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https://www2.i9complete.com/form-remoteaccess/remoteaccess?I9Login=7rnDUOA4mywFb%2bgaE0N4QcXXuPyPNk56Fs4joNvCKbPEinX%2feXkq5...
Submission: On June 29 via manual from US — Scanned from DE
Submission: On June 29 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
<form id="formI9-webfax" novalidate="novalidate" autocomplete="off">
<nav class="enchanter-steps d-md-none" aria-labelledby="nav-tab">
<div class="nav nav-pills nav-fill d-md-none" id="nav-tab">
<a class="nav-link active" id="instructions-tab" data-bs-toggle="tab" disabled="true" href="#instructions" aria-label="Information tab" tabindex="-1">
<img src="/Content/images/FormI9-Responsive/information.svg" class="info-img" alt="information">
<img src="/Content/images/FormI9-Responsive/Tick-icon.svg" class="d-none tick-img" alt="information-done">
</a>
<a class="nav-link" id="divSection1A-tab" data-bs-toggle="tab" disabled="true" href="#divformSection1A" aria-label="employee name and identification" tabindex="-1">
<img src="/Content/images/FormI9-Responsive/person.svg" class="blue-img" alt="employee name and identification">
<img src="/Content/images/FormI9-Responsive/person-white.svg" class="d-none white-img" alt="employee name and identification inprogress">
<img src="/Content/images/FormI9-Responsive/Tick-icon.svg" class="d-none tick-img" alt="employee name and identification done">
</a>
<a class="nav-link" id="divformSection1B-tab" data-bs-toggle="tab" disabled="true" href="#divformSection1B" aria-label="employee address and contact information" tabindex="-1">
<img src="/Content/images/FormI9-Responsive/contact-person.svg" class="blue-img" alt="employee address and contact information">
<img src="/Content/images/FormI9-Responsive/contact-person-white.svg" class="d-none white-img" alt="employee address and contact information inprogress">
<img src="/Content/images/FormI9-Responsive/Tick-icon.svg" class="d-none tick-img" alt="employee address and contact information done">
</a>
<a class="nav-link" id="divformSection1C-tab" data-bs-toggle="tab" disabled="true" href="#divformSection1C" aria-label="employee employment status" tabindex="-1">
<img src="/Content/images/FormI9-Responsive/ballot.svg" class="blue-img" alt="employee employment status">
<img src="/Content/images/FormI9-Responsive/ballot-white.svg" class="d-none white-img" alt="employee employment status inprogress">
<img src="/Content/images/FormI9-Responsive/Tick-icon.svg" class="d-none tick-img" alt="employee employment status done">
</a>
<a class="nav-link" id="divEESignature-tab" data-bs-toggle="tab" disabled="true" href="#divEESignature" aria-label="provide an electronic signature" tabindex="-1">
<img src="/Content/images/FormI9-Responsive/desktop.svg" class="blue-img" alt="provide an electronic signature">
<img src="/Content/images/FormI9-Responsive/desktop-white.svg" class="d-none white-img" alt="provide an electronic signature inprogress">
</a>
</div>
</nav>
<div class="tab-content tacker-mob-cls">
<div id="divformSection1Chevron" class="box-module box-module-01 backWhite tab-pane fade d-md-block opacity-100 mt-0 pt-2" aria-label="section1 chevron">
<div class="moduleContent emp-modulecontent mobi-head" role="form" aria-label="section1 chevron">
<fieldset>
<legend hidden="">Progression</legend>
<h2 class="header-style-01 header-style-size-05">Progression</h2>
<div class="top-arrows-fleft" id="div_chevrons" style="padding-top: 11px !important;">
<ul class="float" id="ul_chevron">
<li class="new-sprite-bars new-sprite-bars-red">
<span class=" padding-top7">Complete Section 1<br>02/09/2021</span>
</li>
<li class="new-sprite-bars new-sprite-bars-transparent">
<span class="text-color-black ">Identify Authorized Representative Due:<br>02/12/2021</span>
</li>
<li class="new-sprite-bars new-sprite-bars-transparent">
<span class="text-color-black padding-top7">Form I-9 Next Steps<br></span>
</li>
</ul>
<script type="text/javascript">
$("#ul_chevron li a[href='']").each(function() {
link_section2_parent = $(this).parent();
link_section2_parent.html($(this).html());
});
</script>
<div class="clear"></div>
</div>
</fieldset>
</div>
<!-- end moduleContent-->
<div class="clear"></div>
</div>
<div class="tab-pane fade show active" id="instructions" aria-label="tacker instructions">
<div class="box-module box-module-01 backWhite mt-0 pt-3 pt-md-2" role="region" aria-label="instructions">
<div class="d-md-none mobi-head">
<h2 class="header-style-01 header-style-size-05">Employment Eligibility Verification</h2>
</div>
<table class="d-none d-md-table w-100 mb-4">
<tbody>
<tr>
<td>
<div class="fleft">
<b class="header-style-01 header-style-size-01">USCIS Form I-9</b><br>
<b class="header-style-01 header-style-size-01" role="heading" aria-level="1">Employment Eligibility Verification</b>
</div>
<div class="fright">
<b class="header-style-01 header-style-size-02">Department of Homeland Security</b><br>
<b class="header-style-01 header-style-size-02">U.S. Citizenship and Immigration Services</b>
</div>
</td>
</tr>
</tbody>
</table>
<div class="w-100">
</div>
<div class="fleft">
<b class="header-style-01 header-style-size-02 header-style-size-03 emp-info-atte" role="heading" aria-level="2"><span class="d-block d-md-inline-block">Form I-9 Section 1<span class="d-none d-md-inline-block">:</span></span> Employee Information and Attestation</b><br>
</div>
<div class="fright d-none d-md-block">
<span class="fright header-style-01 header-style-size-04"> I-9 Instructions: <a href="/Content/tracker/pdf/FormI9_EnglishInstruction_Revision11_New.pdf" target="_blank" aria-label="Form I-9 Instructions in English">English</a> |
<a href="/Content/tracker/pdf/FormI9_SpanishInstruction_Revision11_New.pdf" target="_blank" aria-label="Form I-9 Instructions in espanol">Español</a>
</span>
</div>
<div class="w-100">
<p class="margin10Top my-3 d-inline-block pb-3 font-size-12"> Employees must complete and sign Section 1 of Form I-9 no later than the first day of employment, but not before accepting a job offer. </p>
<b class="header-style-01 header-style-size-01 header-style-size-03 d-none d-md-block anti-desc-dsktp">
Anti-Discrimination Notice <a class="tooltip opacity-100 d-md-inline" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="antidiscrimination-notice-tooltip-description" class="tipIcon">
<span class="classic" style="font-weight: normal !important">
It is illegal to discriminate against<br>work-authorized individuals. Employers CANNOT specify which document(s) an employee may present to establish employment authorization and identity.The refusal to hire or continue to employ an individual because the documentation presented has a future expiration date may also constitute illegal discrimination.
<br>
For more information, call the Immigrant and Employee Rights Section (IER) at in the Department of Justice's Civil Rights Division at 1-800-255-7688 (employees), 1-800-255-8155 (employers), or 1-800-237-2515 (TTY), or visit https://www.justice.gov/crt/immigrant-and-employee-rights-section.
</span>
</a>
</b>
<div class="d-md-none">
<b class="anti-desc-mob" id="divAntiDiscriminationNotice" tabindex="0" aria-label="Anti-Discrimination Notice">
<u class="anti-desc"><img src="/Content/images/FormI9-Responsive/select.svg" alt="anti-descrimination-notice">Anti-Discrimination Notice</u>
<br><br>
<span style="color: black; font-weight: normal !important; display: none;" id="spanAntiDiscriminationNotice" tabindex="0">
It is illegal to discriminate against<br>work-authorized individuals. Employers CANNOT specify which document(s) an employee may present to establish employment authorization and identity.The refusal to hire or continue to employ an individual because the documentation presented has a future expiration date may also constitute illegal discrimination.
<br><br>
For more information, call the Immigrant and Employee Rights Section (IER) at in the Department of Justice's Civil Rights Division at 1-800-255-7688 (employees), 1-800-255-8155 (employers), or 1-800-237-2515 (TTY), or visit
<a href="https://www.justice.gov/crt/immigrant-and-employee-rights-section" target="_blank" rel="noopener noreferrer" aria-label="immigrant-and-employee-rights-section">https://www.justice.gov/crt/immigrant-and-employee-rights-section.</a>
</span>
</b>
</div>
<div id="dvEmployeeUnder18ErrorMessage" class="ErrorMessage" style="display: none; margin-bottom: 5px;" aria-live="polite">
<div id="dvEmployeeUnder18ErrorMessageFlash">
<img alt="Complete" src="/Content/tracker/images/redCheck.png" height="12" width="12">
<span style="font-weight: bold; font-size: 16px;">Alert: </span>
<label id="lblDocsMessage" style="font-size: 12px;">Employees under age 18 require special handling and cannot complete Section 1 online. Close this web page and contact your HR representative to complete the Form I-9 in person.</label>
</div>
</div>
</div>
</div>
</div>
<div id="divformSection1A" class="box-module box-module-01 backWhite tab-pane fade d-md-block opacity-100 mt-0 pt-2" aria-label="employee information">
<div class="newUI-moduleLabel-1 d-none d-md-block"><span class="newUI-Svg-Person-1"></span></div>
<div class="moduleContent emp-modulecontent mobi-head" role="form" aria-label="employee information">
<fieldset>
<legend hidden="">Employee Name and Identification</legend>
<h2 class="header-style-01 header-style-size-05">Employee Name and Identification</h2>
<ul class="float page-style-1 p-0 m-0 disp-innit w-100">
<li style="width:240px;" class="pb-md-0 pb-3">
<label for="FirstName">First Name (Given Name):<span class="required page-style-1">*</span></label>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="firstname-tooltip-description" class="tipIcon">
<span class="classic">
Enter your full legal first name.Your first name is your given name.<br>
Some examples of correctly entered first names include Jessica, John-Paul, Tae Young, D’Shaun, Mai.<br>
If you only have one name, enter it in the Last Name field, then enter “Unknown” in this field. You may not enter “Unknown” in both this field and the Last Name field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="firstname-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">First Name (Given Name)</span>
<span>Enter your full legal first name.Your first name is your given name.</span>
<span> Some examples of correctly entered first names include Jessica, John-Paul, Tae Young, D’Shaun, Mai.</span>
<span>If you only have one name, enter it in the Last Name field, then enter “Unknown” in this field. You may not enter “Unknown” in both this field and the Last Name field.</span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input data-val="true" data-val-required="The SenstiveDataIsMasked field is required." id="SenstiveDataIsMasked" name="SenstiveDataIsMasked" type="hidden" value="False">
<input data-val="true" data-val-required="The FormCaseEnum field is required." id="FormCaseEnum" name="FormCaseEnum" type="hidden" value="2">
<input id="NeedToValidationField" name="NeedToValidationField" type="hidden" value="">
<input id="HasPreparerTranslator" name="HasPreparerTranslator" type="hidden" value="">
<input id="EmployeeSignature" name="EmployeeSignature" type="hidden" value="">
<input id="EmployeeSignatureDateStr" name="EmployeeSignatureDateStr" type="hidden" value="">
<input id="PreparerSignature" name="PreparerSignature" type="hidden" value="">
<input data-val="true" data-val-required="The IsSSNRequiredForEverify field is required." id="IsSSNRequiredForEverify" name="IsSSNRequiredForEverify" type="hidden" value="False">
<input id="IsOnSiteSection01" name="IsOnSiteSection01" type="hidden" value="0">
<input class="inputMedMore validationSSN enchanterRequired" id="FirstName" name="FirstName" onblur="FirstNameValidate()" placeholder="Required" required="required" type="text" value="Joel" style="font-style: normal;" autocomplete="off">
<br>
<label class="field-errormsg" id="FirstName_error" data-valmsg-for-id="FirstName" data-valmsg-for=",FirstName,FirstNameMissing," aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<label for="MiddleName">Middle Initial:<span class="required">*</span></label>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="middle-initial-tooltip-description" class="tipIcon">
<span class="classic">
Your middle initial your second given name, or your middle name, if any. If you do not have a middle intial, enter N/A in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="middle-initial-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Middle Initial</span>
<span>Your middle initial your second given name, or your middle name, if any. If you do not have a middle intial, enter N/A in this field.</span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input class="inputMedSm" id="MiddleName" maxlength="3" name="MiddleName" onblur="MiddleNameValidate()" placeholder="Required or N/A" style="width: 120px; font-style: italic;" type="text" value="" autocomplete="off">
<br>
<div id="mid-name-err" style="width:120px"><label class="field-errormsg" id="MiddleName_error" data-valmsg-for-id="MiddleName" data-valmsg-for=",MiddleName,MiddleNameMissing," aria-live="polite"></label></div>
</li>
<li class="pb-md-0 pb-3">
<label for="LastName">Last Name (Family Name):<span class="required">*</span></label>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="lastname-tooltip-description" class="tipIcon">
<span class="classic">
Enter your full legal last name. Your last name is your family name or surname. If you have two last names or a hyphen-ated last name, include both names in this field.<br><br>
Examples of correctly entered last names include De La Cruz, O’Neill, Garcia Lopez, Smith-Johnson, Nguyen.<br><br>
If you only have one name, enter it in this field, then enter “Unknown” in the First Name field. You may not enter “Unknown” in both this field and the First Name field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="lastname-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Last Name (Family Name)</span>
<span> Enter your full legal last name. Your last name is your family name or surname. If you have two last names or a hyphen-ated last name, include both names in this field. </span>
<span> Examples of correctly entered last names include De La Cruz, O’Neill, Garcia Lopez, Smith-Johnson, Nguyen. </span>
<span> If you only have one name, enter it in this field, then enter “Unknown” in the First Name field. You may not enter “Unknown” in both this field and the First Name field. </span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input class="inputMed validationSSN enchanterRequired" id="LastName" name="LastName" onblur="LastNameValidate()" placeholder="Required" required="required" type="text" value="Mora" style="font-style: normal;" autocomplete="off">
<br>
<label class="field-errormsg" id="LastName_error" data-valmsg-for-id="LastName" data-valmsg-for=",LastName,LastNameMissing," aria-live="polite"></label>
</li>
<li>
<label for="MaidenOrOtherName">Other Last Names Used:<span class="required">*</span></label>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" style="position:static;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="other-last-names-used-tooltip-description" class="tipIcon">
<span class="classic last-li-tiptext" style="width:200px !important;margin-top:10px;">
Provide all other last names used, if any, such as maiden name. Enter N/A if you have not used other last names.<br><br>
For example, if you legally changed your last name from Smith to Jones, you should enter the name Smith in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="other-last-names-used-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Other Last Names Used</span>
<span>Provide all other last names used, if any, such as maiden name. Enter N/A if you have not used other last names.</span>
<span>For example, if you legally changed your last name from Smith to Jones, you should enter the name Smith in this field.</span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<div>
<table style="width:100px" class="dob-table">
<tbody>
<tr>
<td><input class="inputMed" id="MaidenOrOtherName" name="MaidenOrOtherName" onblur="MaidenOrOtherNameValidate()" placeholder="Required or N/A" type="text" value="" style="font-style: italic;" autocomplete="off"> </td>
<td>
</td>
</tr>
<tr class="margin-top-9 mb-3" style="display: block;">
<td><label class="field-errormsg" id="MaidenOrOtherName_error" data-valmsg-for-id="MaidenOrOtherName" data-valmsg-for=",MaidenOrOtherName,MaidenNameMissing," aria-live="polite"></label></td>
</tr>
</tbody>
</table>
</div>
</li>
</ul>
<div class="clear"></div>
<ul class="float p-0 m-0">
</ul>
<div class="clear"></div>
<ul class="float page-style-1 p-0 mt-0 mb-3 disp-innit w-100">
<li style="width:240px;" class="pb-md-0 pb-3">
<label for="SocialSecurityNumber"> U.S. Social Security Number: </label>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="u.s.social-security-number-tooltip-description" class="tipIcon">
<span class="classic">
Providing your Social Security number is voluntary on Form I-9 unless your employer participates in E-Verify.<br>
If your employer participates in E-Verify and:<br><br>
1. You have been issued a Social Security number, you must provide it in this field; or<br><br>
2. You have applied for, but have not yet received a Social Security number, leave this field blank until you receive a Social Security number.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="u.s.social-security-number-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">U.S. Social Security Number</span>
<span>Providing your Social Security number is voluntary on Form I-9 unless your employer participates in E-Verify.</span>
<span> If your employer participates in E-Verify and:<br> 1. You have been issued a Social Security number, you must provide it in this field; or<br> 2. You have applied for, but have not yet received a Social Security number,
leave this field blank until you receive a Social Security number. </span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input class="inputMedMore validationSSN" id="SocialSecurityNumber" name="SocialSecurityNumber" onblur="SocialSecurityNumberValidate(false)" placeholder="Optional" type="tel" value="" autocomplete="off">
<br>
<label class="newUI-Input-Hint-1 d-none d-md-block">(###-##-####)</label>
<label class="field-errormsg" id="SocialSecurityNumber_error" data-valmsg-for-id="SocialSecurityNumber" data-valmsg-for=",SocialSecurityNumber,MustEnterSSNForEverify,SSNMissing," style="margin-top: -15px !important;"
aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-1">
<label for="BirthDateStr">Date of Birth:<span class="required">*</span></label>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="date-of-birth-tooltip-description" class="tipIcon">
<span class="classic">
Enter your date of birth as a 2-digit month, 2-digit day, and 4-digit year (mm/dd/yyyy). For example, enter January 8, 1980 as 01/08/1980.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="date-of-birth-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Date of Birth</span>
<span>Enter your date of birth as a 2-digit month, 2-digit day, and 4-digit year (mm/dd/yyyy). For example, enter January 8, 1980 as 01/08/1980. </span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input class="trackerInputDate enchanterRequired hasDatepicker" id="BirthDateStr" name="BirthDateStr" onblur="BirthDateStrValidate()" placeholder="Required" required="required" style="width: 120px; font-style: italic;" type="text"
value="" autocomplete="off">
<br>
<label class="newUI-Input-Hint-1 d-none d-md-block">(mm/dd/yyyy)</label>
<label class="margin-top-9 field-errormsg" id="BirthDateStr_error" data-valmsg-for-id="BirthDateStr" data-valmsg-for=",BirthDateStr,BirthDateMissing," aria-live="polite"></label>
</li>
</ul>
<script type="text/javascript">
var handler = function() {
var val = this.value.replace(/\D/g, '');
var newVal = '';
if (val.length > 4) {
this.value = val;
}
if ((val.length > 3) && (val.length < 6)) {
newVal += val.substr(0, 3) + '-';
val = val.substr(3);
}
if (val.length > 5) {
newVal += val.substr(0, 3) + '-';
newVal += val.substr(3, 2) + '-';
val = val.substr(5);
}
newVal += val;
this.value = newVal.substring(0, 11);
};
var focusHandler = function() {
var val = this.value;
if (val.length === 9) {
val = val.substring(0, 3) + "-" + val.substring(3, 5) + "-" + val.substring(5, 9)
}
this.value = val;
};
$("#SocialSecurityNumber").bind("focus", focusHandler);
$("#SocialSecurityNumber").bind("keyup", handler);
</script>
</fieldset>
</div>
<!-- end moduleContent-->
<div class="clear"></div>
</div>
<!-- end box-module A-->
<div id="divformSection1B" class="box-module box-module-01 backWhite tab-pane fade d-md-block opacity-100 mt-0 pt-3" aria-label="contact information">
<div class="newUI-moduleLabel-1 d-none d-md-block"><span class="newUI-Svg-ContactMail-1"></span></div>
<div class="moduleContent emp-modulecontent mobi-head" role="form" aria-label="contact information">
<fieldset>
<legend hidden="">Employee Address and Contact Information</legend>
<h2 class="header-style-01 header-style-size-05">Employee Address and Contact Information</h2>
<ul class="float page-style-1 p-0 m-0 disp-innit w-100">
<li style="width:240px;" class="pb-md-0 pb-3">
<label for="Address">Address(Street Number and Name):<span class="required">*</span></label>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="address-tooltip-description" class="tipIcon">
<span class="classic">
Enter the street name and number of the current address of your residence. If you are a border commuter from Canada or Mexico, you may enter your Canada or Mexico address in this field.<br><br>
If your residence does not have a physical address, enter a description of the location of your residence, such as “3 miles southwest of Anytown post office near water tower.”
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="address-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Address(Street Number and Name)</span>
<span> Enter the street name and number of the current address of your residence. If you are a border commuter from Canada or Mexico, you may enter your Canada or Mexico address in this field. </span>
<span> If your residence does not have a physical address, enter a description of the location of your residence, such as “3 miles southwest of Anytown post office near water tower.” </span>
</p>
<a href="#" class="close-sec" aria-label="Close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input class="inputMedMore enchanterRequired" id="Address" name="Address" onblur="AddressValidate()" placeholder="Required" required="required" type="text" value="" style="font-style: italic;" autocomplete="off">
<br>
<label class="field-errormsg" id="Address_error" data-valmsg-for-id="Address" data-valmsg-for=",Address,USAddressStreet1Missing," aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<label for="AptNumber">Apt. Number:<span class="required">*</span></label>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="apartment-tooltip-description" class="tipIcon">
<span class="classic">
Enter the number(s) or letter(s) that identify(ies) your apartment. If you do not live in an apartment, enter N/A.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="apartment-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Apt. Number</span>
<span>Enter the number(s) or letter(s) that identify(ies) your apartment. If you do not live in an apartment, enter N/A.</span>
</p>
<a href="#" class="close-sec" aria-label="Close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input class="inputMedLess" id="AptNumber" name="AptNumber" onblur="AptNumberValidate()" placeholder="Required or N/A" type="text" value="" style="font-style: italic;" autocomplete="off">
<br>
<label class="field-errormsg" id="AptNumber_error" data-valmsg-for-id="AptNumber" data-valmsg-for=",AptNumber,AptNumberMissing," aria-live="polite"></label>
<div class="clear"></div>
</li>
</ul>
<ul class="float page-style-1 p-0 m-0 disp-innit w-100">
<li style="width:240px;" class="pb-md-0 pb-3">
<label for="City">City or Town:<span class="required">*</span></label>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="city-or-town-tooltip-description" class="tipIcon">
<span class="classic">
Enter your city, town or village in this field.<br><br>
If your residence is not located in a city, town or village, enter your country, township, reservation, etc., in this field. If you are a border commuter from Canada, enter your city and province in this field. If you are a border commuter from Mexico, enter your city and state in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="city-or-town-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">City or Town</span>
<span>Enter your city, town or village in this field.</span>
<span> If your residence is not located in a city, town or village, enter your country, township, reservation, etc., in this field. If you are a border commuter from Canada, enter your city and province in this field. If you are
a border commuter from Mexico, enter your city and state in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="Close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input class="inputMedMore enchanterRequired" id="City" name="City" onblur="CityValidate()" placeholder="Required" required="required" type="text" value="" style="font-style: italic;" autocomplete="off">
<br>
<label class="field-errormsg" id="City_error" data-valmsg-for-id="City" data-valmsg-for=",City,USAddressCityMissing," aria-live="polite"></label>
</li>
<li class="select-style-1 pb-md-0 pb-3">
<label for="State" id="State_label">State:<span class="required">*</span></label>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="state-tooltip-description" class="tipIcon">
<span class="classic">
Select the abbreviation of your state or territory from the drop-down list. You may also type the first letter of the abbreviation and use the down arrow to select your state or territory.<br><br>
If you are a border commuter from Canada or Mexico, you should choose your country abbreviation, located at the end of the drop-down list.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="state-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">State</span>
<span> Select the abbreviation of your state or territory from the drop-down list. You may also type the first letter of the abbreviation and use the down arrow to select your state or territory. </span>
<span> If you are a border commuter from Canada or Mexico, you should choose your country abbreviation, located at the end of the drop-down list. </span>
</p>
<a href="#" class="close-sec" aria-label="Close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<span title="" class="k-widget k-dropdown k-header inputMed enchanterRequired" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="State_listbox" aria-labelledby="State_label"
aria-live="polite" aria-disabled="false" aria-busy="false" aria-activedescendant="200b6410-d1ec-4c71-b4bb-d0d0e1bfb1b3" style="font-style: italic;"><span unselectable="on" class="k-dropdown-wrap k-state-default"><span
unselectable="on" class="k-input"><None></span><span unselectable="on" class="k-select" aria-label="select"><span class="k-icon k-i-arrow-60-down"></span></span></span><input class="inputMed enchanterRequired" id="State"
name="State" type="text" value="" style="font-style: italic; display: none;" autocomplete="off" data-role="dropdownlist"></span>
<script>
kendo.syncReady(function() {
jQuery("#State").kendoDropDownList({
"dataTextField": "Text",
"dataValueField": "Value",
"dataSource": [{
"Text": "<None>",
"Value": "",
"Selected": false
}, {
"Text": "Alabama",
"Value": "Alabama",
"Selected": false
}, {
"Text": "Alaska",
"Value": "Alaska",
"Selected": false
}, {
"Text": "Arizona",
"Value": "Arizona",
"Selected": false
}, {
"Text": "Arkansas",
"Value": "Arkansas",
"Selected": false
}, {
"Text": "California",
"Value": "California",
"Selected": false
}, {
"Text": "Colorado",
"Value": "Colorado",
"Selected": false
}, {
"Text": "Connecticut",
"Value": "Connecticut",
"Selected": false
}, {
"Text": "Delaware",
"Value": "Delaware",
"Selected": false
}, {
"Text": "District of Columbia",
"Value": "District of Columbia",
"Selected": false
}, {
"Text": "Federated States Of Micronesia",
"Value": "Federated States Of Micronesia",
"Selected": false
}, {
"Text": "Florida",
"Value": "Florida",
"Selected": false
}, {
"Text": "Georgia",
"Value": "Georgia",
"Selected": false
}, {
"Text": "Guam",
"Value": "Guam",
"Selected": false
}, {
"Text": "Hawaii",
"Value": "Hawaii",
"Selected": false
}, {
"Text": "Idaho",
"Value": "Idaho",
"Selected": false
}, {
"Text": "Illinois",
"Value": "Illinois",
"Selected": false
}, {
"Text": "Indiana",
"Value": "Indiana",
"Selected": false
}, {
"Text": "Iowa",
"Value": "Iowa",
"Selected": false
}, {
"Text": "Kansas",
"Value": "Kansas",
"Selected": false
}, {
"Text": "Kentucky",
"Value": "Kentucky",
"Selected": false
}, {
"Text": "Louisiana",
"Value": "Louisiana",
"Selected": false
}, {
"Text": "Maine",
"Value": "Maine",
"Selected": false
}, {
"Text": "Marshall Islands",
"Value": "Marshall Islands",
"Selected": false
}, {
"Text": "Maryland",
"Value": "Maryland",
"Selected": false
}, {
"Text": "Massachusetts",
"Value": "Massachusetts",
"Selected": false
}, {
"Text": "Michigan",
"Value": "Michigan",
"Selected": false
}, {
"Text": "Minnesota",
"Value": "Minnesota",
"Selected": false
}, {
"Text": "Mississippi",
"Value": "Mississippi",
"Selected": false
}, {
"Text": "Missouri",
"Value": "Missouri",
"Selected": false
}, {
"Text": "Montana",
"Value": "Montana",
"Selected": false
}, {
"Text": "Nebraska",
"Value": "Nebraska",
"Selected": false
}, {
"Text": "Nevada",
"Value": "Nevada",
"Selected": false
}, {
"Text": "New Hampshire",
"Value": "New Hampshire",
"Selected": false
}, {
"Text": "New Jersey",
"Value": "New Jersey",
"Selected": false
}, {
"Text": "New Mexico",
"Value": "New Mexico",
"Selected": false
}, {
"Text": "New York",
"Value": "New York",
"Selected": false
}, {
"Text": "North Carolina",
"Value": "North Carolina",
"Selected": false
}, {
"Text": "North Dakota",
"Value": "North Dakota",
"Selected": false
}, {
"Text": "Northern Mariana Islands",
"Value": "Northern Mariana Islands",
"Selected": false
}, {
"Text": "Ohio",
"Value": "Ohio",
"Selected": false
}, {
"Text": "Oklahoma",
"Value": "Oklahoma",
"Selected": false
}, {
"Text": "Oregon",
"Value": "Oregon",
"Selected": false
}, {
"Text": "Palau",
"Value": "Palau",
"Selected": false
}, {
"Text": "Pennsylvania",
"Value": "Pennsylvania",
"Selected": false
}, {
"Text": "Puerto Rico",
"Value": "Puerto Rico",
"Selected": false
}, {
"Text": "Rhode Island",
"Value": "Rhode Island",
"Selected": false
}, {
"Text": "South Carolina",
"Value": "South Carolina",
"Selected": false
}, {
"Text": "South Dakota",
"Value": "South Dakota",
"Selected": false
}, {
"Text": "Tennessee",
"Value": "Tennessee",
"Selected": false
}, {
"Text": "Texas",
"Value": "Texas",
"Selected": false
}, {
"Text": "Utah",
"Value": "Utah",
"Selected": false
}, {
"Text": "Vermont",
"Value": "Vermont",
"Selected": false
}, {
"Text": "Virgin Islands Of The U.S.",
"Value": "Virgin Islands Of The U.S.",
"Selected": false
}, {
"Text": "Virginia",
"Value": "Virginia",
"Selected": false
}, {
"Text": "Washington",
"Value": "Washington",
"Selected": false
}, {
"Text": "West Virginia",
"Value": "West Virginia",
"Selected": false
}, {
"Text": "Wisconsin",
"Value": "Wisconsin",
"Selected": false
}, {
"Text": "Wyoming",
"Value": "Wyoming",
"Selected": false
}, {
"Text": "Canada",
"Value": "Canada",
"Selected": false
}, {
"Text": "Mexico",
"Value": "Mexico",
"Selected": false
}]
});
});
</script>
<br>
<label class="field-errormsg" id="State_error" data-valmsg-for-id="State" data-valmsg-for=",State,USAddressStateMissing," data-valmsg-for-id-match-type="all" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<label for="ZipCode">Zip Code:<span class="required">*</span></label>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="zipcode-tooltip-description" class="tipIcon">
<span class="classic">
Enter your 5-digit ZIP code in this field.<br><br>
If you are a border commuter from Canada or Mexico, enter your 5- or 6-digit postal code in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="zipcode-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Zip Code</span>
<span>Enter your 5-digit ZIP code in this field.</span>
<span> If you are a border commuter from Canada or Mexico, enter your 5- or 6-digit postal code in this field.</span>
</p>
<a href="#" class="close-sec" aria-label="Close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input class="inputMedMore enchanterRequired" id="ZipCode" name="ZipCode" onblur="ZipCodeValidate()" placeholder="Required" required="required" type="text" value="" style="font-style: italic;" autocomplete="off">
<br>
<label class="field-errormsg" id="ZipCode_error" data-valmsg-for-id="ZipCode" data-valmsg-for=",ZipCode,USAddressZipMissing," aria-live="polite"></label>
<div class="clear"></div>
</li>
</ul>
<ul class="float page-style-1 disp-innit p-0 m-0 w-100">
<li style="width:240px;">
<label for="TelephoneNumber">Employee's Telephone Number:<span class="required">*</span></label>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="employees-telephone-number-tooltip-description" class="tipIcon">
<span class="classic">Providing your telephone number is optional for Form I-9. Enter only the numbers of your 9- or 10-digit telephone number. Enter N/A if you do not enter your telephone number.</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="employees-telephone-number-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Employee's Telephone Number</span>
<span> Providing your telephone number is optional for Form I-9. Enter only the numbers of your 9- or 10-digit telephone number. Enter N/A if you do not enter your telephone number. </span>
</p>
<a href="#" class="close-sec" aria-label="Close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input class="inputMedMore" id="TelephoneNumber" name="TelephoneNumber" onblur="TelephoneNumberValidate()" placeholder="Required or N/A" type="tel" value="" autocomplete="off">
<br>
<label class="newUI-Input-Hint-1 d-none d-md-block">(###-###-####)</label>
<div class="d-md-none formi9responsive-showmobileonly telephone-naoption"><input type="checkbox" id="telephoneNumberNA" class="chkExpiresNotApplicable noTriggerKsal chk-style-2"><span class="mleft5">Not Applicable (N/A)</span></div>
<label class="mb-3 pt-md-3 pt-1 field-errormsg" id="TelephoneNumber_error" data-valmsg-for-id="TelephoneNumber" data-valmsg-for=",TelephoneNumber,TelephoneMissing," style="display: inline-block; margin-top: -15px !important;"
aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<label for="Email">Employee's Email Address:<span class="required">*</span></label>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="employees-email-address-tooltip-description" class="tipIcon">
<span class="classic">
Providing your e-mail address is optional on Form I-9. To enter your e-mail address, use this format: name@site.domain. One reason the Department of Homeland Security (DHS) may e-mail you is if your employer uses E-Verify and DHS learns of a potential mismatch between the information provided and the information in government records. This e-mail would contain information on how to begin to resolve the potential mismatch. Enter N/A if you do not enter your e-mail address. You may use either your personal or work e-mail address in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="employees-email-address-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Employee's Email Address</span>
<span> Providing your e-mail address is optional on Form I-9. To enter your e-mail address, use this format: name@site.domain. One reason the Department of Homeland Security (DHS) may e-mail you is if your employer uses E-Verify
and DHS learns of a potential mismatch between the information provided and the information in government records. This e-mail would contain information on how to begin to resolve the potential mismatch. Enter N/A if you do
not enter your e-mail address. You may use either your personal or work e-mail address in this field. </span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input class="inputMed" id="Email" name="Email" onblur="EmailValidate()" placeholder="Required or N/A" type="text" value="joelm@sentinelone.com" style="font-style: normal;" autocomplete="off">
<br>
<label class="field-errormsg" id="Email_error" data-valmsg-for-id="Email" data-valmsg-for=",Email,EmailAddressMissing," aria-live="polite"></label>
<div class="clear"></div>
</li>
</ul>
<script type="text/javascript">
var handler = function() {
var val = this.value.replace(/\D/g, '');
var newVal = '';
if (val.length > 4) {
this.value = val;
}
if ((val.length > 3) && (val.length < 6)) {
newVal += val.substr(0, 3) + '-';
val = val.substr(3);
}
if (val.length > 6) {
newVal += val.substr(0, 3) + '-';
newVal += val.substr(3, 3) + '-';
val = val.substr(6);
}
newVal += val;
this.value = newVal.substring(0, 12);
};
//$("#TelephoneNumber").bind("keyup", handler);
$('#telephoneNumberNA').change(function() {
var chk = $(this);
var expInput = $("#TelephoneNumber");
if (chk.prop('checked')) {
expInput.val('N/A');
expInput.attr("disabled", "disabled");
} else {
expInput.val("");
expInput.removeAttr("disabled");
}
});
</script>
<div class="clear"></div>
</fieldset>
</div>
<!-- end modContent-->
<div class="clear"></div>
</div>
<!-- end box-module B-->
<div id="divformSection1C" class="box-module box-module-01 backWhite tab-pane fade d-md-block opacity-100 m-0 pt-2" aria-label="employee status information">
<div class="newUI-moduleLabel-1 d-none d-md-block"><span class="newUI-Svg-Ballot-1"></span></div>
<div class="moduleContent emp-modulecontent mobi-head" role="form" aria-label="employee status information">
<fieldset>
<legend hidden="">Employee Employment Status</legend>
<h2 class="header-style-01 header-style-size-05">Employee Employment Status</h2>
<style type="text/css">
#AlienUSCISNumber.inputMed {
width: 150px !important;
}
.inputLarger {
width: 200px !important;
}
.tblAlienOption {
width: 100% !important;
margin-top: 20px !important;
}
.tdFirst {
width: 35px !important;
}
.tdSeparator {
width: 50px !important;
height: 15px !important;
}
.tdOR {
padding-left: 60px !important;
font-weight: bold !important;
}
</style>
<div id="divSection2DocumentNotMatchErrorMessage" style="display: none; color: #FF0000;">Section 2 Document(s) do not match the Employment Status type in Section 1.</div>
<div class="d-md-none mt-3">
<b class="anti-desc-mob" id="divImpNote" tabindex="0" aria-label="Important Note">
<u class="anti-desc"><img src="/Content/images/FormI9-Responsive/select.svg" alt="important-note">Important Note</u>
<br><br>
<span style="color: black; font-weight: normal !important; display: none;" id="spanImpNote" tabindex="0">
I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in connection with the completion of this form.
