Foreign Passport Number. Country of Issuance: QR Code - Section 1 Do Not Write In This Space Today's Date (mm/dd/yyyy) Signature of Employee I did not use a preparer or translator. A preparer(s) and/or translator(s) assisted the employee in completing Section 1. Signature of Preparer or Translator Today's Date (mm/dd/yyyy) Last Name (Family Name) First Name (Given Name) Address (Street Number and Name) City or Town State ZIP Code U.S. Citizenship and Immigration Services
Foreign Passport Number. Country of Issuance: Today's Date (mm/dd/yyyy) Signature of Employee I did not use a preparer or translator. A preparer(s) and/or translator(s) assisted the employee in completing Section 1. Signature of Preparer or Translator Today's Date (mm/dd/yyyy) Last Name (Family Name) First Name (Given Name) Address (Street Number and Name) City or Town State ZIP Code U.S. Citizenship and Immigration Services
Foreign Passport Number. Country of Issuance: QR Code - Section 1 Do Not Write In This Space Signature of Employee Today's Date (mm/dd/yyyy) I did not use a preparer or translator. A preparer(s) and/or translator(s) assisted the employee in completing Section 1. Signature of Preparer or Translator Today's Date (mm/dd/yyyy) Last Name (Family Name) First Name (Given Name) Address (Street Number and Name) City or Town State ZIP Code Form I-9 11/14/2016 N Page 1 of 3 U.S. Citizenship and Immigration Services
