I-9 Supplement FRM TOC

I9Supplement-010-FRM-TOC-REV-OMBReview-09132022.docx

Employment Eligibility Verification

I-9 Supplement FRM TOC

OMB: 1615-0047

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TABLE OF CHANGES – FORM

Form I-9, Supplement, Section 1 Preparer and/or Translator Certification

OMB Number: 1615-0047

09/13/2022


Reason for Revision: Revision

Project Phase: OMBReview


Legend for Proposed Text:

  • Black font = Current text

  • Red font = Changes


Expires 10/31/2022

Edition Date 10/21/2019



Current Page Number and Section

Current Text

Proposed Text

Page 1, Employee Name

[Page 1]


Employee Name:

Last Name (Family Name)

First Name (Given Name)

Middle Initial


This entire supplement is being incorporated into the I-9 itself.

Page 1, Instructions

[Page 1]


Instructions: This supplement may be used if extra spaces are required to document more than one preparer and/or translator assisting an employee in completing Section 1 of Form I-9. The preparer and/or translator must enter the employee's name in the spaces provided. Each preparer or translator must complete, sign and date a separate certification area. Employers must retain completed supplement sheets with the employee's completed Form I-9.


This entire supplement is being incorporated into the I-9 itself.

Page 1, (Attest)

[Page 1]


I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct.


Signature of Preparer or Translator

Date (mm/dd/yyyy)

Last Name (Family Name)

First Name (Given Name)

Address (Street Number and Name)

City or Town

State

ZIP Code



[Page 1]


I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct.


Signature of Preparer or Translator

Date (mm/dd/yyyy)

Last Name (Family Name)

First Name (Given Name)

Address (Street Number and Name)

City or Town

State

ZIP Code


I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct.


Signature of Preparer or Translator

Date (mm/dd/yyyy)

Last Name (Family Name)

First Name (Given Name)

Address (Street Number and Name)

City or Town

State

ZIP Code


I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct.


Signature of Preparer or Translator

Date (mm/dd/yyyy)

Last Name (Family Name)

First Name (Given Name)

Address (Street Number and Name)

City or Town

State

ZIP Code


This entire supplement is being incorporated into the I-9 itself.








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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorValentine, Brian R
File Modified0000-00-00
File Created2022-09-26

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