</span>
</b>
</div>
<p class="d-none d-md-block">I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in connection with the completion of this form.</p>
<p class="emp-info-atte mb-0">I attest, under penalty of perjury, that I am (check one of the following):<span class="required">*</span></p>
<div><label class="field-errormsg" id="employment_stats_error" data-valmsg-for-id="employment-stats" data-valmsg-for=",StatusCodeMissing,StatusDocMismatch," aria-live="polite"></label></div>
<input type="hidden" id="Section1CAlienNumberAATW">
<input type="hidden" id="Section1CUSCISNumberAATW">
<input type="hidden" id="Section1CAlienNumber">
<input type="hidden" id="Section1CUSCISNumber">
<input type="hidden" id="hiddenLawFulPermanentNumberType" value="0">
<input type="hidden" id="hiddenAlienNumberType" value="0">
<input type="hidden" id="hiddenAlienOptionsNumber" value="0">
<ul id="employment-stats" class="radioList customRadioList">
<li class="margin-bottom-1">
<span class="radio" aria-checked="false" tabindex="0" role="radio" aria-label="1. A citizen of the United States"></span><input aria-label="1. A citizen of the United States" class="styled" data-val="true"
data-val-required="The PersonStatus field is required." id="PersonStatus1" name="PersonStatus" type="radio" value="1">
<label for="PersonStatus1" class="fw-normal"></label>
<span class="radio-title" role="heading" aria-level="3"><span class="d-none d-md-inline-block">1.</span> A citizen of the United States</span>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="A-citizen-of-the-United-States-tooltip-description" class="tipIcon">
<span class="classic">Select this status if it applies to you. If you select this option, the rest of the fields in this area will contain N/A.</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" id="pop1" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="A-citizen-of-the-United-States-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" id="form1" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">A citizen of the United States</span>
<span>Select this status if it applies to you. If you select this option, the rest of the fields in this area will contain N/A.</span>
</p>
<a href="#" class="close-sec" aria-label="Close" tabindex="-1">
<span class="close" id="close1" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</li>
<li class="margin-bottom-1">
<label class="fw-normal" for="PersonStatus2"></label>
<span class="radio" aria-checked="false" tabindex="0" role="radio" aria-label="2. A noncitizen national of the United States (see instructions)"></span><input aria-label="2. A noncitizen national of the United States (see instructions)"
class="styled" id="PersonStatus2" name="PersonStatus" type="radio" value="4">
<span class="radio-title" role="heading" aria-level="3"><span class="d-none d-md-inline-block">2.</span> A noncitizen national of the United States (see instructions)</span>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="A-noncitizen-national-of-the-United-States-tooltip-description" class="tipIcon"><span class="classic">
Select this status if it applies to you. If you select this option, the rest of the fields in this area will contain N/A.<br><br>
A noncitizen national of the United States is an individual born in American Samoa, certain former citizens of the former Trust Territory of the Pacific Islands, and certain children of noncitizen nationals born abroad.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="A-noncitizen-national-of-the-United-States-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">A noncitizen national of the United States</span>
<span>Select this status if it applies to you. If you select this option, the rest of the fields in this area will contain N/A.</span>
<span> A noncitizen national of the United States is an individual born in American Samoa, certain former citizens of the former Trust Territory of the Pacific Islands, and certain children of noncitizen nationals born abroad.
</span>
</p>
<a href="#" class="close-sec" aria-label="Close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</li>
<li class="margin-bottom-1">
<label class="fw-normal" for="PersonStatus3"></label>
<span class="radio" aria-checked="false" tabindex="0" role="radio" aria-label="3. A lawful permanent resident"></span><input aria-label="3. A lawful permanent resident" class="styled" id="PersonStatus3" name="PersonStatus" type="radio"
value="2">
<span class="radio-title" role="heading" aria-level="3"><span class="d-none d-md-inline-block">3.</span> A lawful permanent resident </span>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="A-lawful-permanent-resident-tooltip-description" class="tipIcon">
<span class="classic" style="width: 500px !important;top:-70px !important;">
Select this status if it applies to you. If you select this option, the fields associated with the alien authorized to work status will contain N/A.<br><br>
A lawful permanent resident is an individual 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. This term includes conditional residents.<br><br>
If you select this option, you must enter either your <strong>Alien Registration Number or USCIS Number</strong> in the field provided. At this time, the USCIS Number is the same as the A-number without the “A” prefix.<br><br>
Asylees and refugees should not select this status, but should instead select “An alien authorized to work.”
</span>
</a>
<span class="poplawful opacity-100 d-inline d-md-none"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="A-lawful-permanent-resident-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form_lawful" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">A lawful permanent resident</span>
<span>Select this status if it applies to you. If you select this option, the fields associated with the alien authorized to work status will contain N/A.</span>
<span> A lawful permanent resident is an individual 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. This term includes
conditional residents. </span>
<span> If you select this option, you must enter either your <strong>Alien Registration Number or USCIS Number</strong> in the field provided. At this time, the USCIS Number is the same as the A-number without the “A” prefix.
</span>
<span> Asylees and refugees should not select this status, but should instead select “An alien authorized to work.” </span>
</p>
<a href="#" class="close-sec" aria-label="Close" tabindex="-1">
<span class="closelawful">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<div class="box-dependent box-additional" id="divStatus2" style="border:none !important;box-shadow:none !important;margin-top:0px !important;padding-top:5px !important;padding-bottom:0px !important;">
<p class="mt-2 d-inline" role="heading" aria-level="4">If you are a lawful permanent resident, please provide your Alien Registration Number/USCIS Number. <span class="required d-md-none">*</span></p>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="please-provide-your-Alien-Registration-Number/USCIS-Number-tooltip-description"
class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Alien Registration Number/USCIS Number</span>
<span> Lawful permanent residents must enter their 7- to 9-digit Alien Registration Number or USCIS Number here. For numbers with fewer than nine digits, add leading zero(s). For example, a number of "1234567" should be
entered as "001234567". </span>
<span> At this time, the USCIS Number is the same as the A-number without the “A” prefix. To do so, enter the number in the space provided, then select either Alien Registration Number or USCIS Number from the drop-down. If
you select Alien Registration Number from the drop-down, an “A” will appear before the number you entered. </span>
</p>
<a href="#" class="close-sec" aria-label="Close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<div class="radio-3">
<div class="d-md-inline-flex">
<div>
<span class="f20-l28 f-w300 d-none d-md-inline-block mt-2"><b>Alien Registration Number/USCIS Number: </b></span><span class="required d-none d-md-inline-block">*</span>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="please-provide-your-Alien-Registration-Number/USCIS-Number-tooltip-description" class="tipIcon">
<span class="classic">
Lawful permanent residents must enter their 7- to 9-digit Alien Registration Number or USCIS Number here. For numbers with fewer than nine digits, add leading zero(s). For example, a number of "1234567" should be entered as "001234567".
<br><br>
At this time, the USCIS Number is the same as the A-number without the “A” prefix. To do so, enter the number in the space provided, then select either Alien Registration Number or USCIS Number from the drop-down. If you select Alien Registration Number from the drop-down, an “A” will appear before the number you entered.
</span>
</a>
</div>
<div class="tab mt-3 d-md-none">
<button type="button" class="tablinks" onclick="ShowActiveTab(event, 'Section1CAlienNumber')" id="btnAlienNumber">Alien Registration Number</button>
<button type="button" class="tablinks" onclick="ShowActiveTab(event, 'Section1CUSCISNumber')" id="btnUSCISNumber">USCIS Number</button>
</div>
<div class="d-flex mt-3 mt-md-1 px-md-3">
<div class="atag-mob">
<label id="lblAtag" for="AlienUSCISNumber" style="display:none">A</label>
</div>
<div class="atag-input">
<input aria-label="Alien Registration Number or USCIS Number:*" class="inputMed enchanterRequired" id="AlienUSCISNumber" name="AlienUSCISNumber" onblur="AlienUSCISNumberValidate()" placeholder="Required" type="tel" value="">
<div class="alien-desktop-required">
<div class="d-none d-md-block"><label class="newUI-Input-Hint-1">(###-###-###)</label></div>
</div>
<div class="alien-desk-errormsg"><label class="field-errormsg" id="AlienUSCISNumber_error" data-valmsg-for-id="AlienUSCISNumber" data-valmsg-for="AlienUSCISNumber" aria-live="polite"></label></div>
</div>
<div class="select-style-1 select-style-4 ms-md-4 d-none d-md-inline-block">
<label for="NumberType" id="NumberType_label"></label>
<span title="" class="k-widget k-dropdown k-header section1SignatureBoxCountry" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="NumberType_listbox"
aria-labelledby="NumberType_label" aria-live="polite" aria-disabled="false" aria-busy="false" aria-activedescendant="dab73aea-c3c8-4602-a4ef-8129d9eda4b6" style="font-style: normal;"><span unselectable="on"
class="k-dropdown-wrap k-state-default"><span unselectable="on" class="k-input"> <Select One> </span><span unselectable="on" class="k-select" aria-label="select"><span
class="k-icon k-i-arrow-60-down"></span></span></span><input class="section1SignatureBoxCountry" id="NumberType" name="NumberType" type="text" value="0" autocomplete="off" data-role="dropdownlist"
style="font-style: normal; display: none;"></span>
<script>
kendo.syncReady(function() {
jQuery("#NumberType").kendoDropDownList({
"dataTextField": "Text",
"dataValueField": "Value",
"value": "0",
"dataSource": [{
"Text": " <Select One> ",
"Value": "0",
"Selected": true
}, {
"Text": "Alien Registration Number",
"Value": "1",
"Selected": false
}, {
"Text": "USCIS Number",
"Value": "2",
"Selected": false
}]
});
});
</script>
<div class="alien-desk-errormsg mt-md-3">
<label class="field-errormsg" id="NumberType_error" data-valmsg-for-id="NumberType" data-valmsg-for="NumberType" style="display: block; margin-top: -15px !important;" aria-live="polite"></label>
</div>
</div>
</div>
</div>
</div>
</div>
</li>
<li class="margin-bottom-1">
<label class="fw-normal" for="PersonStatus4"></label>
<span class="radio" aria-checked="false" tabindex="0" role="radio" aria-label="4. An alien authorized to work"></span><input aria-label="4. An alien authorized to work" class="styled" id="PersonStatus4" name="PersonStatus" type="radio"
value="3">
<span class="radio-title" role="heading" aria-level="3"><span class="d-none d-md-inline-block">4.</span> An alien authorized to work </span>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="An-alien-authorized-to-work-tooltip-description" class="tipIcon">
<span class="classic" style="width: 500px !important;">
Select this status if it applies to you. If you select this option, the fields associated with the lawful permanent resident status will contain N/A.<br><br>
An alien authorized to work is an individual who is not a citizen or national of the United States, or a lawful permanent resident, but is authorized to work in the United States.<br><br>
If you select this option, you must enter the expiration date of your employment authorization, if any, and either the Alien Registration Number/USCIS Number or the Form I-94 Admission Number in the fields below.
</span>
</a>
<span class="popAlien opacity-100 d-inline d-md-none"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="An-alien-authorized-to-work-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form_Alien" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">An alien authorized to work</span>
<span>Select this status if it applies to you. If you select this option, the fields associated with the lawful permanent resident status will contain N/A.</span>
<span>An alien authorized to work is an individual who is not a citizen or national of the United States, or a lawful permanent resident, but is authorized to work in the United States. </span>
<span> If you select this option, you must enter the expiration date of your employment authorization, if any, and either the Alien Registration Number/USCIS Number or the Form I-94 Admission Number in the fields below.</span>
</p>
<a href="#" class="close-sec" aria-label="Close" tabindex="-1">
<span class="closeAlien">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<div class="box-dependent box-additional" style="border:0px !important;box-shadow:none !important;" id="divStatus3">
<p role="heading" aria-level="4">If you are an alien authorized to work, please provide the following additional information.</p>
<div class="float">
<div class="newUI-moduleLabel-2 d-none d-md-inline-block me-2">
<div>1</div>
</div>
<div>
<span><b>Date authorized to work until </b><span class="required">*</span></span>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Date-authorized-to-work-until-tooltip-description" class="tipIcon">
<span class="classic">
If you select this option, enter the date that your employment authorization expires, if any, in this field.<br><br>
In most cases, your employment authorization expiration date is on the document(s) evidencing your employment authorization. In some cases, your employment authorization document may have been automatically extended; in these cases, you should enter the expiration date of the automatic extension in this field.<br><br>
Refugees, asylees and certain citizens of the Federated States of Micronesia, the Republic of the Marshall Islands, or Palau, and other foreign nationals whose employment authorization does not expires should select the N/A checkbox.
</span>
</a>
<span class="d-none d-md-inline-block">Some aliens may check the N/A Checkbox. Hover over the <img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="hover-over-tooltip-description" class="tipIcon mb-1"> for
instructions.</span>
<br>
<div>
<div class="mt-2 d-block d-md-inline-flex mb-md-1" style="width:100%">
<div class="ms-md-4 d-md-flex">
<label></label>
<div><input aria-label="Date authorized to work until *" class="trackerInputDate enchanterrequired hasDatepicker" id="AlienAuthorizationDateStr" name="AlienAuthorizationDateStr" onblur="AlienAuthorizationDateStrValidate()"
placeholder="Required" type="text" value="" autocomplete="off" style="font-style: italic;"></div>
</div>
<div>
<div class="na-input mx-md-2 mt-2 mt-md-0">
<input type="checkbox" class="mright10 chk-style-2" id="AlienAuthorizationDateNA" name="AlienAuthorizationDateNA" value="false">
<label class="f16-l20" for="AlienAuthorizationDateNA"> N/A (Not Applicable) </label>
</div>
</div>
</div>
<div class="mt-1 ms-md-4">
<label class="field-errormsg" id="AlienAuthorizationDateStr_error" data-valmsg-for-id="AlienAuthorizationDateStr" data-valmsg-for=",AlienAuthorizationDateStr,AlienAuthenticationEndDateMissing,"
style="margin-bottom: 10px !important;" aria-live="polite"></label>
<label class="field-errormsg" data-valmsg-for-id="AlienAuthorizationDateNA" data-valmsg-for="AlienAuthorizationDateNA" aria-live="polite"></label>
</div>
</div>
<div class="d-md-none mb-4 section3-antidisc">
<b class="header-style-01 header-style-size-01 header-style-size-03" id="divAntiDiscriminationNoticeSectionC" tabindex="0" aria-label="Some aliens may check the N/A Checkbox">
<u class="anti-desc-sectionc"><img src="/Content/images/FormI9-Responsive/select.svg" alt="Some-aliens-may-check-the-N/A-Checkbox">Some aliens may check the N/A Checkbox</u>
<span style="color: black; font-weight: normal !important; display: none;" id="spanAntiDiscriminationNoticeSectionC" tabindex="0">
If you select this option, enter the date that your employment authorization expires, if any, in this field.<br><br>
In most cases, your employment authorization expiration date is on the document(s) evidencing your employment authorization. In some cases, your employment authorization document may have been automatically extended; in these cases, you should enter the expiration date of the automatic extension in this field.<br><br>
Refugees, asylees and certain citizens of the Federated States of Micronesia, the Republic of the Marshall Islands, or Palau, and other foreign nationals whose employment authorization does not expires should select the N/A checkbox.
</span>
</b>
</div>
</div>
</div>
<div class="clear"></div>
<div class="float disp-innit indent-radio">
<div>
<div class="newUI-moduleLabel-2 d-none d-md-inline-block me-2">
<div>2</div>
</div>
</div>
<div>
<span role="heading" aria-level="4"> Aliens authorized to work must provide only one of the following document numbers to complete Form I-9: </span>
<span>An Alien Registration Number/USCIS Number OR Form I-94 Admission Number OR Foreign Passport Number. </span><span class="required">*</span>
<br>
<label class="field-errormsg" id="AlienOption_error" data-valmsg-for-id="tblAlienOption" data-valmsg-for="AlienOption" aria-live="polite"></label>
<div class="alien-subradio">
<div id="divAlienOption1">
<div id="tblAlienOption" class="tblAlienOption d-md-inline-flex mt-md-1">
<div class="alien-sec">
<label for="AlienOption1"></label>
<span class="radio" aria-checked="false" tabindex="0" role="radio" aria-label="Alien Registration Number or USCIS Number:"></span><input aria-label="Alien Registration Number or USCIS Number:" class="styled"
data-val="true" data-val-required="The AlienOption field is required." id="AlienOption1" name="AlienOption" type="radio" value="AlienUSCIS">
<span class="f20-l24 f-w300 alien-radiolabel"><b>Alien Registration Number/USCIS Number:</b></span>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Alien-Registration-Number/USCIS-Number-tooltip-description" class="tipIcon">
<span class="classic" style="width: 400px">
Enter your 7- to 9-digit Alien Registration Number (A-Number)/USCIS Number, if any, in this field. To do so, enter the number in the space provided, then select either Alien Registration Number or USCIS Number from the drop-down. If you select Alien Registration Number from the drop-down, an “A” will appear before the number you entered. Currently, the USCIS number is the same as the Alien number without the “A” prefix. If you do not provide an Alien Registration Number/USCIS Number, enter either a Form I-94 Admission Number or Foreign Passport Number in the fields provided. This field will then be populated with N/A.<br><br>
Aliens authorized to work must enter one of the following to complete Section 1:<br>
1. Alien Registration Number (A-Number)/USCIS Number or<br>
2. Form I-94 Admission Number or<br>
3. Foreign Passport Number and the Country of Issuance.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" id="pop1" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Alien-Registration-Number/USCIS-Number-tooltip-description"
class="tipIcon"></span>
<div>
<div class="overlay_form" id="form1" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Alien Registration Number/USCIS Number</span>
<span> Enter your 7- to 9-digit Alien Registration Number (A-Number)/USCIS Number, if any, in this field. To do so, enter the number in the space provided, then select either Alien Registration Number or USCIS
Number from the drop-down. If you select Alien Registration Number from the drop-down, an “A” will appear before the number you entered. Currently, the USCIS number is the same as the Alien number without the “A”
prefix. If you do not provide an Alien Registration Number/USCIS Number, enter either a Form I-94 Admission Number or Foreign Passport Number in the fields provided. This field will then be populated with N/A.
</span>
<span> Aliens authorized to work must enter one of the following to complete Section 1:<br> 1. Alien Registration Number (A-Number)/USCIS Number or<br> 2. Form I-94 Admission Number or<br> 3. Foreign Passport
Number and the Country of Issuance. </span>
</p>
<a href="#" class="close-sec" aria-label="Close" tabindex="-1">
<span class="close" id="close1" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<div class="or-txt my-2 my-md-2 d-none d-md-block">
<div class="tdOR">OR</div>
</div>
</div>
<div class="alien-sec4 px-md-2" id="divAlienNumberAATW">
<div class="tab mt-2 d-md-none">
<button type="button" class="tablinks" onclick="ShowActiveTab(event, 'Section1CAlienNumberAATW')" id="btnAlienNumberAATW">Alien Registration Number</button>
<button type="button" class="tablinks" onclick="ShowActiveTab(event, 'Section1CUSCISNumberAATW')" id="btnUSCISNumberAATW">USCIS Number</button>
</div>
<div class="d-flex mt-md-0 mt-2 mb-md-1">
<div class="atag-mob atag-mob1">
<label id="lblAtagAATW" style="display:none;">A</label>
</div>
<div class="atag-input">
<input aria-label="Alien Registration Number or USCIS Number:" class="input-style-section1-1 enchanterrequired enchanterrequired" id="AlienUSCISNumberAATW" name="AlienUSCISNumberAATW"
onblur="AlienUSCISNumberAATWValidate()" placeholder="Required" type="tel" value="" disabled="disabled">
<div class="d-none d-md-block newUI-Input-Hint-1">(###-###-###)</div>
<div class="alien-desk-errormsg">
<label class="field-errormsg" id="AlienUSCISNumberAATW_error" data-valmsg-for-id="AlienUSCISNumberAATW" data-valmsg-for="AlienUSCISNumberAATW" aria-live="polite"></label>
</div>
</div>
<div class="select-style-1 select-style-4 ms-md-4 d-none d-md-inline-block">
<label for="NumberTypeAATW" id="NumberTypeAATW_label"></label>
<span title="" class="k-widget k-dropdown k-header section1SignatureBoxCountry" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" aria-owns="NumberTypeAATW_listbox"
aria-labelledby="NumberTypeAATW_label" aria-live="polite" aria-disabled="true" aria-busy="false" aria-activedescendant="d7633a90-d581-4791-ab2a-ec8911ac1a3c" style="font-style: normal;"><span unselectable="on"
class="k-dropdown-wrap k-state-disabled"><span unselectable="on" class="k-input"> <Select One> </span><span unselectable="on" class="k-select" aria-label="select"><span
class="k-icon k-i-arrow-60-down"></span></span></span><input class="section1SignatureBoxCountry" id="NumberTypeAATW" name="NumberTypeAATW" type="text" value="0" autocomplete="off" data-role="dropdownlist"
style="font-style: normal; display: none;" disabled="disabled"></span>
<script>
kendo.syncReady(function() {
jQuery("#NumberTypeAATW").kendoDropDownList({
"dataTextField": "Text",
"dataValueField": "Value",
"value": "0",
"dataSource": [{
"Text": " <Select One> ",
"Value": "0",
"Selected": true
}, {
"Text": "Alien Registration Number",
"Value": "1",
"Selected": false
}, {
"Text": "USCIS Number",
"Value": "2",
"Selected": false
}]
});
});
</script>
<div class="alien-desk-errormsg mt-md-3">
<label class="field-errormsg" id="NumberTypeAATW_error" data-valmsg-for-id="NumberTypeAATW" data-valmsg-for="NumberTypeAATW" style="display: block; margin-top: -15px !important;" aria-live="polite"></label>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="d-md-flex mt-3 mb-3 my-md-0" id="divAlienOption2">
<div class="me-md-5 mb-2 mb-md-0">
<label for="AlienOption2"></label>
<span class="radio" aria-checked="false" tabindex="0" role="radio" aria-label="Form I-94 Admission Number:"></span><input aria-label="Form I-94 Admission Number:" class="styled" id="AlienOption2" name="AlienOption"
type="radio" value="AdmissionNumber">
<span class="f20-l24 f-w300 alien-radiolabel"><b>Form I-94 Admission Number:</b></span>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Form-I-94-Admission-Number-tooltip-description" class="tipIcon">
<span class="classic" style="width: 350px">
Enter your 11-digit I-94 admission number or 9 digits followed by one letter followed by one digit (e.g. #########A#) in this field. If you do not provide an I-94 Admission Number, enter either an Alien Registration Number/USCIS Number or a Foreign Passport number in the fields provided. This field will then be populated with N/A.<br><br>
Aliens authorized to work must enter one of the following to complete Section 1:<br>
1. Alien Registration Number (A-Number) /USCIS Number or<br>
2. Form I-94 Admission Number or<br>
3. Foreign Passport Number and the Country of Issuance.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Form-I-94-Admission-Number-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Form I-94 Admission Number</span>
<span>Enter your 11-digit I-94 admission number or 9 digits followed by one letter followed by one digit (e.g. #########A#) in this field. If you do not provide an I-94 Admission Number, enter either an Alien
Registration Number/USCIS Number or a Foreign Passport number in the fields provided. This field will then be populated with N/A.</span>
<span> Aliens authorized to work must enter one of the following to complete Section 1:<br> 1. Alien Registration Number (A-Number) /USCIS Number or<br> 2. Form I-94 Admission Number or<br> 3. Foreign Passport Number
and the Country of Issuance. </span>
</p>
<a href="#" class="close-sec" aria-label="Close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<div class="or-txt my-2 my-md-2 d-none d-md-block">
<div class="tdOR">OR</div>
</div>
</div>
<div class="alien-sec4 mb-md-2 ms-md-2 px-md-4" id="divAdmissionNumber">
<input aria-label="Form I-94 Admission Number:" class="input-style-section1-1 mx-md-1" id="AdmissionNumber" name="AdmissionNumber" onblur="AdmissionNumberValidate()" placeholder="N/A" type="text" value="" autocomplete="off"
disabled="disabled" style="font-style: italic;">
<div class="admission-error-msg">
<label class="field-errormsg" id="AdmissionNumber_error" data-valmsg-for-id="AdmissionNumber" data-valmsg-for="AdmissionNumber" for="AdmissionNumber" aria-live="polite"></label>
</div>
</div>
</div>
<div class="mt-md-0" id="divAlienOption3">
<div class="me-md-5 mb-2 d-md-flex mb-md-0">
<span class="passport-desk-radio">
<label for="AlienOption3"></label>
<span class="radio" aria-checked="false" tabindex="0" role="radio" aria-label="Foreign Passport Number:"></span><input aria-label="Foreign Passport Number:" class="styled" id="AlienOption3" name="AlienOption" type="radio"
value="ForeignPassportNumber">
<span class="f20-l24 f-w300 alien-radiolabel"><b>Foreign Passport Number:</b></span>
</span>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Foreign-Passport-Number-tooltip-description" class="tipIcon">
<span class="classic" style="width: 362px">
Enter your 6- to 12-digit alpha numeric Foreign Passport Number in this field. For numbers with fewer than 6-digits, add a leading zero(s). For example, a number of "A1234" should be entered as "0A1234." If you do not provide a Foreign Passport number, enter either your Alien Number/USCIS Number or your I-94 Admission Number in the fields provided. This field will then be populated with N/A.<br><br>
Aliens authorized to work must enter one of the following to complete Section 1:<br>
1. Alien Registration Number (A-Number)/USCIS Number or<br>
2. Form I-94 Admission Number or<br>
3. Foreign Passport Number and the Country of Issuance.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Foreign-Passport-Number-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title"><b>Foreign Passport Number</b></span>
<span> Enter your Foreign Passport Number in this field. If you do not provide a foreign passport number, enter either your Alien Number/USCIS Number or your I-94 admission number in the fields provided. This field
will then be populated with N/A. </span>
<span> Aliens authorized to work must enter one of the following to complete Section 1:<br> 1. Alien Registration Number (A-Number)/USCIS Number or<br> 2. Form I-94 Admission Number or<br> 3. Foreign Passport
Number and the Country of Issuance. </span>
</p>
<a href="#" class="close-sec" aria-label="Close" tabindex="-1">
<span class="close" id="close1" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</div>
<div class="alien-sec4 px-md-5 ms-md-5" id="divForeignPassportNumber">
<input aria-label="Foreign Passport Number:" class="input-style-section1-1" id="ForeignPassportNumber" name="ForeignPassportNumber" onblur="ForeignPassportNumberValidate()" placeholder="N/A" type="text" value=""
autocomplete="off" disabled="disabled" style="font-style: italic;">
<label class="field-errormsg ms-md-2 mb-md-1 d-block" id="ForeignPassportNumber_error" data-valmsg-for-id="ForeignPassportNumber" data-valmsg-for=",ForeignPassportNumber,ForeignPassportNumberMissingOrNotNA,"
for="ForeignPassportNumber" aria-live="polite"></label>
</div>
</div>
<div class="d-md-flex mt-2 mt-md-0 alien-sec4" id="divIssuingCountry">
<div class="me-md-5 mb-2 pe-md-3 ps-md-1">
<span class="ms-md-4 ps-md-1 f20-l24 f-w300"><b>Issuing Country:</b><span class="required d-md-none">*</span></span>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Issuing-Country-tooltip-description" class="tipIcon">
<span class="classic" style="width: 362px">
If you entered your foreign passport number in the Foreign Passport Number field, select the country of issuance of the foreign passport you used to enter the United States from the drop-down list provided. You may also type the first letter of the country and use the down arrow to select your country of issuance.<br><br>
If you entered an Alien Registration Number/USCIS Number or I-94 admission number, or you entered N/A in the Foreign Passport Number field, this field will contain N/A.<br><br>
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" id="pop1" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Issuing-Country-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" id="form1" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title"><b>Issuing Country</b></span>
<span>If you entered your foreign passport number in the Foreign Passport Number field, select the country of issuance of the foreign passport you used to enter the United States from the drop-down list provided.
