer/translator filled the document, they must sign and complete the above section.

Section 2

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