11-25-13 Common Council Agenda & Packet

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All employees must attest in Section 1,under penalty of perjury, to their citizenship or immigration status by checking one of the following four boxes provided on the form: 1. A citizen of the United States 2. A noncitizen national of the United States: Noncitizen nationals of the United States are persons born in American Samoa, certain former citizens of the former Trust Territory of the Pacific Islands,and certain children of noncitizen nationals born abroad. 3. A lawful permanent resident: A lawful permanent resident is any person who is not a U.S. citizen and who resides in the United States under legally recognized and lawfully recorded permanent residence as an immigrant. The term "lawful permanent resident" includes conditional residents. If you check this box, write either your Alien Registration Number(A-Number) or USCIS Number in the field next to your selection. At this time,the USCIS Number is the same as the A-Number without the"A"prefix. 4. An alien authorized to work: If you are not a citizen or national of the United States or a lawful permanent resident, but are authorized to work in the United States, check this box. If you check this box: a. Record the date that your employment authorization expires, if any. Aliens whose employment authorization does not expire, such as refugees, asylees, and certain citizens of the Federated States of Micronesia,the Republic of the Marshall Islands, or Palau,may write"N/A" on this line. b. Next, enter your Alien Registration Number(A-Number)/USCIS Number. At this time, the USCIS Number is the same as your A-Number without the"A" prefix. If you have not received an A-Number/USCIS Number, record your Admission Number. You can find your Admission Number on Form 1-94,"Arrival-Departure Record,"or as directed by USCIS or U.S. Customs and Border Protection(CBP). (1) If you obtained your admission number from CBP in connection with your arrival in the United States, then also record information about the foreign passport you used to enter the United States(number and country of issuance). (2) If you obtained your admission number from USCIS within the United States,or you entered the United States without a foreign passport, you must write "N-A" in the Foreign Passport Number and Country of Issuance fields. Sign your name in the "Signature of Employee" block and record the date you completed and signed Section 1. By signing and dating this form,you attest that the citizenship or immigration status you selected is correct and that you are aware that you may be imprisoned and/or fined for snaking false statements or using false documentation when completing this form. To fully complete this form,you must present to your employer documentation that establishes your identity and employment authorization. Choose which documents to present from the Lists of Acceptable Documents, found on the last page of this form. You trust present this documentation no later than the third day after beginning employment, although you may present the required documentation before this date. Preparer and/or Translator Certification The Preparer and/or Translator Certification must be completed if the employee requires assistance to complete Section I (e.g., the employee needs the instructions or responses translated, someone other than the employee fills out the information blocks, or someone with disabilities needs additional assistance). The employee must still sign Section 1. Minors and Certain Employees with Disabilities (Special Placement) Parents or legal guardians assisting minors(individuals under 18) and certain employees with disabilities should review the guidelines in the Handbook for Employers:Instructions for Completing Farm I-9(M-274) on www.uscis.gov/ 1-9Central before completing Section 1. These individuals have special procedures for establishing identity if they cannot present an identity document for Form 1-9. The special procedures include(1)the parent or legal guardian filling out Section 1 and writing "minor under age 18" or"special placement,"whichever applies, in the employee signature block; and (2) the employer writing"minor under age 18" or"special placement" under List B in Section 2. Fonn 1-9 Instructions 03/08/13 N Page 2 of 9