You may also type the first letter of the country and use the down arrow to select your country of issuance.</span>
<span> If you entered an Alien Registration Number/USCIS Number or I-94 admission number, or you entered N/A in the Foreign Passport Number field, this field will contain N/A. </span>
</p>
<a href="#" class="close-sec" aria-label="Close" tabindex="-1">
<span class="close" id="close1" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</div>
<div class="issue-country-desktop">
<div class="select-style-1 select-style-4 select-drop">
<span title="" class="k-widget k-dropdown k-header section1SignatureBoxCountry" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" aria-owns="CountryOfIssuance_listbox"
aria-labelledby="CountryOfIssuance_error" aria-live="polite" aria-disabled="true" aria-busy="false" aria-activedescendant="a53caf6b-08ef-4e6d-8ef7-8d749b790a78" style="font-style: italic;"><span unselectable="on"
class="k-dropdown-wrap k-state-disabled"><span unselectable="on" class="k-input"><None></span><span unselectable="on" class="k-select" aria-label="select"><span
class="k-icon k-i-arrow-60-down"></span></span></span><input class="section1SignatureBoxCountry" id="CountryOfIssuance" name="CountryOfIssuance" type="text" value="" autocomplete="off" data-role="dropdownlist"
style="font-style: italic; display: none;" disabled="disabled"></span>
<script>
kendo.syncReady(function() {
jQuery("#CountryOfIssuance").kendoDropDownList({
"dataTextField": "Text",
"dataValueField": "Value",
"dataSource": [{
"Text": "<None>",
"Value": "",
"Selected": false
}, {
"Text": "AFGHANISTAN",
"Value": "AFG",
"Selected": false
}, {
"Text": "ÅLAND ISLANDS",
"Value": "ALA",
"Selected": false
}, {
"Text": "ALBANIA",
"Value": "ALB",
"Selected": false
}, {
"Text": "ALGERIA",
"Value": "DZA",
"Selected": false
}, {
"Text": "AMERICAN SAMOA",
"Value": "ASM",
"Selected": false
}, {
"Text": "ANDORRA",
"Value": "AND",
"Selected": false
}, {
"Text": "ANGOLA",
"Value": "AGO",
"Selected": false
}, {
"Text": "ANGUILLA",
"Value": "AIA",
"Selected": false
}, {
"Text": "ANTARCTICA",
"Value": "ATA",
"Selected": false
}, {
"Text": "ANTIGUA AND BARBUDA",
"Value": "ATG",
"Selected": false
}, {
"Text": "ARGENTINA",
"Value": "ARG",
"Selected": false
}, {
"Text": "ARMENIA",
"Value": "ARM",
"Selected": false
}, {
"Text": "ARUBA",
"Value": "ABW",
"Selected": false
}, {
"Text": "AUSTRALIA",
"Value": "AUS",
"Selected": false
}, {
"Text": "AUSTRIA",
"Value": "AUT",
"Selected": false
}, {
"Text": "AZERBAIJAN",
"Value": "AZE",
"Selected": false
}, {
"Text": "BAHAMAS",
"Value": "BHS",
"Selected": false
}, {
"Text": "BAHRAIN",
"Value": "BHR",
"Selected": false
}, {
"Text": "BANGLADESH",
"Value": "BGD",
"Selected": false
}, {
"Text": "BARBADOS",
"Value": "BRB",
"Selected": false
}, {
"Text": "BELARUS",
"Value": "BLR",
"Selected": false
}, {
"Text": "BELGIUM",
"Value": "BEL",
"Selected": false
}, {
"Text": "BELIZE",
"Value": "BLZ",
"Selected": false
}, {
"Text": "BENIN",
"Value": "BEN",
"Selected": false
}, {
"Text": "BERMUDA",
"Value": "BMU",
"Selected": false
}, {
"Text": "BHUTAN",
"Value": "BTN",
"Selected": false
}, {
"Text": "BOLIVIA, PLURINATIONAL STATE OF",
"Value": "BOL",
"Selected": false
}, {
"Text": "BOSNIA AND HERZEGOVINA",
"Value": "BIH",
"Selected": false
}, {
"Text": "BOTSWANA",
"Value": "BWA",
"Selected": false
}, {
"Text": "BOUVET ISLAND",
"Value": "BVT",
"Selected": false
}, {
"Text": "BRAZIL",
"Value": "BRA",
"Selected": false
}, {
"Text": "BRITISH INDIAN OCEAN TERRITORY",
"Value": "IOT",
"Selected": false
}, {
"Text": "BRUNEI DARUSSALAM",
"Value": "BRN",
"Selected": false
}, {
"Text": "BULGARIA",
"Value": "BGR",
"Selected": false
}, {
"Text": "BURKINA FASO",
"Value": "BFA",
"Selected": false
}, {
"Text": "BURUNDI",
"Value": "BDI",
"Selected": false
}, {
"Text": "CAMBODIA",
"Value": "KHM",
"Selected": false
}, {
"Text": "CAMEROON",
"Value": "CMR",
"Selected": false
}, {
"Text": "CANADA",
"Value": "CAN",
"Selected": false
}, {
"Text": "CAPE VERDE",
"Value": "CPV",
"Selected": false
}, {
"Text": "CAYMAN ISLANDS",
"Value": "CYM",
"Selected": false
}, {
"Text": "CENTRAL AFRICAN REPUBLIC",
"Value": "CAF",
"Selected": false
}, {
"Text": "CHAD",
"Value": "TCD",
"Selected": false
}, {
"Text": "CHILE",
"Value": "CHL",
"Selected": false
}, {
"Text": "CHINA",
"Value": "CHN",
"Selected": false
}, {
"Text": "CHRISTMAS ISLAND",
"Value": "CXR",
"Selected": false
}, {
"Text": "COCOS (KEELING) ISLANDS",
"Value": "CCK",
"Selected": false
}, {
"Text": "COLOMBIA",
"Value": "COL",
"Selected": false
}, {
"Text": "COMOROS",
"Value": "COM",
"Selected": false
}, {
"Text": "CONGO",
"Value": "COG",
"Selected": false
}, {
"Text": "CONGO, DEMOCRATIC REPUBLIC OF THE",
"Value": "COD",
"Selected": false
}, {
"Text": "COOK ISLANDS",
"Value": "COK",
"Selected": false
}, {
"Text": "COSTA RICA",
"Value": "CRI",
"Selected": false
}, {
"Text": "CÔTE D'IVOIRE",
"Value": "CIV",
"Selected": false
}, {
"Text": "CROATIA",
"Value": "HRV",
"Selected": false
}, {
"Text": "CUBA",
"Value": "CUB",
"Selected": false
}, {
"Text": "CYPRUS",
"Value": "CYP",
"Selected": false
}, {
"Text": "CZECH REPUBLIC",
"Value": "CZE",
"Selected": false
}, {
"Text": "DENMARK",
"Value": "DNK",
"Selected": false
}, {
"Text": "DJIBOUTI",
"Value": "DJI",
"Selected": false
}, {
"Text": "DOMINICA",
"Value": "DMA",
"Selected": false
}, {
"Text": "DOMINICAN REPUBLIC",
"Value": "DOM",
"Selected": false
}, {
"Text": "ECUADOR",
"Value": "ECU",
"Selected": false
}, {
"Text": "EGYPT",
"Value": "EGY",
"Selected": false
}, {
"Text": "EL SALVADOR",
"Value": "SLV",
"Selected": false
}, {
"Text": "EQUATORIAL GUINEA",
"Value": "GNQ",
"Selected": false
}, {
"Text": "ERITREA",
"Value": "ERI",
"Selected": false
}, {
"Text": "ESTONIA",
"Value": "EST",
"Selected": false
}, {
"Text": "ESWATINI",
"Value": "SWZ",
"Selected": false
}, {
"Text": "ETHIOPIA",
"Value": "ETH",
"Selected": false
}, {
"Text": "FALKLAND ISLANDS (MALVINAS)",
"Value": "FLK",
"Selected": false
}, {
"Text": "FAROE ISLANDS",
"Value": "FRO",
"Selected": false
}, {
"Text": "FEDERATED STATES OF MICRONESIA",
"Value": "FSM",
"Selected": false
}, {
"Text": "FIJI",
"Value": "FJI",
"Selected": false
}, {
"Text": "FINLAND",
"Value": "FIN",
"Selected": false
}, {
"Text": "FRANCE",
"Value": "FRA",
"Selected": false
}, {
"Text": "FRENCH GUIANA",
"Value": "GUF",
"Selected": false
}, {
"Text": "FRENCH POLYNESIA",
"Value": "PYF",
"Selected": false
}, {
"Text": "FRENCH SOUTHERN TERRITORIES",
"Value": "ATF",
"Selected": false
}, {
"Text": "GABON",
"Value": "GAB",
"Selected": false
}, {
"Text": "GAMBIA",
"Value": "GMB",
"Selected": false
}, {
"Text": "GEORGIA",
"Value": "GEO",
"Selected": false
}, {
"Text": "GERMANY",
"Value": "DEU",
"Selected": false
}, {
"Text": "GHANA",
"Value": "GHA",
"Selected": false
}, {
"Text": "GIBRALTAR",
"Value": "GIB",
"Selected": false
}, {
"Text": "GREECE",
"Value": "GRC",
"Selected": false
}, {
"Text": "GREENLAND",
"Value": "GRL",
"Selected": false
}, {
"Text": "GRENADA",
"Value": "GRD",
"Selected": false
}, {
"Text": "GUADELOUPE",
"Value": "GLP",
"Selected": false
}, {
"Text": "GUAM",
"Value": "GUM",
"Selected": false
}, {
"Text": "GUATEMALA",
"Value": "GTM",
"Selected": false
}, {
"Text": "GUERNSEY",
"Value": "GGY",
"Selected": false
}, {
"Text": "GUINEA",
"Value": "GIN",
"Selected": false
}, {
"Text": "GUINEA-BISSAU",
"Value": "GNB",
"Selected": false
}, {
"Text": "GUYANA",
"Value": "GUY",
"Selected": false
}, {
"Text": "HAITI",
"Value": "HTI",
"Selected": false
}, {
"Text": "HEARD ISLAND AND MCDONALD ISLANDS",
"Value": "HMD",
"Selected": false
}, {
"Text": "HOLY SEE (VATICAN CITY STATE)",
"Value": "VAT",
"Selected": false
}, {
"Text": "HONDURAS",
"Value": "HND",
"Selected": false
}, {
"Text": "HONG KONG",
"Value": "HKG",
"Selected": false
}, {
"Text": "HUNGARY",
"Value": "HUN",
"Selected": false
}, {
"Text": "ICELAND",
"Value": "ISL",
"Selected": false
}, {
"Text": "INDIA",
"Value": "IND",
"Selected": false
}, {
"Text": "INDONESIA",
"Value": "IDN",
"Selected": false
}, {
"Text": "IRAN, ISLAMIC REPUBLIC OF",
"Value": "IRN",
"Selected": false
}, {
"Text": "IRAQ",
"Value": "IRQ",
"Selected": false
}, {
"Text": "IRELAND",
"Value": "IRL",
"Selected": false
}, {
"Text": "ISLE OF MAN",
"Value": "IMN",
"Selected": false
}, {
"Text": "ISRAEL",
"Value": "ISR",
"Selected": false
}, {
"Text": "ITALY",
"Value": "ITA",
"Selected": false
}, {
"Text": "JAMAICA",
"Value": "JAM",
"Selected": false
}, {
"Text": "JAPAN",
"Value": "JPN",
"Selected": false
}, {
"Text": "JERSEY",
"Value": "JEY",
"Selected": false
}, {
"Text": "JORDAN",
"Value": "JOR",
"Selected": false
}, {
"Text": "KAZAKHSTAN",
"Value": "KAZ",
"Selected": false
}, {
"Text": "KENYA",
"Value": "KEN",
"Selected": false
}, {
"Text": "KIRIBATI",
"Value": "KIR",
"Selected": false
}, {
"Text": "KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF",
"Value": "PRK",
"Selected": false
}, {
"Text": "KOREA, REPUBLIC OF",
"Value": "KOR",
"Selected": false
}, {
"Text": "KOSOVO",
"Value": "KVO",
"Selected": false
}, {
"Text": "KUWAIT",
"Value": "KWT",
"Selected": false
}, {
"Text": "KYRGYZSTAN",
"Value": "KGZ",
"Selected": false
}, {
"Text": "LAO PEOPLE'S DEMOCRATIC REPUBLIC",
"Value": "LAO",
"Selected": false
}, {
"Text": "LATVIA",
"Value": "LVA",
"Selected": false
}, {
"Text": "LEBANON",
"Value": "LBN",
"Selected": false
}, {
"Text": "LESOTHO",
"Value": "LSO",
"Selected": false
}, {
"Text": "LIBERIA",
"Value": "LBR",
"Selected": false
}, {
"Text": "LIBYAN ARAB JAMAHIRIYA",
"Value": "LBY",
"Selected": false
}, {
"Text": "LIECHTENSTEIN",
"Value": "LIE",
"Selected": false
}, {
"Text": "LITHUANIA",
"Value": "LTU",
"Selected": false
}, {
"Text": "LUXEMBOURG",
"Value": "LUX",
"Selected": false
}, {
"Text": "MACAO",
"Value": "MAC",
"Selected": false
}, {
"Text": "MACEDONIA, NORTH",
"Value": "MKD",
"Selected": false
}, {
"Text": "MADAGASCAR",
"Value": "MDG",
"Selected": false
}, {
"Text": "MALAWI",
"Value": "MWI",
"Selected": false
}, {
"Text": "MALAYSIA",
"Value": "MYS",
"Selected": false
}, {
"Text": "MALDIVES",
"Value": "MDV",
"Selected": false
}, {
"Text": "MALI",
"Value": "MLI",
"Selected": false
}, {
"Text": "MALTA",
"Value": "MLT",
"Selected": false
}, {
"Text": "MARTINIQUE",
"Value": "MTQ",
"Selected": false
}, {
"Text": "MAURITANIA",
"Value": "MRT",
"Selected": false
}, {
"Text": "MAURITIUS",
"Value": "MUS",
"Selected": false
}, {
"Text": "MAYOTTE",
"Value": "MYT",
"Selected": false
}, {
"Text": "MEXICO",
"Value": "MEX",
"Selected": false
}, {
"Text": "MOLDOVA, REPUBLIC OF",
"Value": "MDA",
"Selected": false
}, {
"Text": "MONACO",
"Value": "MCO",
"Selected": false
}, {
"Text": "MONGOLIA",
"Value": "MNG",
"Selected": false
}, {
"Text": "MONTENEGRO",
"Value": "MNE",
"Selected": false
}, {
"Text": "MONTSERRAT",
"Value": "MSR",
"Selected": false
}, {
"Text": "MOROCCO",
"Value": "MAR",
"Selected": false
}, {
"Text": "MOZAMBIQUE",
"Value": "MOZ",
"Selected": false
}, {
"Text": "MYANMAR",
"Value": "MMR",
"Selected": false
}, {
"Text": "NAMIBIA",
"Value": "NAM",
"Selected": false
}, {
"Text": "NAURU",
"Value": "NRU",
"Selected": false
}, {
"Text": "NEPAL",
"Value": "NPL",
"Selected": false
}, {
"Text": "NETHERLANDS",
"Value": "NLD",
"Selected": false
}, {
"Text": "NETHERLANDS ANTILLES",
"Value": "ANT",
"Selected": false
}, {
"Text": "NEW CALEDONIA",
"Value": "NCL",
"Selected": false
}, {
"Text": "NEW ZEALAND",
"Value": "NZL",
"Selected": false
}, {
"Text": "NICARAGUA",
"Value": "NIC",
"Selected": false
}, {
"Text": "NIGER",
"Value": "NER",
"Selected": false
}, {
"Text": "NIGERIA",
"Value": "NGA",
"Selected": false
}, {
"Text": "NIUE",
"Value": "NIU",
"Selected": false
}, {
"Text": "NORFOLK ISLAND",
"Value": "NFK",
"Selected": false
}, {
"Text": "NORTHERN MARIANA ISLANDS",
"Value": "MNP",
"Selected": false
}, {
"Text": "NORWAY",
"Value": "NOR",
"Selected": false
}, {
"Text": "OMAN",
"Value": "OMN",
"Selected": false
}, {
"Text": "PAKISTAN",
"Value": "PAK",
"Selected": false
}, {
"Text": "PALAU",
"Value": "PLW",
"Selected": false
}, {
"Text": "PALESTINIAN TERRITORY, OCCUPIED",
"Value": "PSE",
"Selected": false
}, {
"Text": "PANAMA",
"Value": "PAN",
"Selected": false
}, {
"Text": "PAPUA NEW GUINEA",
"Value": "PNG",
"Selected": false
}, {
"Text": "PARAGUAY",
"Value": "PRY",
"Selected": false
}, {
"Text": "PERU",
"Value": "PER",
"Selected": false
}, {
"Text": "PHILIPPINES",
"Value": "PHL",
"Selected": false
}, {
"Text": "PITCAIRN",
"Value": "PCN",
"Selected": false
}, {
"Text": "POLAND",
"Value": "POL",
"Selected": false
}, {
"Text": "PORTUGAL",
"Value": "PRT",
"Selected": false
}, {
"Text": "PUERTO RICO",
"Value": "PRI",
"Selected": false
}, {
"Text": "QATAR",
"Value": "QAT",
"Selected": false
}, {
"Text": "Republic of the Marshall Islands (RMI)",
"Value": "MHL",
"Selected": false
}, {
"Text": "RÉUNION",
"Value": "REU",
"Selected": false
}, {
"Text": "ROMANIA",
"Value": "ROU",
"Selected": false
}, {
"Text": "RUSSIAN FEDERATION",
"Value": "RUS",
"Selected": false
}, {
"Text": "RWANDA",
"Value": "RWA",
"Selected": false
}, {
"Text": "SAINT BARTHÉLEMY",
"Value": "BLM",
"Selected": false
}, {
"Text": "SAINT HELENA, ASCENSION AND TRISTAN DA CUNHA",
"Value": "SHN",
"Selected": false
}, {
"Text": "SAINT KITTS AND NEVIS",
"Value": "KNA",
"Selected": false
}, {
"Text": "SAINT LUCIA",
"Value": "LCA",
"Selected": false
}, {
"Text": "SAINT MARTIN (FRENCH PART)",
"Value": "MAF",
"Selected": false
}, {
"Text": "SAINT PIERRE AND MIQUELON",
"Value": "SPM",
"Selected": false
}, {
"Text": "SAINT VINCENT AND THE GRENADINES",
"Value": "VCT",
"Selected": false
}, {
"Text": "SAMOA",
"Value": "WSM",
"Selected": false
}, {
"Text": "SAN MARINO",
"Value": "SMR",
"Selected": false
}, {
"Text": "SAO TOME AND PRINCIPE",
"Value": "STP",
"Selected": false
}, {
"Text": "SAUDI ARABIA",
"Value": "SAU",
"Selected": false
}, {
"Text": "SENEGAL",
"Value": "SEN",
"Selected": false
}, {
"Text": "SERBIA",
"Value": "SRB",
"Selected": false
}, {
"Text": "SEYCHELLES",
"Value": "SYC",
"Selected": false
}, {
"Text": "SIERRA LEONE",
"Value": "SLE",
"Selected": false
}, {
"Text": "SINGAPORE",
"Value": "SGP",
"Selected": false
}, {
"Text": "SLOVAKIA",
"Value": "SVK",
"Selected": false
}, {
"Text": "SLOVENIA",
"Value": "SVN",
"Selected": false
}, {
"Text": "SOLOMON ISLANDS",
"Value": "SLB",
"Selected": false
}, {
"Text": "SOMALIA",
"Value": "SOM",
"Selected": false
}, {
"Text": "SOUTH AFRICA",
"Value": "ZAF",
"Selected": false
}, {
"Text": "SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS",
"Value": "SGS",
"Selected": false
}, {
"Text": "SPAIN",
"Value": "ESP",
"Selected": false
}, {
"Text": "SRI LANKA",
"Value": "LKA",
"Selected": false
}, {
"Text": "STATELESS",
"Value": "STL",
"Selected": false
}, {
"Text": "SUDAN",
"Value": "SDN",
"Selected": false
}, {
"Text": "SURINAME",
"Value": "SUR",
"Selected": false
}, {
"Text": "SVALBARD AND JAN MAYEN",
"Value": "SJM",
"Selected": false
}, {
"Text": "SWEDEN",
"Value": "SWE",
"Selected": false
}, {
"Text": "SWITZERLAND",
"Value": "CHE",
"Selected": false
}, {
"Text": "SYRIAN ARAB REPUBLIC",
"Value": "SYR",
"Selected": false
}, {
"Text": "TAIWAN",
"Value": "TWN",
"Selected": false
}, {
"Text": "TAJIKISTAN",
"Value": "TJK",
"Selected": false
}, {
"Text": "TANZANIA, UNITED REPUBLIC OF",
"Value": "TZA",
"Selected": false
}, {
"Text": "THAILAND",
"Value": "THA",
"Selected": false
}, {
"Text": "TIMOR-LESTE",
"Value": "TLS",
"Selected": false
}, {
"Text": "TOGO",
"Value": "TGO",
"Selected": false
}, {
"Text": "TOKELAU",
"Value": "TKL",
"Selected": false
}, {
"Text": "TONGA",
"Value": "TON",
"Selected": false
}, {
"Text": "TRINIDAD AND TOBAGO",
"Value": "TTO",
"Selected": false
}, {
"Text": "TUNISIA",
"Value": "TUN",
"Selected": false
}, {
"Text": "TURKEY",
"Value": "TUR",
"Selected": false
}, {
"Text": "TURKMENISTAN",
"Value": "TKM",
"Selected": false
}, {
"Text": "TURKS AND CAICOS ISLANDS",
"Value": "TCA",
"Selected": false
}, {
"Text": "TUVALU",
"Value": "TUV",
"Selected": false
}, {
"Text": "UGANDA",
"Value": "UGA",
"Selected": false
}, {
"Text": "UKRAINE",
"Value": "UKR",
"Selected": false
}, {
"Text": "UNITED ARAB EMIRATES",
"Value": "ARE",
"Selected": false
}, {
"Text": "UNITED KINGDOM",
"Value": "GBR",
"Selected": false
}, {
"Text": "UNITED STATES MINOR OUTLYING ISLANDS",
"Value": "UMI",
"Selected": false
}, {
"Text": "URUGUAY",
"Value": "URY",
"Selected": false
}, {
"Text": "UZBEKISTAN",
"Value": "UZB",
"Selected": false
}, {
"Text": "VANUATU",
"Value": "VUT",
"Selected": false
}, {
"Text": "VENEZUELA, BOLIVARIAN REPUBLIC OF",
"Value": "VEN",
"Selected": false
}, {
"Text": "VIET NAM",
"Value": "VNM",
"Selected": false
}, {
"Text": "VIRGIN ISLANDS (BRITISH)",
"Value": "VGB",
"Selected": false
}, {
"Text": "VIRGIN ISLANDS (U.S.)",
"Value": "VIR",
"Selected": false
}, {
"Text": "WALLIS AND FUTUNA",
"Value": "WLF",
"Selected": false
}, {
"Text": "WESTERN SAHARA",
"Value": "ESH",
"Selected": false
}, {
"Text": "YEMEN",
"Value": "YEM",
"Selected": false
}, {
"Text": "ZAMBIA",
"Value": "ZMB",
"Selected": false
}, {
"Text": "ZIMBABWE",
"Value": "ZWE",
"Selected": false
}]
});
});
</script>
<br>
<label class="field-errormsg" id="CountryOfIssuance_error" data-valmsg-for-id="CountryOfIssuance" data-valmsg-for="ForeignPassportCountryIssuanceMissing" for="CountryOfIssuance" aria-live="polite"></label>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="clear"></div>
</div>
<!--end box additional -->
</li>
</ul>
<script type="text/javascript">
$(function() {
var windowWidth = $(window).width();
$("#PersonStatus3").parent().on('click', 'span', function() {
if (windowWidth < 768) {
$('#btnAlienNumber').click();
}
})
$("#spanImpNote").hide();
$("#divImpNote").on("click keypress", function(event) {
$("#spanImpNote").toggle();
$('.anti-desc img').toggleClass('anti-desc-not-rotated');
$("#spanImpNote").focus();
});
$('#divAlienOption1').click(function(e) {
//nothing to do
});
$('#divAlienOption2').click(function(e) {
if (windowWidth < 768) {
$("#divAlienNumberAATW").hide();
$("#divAdmissionNumber").show();
$("#divForeignPassportNumber").hide();
$("#divIssuingCountry").hide();
}
});
$('#divAlienOption3').click(function(e) {
if (windowWidth < 768) {
$("#divAlienNumberAATW").hide();
$("#divAdmissionNumber").hide();
$("#divForeignPassportNumber").show();
$("#divIssuingCountry").show();
}
});
$("#AlienOption1").parent().on('click', 'span', function() {
$("#AdmissionNumber").val('');
$("#ForeignPassportNumber").val('');
$("#ForeignPassportNumber").val('');
$("#CountryOfIssuance").val('');
$("#CountryOfIssuance").data("kendoDropDownList").value("");
if (windowWidth < 768) {
$("#divAlienNumberAATW").show();
$("#divAdmissionNumber").hide();
$("#divForeignPassportNumber").hide();
$("#divIssuingCountry").hide();
$('#btnAlienNumberAATW').click();
$("#AlienUSCISNumberAATW").attr("placeholder", "Required (###-###-###)");
} else {
$("#AlienUSCISNumberAATW").attr("placeholder", "Required");
}
})
$("#AlienOption2").parent().on('click', 'span', function() {
$("#AlienUSCISNumberAATW").val('');
$("#ForeignPassportNumber").val('');
$("#CountryOfIssuance").val('');
$("#CountryOfIssuance").data("kendoDropDownList").value("");
$("#NumberTypeAATW").data("kendoDropDownList").value("0");
//$("#divAlienNumberAATW").hide();
//$("#divAdmissionNumber").show();
//$("#divForeignPassportNumber").hide();
//$("#divIssuingCountry").hide();
})
$("#AlienOption3").parent().on('click', 'span', function() {
$("#AdmissionNumber").val('');
$("#AlienUSCISNumberAATW").val('');
$("#ForeignPassportNumber").val('');
$("#CountryOfIssuance").val('');
$("#CountryOfIssuance").data("kendoDropDownList").value("");
$("#NumberTypeAATW").data("kendoDropDownList").value("0");
//$("#divAlienNumberAATW").hide();
//$("#divAdmissionNumber").hide();
//$("#divForeignPassportNumber").show();
//$("#divIssuingCountry").show();
})
var agreeChked = $('[name="AlienAuthorizationDateNA"][type="Checkbox"]').prop('checked');
if (agreeChked) {
$('[name="AlienAuthorizationDateNA"]:hidden').val(true);
} else {
$('[name="AlienAuthorizationDateNA"]:hidden').val(false);
}
});
$('[name="AlienAuthorizationDateNA"][type="Checkbox"]').click(function() {
if ($(this).prop('checked')) $('[name="AlienAuthorizationDateNA"]:hidden').val(true);
else $('[name="AlienAuthorizationDateNA"]:hidden').val(false);
});
var digitsHandler = function() {
var val = this.value.replace(/\D/g, '');
var newVal = '';
if (val.length > 4) {
this.value = val;
}
if ((val.length > 3) && (val.length < 6)) {
newVal += val.substr(0, 3) + '-';
val = val.substr(3);
}
if (val.length > 6) {
newVal += val.substr(0, 3) + '-';
newVal += val.substr(3, 3) + '-';
val = val.substr(6);
}
newVal += val;
this.value = newVal.substring(0, 11);
};
$("#AlienUSCISNumberAATW").bind("keyup", digitsHandler);
$("#AlienUSCISNumber").bind("keyup", digitsHandler);
$(document).ready(function() {
//open tool-tip popup mobile
$(".pop").on("click keypress", function(event) {
$(this).parent().find("div .overlay_form").fadeIn(500);
$('#sticky-footer').css('opacity', 0);
PositionForInformationPopup();
document.getElementById('btnGeneralInfo').click();
//$('#btnGeneralInfo').click();
});
//close tool-tip popup
$(".close").on("click keypress", function(event) {
$('.k-window-titlebar.k-header').css('visibility', 'visible');
$('#sticky-footer').css('opacity', 1);
$(".overlay_form").fadeOut(500);
return false;
});
function PositionForInformationPopup() {
if (!$(".overlay_form").is(':visible')) {
return;
}
$(".overlay_form").css({
left: ($(window).width() - $('.overlay_form').width()) / 100,
top: ($(window).width() - $('.overlay_form').width()) / 100,
position: 'absolute'
});
if ($(".overlay_form").is(':visible')) {
$('.k-window-titlebar.k-header').css('visibility', 'hidden');
}
}
//open tool-tip popup
$(".poplawful").on("click keypress", function(event) {
$(this).parent().find("div .overlay_form_lawful").fadeIn(500);
$('#sticky-footer').css('opacity', 0);
PositionForlawfulInfomrationPopup();
document.getElementById('btnGeneralInfo').click();
//$('#btnGeneralInfo').click();
});
//close tool-tip popup
$(".closelawful").on("click keypress", function(event) {
$('#sticky-footer').css('opacity', 1);
$(".overlay_form_lawful").fadeOut(500);
return false;
});
function PositionForlawfulInfomrationPopup() {
if (!$(".overlay_form_lawful").is(':visible')) {
return;
}
$(".overlay_form_lawful").css({
left: ($(window).width() - $('.overlay_form_lawful').width()) / 100,
top: ($(window).width() - $('.overlay_form_lawful').width()) / 100,
position: 'absolute'
});
}
//open tool-tip popup
$(".popAlien").on("click keypress", function(event) {
$(this).parent().find("div .overlay_form_Alien").fadeIn(500);
$('#sticky-footer').css('opacity', 0);
PositionForAlienInfomrationPopup();
document.getElementById('btnGeneralInfo').click();
//$('#btnGeneralInfo').click();
});
//close tool-tip popup
$(".closeAlien").on("click keypress", function(event) {
$('#sticky-footer').css('opacity', 1);
$(".overlay_form_Alien").fadeOut(500);
return false;
});
function PositionForAlienInfomrationPopup() {
if (!$(".overlay_form_Alien").is(':visible')) {
return;
}
$(".overlay_form_Alien").css({
left: ($(window).width() - $('.overlay_form_Alien').width()) / 100,
top: ($(window).width() - $('.overlay_form_Alien').width()) / 100,
position: 'absolute'
});
}
$('input[type = "checkbox"]').on('keypress', function(event) {
if (event.which === 13) {
this.checked = !this.checked;
}
});
if ($(window).width() < 768) {
var hiddenLawFulPermanentNumberType = $("#hiddenLawFulPermanentNumberType").val();
var hiddenAlienNumberType = $("#hiddenAlienNumberType").val();
var hiddenAlienOptionsNumber = $("#hiddenAlienOptionsNumber").val();
setTimeout(function() {
if (hiddenLawFulPermanentNumberType > 0) {
if (hiddenLawFulPermanentNumberType == 1) {
$('#btnAlienNumber').click();
} else if (hiddenLawFulPermanentNumberType == 2) {
$('#btnUSCISNumber').click();
}
} else {
if (hiddenAlienNumberType > 0) {
$("#divAlienNumberAATW").show();
if (hiddenAlienNumberType == 1) {
$('#btnAlienNumberAATW').click();
} else if (hiddenAlienNumberType == 2) {
$('#btnUSCISNumberAATW').click();
}
}
}
if (hiddenAlienOptionsNumber > 0) {
if (hiddenAlienOptionsNumber == 2) {
$("#divAdmissionNumber").show();
} else if (hiddenAlienOptionsNumber == 3) {
$("#divForeignPassportNumber").show();
$("#divIssuingCountry").show();
}
}
}, 200);
}
});
</script>
<div class="clear"></div>
</fieldset>
</div>
<!-- end modContent-->
<div class="clear"></div>
<!-- end box-module C-->
<input id="QueryString" name="QueryString" type="hidden" value="7rnDUOA4mywFb%2bgaE0N4QcXXuPyPNk56Fs4joNvCKbPEinX%2feXkq5x%2fISHEXTTwfpGL7o7qgl8HjwiYpGbh0LrAiPK1iAhjKLubZ25dxC%2fo%3d">
<input data-val="true" data-val-required="The EmployeeId field is required." id="EmployeeId" name="EmployeeId" type="hidden" value="5628028">
<input data-val="true" data-val-required="The I9Id field is required." id="I9Id" name="I9Id" type="hidden" value="5796382">
<input id="MultiUseLinkId" name="MultiUseLinkId" type="hidden" value="0">
<input id="IsSSNRequiredForEverify" name="IsSSNRequiredForEverify" type="hidden" value="False">
<input data-val="true" data-val-required="The FormI9Revision field is required." id="FormI9Revision" name="FormI9Revision" type="hidden" value="11">
<input id="Section2Doc_ShowDocumentSelector" name="Section2Doc.ShowDocumentSelector" type="hidden" value="1">
<input id="I9Login" name="I9Login" type="hidden" value="7rnDUOA4mywFb+gaE0N4QcXXuPyPNk56Fs4joNvCKbPEinX/eXkq5x/ISHEXTTwfpGL7o7qgl8HjwiYpGbh0LrAiPK1iAhjKLubZ25dxC/o=">
</div>
<div class="box-module box-module-01 backWhite" id="divSection2A" style="display: none;">
<div class="newUI-moduleLabel-1"><span class="svg-desktop-section1"></span></div>
<div class="moduleContent emp-modulecontent" id="divElectronicSignature">
<span class="aHideDocsListViewAjax">
<a class="FormI9Help" onclick="javascript:HideS2A(); return false;" href="#">I Do Not Have My Documents Available At This Time </a>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="I Do Not Have My Documents Available At This Time" class="tipIcon">
<span class="classic">
Your employer has requested that you select and enter your identity and work authorization document information at this time.
If you do not have access to these documents, click the link to skip this step. You must still present these documents to your employer for examination when you begin work.
</span>
</a> </span>
<a href="#" class="aShowDocsListViewAjax FormI9Help" style="display: none;" onclick="javascript:ShowS2A(); return false;">Click to Select Employment Verification Documents</a>
<br>
<br>
<div class="divS2">
<div>
<span class="div-header-title-1"> Employment Verification Documents </span>
<span class="font-size-3 margin-left-1">(The Employee must present one document from List A OR one document from List B and List C).</span>
</div>
<br>
<p>Use the drop-down menu to select a document from List A or one from List B and C. Then, enter the respective document number(s) and <br>expiration date(s).</p>
<ul class="float select-style-1" id="undo">
<li>
<br>
<label class="fontsize-sytle-01">Document Type</label>
</li>
<li class="width-200"> <b>List A</b><br>
<span title="" class="k-widget k-dropdown k-header" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="docTypeListA_listbox" aria-live="polite" aria-disabled="false" aria-busy="false"
aria-activedescendant="ce7d80fa-18cd-49e9-ad50-9f0d42fc0ecf" style=""><span unselectable="on" class="k-dropdown-wrap k-state-default"><span unselectable="on" class="k-input">Select</span><span unselectable="on" class="k-select"
aria-label="select"><span class="k-icon k-i-arrow-60-down"></span></span></span><select id="docTypeListA" data-role="dropdownlist" style="display: none;">
<option value="" selected="selected">Select</option>
</select></span>
</li>
<li class="width-200"> <b>List B</b><br>
<span title="" class="k-widget k-dropdown k-header" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="docTypeListB_listbox" aria-live="polite" aria-disabled="false" aria-busy="false"
aria-activedescendant="a250b8a9-5133-4b28-bee8-65ab2f8382b7" style=""><span unselectable="on" class="k-dropdown-wrap k-state-default"><span unselectable="on" class="k-input">Select</span><span unselectable="on" class="k-select"
aria-label="select"><span class="k-icon k-i-arrow-60-down"></span></span></span><select id="docTypeListB" data-role="dropdownlist" style="display: none;">
<option value="" selected="selected">Select</option>
</select></span>
</li>
<li class="width-200"> <b>List C</b><br>
<span title="" class="k-widget k-dropdown k-header" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="docTypeListC_listbox" aria-live="polite" aria-disabled="false" aria-busy="false"
aria-activedescendant="63b58f9c-99e0-4ece-b8f7-2a8436d1d898" style=""><span unselectable="on" class="k-dropdown-wrap k-state-default"><span unselectable="on" class="k-input">Select</span><span unselectable="on" class="k-select"
aria-label="select"><span class="k-icon k-i-arrow-60-down"></span></span></span><select id="docTypeListC" data-role="dropdownlist" style="display: none;">
<option value="" selected="selected">Select</option>
</select></span>
</li>
</ul>
<div class="float-left">
<label data-valmsg-for-id="docTypeListA" data-valmsg-for="ListADocumentType"></label>
</div>
</div>
</div>
<!-- end moduleContent-->
<div class="clear"></div>
</div>
<!-- end box-module-->
<div class="box-module box-module-01 backWhite" id="divSection2A1" style="display: none;">
<div class="moduleLabel"><span class="svg-desktop-section1"></span></div>
<div class="moduleContent" id="divElectronicSignature">
<span class="aHideDocsListViewAjax">
<a class="FormI9Help" onclick="javascript:HideS2A1(); return false;" href="#">I Do Not Have My Documents Available At This Time </a>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="I Do Not Have My Documents Available At This Time" class="tipIcon">
<span class="classic">
Your employer has requested that you select and enter your identity and work authorization document information at this time.
If you do not have access to these documents, click the link to skip this step. You must still present these documents to your employer for examination when you begin work.
