SECTION 2 - Completed by the EMPLOYER
List A - One Document Only
- Cannot be completed in conjunction with B & C documents.
- Employer verified approved documents selected by employee.
- Complete title, issuing authority, document # and expiration date (if any).
List B - 2 Documents
- Cannot be completed in conjunction with B & C documents.
- Employer verified approved documents selected by employee.
- Complete title, issuing authority, document # and expiration date (if any).
Certification
- Completed by employer representative who verified documents for authorization to work.
- Must be authorized and completed with 3 days of hire.
- Representative must print and sign name and date .
- Business name and full address must be completed.
SECTION 3 - Completed by EMPLOYER
Updating & Recertification
- Update if employee is rehired, changes their name or has a new authorization document as the previous document expired.
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