Employment Authorization Application Form

November 30, 2009

in Application Forms

Before you are hired for a job in the United States you have prove that you are a citizen by filling an Employment Eligibility Verification form (Form 1-9). Employers are required by law to ensure that new employees are eligible to work in the U.S. Below is such a form to help you know what to expect when applying for that job.

Personal Information

Surname: _______________________________________

Middle name: ____________________________________

First Name: ____________________________________

DOB (day/month/year):______________________________

Social security Number: _____________________________

Address (City, State, Zip code):_________________________

I am aware that the consequences of providing any false information will lead to

my imprisonment/fine under the federal law.

I attest that the information provided below is correct.

I confirm that I am (Tick where appropriate)

  • A citizen of the U.S________________________________________________
  • A non citizen national of the U.S_____________________________________
  • Legally a Permanent Resident of U.S _________________________________
  • An alien but authorized to work in the US (specify till when)__________________________

Signature of employee ___________

Date __________________

……………………………………………

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