</span>
</a> </span>
<br>
<br>
<div class="divS2">
<style>
.k-window-title {
padding-top: 3px;
}
.k-window-titlebar {
font-size: 14px;
height: 23px
}
.butWhite {
padding: 7px 40px;
border: 1px solid #ffffff;
color: #000000;
font-weight: bold;
-moz-border-radius: 4px;
-webkit-border-radius: 4px;
border-radius: 4px;
cursor: pointer;
-webkit-box-shadow: 1px 2px 6px #cccccc;
-moz-box-shadow: 1px 2px 6px #cccccc;
box-shadow: 1px 2px 6px #cccccc;
}
.butGrayThis {
padding: 7px 40px;
border: 1px solid #ffffff;
color: #ffffff;
font-weight: bold;
background-color: #c9c8c8;
-moz-border-radius: 4px;
-webkit-border-radius: 4px;
border-radius: 4px;
cursor: not-allowed;
-webkit-box-shadow: 1px 2px 6px #cccccc;
-moz-box-shadow: 1px 2px 6px #cccccc;
box-shadow: 1px 2px 6px #cccccc;
}
</style>
<div class="container flex">
<div class="w-80">
<h2 class="mustbefixed header-style-01 header-style-size-05 d-none d-md-inline-block"> Employment Verification Documents <span class="font-size-3 margin-left-1 d-none"
style="color: #000000 !important;font-weight: normal !important;">(The Employee Must Present One Document from List A OR one document from List B and List C)</span>
</h2>
</div>
<div class="w-20 mr-2">
<div id="reset-switch" class="fright pt-2 classic-new-switch d-none d-md-block" style="z-index: 9; position: absolute; right: 15%; top: 2.4%; display: none !important;">
<a href="#/" class="aClearDocument FormI9Help font-size-12 text-underline" id="switchToClassicView-reset">
<img src="/Content/images/FormI9-Responsive/switch-view.svg" class="info-img switch-img" alt="switch view">
Switch to Classic View
</a>
<a href="#/" class="aClearDocument FormI9Help font-size-12 text-underline" id="switchToNewView-reset">
<img src="/Content/images/FormI9-Responsive/switch-view.svg" class="info-img switch-img" alt="switch view">
Switch to New View
</a>
</div>
<div class="d-none d-md-inline-block fright w-100 reset-btn" href="#" onclick="javascript:ClearClickOnSection2(); return false;" onkeypress="javascript:ClearClickOnSection2(); return false;" tabindex="0" role="button"
aria-label="reset document selection">
<div class="aClearDocument btn-style-6 btn-font-2 btn-size-12 fright mright20">
<span class="vertical-style-2">
<span class="newUI-svg-reset"></span>
<span>Reset</span>
</span>
</div>
</div>
</div>
</div>
<br>
<p class="p-sytle p-sytle-03 d-none use-dropdown-b-c"> Use the drop-down menu to select a document from List A or one from List B and C. Then, enter the respective document number(s) and expiration date(s). Click the (i) button for more
information about a specific document. </p>
<input id="EmployeeId" name="EmployeeId" type="hidden" value="5628028">
<input id="I9Id" name="I9Id" type="hidden" value="5796382">
<input data-val="true" data-val-required="The ListADocId field is required." id="ListADocId" name="ListADocId" type="hidden" value="0">
<input data-val="true" data-val-required="The ListBDocId field is required." id="ListBDocId" name="ListBDocId" type="hidden" value="0">
<input data-val="true" data-val-required="The ListCDocId field is required." id="ListCDocId" name="ListCDocId" type="hidden" value="0">
<input id="FormCaseEnum" name="FormCaseEnum" type="hidden" value="2">
<input id="ShowDocumentSelector" name="ShowDocumentSelector" type="hidden" value="1">
<input id="SenstiveDataIsMasked" name="SenstiveDataIsMasked" type="hidden" value="False">
<input data-val="true" data-val-required="The Section2Saved field is required." id="Section2Saved" name="Section2Saved" type="hidden" value="False">
<input data-val="true" data-val-required="The EnableNewSection2And3DocumentDataLayout field is required." id="EnableNewSection2And3DocumentDataLayout" name="EnableNewSection2And3DocumentDataLayout" type="hidden" value="False">
<input id="SocialSecurityNumber" name="SocialSecurityNumber" type="hidden" value="">
<input id="MultiUseLinkId" name="MultiUseLinkId" type="hidden" value="0">
<input type="hidden" id="USCISNumber">
<input type="hidden" id="AlienNumber">
<input type="hidden" id="isCOVID19Date" value="false">
<input type="hidden" id="hiddenMobileListADoc2Number">
<input type="hidden" id="hiddenMobileListADoc1Number">
<input type="hidden" id="hiddenListAI94Type">
<input type="hidden" id="hiddenListADoc2IssuingAuthority">
<input type="hidden" id="hiddenMobileAttachmentType" value="0">
<input type="hidden" id="hiddenMobileShowAdditionalDoc" value="false">
<div class="mb-4 d-md-none list-a-selected">
<p id="pSelectedDocumentListA" class="p-0">
<b>List A: </b><span id="divListaSelectedDocument" class="pSelectedDocumentspan"></span>
<button type="button" class="btn btn-default open-model doc-tooltip doc-tooltip-A p-0 m-0 pSelectedDocumenttooltip" value="0" id="btnListaSelectedDocument">
<img src="/Content/tracker/images/icon-info.png" alt="Select Employee Document Type-tooltip-description" class="tipIcon">
</button>
</p>
<p id="pSelectedDocumentListB" class="p-0">
<b>List B: </b><span id="divListbSelectedDocument" class="pSelectedDocumentspan"></span>
<button type="button" class="btn btn-default open-model doc-tooltip doc-tooltip-B p-0 m-0 pSelectedDocumenttooltip" value="0" id="btnListbSelectedDocument">
<img src="/Content/tracker/images/icon-info.png" alt="Select Employee Document Type-tooltip-description" class="tipIcon">
</button>
</p>
<p id="pSelectedDocumentListC" class="p-0">
<b>List C: </b><span id="divListcSelectedDocument" class="pSelectedDocumentspan"></span>
<button type="button" class="btn btn-default open-model doc-tooltip doc-tooltip-C p-0 m-0 pSelectedDocumenttooltip" value="0" id="btnListcSelectedDocument">
<img src="/Content/tracker/images/icon-info.png" alt="Select Employee Document Type-tooltip-description" class="tipIcon">
</button>
</p>
</div>
<div class="d-none d-md-inline-flex w-100 mb-3 doc-sel-1" id="divDocumentTypeSelected">
<div class="fleft d-none d-md-inline-flex emp-doc-text">
<div class="newUI-moduleLabel-2 circle-num">
<div>1</div>
</div>
<p class="px-2 mb-0 pe-4"> Select Employee Document Type </p>
</div>
<div class="tab fright w-67 tab-a-b">
<button class="tablinks active" type="button" id="btnListA"><b>List A <span class="d-none d-md-inline">(Both Identity & Employment Eligibility)</span></b></button>
<button class="tablinks" type="button"
id="btnListBC"><b>List B <span class="d-none d-md-inline">(Identity) and</span><span class="d-md-none">&</span> List C <span class="d-none d-md-inline">(Employment Authorization)</span></b></button>
</div>
</div>
<fieldset class="w-100">
<legend hidden="">List A document information form</legend>
<table id="tableListA" cellspacing="0" cellpadding="0" border="0" class="table-style-01 fleft select-style-1 select-style-5 required-style-01 table-style-03 selected-document-amend-sec2 w-mobile-100 font-size-12">
<tbody>
<tr class="doc-sel-2">
<td class="newUI-moduleLabel-2 p-0">
<div>2</div>
</td>
<td style="position: absolute; left: 10%; padding: 1px 0;" class="list-a-doc-text">Select the <b>List A document</b> provided by the Employee and provide the document details:</td>
</tr>
<tr class="d-none font-size-12 list-A-table">
<th class="width-90"></th>
<th>
<div class="input-width-01 centerAlign">List A</div>
</th>
</tr>
<tr id="trListADocumentType" class="d-none d-md-table-row">
<td>
<label for="ListADocumentTypeName" class="f-w900 f18-l24" id="ListADocumentTypeName_label">Document Type:</label>
</td>
<td>
<div id="docNewA">
<span title="" class="k-widget k-dropdown k-header input-width-01 reSelect" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="ListADocumentTypeName_listbox"
aria-labelledby="ListADocumentTypeName_label" aria-live="polite" aria-disabled="false" aria-busy="false" aria-activedescendant="5ff9c688-190c-41b8-aab3-e1de9a044455" style="font-style: italic;"><span unselectable="on"
class="k-dropdown-wrap k-state-default"><span unselectable="on" class="k-input"><Select One></span><span unselectable="on" class="k-select" aria-label="select"><span
class="k-icon k-i-arrow-60-down"></span></span></span><input class="input-width-01 reSelect" id="ListADocumentTypeName" name="ListADocumentTypeName" type="text" value="" style="font-style: italic; display: none;"
autocomplete="off" data-role="dropdownlist"></span>
<script>
kendo.syncReady(function() {
jQuery("#ListADocumentTypeName").kendoDropDownList({
"dataTextField": "Text",
"dataValueField": "Value",
"dataSource": [{
"Text": "<Select One>",
"Value": "",
"Selected": false
}]
});
});
</script> <span class="required d-none d-md-inline">*</span>
<input data-val="true" data-val-required="The ListADocumentType field is required." id="ListADocumentType" name="ListADocumentType" type="hidden" value="0">
<a class="tooltip aListADocumentTypeA opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="ListADocumentTypeA-tooltip" class="tipIcon">
<span class="classic aSpanListADocumentTypeA"></span>
</a>
<label data-valmsg-for-id="ListADocumentTypeName" data-valmsg-for="ListADocumentType" aria-live="polite"></label>
<label id="docAval"></label>
</div>
</td>
</tr>
<tr class="d-md-none">
<td colspan="2" class="mb-0">
<div>
<label class="f-w900 f18-l24">Attachment:</label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" alt="attachment-tooltip-description" class="tipIcon"></span>
<div class="pt-3">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Attachment</span>
<span>Attachment. </span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<img id="base64image" class="base64image" style="display:none;" alt="upload file">
<input type="file" accept="image/*" name="fileToUpload" id="inp" hidden="" capture="camera" aria-label="Attachment">
<img src="/Content/images/FormI9-Responsive/Icon-camera.svg" alt="camera"><a id="take-picture-link" class="ps-2" href="#!"><label id="take-picture" class="take-picture">Take picture</label></a>
</div>
</td>
</tr>
<tr class="d-md-none sec2amend-takepic">
<td colspan="2">
<div id="Section2AttachmentPanel" class="mt-3"></div>
</td>
</tr>
<tr class="trI551Passport" id="trPassportI94Doc" style="display: none;">
<td>
<label class="lblI551Passport f-w900 f18-l24">Foreign Passport</label>
<label class="lblI551_I94Doc f-w900 f18-l24" style="display: none;">I-94 Document</label>
</td>
<td></td>
</tr>
<tr class="trNormal" id="trdcAUSCIS" style="display:none">
<td>
<label for="AlienUSCISNum" class="f-w900 f18-l24">A-Number/USCIS Number:<span class="required d-md-none">*</span></label>
</td>
<td>
<input class="input-width-01" disabled="disabled" id="AlienUSCISNum" name="ListADoc3Number" placeholder="Required" type="text" value="" autocomplete="off" style="font-style: italic;">
<span class="required d-none d-md-inline">*</span>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="a-Number/USCIS-Number-tooltip" class="tipIcon">
<span class="classic">Enter the 7- to 9-digit Alien Registration Number (A-Number)/USCIS Number, in this field. The A-Number/USCIS Number can be found on the face of the EAD Card (Form I-766). For numbers with fewer than nine digits, add leading zero(s). For example, a number of "1234567" should be entered as "001234567".</span>
</a>
<label data-valmsg-for-id="AlienUSCISNum" data-valmsg-for="A-Number/USCIS Number" aria-live="polite"></label>
<label data-valmsg-for-id="AlienUSCISNum" data-valmsg-for="ListADoc3Number" aria-live="polite"></label>
</td>
</tr>
<tr id="trListAIssuingAuthority" class="trNormal trI551Passport">
<td>
<label for="ListADoc1IssuingAuthority" class="f-w900 f18-l24">Issuing Authority:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Issuing Authority-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Issuing Authority</span>
<span class="classic spanIssuingAuthorityA"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<input class="input-width-01" id="ListADoc1IssuingAuthority" name="ListADoc1IssuingAuthority" placeholder="Required" type="text" value="" style="font-style: italic;" autocomplete="off">
<span class="required d-none d-md-inline">*</span>
<a class="tooltip aIssuingAuthorityA opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Issuing Authority-tooltip" class="tipIcon">
<span class="classic spanIssuingAuthorityA"></span>
</a>
<label data-valmsg-for-id="ListADoc1IssuingAuthority" data-valmsg-for="ListADoc1IssuingAuthority" aria-live="polite"></label>
</td>
</tr>
<tr id="trListAIssuingAuthorityForI94" style="display: none;">
<td>
<label class="f-w900 f18-l24" for="ListAIssuingAuthorityForI94">Issuing Authority:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Issuing Authority-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Issuing Authority</span>
<span class="classic spanIssuingAuthorityA"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td class="mb-4 pb-3">
<select class="input-width-01 DDLBHeight" id="ListAIssuingAuthorityForI94" name="ListAIssuingAuthorityForI94" onchange="ListA_I94_IssuingAuthority_SelectEvent(this)" placeholder="Required" style="width:206px;">
<option value=""><None></option>
<option value="AFG">AFGHANISTAN</option>
<option value="ALA">ÅLAND ISLANDS</option>
<option value="ALB">ALBANIA</option>
<option value="DZA">ALGERIA</option>
<option value="ASM">AMERICAN SAMOA</option>
<option value="AND">ANDORRA</option>
<option value="AGO">ANGOLA</option>
<option value="AIA">ANGUILLA</option>
<option value="ATA">ANTARCTICA</option>
<option value="ATG">ANTIGUA AND BARBUDA</option>
<option value="ARG">ARGENTINA</option>
<option value="ARM">ARMENIA</option>
<option value="ABW">ARUBA</option>
<option value="AUS">AUSTRALIA</option>
<option value="AUT">AUSTRIA</option>
<option value="AZE">AZERBAIJAN</option>
<option value="BHS">BAHAMAS</option>
<option value="BHR">BAHRAIN</option>
<option value="BGD">BANGLADESH</option>
<option value="BRB">BARBADOS</option>
<option value="BLR">BELARUS</option>
<option value="BEL">BELGIUM</option>
<option value="BLZ">BELIZE</option>
<option value="BEN">BENIN</option>
<option value="BMU">BERMUDA</option>
<option value="BTN">BHUTAN</option>
<option value="BOL">BOLIVIA, PLURINATIONAL STATE OF</option>
<option value="BIH">BOSNIA AND HERZEGOVINA</option>
<option value="BWA">BOTSWANA</option>
<option value="BVT">BOUVET ISLAND</option>
<option value="BRA">BRAZIL</option>
<option value="IOT">BRITISH INDIAN OCEAN TERRITORY</option>
<option value="BRN">BRUNEI DARUSSALAM</option>
<option value="BGR">BULGARIA</option>
<option value="BFA">BURKINA FASO</option>
<option value="BDI">BURUNDI</option>
<option value="KHM">CAMBODIA</option>
<option value="CMR">CAMEROON</option>
<option value="CAN">CANADA</option>
<option value="CPV">CAPE VERDE</option>
<option value="CYM">CAYMAN ISLANDS</option>
<option value="CAF">CENTRAL AFRICAN REPUBLIC</option>
<option value="TCD">CHAD</option>
<option value="CHL">CHILE</option>
<option value="CHN">CHINA</option>
<option value="CXR">CHRISTMAS ISLAND</option>
<option value="CCK">COCOS (KEELING) ISLANDS</option>
<option value="COL">COLOMBIA</option>
<option value="COM">COMOROS</option>
<option value="COG">CONGO</option>
<option value="COD">CONGO, DEMOCRATIC REPUBLIC OF THE</option>
<option value="COK">COOK ISLANDS</option>
<option value="CRI">COSTA RICA</option>
<option value="CIV">CÔTE D'IVOIRE</option>
<option value="HRV">CROATIA</option>
<option value="CUB">CUBA</option>
<option value="CYP">CYPRUS</option>
<option value="CZE">CZECH REPUBLIC</option>
<option value="DNK">DENMARK</option>
<option value="DJI">DJIBOUTI</option>
<option value="DMA">DOMINICA</option>
<option value="DOM">DOMINICAN REPUBLIC</option>
<option value="ECU">ECUADOR</option>
<option value="EGY">EGYPT</option>
<option value="SLV">EL SALVADOR</option>
<option value="GNQ">EQUATORIAL GUINEA</option>
<option value="ERI">ERITREA</option>
<option value="EST">ESTONIA</option>
<option value="SWZ">ESWATINI</option>
<option value="ETH">ETHIOPIA</option>
<option value="FLK">FALKLAND ISLANDS (MALVINAS)</option>
<option value="FRO">FAROE ISLANDS</option>
<option value="FSM">FEDERATED STATES OF MICRONESIA</option>
<option value="FJI">FIJI</option>
<option value="FIN">FINLAND</option>
<option value="FRA">FRANCE</option>
<option value="GUF">FRENCH GUIANA</option>
<option value="PYF">FRENCH POLYNESIA</option>
<option value="ATF">FRENCH SOUTHERN TERRITORIES</option>
<option value="GAB">GABON</option>
<option value="GMB">GAMBIA</option>
<option value="GEO">GEORGIA</option>
<option value="DEU">GERMANY</option>
<option value="GHA">GHANA</option>
<option value="GIB">GIBRALTAR</option>
<option value="GRC">GREECE</option>
<option value="GRL">GREENLAND</option>
<option value="GRD">GRENADA</option>
<option value="GLP">GUADELOUPE</option>
<option value="GUM">GUAM</option>
<option value="GTM">GUATEMALA</option>
<option value="GGY">GUERNSEY</option>
<option value="GIN">GUINEA</option>
<option value="GNB">GUINEA-BISSAU</option>
<option value="GUY">GUYANA</option>
<option value="HTI">HAITI</option>
<option value="HMD">HEARD ISLAND AND MCDONALD ISLANDS</option>
<option value="VAT">HOLY SEE (VATICAN CITY STATE)</option>
<option value="HND">HONDURAS</option>
<option value="HKG">HONG KONG</option>
<option value="HUN">HUNGARY</option>
<option value="ISL">ICELAND</option>
<option value="IND">INDIA</option>
<option value="IDN">INDONESIA</option>
<option value="IRN">IRAN, ISLAMIC REPUBLIC OF</option>
<option value="IRQ">IRAQ</option>
<option value="IRL">IRELAND</option>
<option value="IMN">ISLE OF MAN</option>
<option value="ISR">ISRAEL</option>
<option value="ITA">ITALY</option>
<option value="JAM">JAMAICA</option>
<option value="JPN">JAPAN</option>
<option value="JEY">JERSEY</option>
<option value="JOR">JORDAN</option>
<option value="KAZ">KAZAKHSTAN</option>
<option value="KEN">KENYA</option>
<option value="KIR">KIRIBATI</option>
<option value="PRK">KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF</option>
<option value="KOR">KOREA, REPUBLIC OF</option>
<option value="KVO">KOSOVO</option>
<option value="KWT">KUWAIT</option>
<option value="KGZ">KYRGYZSTAN</option>
<option value="LAO">LAO PEOPLE'S DEMOCRATIC REPUBLIC</option>
<option value="LVA">LATVIA</option>
<option value="LBN">LEBANON</option>
<option value="LSO">LESOTHO</option>
<option value="LBR">LIBERIA</option>
<option value="LBY">LIBYAN ARAB JAMAHIRIYA</option>
<option value="LIE">LIECHTENSTEIN</option>
<option value="LTU">LITHUANIA</option>
<option value="LUX">LUXEMBOURG</option>
<option value="MAC">MACAO</option>
<option value="MKD">MACEDONIA, NORTH</option>
<option value="MDG">MADAGASCAR</option>
<option value="MWI">MALAWI</option>
<option value="MYS">MALAYSIA</option>
<option value="MDV">MALDIVES</option>
<option value="MLI">MALI</option>
<option value="MLT">MALTA</option>
<option value="MTQ">MARTINIQUE</option>
<option value="MRT">MAURITANIA</option>
<option value="MUS">MAURITIUS</option>
<option value="MYT">MAYOTTE</option>
<option value="MEX">MEXICO</option>
<option value="MDA">MOLDOVA, REPUBLIC OF</option>
<option value="MCO">MONACO</option>
<option value="MNG">MONGOLIA</option>
<option value="MNE">MONTENEGRO</option>
<option value="MSR">MONTSERRAT</option>
<option value="MAR">MOROCCO</option>
<option value="MOZ">MOZAMBIQUE</option>
<option value="MMR">MYANMAR</option>
<option value="NAM">NAMIBIA</option>
<option value="NRU">NAURU</option>
<option value="NPL">NEPAL</option>
<option value="NLD">NETHERLANDS</option>
<option value="ANT">NETHERLANDS ANTILLES</option>
<option value="NCL">NEW CALEDONIA</option>
<option value="NZL">NEW ZEALAND</option>
<option value="NIC">NICARAGUA</option>
<option value="NER">NIGER</option>
<option value="NGA">NIGERIA</option>
<option value="NIU">NIUE</option>
<option value="NFK">NORFOLK ISLAND</option>
<option value="MNP">NORTHERN MARIANA ISLANDS</option>
<option value="NOR">NORWAY</option>
<option value="OMN">OMAN</option>
<option value="PAK">PAKISTAN</option>
<option value="PLW">PALAU</option>
<option value="PSE">PALESTINIAN TERRITORY, OCCUPIED</option>
<option value="PAN">PANAMA</option>
<option value="PNG">PAPUA NEW GUINEA</option>
<option value="PRY">PARAGUAY</option>
<option value="PER">PERU</option>
<option value="PHL">PHILIPPINES</option>
<option value="PCN">PITCAIRN</option>
<option value="POL">POLAND</option>
<option value="PRT">PORTUGAL</option>
<option value="PRI">PUERTO RICO</option>
<option value="QAT">QATAR</option>
<option value="MHL">Republic of the Marshall Islands (RMI)</option>
<option value="REU">RÉUNION</option>
<option value="ROU">ROMANIA</option>
<option value="RUS">RUSSIAN FEDERATION</option>
<option value="RWA">RWANDA</option>
<option value="BLM">SAINT BARTHÉLEMY</option>
<option value="SHN">SAINT HELENA, ASCENSION AND TRISTAN DA CUNHA</option>
<option value="KNA">SAINT KITTS AND NEVIS</option>
<option value="LCA">SAINT LUCIA</option>
<option value="MAF">SAINT MARTIN (FRENCH PART)</option>
<option value="SPM">SAINT PIERRE AND MIQUELON</option>
<option value="VCT">SAINT VINCENT AND THE GRENADINES</option>
<option value="WSM">SAMOA</option>
<option value="SMR">SAN MARINO</option>
<option value="STP">SAO TOME AND PRINCIPE</option>
<option value="SAU">SAUDI ARABIA</option>
<option value="SEN">SENEGAL</option>
<option value="SRB">SERBIA</option>
<option value="SYC">SEYCHELLES</option>
<option value="SLE">SIERRA LEONE</option>
<option value="SGP">SINGAPORE</option>
<option value="SVK">SLOVAKIA</option>
<option value="SVN">SLOVENIA</option>
<option value="SLB">SOLOMON ISLANDS</option>
<option value="SOM">SOMALIA</option>
<option value="ZAF">SOUTH AFRICA</option>
<option value="SGS">SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS</option>
<option value="ESP">SPAIN</option>
<option value="LKA">SRI LANKA</option>
<option value="STL">STATELESS</option>
<option value="SDN">SUDAN</option>
<option value="SUR">SURINAME</option>
<option value="SJM">SVALBARD AND JAN MAYEN</option>
<option value="SWE">SWEDEN</option>
<option value="CHE">SWITZERLAND</option>
<option value="SYR">SYRIAN ARAB REPUBLIC</option>
<option value="TWN">TAIWAN</option>
<option value="TJK">TAJIKISTAN</option>
<option value="TZA">TANZANIA, UNITED REPUBLIC OF</option>
<option value="THA">THAILAND</option>
<option value="TLS">TIMOR-LESTE</option>
<option value="TGO">TOGO</option>
<option value="TKL">TOKELAU</option>
<option value="TON">TONGA</option>
<option value="TTO">TRINIDAD AND TOBAGO</option>
<option value="TUN">TUNISIA</option>
<option value="TUR">TURKEY</option>
<option value="TKM">TURKMENISTAN</option>
<option value="TCA">TURKS AND CAICOS ISLANDS</option>
<option value="TUV">TUVALU</option>
<option value="UGA">UGANDA</option>
<option value="UKR">UKRAINE</option>
<option value="ARE">UNITED ARAB EMIRATES</option>
<option value="GBR">UNITED KINGDOM</option>
<option value="UMI">UNITED STATES MINOR OUTLYING ISLANDS</option>
<option value="URY">URUGUAY</option>
<option value="UZB">UZBEKISTAN</option>
<option value="VUT">VANUATU</option>
<option value="VEN">VENEZUELA, BOLIVARIAN REPUBLIC OF</option>
<option value="VNM">VIET NAM</option>
<option value="VGB">VIRGIN ISLANDS (BRITISH)</option>
<option value="VIR">VIRGIN ISLANDS (U.S.)</option>
<option value="WLF">WALLIS AND FUTUNA</option>
<option value="ESH">WESTERN SAHARA</option>
<option value="YEM">YEMEN</option>
<option value="ZMB">ZAMBIA</option>
<option value="ZWE">ZIMBABWE</option>
</select> <span class="required d-none d-md-inline">*</span>
<a class="tooltip aIssuingAuthorityA opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Issuing Authority-tooltip" class="tipIcon">
<span class="classic spanIssuingAuthorityA"></span>
</a>
<label data-valmsg-for-id="ListAIssuingAuthorityForI94" data-valmsg-for="ListADoc1IssuingAuthority" aria-live="polite"></label>
</td>
</tr>
<tr id="trListAIssuingAuthorityForDoc515" style="display: none;">
<td>
<label class="f-w900 f18-l24" for="ListAIssuingAuthorityForDoc515">Issuing Authority:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Issuing Authority-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Issuing Authority</span>
<span class="classic spanIssuingAuthorityA"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<select class="input-width-01 DDLBHeight" id="ListAIssuingAuthorityForDoc515" name="ListAIssuingAuthorityForDoc515" onchange="ListA_I94515_IssuingAuthority_SelectEvent(this)" placeholder="Required">
<option value=""><Select One></option>
<option value="USCIS">USCIS</option>
<option value="DOJ INS">DOJ INS</option>
</select> <span class="required d-none d-md-inline">*</span>
<a class="tooltip aIssuingAuthorityA opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Issuing Authority-tooltip" class="tipIcon">
<span class="classic spanIssuingAuthorityA"></span>
</a>
<label data-valmsg-for-id="ListAIssuingAuthorityForDoc515" data-valmsg-for="ListADoc1IssuingAuthority" aria-live="polite"></label>
</td>
</tr>
<tr id="blanktitle" style="display: none;">
<td>
<label id="blanklabel" class="f-w900 f18-l24">Issuing Authority:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Issuing Authority-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Issuing Authority</span>
<span class="classic spanIssuingAuthorityA"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td></td>
</tr>
<tr id="trListAIssuingAuthority535" style="display: none;">
<td>
<label class="f-w900 f18-l24" for="ListADoc2IssuingAuthorityDoc535">Issuing Authority:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Issuing Authority-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Issuing Authority</span>
<span class="classic spanIssuingAuthorityA"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<span id="spanListAIssuingAuthorityDoc535">
<select class="input-width-01 DDLBHeight" disabled="disabled " id="ListADoc2IssuingAuthorityDoc535" name="ListADoc2IssuingAuthorityDoc535" onchange="ListADoc535_IssuingAuthority_SelectEvent(this)" placeholder="Required">
<option value="U.S. Department of Homeland Security">U.S. Department of Homeland Security</option>
</select> </span> <span class="required d-none d-md-inline">*</span>
<a class="tooltip aIssuingAuthorityA opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Issuing Authority-tooltip" class="tipIcon">
<span class="classic spanIssuingAuthorityA"></span>
</a>
<label data-valmsg-for-id="spanListAIssuingAuthorityDoc535" data-valmsg-for="ListADoc1IssuingAuthority" aria-live="polite"></label>
</td>
</tr>
<tr id="ListADoc1Numbertr" class="trNormal trI551Passport">
<td>
<label id="lblPassport" class="f-w900 f18-l24">Passport </label>
<label class="lblI551_I94Docf-w900 f18-l24" style="display: none;">I-94 </label>
<label class="lblI551_Card f-w900 f18-l24" style="display: none;">Card Number:<span class="required d-md-none">*</span></label>
<label id="ListADoc1NumbertrLabel" class="lblI551_I94Doc f-w900 f18-l24" for="ListADoc1Number">Document #:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Document-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Document</span>
<span class="classic spanDoc1NumListA"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<input class="input-width-01" id="ListADoc1Number" name="ListADoc1Number" placeholder="Required" type="text" value="" style="font-style: italic;" autocomplete="off">
<span class="required d-none d-md-inline" style="display:">*</span>
<a class="tooltip aDoc1NumListA opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Document-tooltip" class="tipIcon">
<span class="classic spanDoc1NumListA"></span>
</a>
<label data-valmsg-for-id="ListADoc1Number" data-valmsg-for="ListADoc1Number" aria-live="polite"></label>
</td>
</tr>
<tr id="trListADoc1Expires" class="trNormal trI551Passport">
<td>
<div>
<label class="lblI551Passport f-w900 f18-l24" style="display: none;">Passport </label>
<label class="lblI551_I94Doc f-w900 f18-l24" style="display: none;">I-94 </label>
<label id="trListADoc1ExpiresLabel" class="f-w900 f18-l24" for="ListADoc1Expires">Expires:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Expires-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Expires</span>
<span> Enter the expiration date of the document you selected. <br>
<br> A document is not acceptable if it has already expired. An unexpired document includes a document where the expiration date shown on the face of a document has been automatically extended, such as for individuals
with Temporary Protected Status. <br>
<br> If the document does not have an expiration date, select N/A. </span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</div>
</td>
<td>
<div>
<div id="divListADoc1Expires">
<input class="trackerInputDate input-width-02 hasDatepicker" id="ListADoc1Expires" name="ListADoc1Expires" placeholder="MM/DD/YYYY" type="text" value="" style="font-style: italic;" autocomplete="off">
<span class="required requiredDate expiresListA d-none d-md-inline" style="margin:0px;">*</span>
<a class="tooltip aDoc1ExpiresListA opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="expires-tooltip" class="tipIcon">
<span class="classic spanDoc1ExpiresListA"></span>
<span class="classic spanDoc1ExpiresListA2" style="display:none;">
Enter the expiration date of the document you selected.
<br>
<br>
A document is not acceptable if it has already expired. An unexpired document includes a document where the expiration date shown on the face of a document has been automatically extended, such as for individuals with Temporary Protected Status.
<br>
<br>
If the document does not have an expiration date, select N/A.
</span>
</a>
<label data-valmsg-for-id="ListADoc1Expires" data-valmsg-for="ListADoc1Expires" aria-live="polite"></label>
</div>
<div style="margin-top:5px;" id="divListADoc1ExpiresNA">
<input type="checkbox" id="chkListADoc1ExpiresNA" class="chkExpiresNotApplicable noTriggerKsal chk-style-2"><span class="mleft5 ps-1 font-weight-20-normal">Not Applicable (N/A)</span>
<input type="hidden" name="ListADoc1ExpiresOptional" id="ListADoc1ExpiresOptional">
<input type="hidden" name="hidListADoc1ExpiresNotApplicable" id="hidListADoc1ExpiresNotApplicable" value="0">
</div>
<label id="lblASpace" for="chkListADoc1ExpiresNA"> </label>
</div>
</td>
</tr>
<tr class="trI551Stamp" style="display: none;">
<td>
<label id="lblI551Stamp" class="f-w900 f18-l24">Temporary I-551 Stamp</label>
<label id="lblI551MRIV" class="f-w900 f18-l24" style="display: none;">I-551 Printed Notation on a MRIV</label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Temporary I-551 Stamp-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Issuing Authority</span>
<span class="classic spanDoc2IssuingAuthorityA"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td></td>
</tr>
<tr class="trI94 doc94 doc73 docEAD trI551Stamp" id="trDocEAD" style="display: none;">
<td>
<label class="I94 f-w900 f18-l24" for="ListADoc2IssuingAuthority">I-94 Issuing Authority:<span class="required d-md-none">*</span></label>
<label class="I20EAD f-w900 f18-l24" style="display: none;">I-20 Issuing Authority:<span class="required d-md-none">*</span></label>
<label class="lblI551Stamp f-w900 f18-l24" style="display: none;">Issuing Authority:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Issuing Authority-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Issuing Authority</span>
<span class="classic spanDoc2IssuingAuthorityA"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<input id="ListADoc2Title" name="ListADoc2Title" type="hidden" value="">
<span id="spanListADoc2IssuingAuthority"><input class="input-width-01" id="ListADoc2IssuingAuthority" name="ListADoc2IssuingAuthority" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"></span>
<span id="spanListADoc2IssuingAuthorityI94" style="display: none;">
<select class="input-width-01 DDLBHeight" id="ListADoc2IssuingAuthorityI94" name="ListADoc2IssuingAuthorityI94" onchange="ListA_I94_IssuingAuthorityDoc2_SelectEvent(this)" placeholder="Required" style="width:206px;">
<option value=""><Select One></option>
<option value="U.S. Customs and Border Protection">U.S. Customs and Border Protection</option>
<option value="USCIS">USCIS</option>
</select> </span>
<span id="spanListADoc2IssuingAuthorityDoc732" style="display: none;">
<select class="input-width-01 DDLBHeight" id="ListADoc2IssuingAuthorityDoc732" name="ListADoc2IssuingAuthorityDoc732" onchange="ListADoc732_IssuingAuthority_SelectEvent(this)" placeholder="Required" style="width:206px;">
<option value=""><Select One></option>
<option value="U.S. Citizenship and Immigration Services">U.S. Citizenship and Immigration Services</option>
<option value="U.S. Customs and Border Protection">U.S. Customs and Border Protection</option>
</select> </span>
<span id="spanListADoc2IssuingAuthorityDoc533" style="display: none;">
<select class="input-width-01 DDLBHeight" id="ListADoc2IssuingAuthorityDoc533" name="ListADoc2IssuingAuthorityDoc533" onchange="ListADoc533_IssuingAuthority_SelectEvent(this)" placeholder="Required" style="width:206px;">
<option value=""><Select One></option>
<option value="U.S. Citizenship and Immigration Services">U.S. Citizenship and Immigration Services</option>
<option value="DOJ Immigration and Naturalization Services">DOJ Immigration and Naturalization Services</option>
</select> </span>
<span id="spanListADoc2IssuingAuthorityDoc534" style="display: none;">
<select class="input-width-01 DDLBHeight" disabled="disabled " id="ListADoc2IssuingAuthorityDoc534" name="ListADoc2IssuingAuthorityDoc534" onchange="ListADoc534_IssuingAuthority_SelectEvent(this)" placeholder="Required"
style="width:206px;">
<option value="U.S. Department of State">U.S. Department of State</option>
</select> </span> <span class="required d-none d-md-inline">*</span>
<a class="tooltip aDoc2IssuingAuthorityA opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Issuing Authority-tooltip" class="tipIcon">
<span class="classic spanDoc2IssuingAuthorityA"></span>
</a>
<label data-valmsg-for-id="ListADoc2IssuingAuthority" data-valmsg-for="ListADoc2IssuingAuthority" data-valmsg-for-id-match-type="all" aria-live="polite"></label>
<label data-valmsg-for-id="ListADoc2IssuingAuthorityI94" data-valmsg-for="ListADoc2IssuingAuthority" aria-live="polite"></label>
<label data-valmsg-for-id="ListADoc2IssuingAuthorityDoc732" data-valmsg-for="ListADoc2IssuingAuthority" aria-live="polite"></label>
<label data-valmsg-for-id="ListADoc2IssuingAuthorityDoc533" data-valmsg-for="ListADoc2IssuingAuthority" aria-live="polite"></label>
<label data-valmsg-for-id="ListADoc2IssuingAuthorityDoc534" data-valmsg-for="ListADoc2IssuingAuthority" aria-live="polite"></label>
</td>
</tr>
<tr class="trI94 doc94 doc73 docEAD trI551Stamp doc797" style="display: none;">
<td>
<label class="I94 f-w900 f18-l24" for="ListADoc2Number">I-94 Document #:<span class="required d-md-none">*</span></label>
<label class="I20EAD f-w900 f18-l24" style="display: none;">I-20 Document #:<span class="required d-md-none">*</span></label>
<label class="lblI551Stamp f-w900 f18-l24" style="display: none;">Temporary I-551 Document #:<span class="required d-none">*</span></label>
<label class="I797C f-w900 f18-l24" style="display: none;">Form I-797C Receipt Number :<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="I-94 Document #-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Document</span>
<span class="classic spanDoc2NumListA"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<input class="input-width-01" id="ListADoc2Number" name="ListADoc2Number" placeholder="Required" type="text" value="" style="font-style: italic;" autocomplete="off">
<span class="required lblOld lblI533Passport d-none d-md-inline" style="display:">*</span>
<a class="tooltip aDoc2NumListA opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="I-94 Document #-tooltip" class="tipIcon">
<span class="classic spanDoc2NumListA"></span>
</a>
<label data-valmsg-for-id="ListADoc2Number" data-valmsg-for="ListADoc2Number" aria-live="polite"></label>
</td>
</tr>
<tr class="trI94 doc94 doc73 trI551Stamp" id="trI94End" style="display: none;">
<td>
<label class="lblOld f-w900 f18-l24" for="ListADoc2Expires">I-94 Expires:<span class="required d-md-none">*</span></label>
<label class="lblI551Stamp f-w900 f18-l24" style="display: none;">Temporary I-551 Expires:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="I-94 Expires-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Expires</span>
<span class="classic spanDoc2ExpiresListA"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td style="vertical-align:top">
<div style="padding:1px;">
<input class="input-width-02 trackerInputDate hasDatepicker" id="ListADoc2Expires" name="ListADoc2Expires" placeholder="MM/DD/YYYY" type="text" value="" style="font-style: italic;" autocomplete="off">
<span class="required requiredDate d-none d-md-inline">*</span>
<a class="tooltip aDoc2ExpiresListA opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="I-94-Expires-tooltip" class="tipIcon">
<span class="classic spanDoc2ExpiresListA"></span>
</a>
</div>
<div style="padding-top:5px;display:none;" id="I94ExpiresDiv">
<input class="chk-style-2" id="I94ExpiresCheckbox" name="I94ExpiresCheckbox" type="checkbox" value="true"> <label class="mleft5" for="I94ExpiresCheckbox">N/A (Not Applicable)</label>
</div>
<div class="clear"></div>
<label data-valmsg-for-id="ListADoc2Expires" data-valmsg-for="ListADoc2Expires" style="display:block;" aria-live="polite"></label>
</td>
</tr>
<tr class="trI94" id="trAdditionalDocs" style="display: none;">
<td>
<label class="lblOld f-w900 f18-l24" for="ListAI94Type" id="ListAI94Type_label">Additional Documents:<span class="required d-md-none">*</span></label>
<label class="lblI551PassportType f-w900 f18-l24" style="display: none;">Temporary I-551 Type<span class="required d-md-none">*</span></label>
</td>
<td>
<div id="divNewAdd">
<div class="div-style-3 fleft w-100 mb-4 mb-md-0 divNewAdd-adddoc">
<input id="ListADoc3Title" name="ListADoc3Title" type="hidden" value="">
<span title="" class="k-widget k-dropdown k-header input-width-01" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="ListAI94Type_listbox" aria-labelledby="ListAI94Type_label"
aria-live="polite" aria-disabled="false" aria-busy="false" style="font-style: italic;"><span unselectable="on" class="k-dropdown-wrap k-state-default"><span unselectable="on" class="k-input"></span><span unselectable="on"
class="k-select" aria-label="select"><span class="k-icon k-i-arrow-60-down"></span></span></span><input class="input-width-01" id="ListAI94Type" name="ListAI94Type" type="text" value=""
style="font-style: italic; display: none;" autocomplete="off" data-role="dropdownlist"></span>
<script>
kendo.syncReady(function() {
jQuery("#ListAI94Type").kendoDropDownList({
"dataTextField": "Text",
"dataValueField": "Value",
"dataSource": []
});
});
</script>
<span class="required d-none d-md-inline" style="padding-left: 6px">*</span>
</div>
<a href="#" class="tooltip opacity-100 d-md-inline d-none" tabindex="0">
<img class="tipIcon" alt="Additional-Documents-tooltip" src="/Content/tracker/images/icon-info.png">
<span class="classic spanAdditionalTooltip">
Certain Foreign National employees may need to present additional documents in support of their List A document in order complete the employment eligibility verification process.
Use this drop-down menu to select the Additional Documents option that pertains to the Foreign employee. Then, enter the respective document number(s) and expiration date(s).
</span>
</a>
<label data-valmsg-for-id="ListAI94Type" data-valmsg-for="ListAI94Type" aria-live="polite"></label>
</div>
<label id="docAddVal"></label>
<div id="mainDivMobileAdditonalDoc" class="d-none">
<div class="mb-4 d-md-none list-a-selected">
<p id="pSelectedAdditionalDocumentListA" class="p-0">
<b>List A: </b><label id="divAdditionalListaSelectedDocument" class="pSelectedDocumentspan"></label>
</p>
</div>
<div id="DivMobileAdditinalDocPanel">
<img src="/Content/tracker/images/documents/ImageNotRequired.png" class="base64image" data-additionaldocname="0" data-originalfile="/Content/tracker/images/documents/single_additional_document.svg" data-addtionaldocname="0"
id="MobileAdditinalDocPanel" data-attachmentid="0" data-additionaldocid="0" data-parentadditionaldocid="0">
<input type="file" accept="image/*" name="fileToUpload" id="inpAAddtionalDoc" hidden="" capture="camera" aria-label="Attachment" data-docid="0" data-additionaldocid="0" data-parentadditionaldocid="0">
<div id="DivMobileAdditinalDocPicturePanel" class="mtop-5 d-none">
<img src="/Content/images/FormI9-Responsive/Icon-camera.svg" alt="camera">
<a id="take-picture-link-A-AdditionalDoc" class="ps-2" href="#!">
<label id="take-picture" class="take-picture">Take picture</label>
</a>
</div>
<div id="DivMobileAdditinalDocReTakePicturePanel" class="d-none mtop-5">
<img src="/Content/images/FormI9-Responsive/Icon-camera.svg" alt="camera" class="m-0">
<input type="button" id="AddtionalDocReTakeButon" onclick="ReTake(AddtionalDocReTakeButon)" data-attachmentid="0" value="Re-Take Picture" class="retake-picture-img"> <input type="button"
id="AddtionalDocDeleteButon" onclick="Delitem(this)" data-attachmentid="0" value="Delete" class="delete-picture-img">
</div>
</div>
</div>
</td>
</tr>
<tr class="trI94 DSOrI20" style="display: none;">
<td>
<label class="DS2019 f-w900 f18-l24">DS-2019 Issuing Authority:<span class="required d-md-none">*</span></label>
<label class="I20 f-w900 f18-l24" for="ListADoc3IssuingAuthority">I-20 Issuing Authority:<span class="required d-md-none">*</span></label>
</td>
<td>
<span class="DS2019"><input class="input-width-01" id="ListADoc3IssuingAuthority" name="ListADoc3IssuingAuthority" placeholder="Required" type="text" value="" style="font-style: italic;" autocomplete="off"></span>
<span class="I20">
<select class="input-width-01 DDLBHeight" id="ListADoc3IssuingAuthorityI94" name="ListADoc3IssuingAuthorityI94" onchange="ListA_I94_IssuingAuthorityDoc3_SelectEvent(this)" placeholder="Required" style="width:206px;">
<option value="U.S. Immigration and Customs Enforcement">U.S. Immigration and Customs Enforcement</option>
<option value="US DOJ INS">US DOJ INS</option>
</select> </span>
<span class="required d-none d-md-inline">*</span>
<label data-valmsg-for-id="ListADoc3IssuingAuthority" data-valmsg-for="ListADoc3IssuingAuthority" aria-live="polite"></label>
<label data-valmsg-for-id="ListADoc3IssuingAuthorityI94" data-valmsg-for="ListADoc3IssuingAuthority" aria-live="polite"></label>
</td>
</tr>
<tr class="trI94 DSOrI20" style="display: none;">
<td>
<label class="DS2019 f-w900 f18-l24">DS-2019 Document #:<span class="required d-md-none">*</span></label>
<label class="I20 f-w900 f18-l24" for="ListADoc3Number">I-20 Document #:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="I-20 Document-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Document</span>
<span class="classic" id="Ds2019I20Docspan">Enter the Form I-20 number (Student and Exchange Visitor Number - SEVIS Number). SEVIS Numbers must start with a letter followed by 10-11 numbers.</span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<input class="input-width-01" id="ListADoc3Number" name="ListADoc3Number" placeholder="Required" type="text" value="" style="font-style: italic;" autocomplete="off">
<span class="required d-none d-md-inline" style="display:">*</span>
<a class="tooltip opacity-100 d-md-inline d-none" style="display:none" href="#" id="DS2019I20doc" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="I-20-Document-tooltip" class="tipIcon">
<span class="classic" id="Ds2019I20Docspan">Enter the Form I-20 number (Student and Exchange Visitor Number - SEVIS Number). SEVIS Numbers must start with a letter followed by 10-11 numbers.</span>
</a>
<label data-valmsg-for-id="ListADoc3Number" data-valmsg-for="ListADoc3Number" aria-live="polite"></label>
</td>
</tr>
<tr class="trI94 doc766 listA3Date" style="display: none;">
<td>
<label class="H1B f-w900 f18-l24" for="ListAFilingDate">H-1B Filing Date:<span class="required d-md-none">*</span></label>
<label class="H2A f-w900 f18-l24">H2A Filling Date:<span class="required d-md-none">*</span></label>
<label class="Extension f-w900 f18-l24">Extension Filing Date:<span class="required d-md-none">*</span></label>
</td>
<td>
<input class="trackerInputDate input-width-02 hasDatepicker" id="ListAFilingDate" name="ListAFilingDate" placeholder="MM/DD/YYYY" type="text" value="" style="font-style: italic;" autocomplete="off">
<span class="required requiredDate d-none d-md-inline">*</span>
<label data-valmsg-for-id="ListAFilingDate" data-valmsg-for="ListAFilingDate" aria-live="polite"></label>
</td>
</tr>
<tr class="trI94 ReverificationDueDate listA3Date" style="display: none;">
<td>
<label for="ListADueDate" class="f-w900 f18-l24">Reverification Due Date:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Reverification Due Date-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Reverification Due Date</span>
<span class="classic spanDoc3ReverificationDueDateListA"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<input class="trackerInputDate input-width-02 hasDatepicker" id="ListADueDate" name="ListADueDate" placeholder="MM/DD/YYYY" type="text" value="" style="font-style: italic;" autocomplete="off">
<span class="required requiredDate d-none d-md-inline">*</span>
<a class="tooltip aDoc3ReverificationDueDateListA opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Reverification-Due-Date-tooltip" class="tipIcon">
<span class="classic spanDoc3ReverificationDueDateListA"></span>
</a>
<label data-valmsg-for-id="ListADueDate" data-valmsg-for="ListADueDate" aria-live="polite"></label>
</td>
</tr>
<tr class="trI94 DSOrI20 doc766 listA3Date" style="display: none;">
<td>
<label class="DS2019 f-w900 f18-l24" for="ListADoc3Expires">DS-2019 Expires:<span class="required d-md-none">*</span></label>
<label class="I20 f-w900 f18-l24">I-20 Expires:<span class="required d-md-none">*</span></label>
<label class="H2A f-w900 f18-l24">H2A Expires:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="expiry-date-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Expiry Date</span>
<span>Enter the work authorization end date from the Form I-20 as the expiry date.</span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<input class="trackerInputDate input-width-02 hasDatepicker" id="ListADoc3Expires" name="ListADoc3Expires" placeholder="MM/DD/YYYY" type="text" value="" style="font-style: italic;" autocomplete="off">
<span class="required requiredDate d-none d-md-inline" style="margin:0px;">*</span>
<a class="tooltip opacity-100 d-md-inline d-none" style="display:none" href="#" id="DS2019I20expire" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="expiry-date-tooltip" class="tipIcon">
<span class="classic" id="Ds2019I20Expiresspan">Enter the work authorization end date from the Form I-20 as the expiry date</span>
</a>
<label data-valmsg-for-id="ListADoc3Expires" data-valmsg-for="ListADoc3Expires" aria-live="polite"></label>
</td>
</tr>
<tr class="trAttachment d-none d-md-table-row">
<td>
<label for="ListAAttachmentNames" class="f-w900 f18-l24">Attachment</label>
</td>
<td>
<input id="ListAAttachmentIds" name="ListAAttachmentIds" type="hidden" value="">
<input aria-readonly="true" class="input-width-01 attachNameListA margin5Bot" id="ListAAttachmentNames" name="ListAAttachmentNames" readonly="readonly" type="text" value="" style="font-style: italic;" autocomplete="off">
<input type="button" value="View or Upload File" id="btn_attach_upload_DocListA" class="sectionupload font-size-2 mtop5 btn-style-6" aria-label="upload document list A">
<label data-valmsg-for-id="ListAAttachmentNames" data-valmsg-for="ListAAttachmentNames" aria-live="polite"></label>
</td>
</tr>
<tr class="trDocAReceiptProvided">
<td></td>
<td>
<div class="fleft chbReceiptProvided inputFullWidth">
<a href="#" class="tooltip receipt-provided" style="display: contents;" tabindex="0">
<input class="chk-style-2" data-val="true" data-val-required="The ListAReceiptProvided field is required." id="ListAReceiptProvided" name="ListAReceiptProvided" type="checkbox" value="false">
<span class="classic hidden">
According to USCIS, an acceptable receipt is not issued for the selected Document Type. Since receipts are not issued for this document, the receipt checkbox is disabled.
</span>
</a>
<label class="label-style-5 mleft5 d-md-inline width-93">
<label class="label-style-6" for="ListAReceiptProvided"> Employee presented an acceptable receipt in lieu <br>of an original document in List A </label>
<a href="#" class="tooltip vertical-style-1 opacity-100 d-md-inline d-none" tabindex="0">
<img class="tipIcon" alt="Employee presented an acceptable receipt in lieu tooltip" src="/Content/tracker/images/icon-info.png">
<span class="classic" style="top: -400px; width: 300px;font-weight: normal !important;">
If an employee is unable to present a required document, the employee can present an acceptable receipt in lieu of an original document (see Handbook for Employer, M-274 for additional USCIS guidance)<br>
<bl>If the employee provides an acceptable receipt, you should:</bl><br>
• Check the receipt checkbox and confirm the correct List Document (A, B or C) is selected<br>
• Enter the document number (if any) in the Document Number field<br>
• Enter the last day that the receipt is valid in the ‘Expires’ date field. Typically, receipts are valid for 90 days from the start date or, in the case of reverification, within 90 days from the date employment authorization expires.<br>
• Advise the employee to present the original document before the receipt expires.<br>
<bl>When the employee provides the original document, you should: </bl><br>
• Uncheck the receipt checkbox<br>
• Update the Issuing Authority, Expires date, and any other document information as necessary based upon the information in the new original document<br>
• Save and resign Section 2
</span>
</a>
</label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Employee presented an acceptable receipt-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content pb-5">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Employee presented an acceptable receipt in lieu <br>of an original document in List C</span>
<span> If an employee is unable to present a required document, the employee can present an acceptable receipt in lieu of an original document (see Handbook for Employer, M-274 for additional USCIS guidance)<br>
<bl>If the employee provides an acceptable receipt, you should:</bl><br> • Check the receipt checkbox and confirm the correct List Document (A, B or C) is selected<br> • Enter the document number (if any) in the
Document Number field<br> • Enter the last day that the receipt is valid in the ‘Expires’ date field. Typically, receipts are valid for 90 days from the start date or, in the case of reverification, within 90 days from
the date employment authorization expires.<br> • Advise the employee to present the original document before the receipt validity period expires.<br>
<bl>When the employee provides the original document, you should:</bl><br> • Uncheck the receipt checkbox<br> • Update the Issuing Authority, Expires date, and any other document information as necessary based upon the
information in the new original document<br> • Save and electronically amend Section 2
</span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</div>
<div class="clear"></div>
<label data-valmsg-for-id="ListAReceiptProvided" data-valmsg-for="ListAReceiptProvided" aria-live="polite"></label>
</td>
</tr>
<tr>
<td colspan="2">
<input type="hidden" value="0" id="DateMismatchWarningflag">
<div id="DateMismatchWarning" class="modal-body alert-block" style="display:none;padding:20px;line-height: 22px;font-size:12px;background-color:#F1F4F9;color:#22638B">
<div style="margin:10px 10px 15px 10px;"> The Authorized to Work Until Date in Section 1 does not match the Employment Authorization Document expiration date in Section 2. </div>
<div style="padding:0px 10px 15px 40px;line-height: 22px;font-size:12px;font-weight:bold">
<b style="color:#000000;">Section 1 Authorized to Work Until Date:</b> <label id="adate" style="color:#E87373;font-weight:bold;padding-left:20px;"></label><br>
<label id="datelabel0" style="font-size:12px;font-weight:bold;color:#000000;">Section 2 Employment Authorization</label> <br>
<label id="datelabel1" style="font-size:12px;font-weight:bold;padding-right:40px;color:#000000;">Document expiration date:</label>
<label id="datelabel2" style="font-size:12px;font-weight:bold;color:#000000;">Section 2 Reverification Due Date:</label>
<label id="edate" style="color:red;padding-left:55px;line-height:30px;color:#E87373 !important;"></label>
</div>
<div style="padding: 0px 10px 15px 10px; "> Please verify that you entered the correct expiration date for the Employment Authorization Document presented by the employee. <br><br> Was the correct date entered in Section 2?<br>
</div>
<br>
<div style="float:left;padding-left:40px;" class="date-mismatch-btn">
<input id="btnYes" type="button" value="Yes, I entered the correct date" class="btn-style-section2-3" style="background-color:#12CBD7 !important;padding:0px !important;width:230px !important;height:40px !important;"
aria-label="Yes, I entered the correct date">
</div>
<div style="float:right;padding-right:40px;" class="date-mismatch-btn">
<input id="btnNo" type="button" value="No, I misentered the date" class="btn-style-section2-3" style="padding:0px !important;width:230px !important;height:40px !important;" aria-label="No, I misentered the date">
</div>
</div>
<div id="DateMismatchWarningY" class="modal-body alert-block" style="display:none;padding:20px;line-height: 22px;font-size:12px;background-color:#F1F4F9;color:#22638B;">
<div> Form I-9 rules state the employment authorization expiration date provided by your employee in Section 1 may not match the document expiration date recorded under List A or List C in Section 2. The earlier date must be
used to determine when reverification is necessary. <br>
<br> Based upon the information provided by the employee in Section 1 and the documents presented for completion of Section 2, this employee has temporary work authorization until <label id="audate"
style="color:#E87373 !important;"></label>. The system will track this date for reverification. <br>
<br> Consider asking the employee if they misentered their Authorized to Work Until Date in Section 1. If the Section 1 date is incorrect, ask the employee to update the date value and complete the Form I-9 amendment process.
<br>
<br> Click Save/Validate Section 2 to Continue.
</div>
<br>
<div style="text-align: -webkit-center;" class="date-mismatch-btn">
<input id="btnConfirmY" type="button" value="Okay" class="btn-style-section2-3" style="background-color:#12CBD7 !important;padding:0px !important;width:200px !important;height:40px !important;" aria-label="Okay">
</div>
</div>
<div id="DateMismatchWarningN" class="modal-body alert-block" style="display:none;padding:20px;line-height: 22px;font-size:12px;color:#22638B;">
<div> The Section 2 Employment Authorization Date must be corrected Please click Okay to close this message, carefully inspect the Employment Authorization Document, and enter the correct Employment Authorization Document
expiration date. Then click the Save/Validate button to proceed.<br><br> Click Okay to Continue. </div>
<br>
<div style="text-align: -webkit-center;" class="date-mismatch-btn">
<input id="btnConfirmN" type="button" value="Okay" class="btn-style-section2-3" style="background-color:#12CBD7 !important;padding:0px !important;width:200px !important;height:40px !important;" aria-label="Okay">
</div>
</div>
</td>
</tr>
</tbody>
</table>
</fieldset>
<fieldset class="list-b-doc-fieldset listbadditional-table">
<legend hidden="">List B document information form</legend>
<table id="tableListB" cellspacing="0" cellpadding="0" border="0" class="table-style-01 fleft select-style-1 select-style-5 required-style-01 table-style-03 selected-document-amend-sec2 w-mobile-100 font-size-12" style="display: none;">
<tbody>
<tr class="doc-sel-2">
<td class="newUI-moduleLabel-2 p-0">
<div>2</div>
</td>
<td style="position: absolute; left: 9.5%; padding: 2px 0px;" class="list-b-doc-text">Select the <b>List B document</b> provided by the Employee and provide the document details:</td>
</tr>
<tr class="d-none list-B-table font-size-12 text-center">
<th class="width-90"></th>
<th>List B</th>
</tr>
<tr class="trDocB d-none d-md-table-row">
<td>
<label for="ListBDocumentTypeName" class="f-w900 f18-l24" id="ListBDocumentTypeName_label">Document Type: </label>
</td>
<td>
<div id="docNewB">
<span title="" class="k-widget k-dropdown k-header input-width-01 reSelect" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="ListBDocumentTypeName_listbox"
aria-labelledby="ListBDocumentTypeName_label" aria-live="polite" aria-disabled="false" aria-busy="false" aria-activedescendant="35c123d6-7ad1-4b3e-8f87-08fe0889d183" style="font-style: italic;"><span unselectable="on"
class="k-dropdown-wrap k-state-default"><span unselectable="on" class="k-input"><Select One></span><span unselectable="on" class="k-select" aria-label="select"><span
class="k-icon k-i-arrow-60-down"></span></span></span><input class="input-width-01 reSelect" id="ListBDocumentTypeName" name="ListBDocumentTypeName" type="text" value="" style="font-style: italic; display: none;"
autocomplete="off" data-role="dropdownlist"></span>
<script>
kendo.syncReady(function() {
jQuery("#ListBDocumentTypeName").kendoDropDownList({
"dataTextField": "Text",
"dataValueField": "Value",
"dataSource": [{
"Text": "<Select One>",
"Value": "",
"Selected": false
}]
});
});
</script> <span class="required d-none d-md-inline">*</span>
<input data-val="true" data-val-required="The ListBDocumentType field is required." id="ListBDocumentType" name="ListBDocumentType" type="hidden" value="0">
<a class="tooltip aListADocumentTypeB opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Document Type-tooltip" class="tipIcon">
<span class="classic aSpanListADocumentTypeB"></span>
</a>
<label data-valmsg-for-id="ListBDocumentTypeName" data-valmsg-for="ListBDocumentType"></label>
<label id="docBval"></label>
</div>
</td>
</tr>
<tr class="d-md-none">
<td colspan="2" class="mb-0">
<div>
<label class="f-w900 f18-l24">Attachment:<span class="required">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" alt="attachment-tooltip-description" class="tipIcon"></span>
<div class="pt-3">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Attachment</span>
<span>Attachment. </span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<img id="base64image" class="base64image" style="display:none;" alt="upload file">
<input type="file" accept="image/*" name="fileToUpload" hidden="" id="inpB" capture="camera" aria-label="Attachment">
<img src="/Content/images/FormI9-Responsive/Icon-camera.svg" alt="camera"><a id="take-picture-link-B" class="ps-2" href="#!"><label id="take-picture" class="take-picture">Take picture</label></a>
</div>
</td>
</tr>
<tr colspan="2" class="d-md-none sec2amend-takepic">
<td>
<div id="Section2BAttachmentPanel" class="mt-3"></div>
</td>
</tr>
<tr class="trDriverLicense" style="display: none;">
<td>
<label for="ListBIdTypes" class="f-w900 f18-l24" id="ListBIdTypes_label">Driver license/ID:<span class="required d-md-none">*</span></label>
</td>
<td>
<span title="" class="k-widget k-dropdown k-header input-width-01" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="ListBIdTypes_listbox" aria-labelledby="ListBIdTypes_label"
aria-live="polite" aria-disabled="false" aria-busy="false" aria-activedescendant="1d4c5e32-a49c-4585-8a31-fe6115a9c146" style="font-style: normal;"><span unselectable="on" class="k-dropdown-wrap k-state-default"><span
unselectable="on" class="k-input"><None></span><span unselectable="on" class="k-select" aria-label="select"><span class="k-icon k-i-arrow-60-down"></span></span></span><input class="input-width-01" data-val="true"
data-val-required="The ListBIdTypes field is required." id="ListBIdTypes" name="ListBIdTypes" type="text" value="0" style="font-style: italic; display: none;" autocomplete="off" data-role="dropdownlist"></span>
<script>
kendo.syncReady(function() {
jQuery("#ListBIdTypes").kendoDropDownList({
"dataTextField": "Text",
"dataValueField": "Value",
"value": "0",
"dataSource": [{
"Text": "<None>",
"Value": "",
"Selected": false
}, {
"Text": "Driver's License",
"Value": "1",
"Selected": false
}, {
"Text": "ID Card",
"Value": "3",
"Selected": false
}]
});
});
</script>
<span class="required requiredDate">*</span>
<br>
<label data-valmsg-for-id="ListBIdTypes" data-valmsg-for="ListBIdTypes" aria-live="polite"></label>
</td>
</tr>
<tr class="trDriverLicense" style="display: none;">
<td>
<label for="ListBState" class="f-w900 f18-l24" id="ListBState_label">State:<span class="required d-md-none">*</span></label>
</td>
<td>
<span title="" class="k-widget k-dropdown k-header input-width-01" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="ListBState_listbox" aria-labelledby="ListBState_label"
aria-live="polite" aria-disabled="false" aria-busy="false" aria-activedescendant="72f27e6e-5fab-4385-b07d-0960fc9b13f4" style="font-style: italic;"><span unselectable="on" class="k-dropdown-wrap k-state-default"><span
unselectable="on" class="k-input"><None></span><span unselectable="on" class="k-select" aria-label="select"><span class="k-icon k-i-arrow-60-down"></span></span></span><input class="input-width-01" id="ListBState"
name="ListBState" type="text" value="" style="font-style: italic; display: none;" autocomplete="off" data-role="dropdownlist"></span>
<script>
kendo.syncReady(function() {
jQuery("#ListBState").kendoDropDownList({
"dataTextField": "Text",
"dataValueField": "Value",
"dataSource": [{
"Text": "<None>",
"Value": "",
"Selected": false
}, {
"Text": "Alabama",
"Value": "AL",
"Selected": false
}, {
"Text": "Alaska",
"Value": "AK",
"Selected": false
}, {
"Text": "America Samoa",
"Value": "AS",
"Selected": false
}, {
"Text": "Arizona",
"Value": "AZ",
"Selected": false
}, {
"Text": "Arkansas",
"Value": "AR",
"Selected": false
}, {
"Text": "California",
"Value": "CA",
"Selected": false
}, {
"Text": "Colorado",
"Value": "CO",
"Selected": false
}, {
"Text": "Connecticut",
"Value": "CT",
"Selected": false
}, {
"Text": "Delaware",
"Value": "DE",
"Selected": false
}, {
"Text": "District of Columbia",
"Value": "DC",
"Selected": false
}, {
"Text": "Florida",
"Value": "FL",
"Selected": false
}, {
"Text": "Georgia",
"Value": "GA",
"Selected": false
}, {
"Text": "Guam",
"Value": "GU",
"Selected": false
}, {
"Text": "Hawaii",
"Value": "HI",
"Selected": false
}, {
"Text": "Idaho",
"Value": "ID",
"Selected": false
}, {
"Text": "Illinois",
"Value": "IL",
"Selected": false
}, {
"Text": "Indiana",
"Value": "IN",
"Selected": false
}, {
"Text": "Iowa",
"Value": "IA",
"Selected": false
}, {
"Text": "Kansas",
"Value": "KS",
"Selected": false
}, {
"Text": "Kentucky",
"Value": "KY",
"Selected": false
}, {
"Text": "Louisiana",
"Value": "LA",
"Selected": false
}, {
"Text": "Maine",
"Value": "ME",
"Selected": false
}, {
"Text": "Maryland",
"Value": "MD",
"Selected": false
}, {
"Text": "Massachusetts",
"Value": "MA",
"Selected": false
}, {
"Text": "Michigan",
"Value": "MI",
"Selected": false
}, {
"Text": "Minnesota",
"Value": "MN",
"Selected": false
}, {
"Text": "Mississippi",
"Value": "MS",
"Selected": false
}, {
"Text": "Missouri",
"Value": "MO",
"Selected": false
}, {
"Text": "Montana",
"Value": "MT",
"Selected": false
}, {
"Text": "Nebraska",
"Value": "NE",
"Selected": false
}, {
"Text": "Nevada",
"Value": "NV",
"Selected": false
}, {
"Text": "New Hampshire",
"Value": "NH",
"Selected": false
}, {
"Text": "New Jersey",
"Value": "NJ",
"Selected": false
}, {
"Text": "New Mexico",
"Value": "NM",
"Selected": false
}, {
"Text": "New York",
"Value": "NY",
"Selected": false
}, {
"Text": "North Carolina",
"Value": "NC",
"Selected": false
}, {
"Text": "North Dakota",
"Value": "ND",
"Selected": false
}, {
"Text": "Northern Mariana Islands",
"Value": "MP",
"Selected": false
}, {
"Text": "Ohio",
"Value": "OH",
"Selected": false
}, {
"Text": "Oklahoma",
"Value": "OK",
"Selected": false
}, {
"Text": "Oregon",
"Value": "OR",
"Selected": false
}, {
"Text": "Pennsylvania",
"Value": "PA",
"Selected": false
}, {
"Text": "Puerto Rico",
"Value": "PR",
"Selected": false
}, {
"Text": "Rhode Island",
"Value": "RI",
"Selected": false
}, {
"Text": "South Carolina",
"Value": "SC",
"Selected": false
}, {
"Text": "South Dakota",
"Value": "SD",
"Selected": false
}, {
"Text": "Tennessee",
"Value": "TN",
"Selected": false
}, {
"Text": "Texas",
"Value": "TX",
"Selected": false
}, {
"Text": "Utah",
"Value": "UT",
"Selected": false
}, {
"Text": "Vermont",
"Value": "VT",
"Selected": false
}, {
"Text": "Virgin Islands Of The U.S.",
"Value": "VI",
"Selected": false
}, {
"Text": "Virginia",
"Value": "VA",
"Selected": false
}, {
"Text": "Washington",
"Value": "WA",
"Selected": false
}, {
"Text": "West Virginia",
"Value": "WV",
"Selected": false
}, {
"Text": "Wisconsin",
"Value": "WI",
"Selected": false
}, {
"Text": "Wyoming",
"Value": "WY",
"Selected": false
}]
});
});
</script> <span class="required requiredDate d-none d-md-inline">*</span>
<br>
<label data-valmsg-for-id="ListBState" data-valmsg-for="ListBState" aria-live="polite"></label>
</td>
</tr>
<tr class="trDocB trListBDocumentTitle" style="display: none;">
<td>
<label for="ListBDoc1DocumentTitle" class="f-w900 f18-l24">Document Title:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Document Name-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Document Title</span>
<span class="classic spanDocumentTitleB"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<input class="input-width-01" id="ListBDocumentTitle" name="ListBDocumentTitle" placeholder="Required" type="text" value="" style="font-style: italic;" autocomplete="off">
</td>
</tr>
<tr class="trDocB">
<td>
<label for="ListBDoc1IssuingAuthority" class="f-w900 f18-l24">Issuing Authority:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Issuing Authority-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Issuing Authority</span>
<span class="classic spanIssuingAuthorityB"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<span id="spanListBIssuingAuthority">
<input class="input-width-01" id="ListBDoc1IssuingAuthority" name="ListBDoc1IssuingAuthority" placeholder="Required" type="text" value="" style="font-style: italic;" autocomplete="off">
<span title="" class="k-widget k-dropdown k-header input-width-01" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="ListBDoc1IssuingAuthorityForDropdown_listbox"
aria-labelledby="ListBDoc1IssuingAuthorityForDropdown_label" aria-live="polite" aria-disabled="false" aria-busy="false" aria-activedescendant="d67ab052-a20c-4ed4-babe-622e91a9c2b4"
style="font-style: normal; display: none;"><span unselectable="on" class="k-dropdown-wrap k-state-default"><span unselectable="on" class="k-input"> <Select One> </span><span unselectable="on" class="k-select"
aria-label="select"><span class="k-icon k-i-arrow-60-down"></span></span></span><input class="input-width-01" id="ListBDoc1IssuingAuthorityForDropdown" name="ListBDoc1IssuingAuthorityForDropdown" type="text"
value=" <Select One> " style="font-style: italic; display: none;" autocomplete="off" data-role="dropdownlist"></span>
<script>
kendo.syncReady(function() {
jQuery("#ListBDoc1IssuingAuthorityForDropdown").kendoDropDownList({
"dataTextField": "Text",
"dataValueField": "Value",
"value": " \u003cSelect One\u003e ",
"dataSource": [{
"Text": " <Select One> ",
"Value": " <Select One> ",
"Selected": true
}, {
"Text": "Alberta",
"Value": "Alberta",
"Selected": false
}, {
"Text": "British Columbia",
"Value": "British Columbia",
"Selected": false
}, {
"Text": "Manitoba",
"Value": "Manitoba",
"Selected": false
}, {
"Text": "New Brunswick",
"Value": "New Brunswick",
"Selected": false
}, {
"Text": "Newfoundland and Labrador",
"Value": "Newfoundland and Labrador",
"Selected": false
}, {
"Text": "Northwest Territories",
"Value": "Northwest Territories",
"Selected": false
}, {
"Text": "Nova Scotia",
"Value": "Nova Scotia",
"Selected": false
}, {
"Text": "Nunavut",
"Value": "Nunavut",
"Selected": false
}, {
"Text": "Ontario",
"Value": "Ontario",
"Selected": false
}, {
"Text": "Prince Edward Island",
"Value": "Prince Edward Island",
"Selected": false
}, {
"Text": "Quebec",
"Value": "Quebec",
"Selected": false
}, {
"Text": "Saskatchewan",
"Value": "Saskatchewan",
"Selected": false
}, {
"Text": "Yukon",
"Value": "Yukon",
"Selected": false
}]
});
});
</script>
</span>
<span id="spanListBIssuingAuthorityList" style="display: none;">
<select aria-label="Issuing Authority" class="input-width-01 DDLBHeight" id="DropdownListBIssuingAuthority" name="DropdownListBIssuingAuthority" onchange="ListB_IssuingAuthority_SelectEvent(this)" placeholder="Required"
style="width:206px;">
<option value=""><None></option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AS">America Samoa</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="GU">Guam</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="MP">Northern Mariana Islands</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="PR">Puerto Rico</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VI">Virgin Islands Of The U.S.</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
</select> </span>
<span class="required d-none d-md-inline">*</span>
<a class="tooltip aIssuingAuthorityB opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Issuing Authority-tooltip" class="tipIcon">
<span class="classic spanIssuingAuthorityB"></span>
</a>
<label class="issues-auth-label" data-valmsg-for-id="ListBDoc1IssuingAuthority" data-valmsg-for="ListBDoc1IssuingAuthority" aria-live="polite"></label>
<label class="issues-auth-label" data-valmsg-for-id="ListBDoc1IssuingAuthorityForDropdown" data-valmsg-for="ListBDoc1IssuingAuthority" for="ListBDoc1IssuingAuthorityForDropdown" aria-live="polite"
id="ListBDoc1IssuingAuthorityForDropdown_label"></label>
<label class="issues-auth-label" data-valmsg-for-id="DropdownListBIssuingAuthority" data-valmsg-for="ListBDoc1IssuingAuthority" aria-live="polite"></label>
</td>
</tr>
<tr class="trDocB">
<td>
<label for="ListBDoc1Number" class="f-w900 f18-l24">Document #:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Document #-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Document</span>
<span class="classic spanDoc1NumListB"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<input class="input-width-01" id="ListBDoc1Number" name="ListBDoc1Number" placeholder="Required" type="text" value="" style="font-style: italic;" autocomplete="off">
<span class="required d-none d-md-inline" style="display:">*</span>
<a class="tooltip aDoc1NumListB opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Document #-tooltip" class="tipIcon">
<span class="classic spanDoc1NumListB"></span>
</a>
<label data-valmsg-for-id="ListBDoc1Number" data-valmsg-for="ListBDoc1Number" aria-live="polite"></label>
</td>
</tr>
<tr id="trListBDoc1Expires" class="trDocB">
<td class="vertical-align-top">
<div>
<label for="ListBDoc1Expires" class="f-w900 f18-l24">Expires:<span class="required d-md-none">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Expires-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Expires</span>
<span class="classic spanDoc1ExpiresListB"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</div>
</td>
<td>
<div style="display: inline-block" class="w-mobile-100">
<div id="divListBDoc1Expires">
<input class="input-width-02 trackerInputDate hasDatepicker" id="ListBDoc1Expires" name="ListBDoc1Expires" placeholder="MM/DD/YYYY" type="text" value="" style="font-style: italic;" autocomplete="off">
<span class="required requiredDate expiresListB d-none d-md-inline" style=" margin-left:0px">*</span>
<label data-valmsg-for-id="ListBDoc1Expires" data-valmsg-for="ListBDoc1Expires" aria-live="polite"></label>
</div>
<label id="lblBSpace" style="display:inline-block; width:75px;"> </label>
</div>
<a class="tooltip aDoc1ExpiresListB opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Expires-tooltip" class="tipIcon">
<span class="classic spanDoc1ExpiresListB"></span>
<span class="classic spanDoc1ExpiresListB2" style="display:none;">
Enter the expiration date of the document you selected.
<br>
<br>
A document is not acceptable if it has already expired. An unexpired document includes a document where the expiration date shown on the face of a document has been automatically extended, such as for individuals with Temporary Protected Status.
<br>
<br>
If the document does not have an expiration date, select N/A.
</span>
</a>
<div style="margin-top:15px;" id="divListBDoc1ExpiresNA">
<input type="checkbox" id="chkListBDoc1ExpiresNA" class="chkExpiresNotApplicable noTriggerKsal chk-style-2" aria-label="Not Applicable (N/A)"><span class="mleft5 ps-1 font-weight-20-normal">Not Applicable (N/A)</span>
<input type="hidden" name="ListBDoc1ExpiresOptional" id="ListBDoc1ExpiresOptional">
<input type="hidden" name="hidListBDoc1ExpiresNotApplicable" id="hidListBDoc1ExpiresNotApplicable" value="0">
</div>
<div style="display: none;" id="divChkAutoExtended">
<input type="checkbox" id="chkAutoExtended" class="chk-style-2"><label class="mleft5" for="chkAutoExtended">Auto-Extended Document</label>
<input type="hidden" id="hiddenAutoExtended" value="">
</div>
<div style="display: none;" id="divChkCOVID19Receipt">
<input type="checkbox" id="chkCOVID19Receipt" class="chk-style-2"><label class="mleft5" for="chkCOVID19Receipt">COVID-19 Receipt</label>
<input type="hidden" id="hiddenCOVID19Receipt" value="">
<a class="tooltip aDoc1ExpiresListB opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="COVID-19-Receipt" class="tipIcon">
<span class="classic">List B documents that expired on or after March 1, 2020 should be treated as an acceptable receipt per DHS policy changes adopted as a response to the COVID-19 pandemic. Within 90 days after DHS’s termination of this temporary policy, the employee will be required to present a valid unexpired document. Note: Per DHS guidelines, it is best if the employee can present the replacement of the actual document that was expired, but if necessary, the employee may choose to present a different List A or List B document or documents and record the new document information in the Additional Information Field. </span>
</a>
</div>
</td>
</tr>
<tr class="trAttachment d-none d-md-table-row">
<td>
<label for="ListBAttachmentNames" class="f-w900 f18-l24">Attachment</label>
</td>
<td>
<input id="ListBAttachmentIds" name="ListBAttachmentIds" type="hidden" value="">
<input class="input-width-01 attachNameListB" id="ListBAttachmentNames" name="ListBAttachmentNames" readonly="readonly" type="text" value="" style="font-style: italic;" autocomplete="off">
<input type="button" id="btn_attach_upload_DocListB" value="View or Upload File" class="font-size-2 btn-style-6 mtop5 sectionupload" aria-label="upload document list B">
<label data-valmsg-for-id="ListBAttachmentNames" data-valmsg-for="ListBAttachmentNames" aria-live="polite"></label>
</td>
</tr>
<tr id="trUnder18" style="display: none;">
<td colspan="2">
<label class="Instructions f-w900 f18-l24">* Not a document</label>
</td>
</tr>
<tr class="trDocB trDocBReceiptProvided">
<td></td>
<td>
<div class="fleft chbReceiptProvided inputFullWidth">
<a href="#" class="tooltip receipt-provided" style="display: contents;" tabindex="0">
<input class="chk-style-2" data-val="true" data-val-required="The ListBReceiptProvided field is required." id="ListBReceiptProvided" name="ListBReceiptProvided" type="checkbox" value="false">
<span class="classic hidden">
According to USCIS, an acceptable receipt is not issued for the selected Document Type. Since receipts are not issued for this document, the receipt checkbox is disabled.
</span>
</a>
<label class="label-style-5 mleft5 d-md-inline width-93">
<label class="label-style-6 doc-accect-check" for="ListBReceiptProvided">Employee presented an acceptable receipt in lieu <br>of an original document in List B</label>
<a href="#" class="tooltip vertical-style-1 opacity-100 d-md-inline d-none" tabindex="0">
<img class="tipIcon" alt="Employee-presented-acceptable-receipt-in-lieu" src="/Content/tracker/images/icon-info.png">
<span class="classic" style="top: -430px">
If an employee is unable to present a required document, the employee can present an acceptable receipt in lieu of an original document (see Handbook for Employer, M-274 for additional USCIS guidance)<br>
<bl>If the employee provides an acceptable receipt, you should:</bl><br>
• Check the receipt checkbox and confirm the correct List Document (A, B or C) is selected<br>
• Enter the document number (if any) in the Document Number field<br>
• Enter the last day that the receipt is valid in the ‘Expires’ date field. Typically, receipts are valid for 90 days from the start date or, in the case of reverification, within 90 days from the date employment authorization expires.<br>
• Advise the employee to present the original document before the receipt validity period expires.<br>
<bl>When the employee provides the original document, you should:</bl><br>
• Uncheck the receipt checkbox<br>
• Update the Issuing Authority, Expires date, and any other document information as necessary based upon the information in the new original document<br>
• Save and electronically amend Section 2
</span>
</a>
</label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Employee presented an acceptable receipt-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content pb-5">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Employee presented an acceptable receipt in lieu <br>of an original document in List C</span>
<span> If an employee is unable to present a required document, the employee can present an acceptable receipt in lieu of an original document (see Handbook for Employer, M-274 for additional USCIS guidance)<br>
<bl>If the employee provides an acceptable receipt, you should:</bl><br> • Check the receipt checkbox and confirm the correct List Document (A, B or C) is selected<br> • Enter the document number (if any) in the
Document Number field<br> • Enter the last day that the receipt is valid in the ‘Expires’ date field. Typically, receipts are valid for 90 days from the start date or, in the case of reverification, within 90 days from
the date employment authorization expires.<br> • Advise the employee to present the original document before the receipt validity period expires.<br>
<bl>When the employee provides the original document, you should:</bl><br> • Uncheck the receipt checkbox<br> • Update the Issuing Authority, Expires date, and any other document information as necessary based upon the
information in the new original document<br> • Save and electronically amend Section 2
</span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</div>
<div class="clear"></div>
<label data-valmsg-for-id="ListBReceiptProvided" data-valmsg-for="ListBReceiptProvided" aria-live="polite"></label>
</td>
</tr>
</tbody>
</table>
</fieldset>
<fieldset class="listbadditional-table">
<legend hidden="">List C document information form</legend>
<table id="tableListC" cellspacing="0" cellpadding="0" border="0" class="table-style-01 fleft select-style-1 select-style-5 required-style-01 table-style-03 selected-document-amend-sec2 w-mobile-100 font-size-12 tableListC-old"
style="display: none;">
<tbody>
<tr class="doc-sel-2">
<td class="newUI-moduleLabel-2 p-0">
<div>3</div>
</td>
<td style="position: absolute; left: 9.5%; padding: 2px 0;" class="list-c-doc-text">Select the <b>List C document</b> provided by the Employee and provide the document details:</td>
</tr>
<tr class="d-none list-C-table font-size-12 text-center">
<th>List C</th>
</tr>
<tr class="d-none d-md-table-row">
<td class="listc-label">
<label for="ListCDocumentTypeName" class="f-w900 f18-l24" id="ListCDocumentTypeName_label">Document Type: </label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Document #-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Document Type</span>
<span class="classic aSpanListADocumentTypeC"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<div id="docNewC">
<span title="" class="k-widget k-dropdown k-header input-width-01 reSelect" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="ListCDocumentTypeName_listbox"
aria-labelledby="ListCDocumentTypeName_label" aria-live="polite" aria-disabled="false" aria-busy="false" aria-activedescendant="d9325e28-9205-47d8-93e2-9d813a54b8e2" style="font-style: italic;"><span unselectable="on"
class="k-dropdown-wrap k-state-default"><span unselectable="on" class="k-input"><Select One></span><span unselectable="on" class="k-select" aria-label="select"><span
class="k-icon k-i-arrow-60-down"></span></span></span><input class="input-width-01 reSelect" id="ListCDocumentTypeName" name="ListCDocumentTypeName" type="text" value="" style="font-style: italic; display: none;"
autocomplete="off" data-role="dropdownlist"></span>
<script>
kendo.syncReady(function() {
jQuery("#ListCDocumentTypeName").kendoDropDownList({
"dataTextField": "Text",
"dataValueField": "Value",
"dataSource": [{
"Text": "<Select One>",
"Value": "",
"Selected": false
}]
});
});
</script> <span class="required d-none d-md-inline">*</span>
<input data-val="true" data-val-required="The ListCDocumentType field is required." id="ListCDocumentType" name="ListCDocumentType" type="hidden" value="0">
<a class="tooltip aListADocumentTypeC opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Document Type-tooltip" class="tipIcon">
<span class="classic aSpanListADocumentTypeC"></span>
</a>
<label data-valmsg-for-id="ListCDocumentTypeName" data-valmsg-for="ListCDocumentType"></label>
<label id="docCVal"></label>
</div>
</td>
</tr>
<tr class="d-md-none">
<td colspan="2" class="mb-0">
<div>
<label class="f-w900 f18-l24">Attachment:<span class="required">*</span></label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" alt="attachment-tooltip-description" class="tipIcon"></span>
<div class="pt-3">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Attachment</span>
<span>Attachment. </span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<img id="base64image" class="base64image" style="display:none;" alt="upload file">
<input type="file" accept="image/*" name="fileToUpload" id="inpC" hidden="" capture="camera" aria-label="Attachment">
<img src="/Content/images/FormI9-Responsive/Icon-camera.svg" alt="camera"><a id="take-picture-link-C" class="ps-2" href="#!"><label id="take-picture" class="take-picture">Take picture</label></a>
</div>
</td>
</tr>
<tr class="d-md-none sec2amend-takepic">
<td colspan="2">
<div id="Section2CAttachmentPanel" class="mt-3"></div>
</td>
</tr>
<tr id="trListCDocumentTitle" class="trListCDocumentTitle" style="display: none;">
<td class="listc-label">
<label for="ListCDocumentTitle" class="f-w900 f18-l24">Document Title:<span class="required d-md-none">*</span> </label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Document #-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Document Title</span>
<span class="classic">Enter the Document Title of the DHS Employment Authorization Document.</span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<input class="input-width-01" id="ListCDocumentTitle" name="ListCDocumentTitle" placeholder="Required" type="text" value="" style="font-style: italic;" autocomplete="off">
<span class="required d-none d-md-inline">*</span>
<a class="tooltip aDocumentTitleC opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Issuing Authority-tooltip" class="tipIcon">
<span class="classic spanDocumentTitleC">
Enter the Document Title of the DHS Employment Authorization Document.
</span>
</a>
<label data-valmsg-for-id="ListCDocumentTitle" data-valmsg-for="ListCDocumentTitle" aria-live="polite"></label>
</td>
</tr>
<tr id="trListCIssuingAuthority">
<td class="listc-label">
<label for="ListCDoc1IssuingAuthority" class="f-w900 f18-l24">Issuing Authority:<span class="required d-md-none">*</span> </label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Document #-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Issuing Authority</span>
<span class="classic spanIssuingAuthorityC"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<input class="input-width-01" id="ListCDoc1IssuingAuthority" name="ListCDoc1IssuingAuthority" placeholder="Required" type="text" value="" style="font-style: italic;" autocomplete="off">
<span class="required d-none d-md-inline">*</span>
<a class="tooltip aIssuingAuthorityC opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Issuing Authority-tooltip" class="tipIcon">
<span class="classic spanIssuingAuthorityC"></span>
</a>
<label data-valmsg-for-id="ListCDoc1IssuingAuthority" data-valmsg-for="ListCDoc1IssuingAuthority" aria-live="polite"></label>
</td>
</tr>
<tr id="trListCIssuingAuthorityForSSN" style="display: none;">
<td class="listc-label">
<label for="ListCDoc1IssuingAuthorityForSSN" class="f-w900 f18-l24">Issuing Authority:<span class="required d-md-none">*</span> </label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Document #-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Issuing Authority</span>
<span class="classic spanIssuingAuthorityC"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<select class="input-width-01 DDLBHeight" id="ListCDoc1IssuingAuthorityForSSN" name="ListCDoc1IssuingAuthorityForSSN" onchange="ListC_SSN_IssuingAuthority_SelectEvent(this)" placeholder="Required" style="width:206px;">
<option value="Social Security Administration">Social Security Administration</option>
<option value="U.S Dept. of Health and Human Services">U.S Dept. of Health and Human Services</option>
<option value="Social Security Board">Social Security Board</option>
<option value="Dept. of Health, Education, and Welfare">Dept. of Health, Education, and Welfare</option>
</select> <span class="required d-none d-md-inline">*</span>
<a class="tooltip aIssuingAuthorityC opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Issuing Authority-tooltip" class="tipIcon">
<span class="classic spanIssuingAuthorityC"></span>
</a>
<label data-valmsg-for-id="ListCDoc1IssuingAuthorityForSSN" data-valmsg-for="ListCDoc1IssuingAuthority" aria-live="polite"></label>
</td>
</tr>
<tr class="d-md-table-row">
<td class="listc-label">
<label for="ListCDoc1Number" class="f-w900 f18-l24">Document#:<span class="required d-md-none">*</span> </label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Document #-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Document</span>
<span class="classic spanDoc1NumListC"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<input class="input-width-01" id="ListCDoc1Number" name="ListCDoc1Number" placeholder="Required" type="text" value="" style="font-style: italic;" autocomplete="off">
<span class="required d-none d-md-inline" style="display:">*</span>
<a class="tooltip aDoc1NumListC opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Document#-tooltip" class="tipIcon">
<span class="classic spanDoc1NumListC"></span>
</a>
<label data-valmsg-for-id="ListCDoc1Number" data-valmsg-for="ListCDoc1Number" aria-live="polite"></label>
</td>
</tr>
<tr id="trListCDoc1Expires" class="d-md-table-row">
<td class="listc-label">
<label for="ListCDoc1Expires" class="f-w900 f18-l24">Expires:<span class="required d-md-none expires-astrerisk">*</span> </label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Expires-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Expires</span>
<span class="classic spanDoc1ExpiresListC"></span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</td>
<td>
<div style="display:inline-block" class="w-mobile-100">
<div id="divListCDoc1Expires">
<input class="trackerInputDate input-width-02 hasDatepicker" id="ListCDoc1Expires" name="ListCDoc1Expires" placeholder="MM/DD/YYYY" type="text" value="" style="font-style: italic;" autocomplete="off">
<span class="required requiredDate expiresListC d-none" style="margin:0px;">*</span>
<label data-valmsg-for-id="ListCDoc1Expires" data-valmsg-for="ListCDoc1Expires" aria-live="polite"></label>
</div>
<label id="lblCSpace" style="display:inline-block; width:75px;"> </label>
</div>
<a class="tooltip aDoc1ExpiresListC opacity-100 d-md-inline d-none" href="#" style="display: none;" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" alt="Expires-tooltip" class="tipIcon">
<span class="classic spanDoc1ExpiresListC"></span>
<span class="classic spanDoc1ExpiresListC2" style="display:none;">
Enter the expiration date of the document you selected.
<br>
<br>
A document is not acceptable if it has already expired. An unexpired document includes a document where the expiration date shown on the face of a document has been automatically extended, such as for individuals with Temporary Protected Status.
<br>
<br>
If the document does not have an expiration date, select N/A.
</span>
</a>
<div style="margin-top:5px;" id="divListCDoc1ExpiresNA">
<input type="checkbox" id="chkListCDoc1ExpiresNA" class="chkExpiresNotApplicable noTriggerKsal chk-style-2" aria-label="Not Applicable (N/A)"><span class="mleft5 ps-1 font-weight-20-normal">Not Applicable (N/A)</span>
<input type="hidden" name="hidListCDoc1ExpiresNotApplicable" id="hidListCDoc1ExpiresNotApplicable" value="0">
<input type="hidden" name="ListCDoc1ExpiresOptional" id="ListCDoc1ExpiresOptional">
</div>
</td>
</tr>
<tr class="d-none d-md-table-row">
<td class="listc-label">
<label for="ListCAttachmentNames" class="f-w900 f18-l24">Attachment: </label>
</td>
<td>
<input id="ListCAttachmentIds" name="ListCAttachmentIds" type="hidden" value="">
<input class="input-width-01 attachNameListC" id="ListCAttachmentNames" name="ListCAttachmentNames" readonly="readonly" type="text" value="" style="font-style: italic;" autocomplete="off">
<input type="button" id="btn_attach_upload_DocListC" value="View or Upload File" class="font-size-2 btn-style-6 mtop5 sectionupload" aria-label="upload document list C">
<label data-valmsg-for-id="ListCAttachmentNames" data-valmsg-for="ListCAttachmentNames" aria-live="polite"></label>
</td>
</tr>
<tr class="d-md-table-row">
<td class="listc-label"></td>
<td>
<div class="fleft chbReceiptProvided inputLarge inputFullWidth">
<a href="#" class="tooltip receipt-provided" style="display: contents;" tabindex="0">
<input class="chk-style-2" data-val="true" data-val-required="The ListCReceiptProvided field is required." id="ListCReceiptProvided" name="ListCReceiptProvided" type="checkbox" value="false">
<span class="classic hidden">
According to USCIS, an acceptable receipt is not issued for the selected Document Type. Since receipts are not issued for this document, the receipt checkbox is disabled.
</span>
</a>
<label class="label-style-5 mleft5 d-md-inline width-93">
<label class="label-style-6 doc-accect-check" for="ListCReceiptProvided"> Employee presented an acceptable receipt in lieu <br>of an original document in List C </label>
<a href="#" class="tooltip vertical-style-1 opacity-100 d-md-inline d-none" tabindex="0">
<img class="tipIcon" alt="Employee-presented-an-acceptable-receipt-in-lieu-tooltip" src="/Content/tracker/images/icon-info.png">
<span class="classic" style="top: -430px;">
If an employee is unable to present a required document, the employee can present an acceptable receipt in lieu of an original document (see Handbook for Employer, M-274 for additional USCIS guidance)<br>
<bl>If the employee provides an acceptable receipt, you should:</bl><br>
• Check the receipt checkbox and confirm the correct List Document (A, B or C) is selected<br>
• Enter the document number (if any) in the Document Number field<br>
• Enter the last day that the receipt is valid in the ‘Expires’ date field. Typically, receipts are valid for 90 days from the start date or, in the case of reverification, within 90 days from the date employment authorization expires.<br>
• Advise the employee to present the original document before the receipt validity period expires.<br>
<bl>When the employee provides the original document, you should:</bl><br>
• Uncheck the receipt checkbox<br>
• Update the Issuing Authority, Expires date, and any other document information as necessary based upon the information in the new original document<br>
• Save and electronically amend Section 2
</span>
</a>
</label>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Employee presented an acceptable receipt-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content pb-5">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Employee presented an acceptable receipt in lieu <br>of an original document in List C</span>
<span> If an employee is unable to present a required document, the employee can present an acceptable receipt in lieu of an original document (see Handbook for Employer, M-274 for additional USCIS guidance)<br>
<bl>If the employee provides an acceptable receipt, you should:</bl><br> • Check the receipt checkbox and confirm the correct List Document (A, B or C) is selected<br> • Enter the document number (if any) in the
Document Number field<br> • Enter the last day that the receipt is valid in the ‘Expires’ date field. Typically, receipts are valid for 90 days from the start date or, in the case of reverification, within 90 days from
the date employment authorization expires.<br> • Advise the employee to present the original document before the receipt validity period expires.<br>
<bl>When the employee provides the original document, you should:</bl><br> • Uncheck the receipt checkbox<br> • Update the Issuing Authority, Expires date, and any other document information as necessary based upon the
information in the new original document<br> • Save and electronically amend Section 2
</span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</div>
<div class="clear"></div>
<label data-valmsg-for-id="ListCReceiptProvided" data-valmsg-for="ListCReceiptProvided" aria-live="polite"></label>
</td>
</tr>
</tbody>
</table>
</fieldset>
<div class="clear"></div>
<div class="margin5Bot font-size-12 pb-2 pb-md-0 pt-3 pt-md-0 ms-md-5 add-info-label">
<b>Additional Information</b>
<a href="#" class="tooltip opacity-100 d-md-inline d-none" tabindex="0">
<img class="tipIcon" alt="Additional-Information-tooltip" src="/Content/tracker/images/icon-info.png">
<span class="classic textBlack" style="bottom: 10px; width: 310px">
Additional Information<br>
Use this space to notate any additional information that you wish to appear in Section 2 of the Form I-9, such as:<br>
• Employment authorization extensions for Temporary Protected Status beneficiaries, F-1 OPT STEM students, CAP-GAP, H-1B and H-2A employees continuing employment with the same employer or changing employers, and other nonimmigrant categories that may receive extensions of stay.<br>
• Additional document(s) that certain nonimmigrant employees may present that cannot be entered fields provided.<br>
• Discrepancies that E-Verify employers must notate when participating in the IMAGE program.<br>
• Any other comments or notations necessary for the employer’s business process.<br>
You may leave this field blank if the employee’s circumstances do not require additional notations.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="additional-informations-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt pb-5" tabindex="0">
<span class="pop-title">Additional Information</span>
<span> Additional Information<br> Use this space to notate any additional information that you wish to appear in Section 2 of the Form I-9, such as:<br> • Employment authorization extensions for Temporary Protected Status
beneficiaries, F-1 OPT STEM students, CAP-GAP, H-1B and H-2A employees continuing employment with the same employer or changing employers, and other nonimmigrant categories that may receive extensions of stay.<br> • Additional
document(s) that certain nonimmigrant employees may present that cannot be entered fields provided.<br> • Discrepancies that E-Verify employers must notate when participating in the IMAGE program.<br> • Any other comments or
notations necessary for the employer’s business process.<br> You may leave this field blank if the employee’s circumstances do not require additional notations. </span>
</p>
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</div>
<label class="mb-3 ms-md-5 add-info-textbox" style="width: 90%;"><textarea aria-label="Additional Information" class="AdditionalInfo" id="AdditionalInfo" name="AdditionalInfo"
style="width:100%;height:80px;max-width: 850px;"></textarea></label>
<label for="hdnAdditionalInfo"><textarea id="hdnAdditionalInfo" name="AdditionalInfo" style="width:100%;height:80px;max-width: 850px;display:none;"></textarea></label>
<div class="eVerifyShow div-style-2" style="display: none;">
<strong class="d-none d-md-inline">IMPORTANT: </strong>A copy of <span style="text-decoration: underline">both the front and back</span> of the document must be retained with the employee's I-9 record, or in the case of a U.S. Passport,
copy the Passport ID page and Passport Barcode page. The photocopies must be of sufficient quality to allow for verification of the photo and written information.
</div>
<input type="hidden" id="hiddenI9ID" value="5796382">
<input id="continueSelectflag" type="hidden" value="0">
<style>
.popup-logo {
background-image: url(/Content/images/FormI9-Responsive/Trackeri9-Logo.png);
}
</style>
<script type="text/javascript">
//TODO:need remove hard code that document type id
var showEverify = "50,51,52";
var listADoc1NumTootip = null;
var trListCExpires = $('#trListCDoc1Expires');
var trListBExpires = $('#trListBDoc1Expires');
var enableNewSection2And3DocumentDataLayout = document.getElementById("EnableNewSection2And3DocumentDataLayout").value;
if (enableNewSection2And3DocumentDataLayout == "False") {
function ShowListABCOnInit() {
if ($("#tableListC #ListCDocumentTypeName").val() == "Birth Certificate (U.S.)") {
$(".cls-birth-certificate").show();
}
var A = parseInt($("#ListADocumentType").val());
var B = parseInt($("#ListBDocumentType").val());
var C = parseInt($("#ListCDocumentType").val());
var listAI94Type = $("#ListAI94Type").val();
if (A <= 0 && B <= 0 && C <= 0) {
$("#divSection2A").show();
$("#divSection2A1").hide();
} else {
setTimeout(function() {
$("#divSection2A").hide();
$("#switchToNewView").hide();
}, 500);
$("#divSection2A1").show();
setTimeout(function() {
if ($(window).width() < 768) {
if (A > 0) {
$('#pSelectedDocumentListA').show();
$('#pSelectedDocumentListB').hide();
$('#pSelectedDocumentListC').hide();
$("#btnListaSelectedDocument").prop('value', A);
$('#divListaSelectedDocument').text($("#ListADocumentTypeName").val().trim());
} else {
$('#pSelectedDocumentListA').hide();
$('#pSelectedDocumentListB').show();
$('#pSelectedDocumentListC').show();
$('#divListbSelectedDocument').text($("#ListBDocumentTypeName").val().trim());
$('#divListcSelectedDocument').text($("#ListCDocumentTypeName").val().trim());
$("#btnListbSelectedDocument").prop('value', B);
$("#btnListcSelectedDocument").prop('value', C);
}
$("#divSection2A1").appendTo($("#divformSection1D"));
setTimeout(function() {
if ($("#ListADoc2Number").val() === "") {
if ($("#hiddenMobileListADoc2Number").val() !== "") {
$("#ListADoc2Number").val($("#hiddenMobileListADoc2Number").val());
}
}
}, 200);
if (enableNewSection2And3DocumentDataLayout == "False") $("#mainDivMobileAdditonalDoc").addClass("d-none");
} else {
$("#divformSection1C").addClass("btnListBC_active");
$("#divDocumentSelectorSection").addClass("documentSelectorClassic");
$("#divAdditionalDocumentSelectorSection").addClass("documentSelectorClassic");
if (isListASelected === 1) {
$("#btnListA").addClass("active");
$("#btnListBC").removeClass("active");
} else {
$("#btnListBC").addClass("active");
$("#btnListA").removeClass("active");
}
$("#divDocumentTypeSelected").addClass("disabled");
$("#divShowDocumenSelectionErrorMessage").hide();
$("#switchToClassicView").hide();
$("#switchToNewView").hide();
$("#switchToClassicView-reset").show();
$("#switchToNewView-reset").hide();
$("#mainDivMobileAdditonalDoc").addClass("d-none");
}
if (mobileListADocumentType !== undefined) {
mobileListADocumentType = parseInt($("#ListADocumentType").val());
}
if (mobileListBDocumentType !== undefined) {
mobileListBDocumentType = parseInt($("#ListBDocumentType").val());
}
if (mobileListCDocumentType !== undefined) {
mobileListCDocumentType = parseInt($("#ListCDocumentType").val());
}
if ($("#ListAI94Type").val() > 0) {
if (mobileListAdditionalDocumentType != undefined) {
mobileListAdditionalDocumentType = $("#ListAI94Type").val();
}
}
}, 10);
}
var listShowValue = A > 0 ? "A" : B > 0 && C > 0 ? "BC" : B > 0 && C <= 0 ? "B" : B <= 0 && C > 0 ? "C" : "A";
switch (listShowValue) {
case "A":
$("#tableListA").show();
$("#tableListB").hide();
$("#tableListC").hide();
if (A == 54) {
DDLBI94ChangeOnListA(listAI94Type, true);
} else if (A == 52) {
DDLBI766ChangeOnListA(listAI94Type);
} else if (A == 53) {
DDLBI551ChangeOnListA(listAI94Type);
} else if (A == "731" || A == "732") {
GetDocTypeForI94OrAuthorization(A);
}
GetDefaultIssuingAuthByDocTypeId(A, "A", true);
break;
case "BC":
$("#tableListA").hide();
$("#tableListB").show();
$("#tableListB").css("width", "50%");
$("#tableListC").show();
$("#tableListC").css("width", "40%");
GetDefaultIssuingAuthByDocTypeId(B, "B", true);
GetDefaultIssuingAuthByDocTypeId(C, "C", true);
break;
case "B":
$("#tableListA").hide();
$("#tableListB").show();
$("#tableListC").hide();
GetDefaultIssuingAuthByDocTypeId(B, "B", true);
break;
case "C":
$("#tableListA").hide();
$("#tableListB").hide();
$("#tableListC").show();
GetDefaultIssuingAuthByDocTypeId(C, "C", true);
break;
default:
break;
}
if (B == 55) {
$(".trDriverLicense").show();
} else {
$(".trDriverLicense").hide();
}
if (C == 67) {
$("#divformSection1B.documentSelectorClassicview #tableListB .trListBDocumentTitle").show();
$("#divformSection1B.documentSelectorNewView #tableListB .trListBDocumentTitle").hide();
$(".trListCDocumentTitle").show();
} else {
$(".trListBDocumentTitle").hide();
$(".trListCDocumentTitle").hide();
}
ChangeDocListBLayout(B);
DisplayDocTooltips(A, B, C);
InitialSection2DocExpiresNA();
}
}
function ChangeDocListUI(doc1, doc2, doc3, doc1desc, doc2desc, doc3desc) {
var originalListADocType = $("#ListADocumentType").val();
var dballAdditionalInfo = "";
if (dballAdditionalInfo.length > 0) {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val());
}
if (doc1 != null) {
ClearFormInDocList("tableListB");
ClearFormInDocList("tableListC");
if ($("#ListADocumentType").val() != doc1) {
ClearFormInDocList("tableListA");
}
} else {
ClearFormInDocList("tableListA");
if ($("#ListBDocumentType").val() != doc2) {
ClearFormInDocList("tableListB");
}
if ($("#ListCDocumentType").val() != doc3) {
ClearFormInDocList("tableListC");
}
}
if (doc1 != null) {
$("#ListADocumentTypeName").kendoDropDownList({
dataTextField: "Text",
dataValueField: "Value",
optionLabel: doc1desc
});
$("#ListADocumentTypeName").val(doc1desc);
$("#ListADocumentType").val(doc1);
if (IsNewViewSelected) {
// $("#docNewA").hide();
// document.getElementById('docAval').innerHTML = doc1desc;
$("#ListADocumentTypeName").data("kendoDropDownList").enable(false);
} else {
$("#ListADocumentTypeName").data("kendoDropDownList").enable(true);
// $("#docNewA").show();
// document.getElementById('docAval').innerHTML = "";
}
$("#tableListA").show();
$("#tableListB").hide();
$("#tableListC").hide();
$(".trI94").hide();
$(".trI551Passport").hide();
$(".trI551Stamp").hide();
$(".trAttachment").show();
$(".trNormal").show();
$(".lblI551_Card").hide();
$("#blanktitle").hide();
$("#trListAIssuingAuthority535").hide();
$("#trListAIssuingAuthorityForDoc515").hide();
$(".lblI551PassportType").hide();
$("#trListAIssuingAuthorityForI94").hide();
$("#spanListADoc2IssuingAuthorityI94").hide();
$("#spanListADoc2IssuingAuthorityDoc732").hide();
$("#spanListADoc2IssuingAuthorityDoc533").hide();
$(".trI94 .lblI551Stamp").hide();
$("#trPassportI94Doc").hide();
//$("#ListADoc2Title").val("");
if (doc1 == "51") {
$(".lblI551_I94Doc").hide();
$("#lblPassport").hide();
$(".lblI551Passport").hide();
$(".lblI551_Card").show();
}
if (doc1 == "54") {
if (originalListADocType != "54") GetDocTypeForI94OrAuthorization(54);
$(".trI94").show();
$("#ListAI94Type").val("0");
DDLBI94ChangeOnListA("", false);
//ReSetTableCss("", true);
$("#ListADoc2Title").val("Form I-94");
$("#ListADoc3Number").attr("disabled", true);
}
if (doc1 == "52") {
GetDocTypeForI94OrAuthorization(52);
$(".trI94").show();
$("#ListAI94Type").val("0");
$("#trdcAUSCIS").show();
if ($("#AlienUSCISNum").length > 0 && $("#AlienUSCISNum").val() == "") {
if ($("#AlienNumber").length > 0 && $("#AlienNumber").val() != "") {
$("#AlienUSCISNum").val($("#AlienNumber").val());
} else if ($("#USCISNumber").length > 0 && $("#USCISNumber").val() != "") {
$("#AlienUSCISNum").val($("#USCISNumber").val());
}
}
//$("#trCountryOfIssuanceDocA").hide();
DDLBI766ChangeOnListA("");
//ReSetTableCss("", true);
$("#AlienUSCISNum").attr("disabled", false);
$("#ListADoc3Number").attr("disabled", true);
} else {
$("#trdcAUSCIS").hide();
$("#AlienUSCISNum").attr("disabled", true);
$("#ListADoc3Number").attr("disabled", false);
}
if (doc1 == "731" || doc1 == "732") {
GetDocTypeForI94OrAuthorization(doc1);
$(".trI94").hide();
$(".doc73").show();
$(".I94").show();
$(".I20EAD").hide();
$(".I797C").hide();
//$("#ListADoc1IssuingAuthority").val("USCIS");
//ReSetTableCss("", true);
$("#ListADoc2Title").val("Form I-94");
} else if (doc1 == "515" || doc1 == "514") {
if (doc1 == "515") {
$("#ListAIssuingAuthorityForDoc515").val("USCIS");
$("#ListAIssuingAuthorityForDoc515").attr("disabled", false);
} else if (doc1 == "514") {
$("#ListAIssuingAuthorityForDoc515").val("DOJ INS");
$("#ListAIssuingAuthorityForDoc515").attr("disabled", true);
}
$("#ListAIssuingAuthorityForDoc515").kendoDropDownList();
}
//show 'Passport' before 'Docement #' when select 50,53,54
if ("50,53,54,533".indexOf(doc1) >= 0) {
$("#lblPassport").show();
} else {
$("#lblPassport").hide();
}
if (doc1 == "53") {
GetDocTypeForI94OrAuthorization(53);
//$(".trI94").show();
$("#ListAI94Type").val("0");
DDLBI551ChangeOnListA("", false);
//$("#ListADoc2IssuingAuthority").val("DHS");
//ReSetTableCss("", true);
}
GetDefaultIssuingAuthByDocTypeId(doc1, "A", false);
disabledReceipt();
} else {
$("#tableListA").hide();
if ($("#ListBDocumentType").val() != doc2) {
$("#tableListB").hide();
$("#ListBDocumentTypeName").kendoDropDownList({
dataTextField: "Text",
dataValueField: "Value",
optionLabel: doc2desc
});
$("#ListBDocumentTypeName").val(doc2desc);
if (IsNewViewSelected) {
// $("#docNewB").hide();
// document.getElementById('docBval').innerHTML = doc2desc;
$("#ListBDocumentTypeName").data("kendoDropDownList").enable(false);
} else {
// $("#docNewB").show();
// document.getElementById('docBval').innerHTML = "";
$("#ListBDocumentTypeName").data("kendoDropDownList").enable(true);
}
$("#ListBDocumentType").val(doc2);
if (doc2 != null) {
$("#tableListB").show();
if (doc3 != null) {
$("#tableListB").css("width", "50%");
}
}
if (doc2 != null && doc2 == "76") {
$("#ListBDoc1Number").val("N/A");
$("#ListBDoc1Number").attr("disabled", true);
}
if (doc2 != null && doc2 == "55") {
$(".trDriverLicense").show();
} else {
$(".trDriverLicense").hide();
}
GetDefaultIssuingAuthByDocTypeId(doc2, "B", false);
}
if ($("#ListCDocumentType").val() != doc3) {
$("#tableListC").hide();
$("#ListCDocumentTypeName").kendoDropDownList({
dataTextField: "Text",
dataValueField: "Value",
optionLabel: doc3desc
});
$("#ListCDocumentTypeName").val(doc3desc);
if (IsNewViewSelected) {
// $("#docNewC").hide();
// document.getElementById('docCVal').innerHTML = doc3desc;
$("#ListCDocumentTypeName").data("kendoDropDownList").enable(false);
} else {
// $("#docNewC").show();
// document.getElementById('docCVal').innerHTML = "";
$("#ListCDocumentTypeName").data("kendoDropDownList").enable(true);
}
$("#ListCDocumentType").val(doc3);
if (doc3 != null) {
$("#tableListC").show();
if (doc2 != null) {
$("#tableListC").css("width", "45%");
}
if (doc3 == 67) {
$("#divformSection1B.documentSelectorClassicview #tableListB .trListBDocumentTitle").show();
$("#divformSection1B.documentSelectorNewView #tableListB .trListBDocumentTitle").hide();
$(".trListCDocumentTitle").show();
} else {
$(".trListBDocumentTitle").hide();
$(".trListCDocumentTitle").hide();
}
}
GetDefaultIssuingAuthByDocTypeId(doc3, "C", false);
}
ChangeDocListBLayout(doc2);
}
if ($("#tableListC #ListCDocumentTypeName").val() == "Birth Certificate (U.S.)") {
$(".cls-birth-certificate").show();
}
disabledReceipt();
DocNumberRemoveReceipt("ListAReceiptProvided", true);
DocNumberRemoveReceipt("ListBReceiptProvided", true);
DocNumberRemoveReceipt("ListCReceiptProvided", true);
}
function DDLBI94ChangeOnListA(secectedIndex, pageLoad) {
$(".trI94").show();
$(".I94").show();
$(".I20EAD").hide();
$(".I797C").hide();
$("#trAdditionalDocs").insertAfter($("#trI94End"));
var hiddenadditionalDocTypesCount = $("#hiddenadditionalDocTypesCount").val();
if (hiddenadditionalDocTypesCount === "0") {
var windowWidth = $(window).width();
if (windowWidth < 768) {
$('#trAdditionalDocs').addClass("d-md-table-row");
} else {
$("#trAdditionalDocs").removeClass("d-md-table-row")
}
} else {
$('#trAdditionalDocs').addClass("d-md-table-row");
}
if (pageLoad != null && pageLoad == false) {
ClearFormInDocListByClass("DSOrI20");
}
$(".trDocAReceiptProvided").show();
$(".redAsterisk").hide();
$("#ListADoc3IssuingAuthority").removeAttr("readonly");
$("#ListADoc3IssuingAuthority").val("");
$("#DS2019I20doc").hide();
$("#DS2019I20expire").hide();
switch (secectedIndex) {
case "1":
$(".doc766").hide();
ShowControlInListASection2(true, false, false, false, false);
$(".doc94").show();
$(".DS2019").hide();
$(".I20").show();
$(".I797C").hide();
$("#DS2019I20doc").show();
$("#DS2019I20expire").show();
$("#ListADoc3IssuingAuthorityI94").kendoDropDownList();
$("#ListADoc3IssuingAuthority").val($("#ListADoc3IssuingAuthorityI94").val());
break;
case "2":
$(".doc766").hide();
ShowControlInListASection2(true, false, false, false, false);
$(".doc94").show();
$(".I20").hide();
$(".DS2019").show();
$(".I797C").hide();
$("#DS2019I20doc").show();
$("#DS2019I20expire").show();
$("#Ds2019I20Docspan").text("Enter the DS-2019 number (Student and Exchange Visitor Number – SEVIS Number). SEVIS Numbers must start with a letter followed by 10-11 numbers.");
$("#Ds2019I20Expiresspan").text("Enter the program end date from the DS-2019 as the expiry date.");
$("#ListADoc3IssuingAuthority").val("U.S. Department of State");
$("#ListADoc3IssuingAuthority").attr("readonly", "readonly");
break;
case "3":
$(".doc766").show();
ShowControlInListASection2(false, true, false, false, true);
break;
case "4":
ShowControlInListASection2(false, false, true, false, true);
$(".doc766").show();
$(".I20").hide();
$(".I797C").hide();
$(".DS2019").hide();
break;
case "5":
$(".doc766").show();
ShowControlInListASection2(false, false, false, true, true);
break;
case "6":
$(".doc766").show();
ShowControlInListASection2(false, false, false, true, true);
break;
default:
$(".doc766").hide();
ShowControlInListASection2(false, false, false, false, false);
$(".doc94").show();
$(".DS2019").hide();
$(".I20").hide();
break;
}
}
function DDLBI766ChangeOnListA(secectedIndex) {
var hiddenadditionalDocTypesCount = $("#hiddenadditionalDocTypesCount").val();
if (hiddenadditionalDocTypesCount === "0") {
var windowWidth = $(window).width();
if (windowWidth < 768) {
$('#trAdditionalDocs').addClass("d-md-table-row");
} else {
$("#trAdditionalDocs").removeClass("d-md-table-row")
}
} else {
$('#trAdditionalDocs').addClass("d-md-table-row");
}
$(".trI94").show();
$(".redAsterisk").show();
switch (secectedIndex) {
case "1":
case "7":
$(".doc94").hide();
$(".doc766").hide();
ShowControlInListASection2(false, false, false, false, true);
break;
case "8":
$(".doc94").hide();
$(".doc766").hide();
ShowControlInListASection2(false, false, false, false, true);
break;
case "9":
$(".doc94").hide();
$(".doc797").show();
$(".DS2019").hide();
$(".I94").hide();
$(".I20EAD").hide();
$(".doc766").hide();
$(".I797C").show();
$("#trAdditionalDocs").insertBefore($("#trDocEAD"));
$(".aDoc2IssuingAuthorityA").hide();
ShowControlInListASection2(false, false, false, false, true);
$(".aDoc2NumListA").show();
$("#ListADoc2Number").val("");
$(".spanDoc2NumListA").html("The Form I-797C Receipt Number typically starts with 3 letters followed by 10 digits (e.g. LIN9876543210)");
break;
case "10":
$(".doc94").hide();
$(".docEAD").show();
ShowControlInListASection2(false, false, false, false, true);
$(".DS2019").hide();
$(".I94").hide();
$(".I20EAD").show();
$(".doc766").hide();
$(".I797C").hide();
$("#trAdditionalDocs").insertBefore($("#trDocEAD"));
if (secectedIndex == "8" || secectedIndex == "9") {
$(".aDoc2IssuingAuthorityA").show();
}
break;
case "13":
$(".doc94").hide();
$(".doc797").show();
ShowControlInListASection2(false, false, false, false, true);
$(".DS2019").hide();
$(".I94").hide();
$(".I20EAD").hide();
$(".doc766").hide();
$(".I797C").show();
$("#trAdditionalDocs").insertBefore($("#trDocEAD"));
$(".aDoc2IssuingAuthorityA").hide();
ShowControlInListASection2(false, false, false, false, true);
$(".aDoc2NumListA").show();
$(".spanDoc2NumListA").html(
"Enter the receipt number on the Form I-797C. The receipt number typically starts with 3 letters followed by 10 digits (e.g. LIN9876543210). Per USCIS guidelines, the I-797C Receipt Number will populate the List A Document Number on the Form I-9 for auto-extended EADs."
);
break;
default:
$(".doc94").hide();
$(".doc766").hide();
ShowControlInListASection2(false, false, false, false, false);
break;
}
}
function DDLBI551ChangeOnListA(secectedIndex) {
var hiddenadditionalDocTypesCount = $("#hiddenadditionalDocTypesCount").val();
if (hiddenadditionalDocTypesCount === "0") {
var windowWidth = $(window).width();
if (windowWidth < 768) {
$('#trAdditionalDocs').addClass("d-md-table-row");
} else {
$("#trAdditionalDocs").removeClass("d-md-table-row")
}
} else {
$('#trAdditionalDocs').addClass("d-md-table-row");
}
$("#trAdditionalDocs").show();
$("#trAdditionalDocs").insertAfter($("#trListADocumentType"));
$("#tableListA tr:gt(2)").hide();
$(".trDocAReceiptProvided").show();
//$(".trI94").show();
$(".redAsterisk").show();
$(".lblI551PassportType").show();
$(".lblOld").hide();
$("#ListADoc2Number").attr("placeholder", "Optional");
switch (secectedIndex) {
case "10":
$("#ListADocumentTypeName").val("Foreign Passport");
$("#ListADoc2Title").val("Temporary I-551 Stamp");
$(".trI551Passport").show();
$(".trI551Stamp").show();
$(".I94").hide();
$("#lblI551Stamp").show();
$("#lblI551MRIV").hide();
$(".lblI551Passport").show();
$(".lblI551_I94Doc").hide();
$(".lblI551Stamp").show();
$(".trAttachment").show();
break;
case "11":
$("#ListADocumentTypeName").val("Foreign Passport");
$("#ListADoc2Title").val("I-551 Printed Notation on a MRIV");
$(".trI551Passport").show();
$(".trI551Stamp").show();
$(".I94").hide();
$("#lblI551Stamp").hide();
$("#lblI551MRIV").show();
$(".lblI551Passport").show();
$(".lblI551_I94Doc").hide();
$(".lblI551Stamp").show();
$(".trAttachment").show();
break;
case "12":
$("#ListADocumentTypeName").val("Form I-94");
$("#ListADoc2Title").val("Temporary I-551 Stamp");
$(".trI551Passport").show();
$(".trI551Stamp").show();
$(".I94").hide();
$(".lblI551_I94Doc").show();
$("#lblPassport").hide();
$("#lblI551Stamp").show();
$("#lblI551MRIV").hide();
$(".lblI551Passport").hide();
$(".lblI551Stamp").show();
$(".trAttachment").show();
$(".aDoc1NumListA").show();
$(".spanDoc1NumListA").html("The I-94 Document Number must contain 11 digits or 9 digits followed by one letter followed by one digit (e.g. #########A#), and match the Admission Number that was entered in Section 1 (if present).");
$(".aDoc1ExpiresListA").hide();
$(".spanDoc1ExpiresListA").html("");
$(".trDocAReceiptProvided").hide();
break;
default:
$(".doc94").hide();
$(".doc766").hide();
ShowControlInListASection2(false, false, false, false, false);
break;
}
}
function ShowControlInListASection2(DSOrI20, H1B, H2A, Extension, ReverificationDueDate) {
if (DSOrI20) $(".DSOrI20").show();
else $(".DSOrI20").hide();
if (H1B) $(".H1B").show();
else $(".H1B").hide();
if (H2A) $(".H2A").show();
else $(".H2A").hide();
if (Extension) $(".Extension").show();
else $(".Extension").hide();
if (ReverificationDueDate) $(".ReverificationDueDate").show();
else $(".ReverificationDueDate").hide();
}
function ChangeUIByListC(isDisabled, num) {
var trName = "trList" + num + "Doc1Expires";
var divName = "divList" + num + "Doc1Expires";
var spaceName = "lbl" + num + "Space";
if (isDisabled) {
$("#" + divName).hide();
$("#" + spaceName).show();
$("#" + trName + " div").each(function(i) {
$(this).addClass("listCDoc1ExpiresNotShow");
$('span.expires-astrerisk').hide();
});
} else {
$("#" + divName).show();
$("#" + spaceName).hide();
$("#" + trName + " div").each(function(i) {
$(this).removeClass("listCDoc1ExpiresNotShow");
$('span.expires-astrerisk').show();
});
}
}
//Now Use this Function to get CountryOfIssuance or Doctype
function GetDocTypeForI94OrAuthorization(docATypeId) {
var listAI94Type = $("#ListAI94Type").data("kendoDropDownList");
var i9Id = $("#I9Id").val();
if (docATypeId > 0 && i9Id > 0) {
$.ajax({
url: "/form-I9/get-docTypeForI94OrAuthorization",
type: 'POST',
async: false,
data: {
docTypeId: docATypeId,
i9Id: i9Id
},
success: function(data) {
if (data != "") {
var countryList = new kendo.data.DataSource({
data: data.countryList
});
$("#ListAIssuingAuthorityForI94").kendoDropDownList({
dataTextField: "Text",
dataValueField: "Value",
dataSource: countryList
});
$("#ListAIssuingAuthorityForI94").val(data.countryCode);
if (docATypeId == "732") {
$("#ListAIssuingAuthorityForI94").val("FSM");
$("#ListADoc1IssuingAuthority").val("FSM");
$("#ListAIssuingAuthorityForI94").kendoDropDownList();
$("#ListAIssuingAuthorityForI94").attr("disabled", true);
} else if (docATypeId == "731") {
$("#ListAIssuingAuthorityForI94").val("MHL");
$("#ListADoc1IssuingAuthority").val("MHL");
$("#ListAIssuingAuthorityForI94").kendoDropDownList();
$("#ListAIssuingAuthorityForI94").attr("disabled", true);
}
}
}
});
var listAI94TypeData = new kendo.data.DataSource({
data: [{
Selected: true,
Value: "0",
Text: "None"
}]
});
listAI94Type.setDataSource(listAI94TypeData);
listAI94TypeData.read();
listAI94Type.value("0");
$("#ListADoc3Title").val("");
}
}
function Doctype551ExpireRequired() {
$("#ListBDoc1IssuingAuthority").val($("#DropdownListBIssuingAuthority").val());
if ($("#ListBDocumentType").val() == 551 && $("#ListBDoc1IssuingAuthority").val() == "PA") {
$("#ListBDoc1Expires").val("");
//$("#ListBDoc1Expires").attr("placeholder", "Required or N/A");
SetExpiresRequiredOrNA("B", true);
} else {
//$("#ListBDoc1Expires").attr("placeholder", "Required");
SetExpiresRequiredOrNA("B", false);
}
}
//event
function ListB_IssuingAuthority_SelectEvent(e) {
// Doctype551ExpireRequired();
$("#ListBDoc1IssuingAuthority").val($("#DropdownListBIssuingAuthority").val());
listBType = $("#ListBDocumentType").val();
var issuingAuthoritySelect = $("#ListBDoc1IssuingAuthority").val();
$("#ListBDoc1Expires").val("");
hideAutoExtendedController();
hideCOVID19ReceiptController();
ShowListBExpirationDateRequiredFor551552(listBType, issuingAuthoritySelect);
ChangeDocListBLayout(listBType);
if ((listBType == "551" || listBType == "552") && $("#DropdownListBIssuingAuthority").val() == "WY") {
//$("#ListBDoc1Expires").attr('placeholder', 'Required or N/A');
SetExpiresRequiredOrNA("B", true);
}
$.ShowSaveBtn($("#divformSection2"));
}
function ListADoc533_IssuingAuthority_SelectEvent(e) {
//var value = e.value;
var value = $("#ListADoc2IssuingAuthorityDoc533").val();
$("#ListADoc2IssuingAuthority").val(value);
$.ShowSaveBtn($("#divformSection2"));
}
function ListADoc732_IssuingAuthority_SelectEvent(e) {
//var value = e.value;
var value = $("#ListADoc2IssuingAuthorityDoc732").val();
$("#ListADoc2IssuingAuthority").val(value);
$.ShowSaveBtn($("#divformSection2"));
}
function ListADoc534_IssuingAuthority_SelectEvent(e) {
//var value = e.value;
var value = $("#ListADoc2IssuingAuthorityDoc534").val();
$("#ListADoc2IssuingAuthority").val(value);
$.ShowSaveBtn($("#divformSection2"));
}
//
function ListADoc535_IssuingAuthority_SelectEvent(e) {
//var value = e.value;
var value = $("#ListADoc2IssuingAuthorityDoc535").val();
$("#ListADoc2IssuingAuthority").val(value);
$.ShowSaveBtn($("#divformSection2"));
}
//
function ListC_SSN_IssuingAuthority_SelectEvent(e) {
//var value = e.value;
var value = $("#ListCDoc1IssuingAuthorityForSSN").val();
$("#ListCDoc1IssuingAuthority").val(value);
$.ShowSaveBtn($("#divformSection2"));
}
function ListA_I94_IssuingAuthority_SelectEvent(e) {
//var value = e.value;
var value = $("#ListAIssuingAuthorityForI94").val();
$("#ListADoc1IssuingAuthority").val(value);
if ($("#ListADocumentType") != null && $("#ListADocumentType").val() != undefined && ($("#ListADocumentType").val() == "533" || $("#ListADocumentType").val() == "534")) {
$("#ListACountryCode").val(value);
}
$.ShowSaveBtn($("#divformSection2"));
}
function ListA_I94515_IssuingAuthority_SelectEvent(e) {
var value = $("#ListAIssuingAuthorityForDoc515").val();
$("#ListADoc1IssuingAuthority").val(value);
$.ShowSaveBtn($("#divformSection2"));
}
function ListA_I94_IssuingAuthorityDoc2_SelectEvent(e) {
//var value = e.value;
var value = $("#ListADoc2IssuingAuthorityI94").val();
$("#ListADoc2IssuingAuthority").val(value);
$.ShowSaveBtn($("#divformSection2"));
}
function ListA_I94_IssuingAuthorityDoc3_SelectEvent(e) {
//var value = e.value;
var value = $("#ListADoc3IssuingAuthorityI94").val();
$("#ListADoc3IssuingAuthority").val(value);
$.ShowSaveBtn($("#divformSection2"));
}
function InitialSection2DocExpiresNA() {
var chkA = $('#chkListADoc1ExpiresNA');
var chkB = $('#chkListBDoc1ExpiresNA');
var chkC = $('#chkListCDoc1ExpiresNA');
if (chkA.prop('checked')) {
var expDateInput = $("#ListADoc1Expires");
expDateInput.val('');
expDateInput.attr("disabled", "disabled");
}
if (chkB.prop('checked')) {
var expDateInput = $("#ListBDoc1Expires");
expDateInput.val('');
expDateInput.attr("disabled", "disabled");
}
if (chkC.prop('checked')) {
var expDateInput = $("#ListCDoc1Expires");
expDateInput.val('');
expDateInput.attr("disabled", "disabled");
}
}
$('#chkListADoc1ExpiresNA').change(function() {
var chk = $(this);
ChkExpiresNAClickEvent(chk, "A");
});
$('#chkListCDoc1ExpiresNA').change(function() {
var chk = $(this);
ChkExpiresNAClickEvent(chk, "C");
});
$('#chkListBDoc1ExpiresNA').change(function() {
var chk = $(this);
ChkExpiresNAClickEvent(chk, "B");
});
function ChkExpiresNAClickEvent(chk, listCategory) {
var expDateInput = $("#List" + listCategory + "Doc1Expires");
var hidNA = $("#hidList" + listCategory + "Doc1ExpiresNotApplicable");
if (chk.prop('checked')) {
var content = "Expirations dates are required if they appear on the document presented by the employee. You have entered N/A into this field.<br/><br/>" +
"Not applicable (N/A) should only be entered if the document does not contain an expiration date.<br/><br/>" + "Are you sure there is no expiration date?";
$.trackerConfirmNew(content, function() {
expDateInput.val('N/A');
expDateInput.attr("disabled", "disabled");
hidNA.val("1");
$.ShowOrHideSaveBtn($("#divformSection2"));
}, function() {
expDateInput.removeAttr("disabled");
expDateInput.val("");
chk.prop('checked', false);
hidNA.val("0");
});
} else {
expDateInput.removeAttr("disabled");
expDateInput.val("");
hidNA.val("0");
$.ShowOrHideSaveBtn($("#divformSection2"));
}
}
function SetExpiresRequiredOrNA(listCategory, requiredNA) {
var aClass = "aDoc1ExpiresList" + listCategory;
var spanClass = "spanDoc1ExpiresList" + listCategory;
var spanClass2 = "spanDoc1ExpiresList" + listCategory + "2";
var divNotApplicable = "divList" + listCategory + "Doc1ExpiresNA";
var optionalHidden = "List" + listCategory + "Doc1ExpiresOptional";
var expDateInput = $("#List" + listCategory + "Doc1Expires");
var hidNA = $("#hidList" + listCategory + "Doc1ExpiresNotApplicable");
var chk = $('#chkList' + listCategory + 'Doc1ExpiresNA');
var autoExtended = $('#divChkAutoExtended');
var covid19 = $('#divChkCOVID19Receipt');
var dis1 = autoExtended.css('display');
var dis2 = covid19.css('display');
// console.log(requiredNA);
if (requiredNA) {
// console.log(spanClass2 + true);
if ((dis1 == "block" || dis2 == "block") && listCategory == "B") {
$('a.' + aClass).find('span.' + spanClass).show();
$('a.' + aClass).find('span.' + spanClass2).hide();
$('#' + divNotApplicable).hide();
} else {
$('a.' + aClass).find('span.' + spanClass).hide();
$('a.' + aClass).find('span.' + spanClass2).show();
$('#' + divNotApplicable).show();
}
$(".expiresList" + listCategory).show();
$('#' + optionalHidden).val(1).data('default', '1');
if (hidNA.val() != "1") {
expDateInput.removeAttr("disabled");
chk.prop('checked', false);
hidNA.val("0");
}
} else {
// console.log(spanClass + false);
$('a.' + aClass).find('span.' + spanClass).show();
$('a.' + aClass).find('span.' + spanClass2).hide();
$('#' + divNotApplicable).hide();
$('#' + optionalHidden).val(0).data('default', '0');
expDateInput.removeAttr("disabled");
chk.prop('checked', false);
hidNA.val("0");
}
}
function GetDefaultIssuingAuthByDocTypeId(docTypeId, listCategory, pageLoad) {
if (docTypeId > 0) {
$(".aDoc1NumList" + listCategory).hide();
$(".aDoc1ExpiresList" + listCategory).hide();
$(".aDoc2NumList" + listCategory).hide();
$(".aDoc2ExpiresList" + listCategory).hide();
$("#I94ExpiresDiv").hide();
clearInitValues();
var i9ID = $("#I9Id").val();
$.post("/form-I9Doc/get-defaultIssuingAuthEverify", {
docTypeId: docTypeId,
i9Id: i9ID
}, function(data) {
if (listCategory == "B") {
if (data.IndividualUnder18DocumentSelected) {
I9DocsEditControl_DisableDocumentListB("B", true);
} else {
I9DocsEditControl_DisableDocumentListB("B", false);
}
if (!data.Doc2Editable) {
I9DocsEditControl_MakeDocumentListBReadonly("B");
}
}
if (pageLoad == undefined || pageLoad == null || pageLoad == false) {
$("#List" + listCategory + "Doc1IssuingAuthority").val(data.DefaultIssuingAuth);
$("#List" + listCategory + "Doc1IssuingAuthority").attr("readonly", data.IssuingAuthEditable == false);
}
if (listCategory == "B" && docTypeId == 76) {
$("#List" + listCategory + "Doc1Number").val("N/A");
$("#List" + listCategory + "Doc1IssuingAuthority").val("N/A");;
$("#List" + listCategory + "Doc1Number").attr("readonly", true);
$("#List" + listCategory + "Doc1IssuingAuthority").attr("readonly", true);
}
ChangeUIByListC(data.NoExpirationDate, listCategory);
if (data.RequreExpirationDate) {
$(".expiresList" + listCategory).show();
//$("#List" + listCategory + "Doc1Expires").attr("placeholder", "Required");
SetExpiresRequiredOrNA(listCategory, false);
} else {
$(".expiresList" + listCategory).hide();
//$("#List" + listCategory + "Doc1Expires").attr("placeholder", "Required or N/A");
//var x = "log 1 " + docTypeId;
// console.log(x);
if (docTypeId == 593 || docTypeId == 76 || docTypeId == 75 || docTypeId == 681 || docTypeId == 682 || docTypeId == 691 || docTypeId == 692 || docTypeId == 693 || docTypeId == 701 || docTypeId == 702 || docTypeId == 642 ||
docTypeId == 662 || docTypeId == 66 || docTypeId == 74 || docTypeId == 65 || docTypeId == 63 || docTypeId == 72) {
//var x1 = "log docid true ";
//console.log(x1);
SetExpiresRequiredOrNA(listCategory, false);
} else {
//var x2 = "log docid false ";
//console.log(x2);
SetExpiresRequiredOrNA(listCategory, true);
}
}
if (data.HasEVPhoto && data.IsEverify) {
$(".eVerifyShow").show();
} else {
$(".eVerifyShow").hide();
}
if (listCategory == "B") {
if (pageLoad == undefined || pageLoad == null || pageLoad == false) resetReceiptCheckbox("ListBReceiptProvided");
changeDocListBLayout551and552(docTypeId, pageLoad)
changeDocListBLayout592(docTypeId);
}
if (data.Doc1NumValidationTooltip != null && data.Doc1NumValidationTooltip != "") {
$(".aDoc1NumList" + listCategory).show();
$(".spanDoc1NumList" + listCategory).html(data.Doc1NumValidationTooltip);
listADoc1NumTootip = data.Doc1NumValidationTooltip;
}
if (data.Doc1ExpirationDateValidationTooltip != null && data.Doc1ExpirationDateValidationTooltip != "") {
$(".aDoc1ExpiresList" + listCategory).show();
//console.log("spanDoc1ExpiresList" + data.Doc1ExpirationDateValidationTooltip + docTypeId)
if (docTypeId == 593 || docTypeId == 76 || docTypeId == 75 || docTypeId == 681 || docTypeId == 682 || docTypeId == 691 || docTypeId == 692 || docTypeId == 693 || docTypeId == 701 || docTypeId == 702 || docTypeId == 642 ||
docTypeId == 662 || docTypeId == 66 || docTypeId == 74 || docTypeId == 65 || docTypeId == 63 || docTypeId == 72) {
var spanDoc1Val = "This document does not expire";
// console.log("spanDoc2ExpiresList true" + spanDoc1Val)
$(".spanDoc1ExpiresList" + listCategory).html(spanDoc1Val);
} else {
//console.log("spanDoc2ExpiresList false" + spanDoc1Val)
$(".spanDoc1ExpiresList" + listCategory).html(data.Doc1ExpirationDateValidationTooltip);
}
}
if (data.Doc2NumValidationTooltip != null && data.Doc2NumValidationTooltip != "") {
$(".aDoc2NumList" + listCategory).show();
if ($("#ListAI94Type").val() == Number(listAI94Doctypes.EADCapGap)) {
$(".spanDoc2NumList" + listCategory).html("The Form I-797C Receipt Number typically starts with 3 letters followed by 10 digits (e.g. LIN9876543210)");
} else {
$(".spanDoc2NumList" + listCategory).html(data.Doc2NumValidationTooltip);
}
}
if (data.Doc2ExpirationDateValidationTooltip != null && data.Doc2ExpirationDateValidationTooltip != "") {
$(".aDoc2ExpiresList" + listCategory).show();
// console.log("spanDoc2ExpiresList" + data.Doc2ExpirationDateValidationTooltip + docTypeId)
if (docTypeId == 593 || docTypeId == 76 || docTypeId == 75 || docTypeId == 681 || docTypeId == 682 || docTypeId == 691 || docTypeId == 692 || docTypeId == 693 || docTypeId == 701 || docTypeId == 702 || docTypeId == 642 ||
docTypeId == 662 || docTypeId == 66 || docTypeId == 74 || docTypeId == 65 || docTypeId == 63 || docTypeId == 72) {
var spanDoc2Val = "This document does not expire";
// console.log("spanDoc2ExpiresList true" + spanDoc1Val)
$(".spanDoc2ExpiresList" + listCategory).html(spanDoc2Val);
} else {
// console.log("spanDoc2ExpiresList false" + spanDoc1Val)
$(".spanDoc2ExpiresList" + listCategory).html(data.Doc2ExpirationDateValidationTooltip);
}
}
var AdditionalTooltip = "Certain Foreign National employees may need to present additional documents in support of their List A document in order complete the employment eligibility verification process. " +
"Use this drop-down menu to select the Additional Documents option that pertains to the Foreign employee. Then, enter the respective document number(s) and expiration date(s).";
if (data.ShowTempI551DDLB) {
AdditionalTooltip = "Select the Temporary I-551 Type that is presented by the employee. There are three different documents that are considered a Temporary I-551 Stamp or Notation:" +
"<br/>1. An unexpired foreign passport with a temporary I-551 stamp" + "<br/>2. An unexpired foreign passport with a temporary I-551 printed notation on a machine-readable immigrant visa (MRIV) " +
"<br/>3. A Form I-94/I-94A with a temporary I-551 stamp and a photograph of the individual" + "<br/><br/>These documents are valid until:" + "<br/>• The expiration date of the temporary I-551 stamp, or " +
"<br/>• If there is no expiration date, one year from date of issue ";
var doc2IssuingAuthority = $("#List" + listCategory + "Doc2IssuingAuthority");
if (doc2IssuingAuthority != null) {
doc2IssuingAuthority.val(data.IssuingAuth2Default);
doc2IssuingAuthority.attr("readonly", data.IssuingAuth2Editable == false);
}
}
$(".spanAdditionalTooltip").html(AdditionalTooltip);
if (docTypeId == '55') {
ShowListBExpirationDateRequired(true);
} else {
//ReSetPlaceholder("tableList" + listCategory);
}
if (listCategory == "C") {
if (pageLoad == undefined || pageLoad == null || pageLoad == false) resetReceiptCheckbox("ListCReceiptProvided");
if (docTypeId == '642') {
$("#trListCIssuingAuthorityForSSN").show();
$("#trListCIssuingAuthority").hide();
var value = $("#ListCDoc1IssuingAuthority").val();
if (value == null || value.length <= 0) {
$("#ListCDoc1IssuingAuthorityForSSN").val("Social Security Administration");
}
$("#ListCDoc1IssuingAuthorityForSSN").kendoDropDownList();
$("#ListCDoc1IssuingAuthority").val($("#ListCDoc1IssuingAuthorityForSSN").val());
$("#List" + listCategory + "Doc1IssuingAuthority").removeAttr("readonly");
$("#List" + listCategory + "Doc1IssuingAuthority").removeAttr("disabled");
} else {
$("#trListCIssuingAuthorityForSSN").hide();
$("#trListCIssuingAuthority").show();
if (docTypeId == '67' || docTypeId == '74' || docTypeId == '66') {
$("#List" + listCategory + "Doc1IssuingAuthority").attr("readonly", true);
} else if (docTypeId == 72 || docTypeId == 63) {
$("#List" + listCategory + "Doc1IssuingAuthority").attr("readonly", data.IssuingAuthEditable == false);
} else {
$("#List" + listCategory + "Doc1IssuingAuthority").removeAttr("readonly");
$("#List" + listCategory + "Doc1IssuingAuthority").removeAttr("disabled");
}
}
if (docTypeId == '662') {
$("#ListCDoc1IssuingAuthority").attr("readonly", true);
}
if (!data.Doc2Editable) {
$("#List" + listCategory + "Doc1IssuingAuthorityForSSN").attr("readonly", true);
$("#List" + listCategory + "Doc1IssuingAuthorityForSSN").kendoDropDownList();
}
}
if (listCategory == "A") {
if (pageLoad == undefined || pageLoad == null || pageLoad == false) resetReceiptCheckbox("ListAReceiptProvided");
$("#ListADoc2Number").removeAttr("disabled");
//show 'Passport' before 'Docement #' when select 50,53,54
if (docTypeId == 50 || docTypeId == 53 || docTypeId == 54 || docTypeId == 533 || docTypeId == 534) {
$("#lblPassport").show();
} else {
$("#lblPassport").hide();
}
switch (parseInt(docTypeId)) {
case 54:
var visibleListADoc2IssuingAuthorityI94 = $("#spanListADoc2IssuingAuthorityI94").is(":visible");
$("#ListAIssuingAuthorityForI94").attr("disabled", false);
$("#trListAIssuingAuthorityForI94").show();
$("#spanListADoc2IssuingAuthorityI94").show();
$("#trListAIssuingAuthorityForDoc515").hide();
$("#spanListADoc2IssuingAuthorityDoc732").hide();
$("#spanListADoc2IssuingAuthority").hide();
//$("#trCountryOfIssuanceDocA").hide();
$("#trListAIssuingAuthority").hide();
$("#ListAIssuingAuthorityForI94").kendoDropDownList();
$("#ListADoc2IssuingAuthorityI94").kendoDropDownList();
if (pageLoad != null && pageLoad == false && !visibleListADoc2IssuingAuthorityI94) {
$("#ListADoc2IssuingAuthorityI94").val("");
}
$("#ListADoc1IssuingAuthority").val($("#ListAIssuingAuthorityForI94").val());
$("#ListADoc2IssuingAuthority").val($("#ListADoc2IssuingAuthorityI94").val());
break;
case 732: //732
$(".trI94").hide();
$(".doc73").show();
$("#trListAIssuingAuthorityForI94").show();
$("#spanListADoc2IssuingAuthorityDoc732").show();
$("#trListAIssuingAuthorityForDoc515").hide();
$("#spanListADoc2IssuingAuthorityI94").hide();
$("#spanListADoc2IssuingAuthority").hide();
//$("#trCountryOfIssuanceDocA").hide();
$("#trListAIssuingAuthority").hide();
$("#ListAIssuingAuthorityForI94").kendoDropDownList();
$("#ListADoc2IssuingAuthorityDoc732").kendoDropDownList();
$("#ListADoc1IssuingAuthority").val($("#ListAIssuingAuthorityForI94").val());
$("#ListADoc1Expires").val();
$("#ListADoc2Title").val("Form I-94/I-94A");
$("#ListADoc2IssuingAuthority").val($("#ListADoc2IssuingAuthorityDoc732").val());
$("#I94ExpiresDiv").show();
if (pageLoad != null && pageLoad == false) {
GetDocTypeForI94OrAuthorization(732);
}
if (!pageLoad) {
$("#I94ExpiresCheckbox").attr("checked", false);
$("#I94ExpiresDiv span").css('background-position', '0px 0px');
}
$("#ListAIssuingAuthorityForI94").attr("disabled", true);
if ($("#I94ExpiresCheckbox").is(":checked")) $("#ListADoc2Expires").attr("Disabled", true);
break;
case 731: //731
$(".trI94").hide();
$(".doc73").show();
$("#trListAIssuingAuthorityForI94").show();
$("#spanListADoc2IssuingAuthorityDoc732").show();
$("#trListAIssuingAuthorityForDoc515").hide();
$("#spanListADoc2IssuingAuthorityI94").hide();
$("#spanListADoc2IssuingAuthority").hide();
//$("#trCountryOfIssuanceDocA").hide();
$("#trListAIssuingAuthority").hide();
$("#ListAIssuingAuthorityForI94").kendoDropDownList();
$("#ListADoc2IssuingAuthorityDoc732").kendoDropDownList();
if (pageLoad != null && pageLoad == false) {
GetDocTypeForI94OrAuthorization(731);
}
$("#ListADoc2Title").val("Form I-94/I-94A");
$("#ListAIssuingAuthority").val($("#ListAIssuingAuthorityForI94").val());
$("#ListADoc2IssuingAuthority").val($("#ListADoc2IssuingAuthorityDoc732").val());
$("#ListAIssuingAuthorityForI94").attr("disabled", true);
$("#I94ExpiresDiv").show();
if (!pageLoad) {
$("#I94ExpiresCheckbox").attr("checked", false);
$("#I94ExpiresDiv span").css('background-position', '0px 0px');
}
if ($("#I94ExpiresCheckbox").is(":checked")) $("#ListADoc2Expires").attr("Disabled", true);
break;
case 533:
case 534:
$("#ListAIssuingAuthorityForI94").attr("disabled", false);
$(".trI551Passport").show();
$("#trListAIssuingAuthority").hide();
$("#trListADoc1Expires .trI551Passport").show();
$("#trListAIssuingAuthority").hide();
$("#trListAIssuingAuthorityForI94").show();
$("#trListADoc1Expires").show();
$("#trListADoc1Expires .lblI551Passport").show();
$(".trI551Stamp").show();
$(".trI94 .I94").hide();
$(".trI94 .I20EAD").hide();
$(".trI94 .I797C").hide();
$(".trI94 .lblOld").hide();
$("#spanListADoc2IssuingAuthority").hide();
$("#spanListADoc2IssuingAuthorityDoc533").show();
$("#ListAIssuingAuthorityForI94").kendoDropDownList();
$("#ListADoc2IssuingAuthorityDoc533").kendoDropDownList();
$("#spanListADoc2IssuingAuthorityDoc534").hide();
//$("#trCountryOfIssuanceDocA").hide();
$("#ListADoc2IssuingAuthority").val($("#ListADoc2IssuingAuthorityDoc533").val());
$("div.chbReceiptProvided input[type='checkbox']").attr("checked", false);
if (docTypeId == '534') {
$("#lblI551Stamp").text(" Machine-Readable Immigrant Visa (MRIV)");
$("#ListADoc2Title").val("Machine-Readable Immigrant Visa (MRIV)");
$("#spanListADoc2IssuingAuthorityDoc533").hide();
$("#spanListADoc2IssuingAuthorityDoc534").hide();
$("#spanListADoc2IssuingAuthority").show();
$("#ListADoc2IssuingAuthority").attr("readonly", "true");
$("#ListADoc2IssuingAuthority").val("U.S. Department of State");
$("#ListADoc2Number").removeAttr("disabled");
} else {
//Card #67 Implement "Foreign Passport with I-551 Stamp" List A Document Type.https://trello.com/c/swA0zIil
$("#lblI551Stamp").text("Temporary I-551 Stamp");
$("#ListADoc2Title").val("Temporary I-551 Stamp");
$("#ListADoc2Number").val("N/A");
$("#ListADoc2Number").attr("disabled", true);
$(".lblI533Passport").show();
}
$(".trI94 .lblI551Stamp").show();
$("#trListAIssuingAuthorityForDoc515").hide();
if (pageLoad != null && pageLoad == false) {
KendoDropdownListSelOption("ListADoc2IssuingAuthorityDoc533", 0)
KendoDropdownListSelOption("ListAIssuingAuthorityForI94", 0)
}
break;
case 535: //535
$("#trListAIssuingAuthorityForDoc515").hide();
$("#blanktitle").show();
$("#blanklabel").text("Temporary I-551 Stamp");
$("#trListAIssuingAuthority").hide();
$("#ListADoc1Numbertr").show();
//$("#trCountryOfIssuanceDocA").hide();
$("#trListAIssuingAuthority535").show();
$("#trListAIssuingAuthority").hide();
$("#ListADoc1NumbertrLabel").text("Temporary I-551 Document #:");
$("#trListADoc1Expires").show();
$("#trListADoc1ExpiresLabel").text("Temporary I-551 Expires:");
$("#ListADoc2Number").removeAttr("disabled");
$("#trListAIssuingAuthorityForI94").hide();
if (pageLoad != null && pageLoad == false) {
GetDocTypeForI94OrAuthorization(535);
}
$("#ListADoc1IssuingAuthority").val($("#ListADoc2IssuingAuthorityDoc535").val());
break;
case 515:
$("#trListAIssuingAuthorityForDoc515").show();
$("#spanListADoc2IssuingAuthorityDoc732").hide();
$("#trListAIssuingAuthorityForI94").hide();
$("#spanListADoc2IssuingAuthorityI94").hide();
$("#spanListADoc2IssuingAuthority").hide();
//$("#trCountryOfIssuanceDocA").hide();
$("#trListAIssuingAuthority").hide();
$("#ListAIssuingAuthorityForDoc515").attr("disabled", false);
$("#ListAIssuingAuthorityForDoc515").kendoDropDownList();
$("#trListAIssuingAuthority").hide();
$("#ListAIssuingAuthority").val($("#ListAIssuingAuthorityForDoc515").val());
break;
case 514:
$("#trListAIssuingAuthorityForDoc515").show();
$("#spanListADoc2IssuingAuthorityDoc732").hide();
$("#trListAIssuingAuthorityForI94").hide();
$("#spanListADoc2IssuingAuthorityI94").hide();
$("#spanListADoc2IssuingAuthority").hide();
//$("#trCountryOfIssuanceDocA").hide();
$("#trListAIssuingAuthority").hide();
$("#ListAIssuingAuthorityForDoc515").attr("disabled", true);
$("#ListAIssuingAuthorityForDoc515").kendoDropDownList();
$("#trListAIssuingAuthority").hide();
$("#ListAIssuingAuthority").val($("#ListAIssuingAuthorityForDoc515").val());
break;
case 861:
$("#spanListADoc2IssuingAuthorityDoc732").hide();
$("#trListAIssuingAuthorityForI94").hide();
$("#spanListADoc2IssuingAuthorityI94").hide();
$("#spanListADoc2IssuingAuthority").hide();
//$("#trCountryOfIssuanceDocA").hide();
$("#trListAIssuingAuthority").hide();
$("#trPassportI94Doc").show();
$("#trPassportI94Doc .lblI551Passport").hide();
$("#trPassportI94Doc .lblI551_I94Doc").show();
$("#trListAIssuingAuthority").show();
$("#ListADoc1IssuingAuthority").val("DHS");
$("#ListADoc1IssuingAuthority").attr("readonly", "readonly")
break;
case 503:
case 504:
$("#ListADoc1IssuingAuthority").attr("readonly", "readonly")
//$("#trCountryOfIssuanceDocA").hide();
break;
case 515:
$("#ListADoc1IssuingAuthority").val("USCIS");
break;
default:
$("#trListAIssuingAuthorityForI94").hide();
$("#spanListADoc2IssuingAuthorityI94").hide();
$("#spanListADoc2IssuingAuthority").show();
$("#trListAIssuingAuthority").show();
}
//ReSetTableCss("", true);
}
if (listCategory == "B") {
$("#List" + listCategory + "DocumentTitle").val(data.DocumentTitle);
$("#List" + listCategory + "DocumentTitle").attr("readonly", true);
}
setListBCExpirationDateHeight();
}, "json");
}
}
function resetReceiptCheckbox(name) {
var chbName = name;
var chb = $("#" + name);
var chbSpan = chb.prev(".checkbox")[0];
if ($('[name="' + chbName + '"]:hidden').val() != 'true') {
//chbSpan.style.backgroundPosition = "0px 0px";
chb.val(false);
$('[name="' + chbName + '"]:hidden').val(false);
chb.removeAttr("checked");
} else {
//chbSpan.style.backgroundPosition = "0px -50px";
chb.val(true);
$('[name="' + chbName + '"]:hidden').val(true);
chb.attr("checked", "checked");
}
}
function I9DocsEditControl_DisableDocumentListB(listCategory, disabled) {
$("#tableList" + listCategory + " .trDocB input").each(function(index) {
if (disabled) {
$(this).addClass("DocEmployerReviewVerificationDisable");
$("#ListBDoc1Number").val("NA");
$("#trUnder18").show();
$(".trAttachment").hide();
$(".trDocBReceiptProvided").hide();
$(this).attr("readonly", true);
$("#ListBDoc1Number").attr("disabled", true);
} else {
$(this).removeClass("DocEmployerReviewVerificationDisable");
$(this).removeAttr("readonly");
$("#trUnder18").hide();
$(".trAttachment").show();
$(".trDocBReceiptProvided").show();
$("#ListBDoc1Number").attr("disabled", false);
}
});
$("#ListBDocumentTypeName").attr("readonly", true);
ChangeDocListBLayout(parseInt($("#ListBDocumentType").val()));
//
}
function I9DocsEditControl_MakeDocumentListBReadonly(listCategory) {
$("#tableList" + listCategory + " .trDocB input").each(function(index) {
$(this).attr("readonly", true);
});
}
function GetI94DocTypeInfoAjax(i94TypeId, listCategory, pageLoad) {
ChangeDatePickerByAddtionalDocument();
if (i94TypeId > 0) {
var listADoc1Expires = $("#ListADoc1Expires").val();
var listADoc2Expires = $("#ListADoc2Expires").val();
$(".aDoc3ReverificationDueDateList" + listCategory).hide();
if ($.ClientSpecialCharsValidate("#divformSection2") == false) return;
$.post("/form-I9/get-I94DocTypeInfo", {
i94TypeId: i94TypeId,
listADoc1Expires: listADoc1Expires,
listADoc2Expires: listADoc2Expires
}, function(data) {
if (data.ReverificationDueDateTooltip != null && data.ReverificationDueDateTooltip != "") {
$(".aDoc3ReverificationDueDateList" + listCategory).show();
$(".spanDoc3ReverificationDueDateList" + listCategory).html(data.ReverificationDueDateTooltip);
}
if (data.DefaultDueDate.length > 0 && i94TypeId != "6" && i94TypeId != "9" && i94TypeId != "13" && i94TypeId != "7" && i94TypeId != "8") {
$("#ListADueDate").val(data.DefaultDueDate);
}
}, "json");
var listADocumentType = $("#ListADocumentType").val();
if (listADocumentType == "54") {
if (i94TypeId == "5") {
$(".trNormal.trI551Passport input[type=text]").val("");
$("#ListACountryCode").data("kendoDropDownList").value("");
$(".trNormal.trI551Passport").hide();
$(".refugeeHide").hide();
} else {
//$(".trNormal.trI551Passport").show();
$(".trI94.doc94.doc73").show();
}
} else if (listADocumentType == "53") {
if (i94TypeId == "12") {
$("#ListADoc1IssuingAuthority").val("DHS");
} else {
$("#ListADoc1IssuingAuthority").val("");
$(".aDoc1NumListA").show();
$(".spanDoc1NumListA").html(listADoc1NumTootip);
}
}
}
}
function ChangeDatePickerByAddtionalDocument() {
var listAI94Type = $("#ListAI94Type").val();
if (listAI94Type == undefined || listAI94Type == "") {
return;
}
var dballAdditionalInfo = "";
if (dballAdditionalInfo == undefined || dballAdditionalInfo === "") {
$('#AdditionalInfo').val("");
}
// FormI20 or DS2019
if (listAI94Type == "1" || listAI94Type == "2") {
$("#ListADoc2Expires").val("D/S");
} else {
if ($("#ListADoc2Expires").val() == "D/S") jqueryDatePickerCustom($("#ListADoc2Expires").val("").removeAttr("disabled"));
}
if (listAI94Type == "9") {
var today = new Date();
var yyyy = today.getFullYear();
var EADCAPDate = "09" + '/' + "30" + '/' + yyyy;
$("#ListADueDate").val(EADCAPDate);
var dballAdditionalInfo = "";
var dbAdditionalType = "";
var addiotinalText = $('#AdditionalInfo').val();
if (dballAdditionalInfo.length == 0) {
if (addiotinalText.length > 0 && addiotinalText.indexOf('CAP-GAP') < 0) {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 CAP-GAP (" + $('#ListADueDate').val() + ")");
} else {
$('#AdditionalInfo').val("Section2 CAP-GAP (" + $('#ListADueDate').val() + ")");
}
} else {
if (dbAdditionalType != "9") {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 CAP-GAP (" + $('#ListADueDate').val() + ")");
}
}
} else {
if (dballAdditionalInfo.length > 0) {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val());
} else {
$('#AdditionalInfo').val("");
}
}
if (listAI94Type == "6") {
if ($("input[id$='ListADoc2Expires']").val() != "") {
$("input[id$='ListADoc2Expires']").trigger("change");
}
if ($("input[id$='ListADueDate']").val() != "") {
$("input[id$='ListADueDate']").trigger("change");
}
}
if (listAI94Type == "3") {
if ($("input[id$='ListADoc2Expires']").val() != "") {
$("input[id$='ListADoc2Expires']").trigger("change");
}
if ($("input[id$='ListAFilingDate']").val() != "") {
$("input[id$='ListAFilingDate']").trigger("change");
}
}
if (listAI94Type == "13") {
if ($("input[id$='ListADoc1Expires']").val() != "") {
$("input[id$='ListADoc1Expires']").trigger("change");
}
}
if (listAI94Type == "7") {
if ($("input[id$='ListADueDate']").val() != "") {
$("input[id$='ListADueDate']").trigger("change");
}
}
if (listAI94Type == "8") {
if ($("input[id$='ListADoc1Expires']").val() != "") {
$("input[id$='ListADoc1Expires']").trigger("change");
}
}
} // End of ChangeDatePickerByAddtionalDocument
$("[id$='ListBState']").change(function() {
ShowListBExpirationDateRequired(false);
});
$("input[id$='ListAFilingDate']").change(function() //99099
{
var listAI94Type = $("#ListAI94Type").val();
var dballAdditionalInfo = "";
var addiotinalText = $('#AdditionalInfo').val();
var dbAdditionalType = "";
if (listAI94Type == "6") {
if ($("input[id$='ListAFilingDate']:visible").length > 0) {
var val = $(this).val();
if (val.length > 0 && new Date(val).toString() != "Invalid Date") {
if (dballAdditionalInfo.length == 0) //only Section2 Case
{
if (addiotinalText.length > 0 && addiotinalText.indexOf('Section2') < 0) {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 240-Day Ext. I-129 Filing Date " + $('#ListAFilingDate').val());
} else {
$('#AdditionalInfo').val("Section2 240-Day Ext. I-129 Filing Date " + $('#ListAFilingDate').val());
}
} else {
if (dbAdditionalType != "6") {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2: 240-Day Ext. I-129 Filing Date " + $('#ListAFilingDate').val());
} else {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val());
}
}
} // End of List date....
}
} else if (listAI94Type == "3") {
if ($("input[id$='ListAFilingDate']:visible").length > 0) {
var val = $(this).val();
if (val.length > 0 && new Date(val).toString() != "Invalid Date") {
if (dballAdditionalInfo.length == 0) //only Section2 Case
{
if (addiotinalText.length > 0 && addiotinalText.indexOf('Section2: AC-21/ I-129 Filing Date') < 0 && dbAdditionalType == "3") {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2: AC-21/ I-129 Filing Date " + $('#ListAFilingDate').val());
} else {
$('#AdditionalInfo').val("Section2 AC-21/ I-129 Filing Date " + $('#ListAFilingDate').val());
}
} else {
if (dbAdditionalType != "3") {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2: AC-21/ I-129 Filing Date " + $('#ListAFilingDate').val());
} else {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val());
}
}
} // End of List date....
}
} else {
if ($("input[id$='ListAFilingDate']:visible").length > 0 && $("input[id$='ListADueDate']:visible").length > 0 && listAI94Type != "3") {
var val = $(this).val();
if (val.length > 0 && new Date(val).toString() != "Invalid Date") {
$("input[id$='ListADueDate']").val(new Date(val).addDays(120).format("MM/dd/yyyy"));
}
}
}
});
var skipAjaxValidateSection2Item = false;
$("input[id$='ListADueDate']").change(function(e) //91143
{
var listAI94Type = $("#ListAI94Type").val();
var dballAdditionalInfo = "";
var dbAdditionalType = "";
var addiotinalText = $('#AdditionalInfo').val();
if (listAI94Type == "13" && $("input[id$='ListADueDate']:visible").length > 0) {
if (dballAdditionalInfo.length == 0) //only Section2 Case
{
if (addiotinalText.length > 0 && addiotinalText.indexOf('Section2 EAD') < 0) {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 EAD EXT " + $('#ListADueDate').val() + " EAD Card Number " + $('#ListADoc1Number').val());
} else {
$('#AdditionalInfo').val("Section2 EAD EXT " + $('#ListADueDate').val() + " EAD Card Number " + $('#ListADoc1Number').val());
}
} else {
if (dbAdditionalType != "13") {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 EAD EXT " + $('#ListADueDate').val() + " EAD Card Number " + $('#ListADoc1Number').val());
}
}
} else if (listAI94Type == "7" && $("input[id$='ListADueDate']:visible").length > 0) {
if (dballAdditionalInfo.length == 0) //only Section2 Case
{
if (addiotinalText.length > 0 && addiotinalText.indexOf('Section2 EAD') < 0) {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 EAD EXT " + $('#ListADueDate').val());
} else {
$('#AdditionalInfo').val("Section2 EAD EXT " + $('#ListADueDate').val());
}
} else {
if (dbAdditionalType != "7") {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 EAD EXT " + $('#ListADueDate').val());
} else {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val());
}
}
} else if (listAI94Type == "8" && $("input[id$='ListADueDate']:visible").length > 0) {
if (dballAdditionalInfo.length == 0) //only Section2 Case
{
if (addiotinalText.length > 0 && addiotinalText.indexOf('Section2 EAD') < 0) {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 EAD EXT " + $('#ListADueDate').val());
} else {
$('#AdditionalInfo').val("Section2 EAD EXT " + $('#ListADueDate').val());
}
} else {
if (dbAdditionalType != "8") {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 EAD EXT " + $('#ListADueDate').val());
} else {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val());
}
}
} else if (listAI94Type == "9") //98346
{
skipAjaxValidateSection2Item = true;
var EADCAPDate = "09" + '/' + "30" + '/' + new Date().getFullYear();
var alertText =
"The EAD cap-gap provides the employee with an extension of status and work authorization through September 30 of the calendar year the employer filed Form I-129, Petition for Nonimmigrant Worker (H-1B petition). You entered a different date. Click Yes to confirm the date entered or click No to reset to the date.";
$.trackerConfirmNew(alertText, function() {
skipAjaxValidateSection2Item = false;
if (dballAdditionalInfo.length == 0) {
if (addiotinalText.length > 0 && addiotinalText.indexOf('CAP-GAP') < 0) {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 CAP-GAP (" + $('#ListADueDate').val() + ")");
} else {
$('#AdditionalInfo').val("Section2 CAP-GAP (" + $('#ListADueDate').val() + ")");
}
} else {
if (dbAdditionalType != "9") {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 CAP-GAP (" + $('#ListADueDate').val() + ")");
}
}
ajaxValidateSection2Item($(this));
$.ShowOrHideSaveBtn($("#divformSection2"));
}, function() {
skipAjaxValidateSection2Item = false;
$("input[id$='ListADueDate']").val(EADCAPDate);
if (dballAdditionalInfo.length == 0) {
if (addiotinalText.length > 0 && addiotinalText.indexOf('CAP-GAP') < 0) {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 CAP-GAP (" + $('#ListADueDate').val() + ")");
} else {
$('#AdditionalInfo').val("Section2 CAP-GAP (" + $('#ListADueDate').val() + ")");
}
} else {
if (dbAdditionalType != "9") {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 CAP-GAP (" + $('#ListADueDate').val() + ")");
}
}
ajaxValidateSection2Item($(this));
$.ShowOrHideSaveBtn($("#divformSection2"));
});
}
});
$("input[id$='ListADoc1Expires']").change(function() //91143
{
var listAI94Type = $("#ListAI94Type").val();
var dballAdditionalInfo = "";
var dbAdditionalType = "";
var addiotinalText = $('#AdditionalInfo').val();
if (listAI94Type == "13") {
if ($("input[id$='ListADoc1Expires']:visible").length > 0) // Part 1 Start
{
var val = $(this).val();
if (val.length > 0 && new Date(val).toString() != "Invalid Date") {
$("input[id$='ListADueDate']").val(new Date(val).addDays(540).format("MM/dd/yyyy"));
}
} // Part1 End
if ($("input[id$='ListADoc1Expires']:visible").length > 0) ////Part 2 Start
{
var val = $(this).val();
if (val.length > 0 && new Date(val).toString() != "Invalid Date") {
if (dballAdditionalInfo.length == 0) //only Section2 Case
{
if (addiotinalText.length > 0 && addiotinalText.indexOf('Section2 EAD') < 0) {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 EAD EXT " + $('#ListADueDate').val() + " EAD Card Number " + $('#ListADoc1Number').val());
} else {
$('#AdditionalInfo').val("Section2 EAD EXT " + $('#ListADueDate').val() + " EAD Card Number " + $('#ListADoc1Number').val());
}
} else {
if (dbAdditionalType != "13") {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 EAD EXT " + $('#ListADueDate').val() + " EAD Card Number " + $('#ListADoc1Number').val());
} else {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val());
}
}
}
} ////Part 2 End...
}
if (listAI94Type == "8") {
if ($("input[id$='ListADoc1Expires']:visible").length > 0) // Part 1 Start
{
var val = $(this).val();
if (val.length > 0 && new Date(val).toString() != "Invalid Date") {
$("input[id$='ListADueDate']").val(new Date(val).addDays(180).format("MM/dd/yyyy"));
}
} // Part1 End
if ($("input[id$='ListADoc1Expires']:visible").length > 0) ////Part 2 Start
{
var val = $(this).val();
if (val.length > 0 && new Date(val).toString() != "Invalid Date") {
if (dballAdditionalInfo.length == 0) //only Section2 Case
{
if (addiotinalText.length > 0 && addiotinalText.indexOf('Section2 EAD') < 0) {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 EAD EXT " + $('#ListADueDate').val());
} else {
$('#AdditionalInfo').val("Section2 EAD EXT " + $('#ListADueDate').val());
}
} else {
if (dbAdditionalType != "8") {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 EAD EXT " + $('#ListADueDate').val());
} else {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val());
}
}
}
} //Part 2 End...
}
});
$("input[id$='ListADoc3Title']").change(function() {
var additionlDocvalue = $("#ListADoc3Title").val();
if (additionlDocvalue == "Nonimmigrant Extension w/ Current Employer") {
if ($("input[id$='ListADoc2Expires']:visible").length > 0 && $("input[id$='ListADueDate']:visible").length > 0) {
var val = $(this).val();
if (val.length > 0 && new Date(val).toString() != "Invalid Date") {
$("input[id$='ListADueDate']").val(new Date(val).addDays(240).format("MM/dd/yyyy"));
}
}
}
if (additionlDocvalue != "Nonimmigrant Extension w/ Current Employer") {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val());
}
});
$("input[id$='ListADoc2Expires']").change(function() {
var listAI94Type = $("#ListAI94Type").val();
if (listAI94Type == "6") {
if ($("input[id$='ListADoc2Expires']:visible").length > 0) {
var val = $(this).val();
if (val.length > 0 && new Date(val).toString() != "Invalid Date") {
$("input[id$='ListADueDate']").val(new Date(val).addDays(240).format("MM/dd/yyyy"));
}
}
}
if (listAI94Type == "3") {
if ($("input[id$='ListADoc2Expires']:visible").length > 0) {
var val = $(this).val();
if (val.length > 0 && new Date(val).toString() != "Invalid Date") {
$("input[id$='ListADueDate']").val(new Date(val).addDays(120).format("MM/dd/yyyy"));
}
}
}
if (listAI94Type == "0") {
$("input[id$='ListADueDate']").val("");
}
});
$("input[id$='ListADoc1Number']").change(function() {
if (IsAdditionalDocumenSelectionWindow === 1) {
$("#hiddenMobileListADoc1Number").val($("#ListADoc1Number").val());
}
var listAI94Type = $("#ListAI94Type").val();
var dballAdditionalInfo = "";
var dbAdditionalType = "";
var addiotinalText = $('#AdditionalInfo').val();
if (listAI94Type == "13") {
if ($("input[id$='ListADoc1Number']").length > 0 && $("input[id$='ListADoc1Expires']:visible").length > 0) ////Part 2 Start
{
if (dballAdditionalInfo.length == 0) //only Section2 Case
{
if (addiotinalText.length > 0 && addiotinalText.indexOf('Section2 EAD') < 0) {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 EAD EXT " + $('#ListADueDate').val() + " EAD Card Number " + $('#ListADoc1Number').val());
} else {
$('#AdditionalInfo').val("Section2 EAD EXT " + $('#ListADueDate').val() + " EAD Card Number " + $('#ListADoc1Number').val());
}
} else {
if (dbAdditionalType != "13") {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val() + "\nSection2 EAD EXT " + $('#ListADueDate').val() + " EAD Card Number " + $('#ListADoc1Number').val());
} else {
$('#AdditionalInfo').val($('#hdnAdditionalInfo').val());
}
}
} ////Part 2 End...
}
});
function ShowListBExpirationDateRequired(notClearInput) {
var state = $("[id$='ListBState']").val();
if (state != null && state != "") {
var expires = $("#ListBDoc1Expires").val();
$.post("/form-I9Doc/get-UnitedStateInfo", {
state: state
}, function(data) {
if (!notClearInput) {
$("[id$='ListBDoc1IssuingAuthority']").val(data.DLIssuingAuthorityName);
}
var listBType = $("#ListBDocumentType").val();
if (listBType != undefined && listBType == "55" && (data.StateName == "Arizona" || data.StateName == "Louisiana" || data.StateName == "Tennessee")) {
data.ExpirationDateRequired = false;
}
if (data.ExpirationDateRequired) {
$(".expiresListB").show();
//$("#ListBDoc1Expires").attr("placeholder", "Required");
SetExpiresRequiredOrNA("B", false);
} else {
$(".expiresListB").hide();
//$("#ListBDoc1Expires").attr("placeholder", "Required or N/A");
SetExpiresRequiredOrNA("B", true);
}
if (expires == null || expires.length <= 0) {
$("#ListBDoc1Expires").val("");
}
//var listBType = $("#ListBDocumentType").val();
//if (listBType != undefined && listBType == "55" && data.StateName == "Arizona") {
// $("#ListBDoc1Expires").attr("placeholder", "Optional");
//}
//ReSetPlaceholder("tableListB");
}, "json");
} else {
$("[id$='ListBDoc1IssuingAuthority']").val("");
}
}
function ShowListBExpirationDateRequiredFor551552(listBType, issuingAuthority) {
var expirationDateRequired = true;
var expires = $("#ListBDoc1Expires").val();
var listBType = $("#ListBDocumentType").val();
if (listBType != undefined && (listBType == "551" || listBType == "552") && (issuingAuthority == "AL" || issuingAuthority == "AK" || issuingAuthority == "AZ" || issuingAuthority == "IL" || issuingAuthority == "LA" || issuingAuthority ==
"MN" || issuingAuthority == "OK" || issuingAuthority == "PA" || issuingAuthority == "TN" || issuingAuthority == "TX" || issuingAuthority == "WA" || issuingAuthority == "WI" || issuingAuthority == "WY" || (listBType == "552" &&
issuingAuthority == "AR"))) {
expirationDateRequired = false;
}
if (expirationDateRequired == true) {
//$("#ListBDoc1Expires").attr("placeholder", "Required");
$(".expiresListB").show();
SetExpiresRequiredOrNA("B", false);
} else {
//$("#ListBDoc1Expires").attr("placeholder", "Required or N/A");
$("#ListBDoc1Expires").removeClass("input-validation-error");
$(".expiresListB").hide
SetExpiresRequiredOrNA("B", true);
}
}
if ($("#ListADocumentType") != null && $("#ListADocumentType").val() != undefined && $("#ListADocumentType").val() == "51") {
$(".lblI551_I94Doc").hide();
$("#lblPassport").hide();
$(".lblI551Passport").hide();
$(".lblI551_Card").show();
}
if ($("#ListADocumentType") != null && $("#ListADocumentType").val() != undefined && $("#ListADocumentType").val() == "52") {
$("#Section1_USCISNumber").val($("#USCISNumber").val());
$("#ListADoc1IssuingAuthority").attr("readonly", "readonly")
$("#trdcAUSCIS").show();
}
function ChangeDocListBLayout(docB) {
if (docB && docB == 76) {
$("#tableListB .trAttachment").hide();
$("#tableListB .trDocBReceiptProvided").hide();
$("#tableListB #trUnder18").show();
$("#tableListB #ListBDoc1Number").val(null);
}
if (docB == 71 || docB == 551 || docB == 552) {
$("#ListBDoc1IssuingAuthority").hide();
//$("#ListBDoc1IssuingAuthority").val("");
$("#ListBDoc1IssuingAuthorityForDropdown").closest(".k-widget").show();
$("#ListBState").val($("#DropdownListBIssuingAuthority").val());
$("#ListBDoc1IssuingAuthorityForDropdown").val($("#DropdownListBIssuingAuthority").val());
$('#ListBDoc1IssuingAuthorityForDropdown').data('default', $("#DropdownListBIssuingAuthority").val());
} else {
$("#spanListBIssuingAuthority").show();
$("#ListBDoc1IssuingAuthority").show();
$("#spanListBIssuingAuthorityList").hide();
$("#ListBDoc1IssuingAuthorityForDropdown").closest(".k-widget").hide();
$("#ListBDoc1IssuingAuthorityForDropdown").val("");
}
}
function changeDocListBLayout551and552(docB, pageLoad) {
if (docB == '551' || docB == '552') {
$("#spanListBIssuingAuthorityList").show();
$("#spanListBIssuingAuthority").hide();
$("#ListBDoc1IssuingAuthority").val($("#DropdownListBIssuingAuthority").val());
if (pageLoad == undefined || pageLoad == null || pageLoad == false) {
$("#DropdownListBIssuingAuthority").val("");
}
$("#DropdownListBIssuingAuthority").kendoDropDownList();
ShowListBExpirationDateRequiredFor551552(docB, $("#ListBDoc1IssuingAuthority").val());
//ReSetTableCss("", true);
}
}
function changeDocListBLayout592(docB) {
if (docB == '592' || docB == '71') {
$("#spanListBIssuingAuthority").show();
$("#spanListBIssuingAuthorityList").hide();
//ReSetTableCss("", true);
}
}
function clearInitValues() {}
function KendoDropdownListSelOption(dopdownListID, index) {
var dopdownList = $("#" + dopdownListID).data("kendoDropDownList");
dopdownList.select(index);
}
function CalculateDocDuedate() {
var docId = parseInt($("#ListADocumentType").val());
var listAI94Type = $("#ListAI94Type").val();
if (docId == '54') {
switch (listAI94Type) {
case "0":
case "None":
$("#ListADueDate").val($("#ListADoc2Expires").val());
break;
case "1":
case "2":
$("#ListADueDate").val($("#ListADoc3Expires").val());
break;
}
}
}
function setListBCExpirationDateHeight() {
trListBExpires.height('auto');
trListCExpires.height('auto');
if (trListBExpires.is(':visible') && trListCExpires.is(':visible')) {
var maxHeight = trListBExpires.height() > trListCExpires.height() ? trListBExpires.height() : trListCExpires.height();
if (trListBExpires.height() < maxHeight) {
trListBExpires.height(maxHeight);
}
if (trListCExpires.height() < maxHeight) {
trListCExpires.height(maxHeight);
}
}
}
var element = document.createElement("div");
element.className = "popup-logo d-md-none";
document.getElementById('listbExpiredDocumentAlert').prepend(element);
var element = document.createElement("div");
element.className = "popup-logo d-md-none";
document.getElementById('acceptableExpiredDocumentAlert').prepend(element);
</script>
</div>
</div>
<!-- end moduleContent-->
<div class="clear"></div>
</div>
<div id="divEESignature" class="ESignature-main tab-pane fade d-md-block opacity-100 mt-0 pt-0" role="form" aria-label="employee signature">
<div class="box-module box-module-01 backWhite">
<div class="newUI-moduleLabel-1 d-none d-md-block"><span class="newUI-Svg-Desktop-1"></span></div>
<div class="moduleContent mobi-head" id="divElectronicSignature" style="width:850px">
<fieldset>
<legend hidden="">Provide an Electronic Signature</legend>
<h2 class="header-style-01 header-style-size-05 electronic-sign-head">Provide an Electronic Signature</h2>
<div id="divElectronicSignature">
<input id="hiddenIsEmployeeUnder18" name="hiddenIsEmployeeUnder18" type="hidden" value="False">
<input id="hiddenenableEverify" name="hiddenenableEverify" type="hidden" value="False">
<br>
<div style="display: none;margin-bottom:10px;" class="divUnder18" parentdivid="divElectronicSignature">
<input type="hidden" name="IsUnder18Flag">
<input type="checkbox" class="mright10 chk-style-2" id="IsUnder18Flag" name="IsUnder18Flag">
<div style="width:calc(100% - 35px);float:right;margin-top:0px;margin-bottom:10px">
<label class="li-sytle-01 f18-l24" for="IsUnder18Flag"> The employee is under the age of 18 and cannot produce a List A or List B document type for Section 2. 'INDIVIDUAL UNDER AGE 18' will automatically appear in the 'Print
Employee Name' field and the parent or legal guardian must complete the Preparer and/or Translator Certification. </label>
<br>
</div>
</div>
<div class="clear"></div>
<div class="alert-box-section1-1" id="divAlertInfoUnder18" style="display: none;margin-bottom:10px;margin-right:10px">
<p class="alert-text-section1-1"> ALERT: The individual who completes the Preparer and/or Translator Certification must be present with you when you present original identity and work authorization documents to your employer or its
representative for verification as required by law. Contact your employer if you cannot meet these requirements for any reason.
<a href="/Content/tracker/pdf/ListOfAcceptableDocuments_EN.pdf" target="_bank">Click to view a list of Acceptable Documents.</a>
</p>
<br>
</div>
<div class="alert-box-section1-1 imp-sign-sec" style="margin-bottom:10px; margin-right:10px">
<p class="alert-text-section1-1">
<span class="d-none d-md-inline-block">***</span><span class="imp-text">IMPORTANT</span><span class="d-none d-md-inline-block">:</span> <span class="d-block d-md-inline-block">YOU ARE SIGNING A U.S. GOVERNMENT FORM</span><span
class="d-none d-md-inline-block">***</span>
</p>
<p class="alert-text-section1-1 imp-signin-text">I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in connection with the completion of this form.</p>
</div>
<ul class="float px-0 mb-0" id="tabstripThree">
<li class="twoLine d-none d-md-block">
<div class="newUI-moduleLabel-2">
<div>1</div>
</div>
</li>
<li class="twoLine imp-signin-text">
<table>
<tbody>
<tr>
<td class="font-size-12 legal-name">
<span role="heading" aria-level="3">Enter your legal name as your electronic signature:</span>
</td>
</tr>
<tr>
<td style="padding-top:8px;">
<label for="EmployeeSignatureName" class="txtFirstName fontsize-sytle-01 d-inline f-w600">Employee Name (First, Middle Initial, and Last)</label>
<span class="required">*</span>
</td>
</tr>
<tr>
<td style="padding-top:6px;">
<input id="EmployeeId" name="EmployeeId" type="hidden" value="5628028">
<input id="I9Id" name="I9Id" type="hidden" value="5796382">
<input id="FormI9Revision" name="FormI9Revision" type="hidden" value="11">
<input id="FormCaseEnum" name="FormCaseEnum" type="hidden" value="2">
<input data-val="true" data-val-required="The PasswordChanged field is required." id="PasswordChanged" name="PasswordChanged" type="hidden" value="False">
<input data-val="true" data-val-required="The DisplaySignaturePassword field is required." id="DisplaySignaturePassword" name="DisplaySignaturePassword" type="hidden" value="False">
<input class="inputLarge enchanterRequired" id="EmployeeSignatureName" name="EmployeeSignatureName" onblur="EmployeeSignatureNameValidate()" placeholder="Required" required="required" type="text" value="Joel Mora"
style="font-style: normal;" autocomplete="off">
<input id="IsElectronicSignature" name="IsElectronicSignature" type="hidden" value="True">
<label class="field-errormsg" id="EmployeeSignatureName_error" data-valmsg-for-id="EmployeeSignatureName" data-valmsg-for="EmployeeSignatureName" aria-live="polite"></label>
</td>
</tr>
</tbody>
</table>
</li>
</ul>
<div class="clear"></div>
<ul class="float px-0 mb-0">
<li class="d-none d-md-block">
<div class="newUI-moduleLabel-2">
<div>2</div>
</div>
</li>
<li style="width: 740px" class="li-sytle-01 i-agree-text legal-name">
<p role="heading" aria-level="3" class="mb-md-0"> Select the box next to “ <strong>I agree</strong>” to acknowledge that you have read and accept the fact that you are signing a U.S. Government Form and that you are aware that
federal law provides for imprisonment and/or fines for false statements or use of false documents in connection with the completion of this Form. </p>
<div style="height:4px;" class="d-none d-md-block"> </div>
<input type="hidden" name="AgreeChecked">
<input type="checkbox" class="mright10 chk-style-2 enchanterRequired" id="AgreeChecked" name="AgreeChecked" required="">
<label class="txtFirstName li-sytle-01" id="i-agree-checkbox" for="AgreeChecked">I agree</label>
<span class="required">*</span>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="i-agree-tooltip-description" class="tipIcon">
<span class="classic" style="width: 450px;">
After completing Section 1, click the “I Agree” checkbox and then click the Sign Section 1 button below
<br><br>
By signing this form, you attest under penalty of perjury (28 U.S.C. §1746) that the information you provided; the citizenship or immigration status you selected; and all information and documentation you provide to your employer, is complete, true and correct, and you are aware that you may face severe penalties provided by law and may be subject to criminal prosecution for knowingly or willfully making false statements or using false documentation when completing this form.
<br><br>
If anyone other than the employee completes Section 1, both the employee and the preparer or translator should complete their respective areas of Section 1, then sign Section 1. If the employee is a minor (individual under age 18) or a person with a disability (who is placed in employment by a nonprofit organization, association or as part of a rehabilitation program) who cannot present an identity document, refer to the section of the Form I-9 instructions titled “Signature of the Employee” for more information.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="i-agree-tooltip-description" class="tipIcon"></span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">I agree</span>
<span> After completing Section 1, click the “I Agree” checkbox and then click the Sign Section 1 button below </span>
<span> By signing this form, you attest under penalty of perjury (28 U.S.C. §1746) that the information you provided; the citizenship or immigration status you selected; and all information and documentation you provide to
your employer, is complete, true and correct, and you are aware that you may face severe penalties provided by law and may be subject to criminal prosecution for knowingly or willfully making false statements or using
false documentation when completing this form. </span>
<span> If anyone other than the employee completes Section 1, both the employee and the preparer or translator should complete their respective areas of Section 1, then sign Section 1. If the employee is a minor (individual
under age 18) or a person with a disability (who is placed in employment by a nonprofit organization, association or as part of a rehabilitation program) who cannot present an identity document, refer to the section of the
Form I-9 instructions titled “Signature of the Employee” for more information. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<div><label class="field-errormsg" id="AgreeChecked_error" data-valmsg-for-id="AgreeChecked" data-valmsg-for="AgreeChecked" aria-live="polite"></label></div>
</li>
</ul>
<div class="clear"></div>
<ul class="float px-0 m-0">
<li class="d-none d-md-block">
<div class="newUI-moduleLabel-2">
<div>3</div>
</div>
</li>
<li class="trans-li-width" style="width: 740px">
<strong class="font-size-12 prep-tras-cert emp-info-atte" role="heading" aria-level="3">Preparer and/or Translator Certification <span class="d-none d-inline-block">(select one)</span>:</strong><span class="required">*</span>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Preparer-and/or-Translator-Certification-tooltip-description" class="tipIcon">
<span class="classic" style="font-size: 12px; width: 550px;">
Select the number of preparers and/or translators you used to complete the form if any. If you are the employee and you did not use a preparer or translator, you must select the first option marked “I did not use a preparer or translator.”
<br><br>
If one or more preparers or translators assist the employee in completing Section 1, the preparer or translator must select the second box marked “A preparer(s) and/or translator(s) assisted the employee in completing Section 1” and complete the rest of the fields below.
<br><br>
The preparer and/or translator also must select the number of Certification areas needed from the dropdown provided. There is no limit to the number of preparers and/or translators that can be used, however each additional preparer and/or translator must complete and sign a separate Certification area. When more than 5 preparer/translator certification are required, the Supplement for Section 1 Preparer and/or Translator must be printed and preparer/translator 6 and beyond must complete the certification on paper.
<br><br>
Parents or legal guardians attesting to the identity of minors (individuals under 18) and individuals attesting to the identity of certain employees with disabilities must complete this section.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="Preparer-and/or-Translator-Certification-tooltip-description" class="tipIcon"></span>
<div class="d-md-none trans-certificate-tooltip">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Preparer and/or Translator Certification</span>
<span> Select the number of preparers and/or translators you used to complete the form if any. If you are the employee and you did not use a preparer or translator, you must select the first option marked “I did not use a
preparer or translator.” </span>
<span> If one or more preparers or translators assist the employee in completing Section 1, the preparer or translator must select the second box marked “A preparer(s) and/or translator(s) assisted the employee in completing
Section 1” and complete the rest of the fields below. </span>
<span> The preparer and/or translator also must select the number of Certification areas needed from the dropdown provided. There is no limit to the number of preparers and/or translators that can be used, however each
additional preparer and/or translator must complete and sign a separate Certification area. When more than 5 preparer/translator certification are required, the Supplement for Section 1 Preparer and/or Translator must be
printed and preparer/translator 6 and beyond must complete the certification on paper. </span>
<span> Parents or legal guardians attesting to the identity of minors (individuals under 18) and individuals attesting to the identity of certain employees with disabilities must complete this section. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<label class="field-errormsg" id="HasPreparerTranslator_error" data-valmsg-for-id="divPreparerTranslatorSelect" data-valmsg-for="HasPreparerTranslator" aria-live="polite"></label>
</li>
</ul>
<div class="clear"></div>
<div id="divPreparerTranslatorSelect">
<div class="my-2">
<ul class="radioList customRadioList font-size-12 prep-tras-cert">
<li>
<span class="radio" aria-checked="false" tabindex="0" role="radio" aria-label="I did not use a preparer or translator"></span><input aria-label="I did not use a preparer or translator" class="styled"
id="HasPreparerTranslatorFalse" name="HasPreparerTranslator" type="radio" value="False"> <label class="fw-normal prep-label-font"><span role="heading" aria-level="4">I did not use a preparer or translator</span></label>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="I-did-not-use-a-preparer-or-translator-tooltip-description" class="tipIcon">
<span class="classic" style="font-size: 12px;">
If you are the employee and you did not use a preparer or translator, you must select this box “I did not use a preparer or translator.”
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="I-did-not-use-a-preparer-or-translator-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">I did not use a preparer or translator</span>
<span> If you are the employee and you did not use a preparer or translator, you must select this box “I did not use a preparer or translator.” </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</li>
</ul>
</div>
<div class="mt-2">
<ul class="radioList customRadioList font-size-12 prep-tras-cert">
<li class="select-style-1 select-style-6">
<span class="radio" aria-checked="false" tabindex="0" role="radio" aria-label="A preparer(s) and/or translator(s) assisted the employee in completing Section 1"></span><input
aria-label="A preparer(s) and/or translator(s) assisted the employee in completing Section 1" class="styled" id="HasPreparerTranslatorTrue" name="HasPreparerTranslator" type="radio" value="True"><label
class="fw-normal prep-label-font"><span role="heading" aria-level="4"> A preparer(s) and/or translator(s) assisted the employee in completing Section 1</span></label>
<a class="tooltip opacity-100 d-md-inline d-none" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="A-preparer(s)-and/or-translator(s)-assisted-the-employee-in-completing-Section1-tooltip-description" class="tipIcon">
<span class="classic font-size-12">
If one or more preparers or translators assist the employee in completing Section 1, the preparer or translator must select this box “A preparer(s) and/or translator(s) assisted the employee in completing Section 1.” The preparer and/or translator also must select the number of Certification areas needed from the dropdown provided. If this box is selected, the preparer or translator must complete the rest of the fields below.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17"
alt="A-preparer(s)-and/or-translator(s)-assisted-the-employee-in-completing-Section1-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">A preparer(s) and/or translator(s) assisted the employee in completing Section 1</span>
<span> If one or more preparers or translators assist the employee in completing Section 1, the preparer or translator must select this box “A preparer(s) and/or translator(s) assisted the employee in completing Section
1.” The preparer and/or translator also must select the number of Certification areas needed from the dropdown provided. If this box is selected, the preparer or translator must complete the rest of the fields below.
</span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<span id="PreparerCountSpan" class="countspan-txt" style="display: none;">
<label for="PreparerCount" id="PreparerCount_label">How Many?</label><span class="required">*</span>
<span title="" class="k-widget k-dropdown k-header inputSmall" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="PreparerCount_listbox" aria-labelledby="PreparerCount_label"
aria-live="polite" aria-disabled="false" aria-busy="false" aria-activedescendant="c617c7c0-02c1-4635-876a-ad660a740365" style="font-style: normal;"><span unselectable="on" class="k-dropdown-wrap k-state-default"><span
unselectable="on" class="k-input"></span><span unselectable="on" class="k-select" aria-label="select"><span class="k-icon k-i-arrow-60-down"></span></span></span><input class="inputSmall" data-val="true"
data-val-required="The PreparerCount field is required." id="PreparerCount" name="PreparerCount" type="text" value="0" style="font-style: normal; display: none;" autocomplete="off" data-role="dropdownlist"></span>
<script>
kendo.syncReady(function() {
jQuery("#PreparerCount").kendoDropDownList({
"dataTextField": "Text",
"dataValueField": "Value",
"value": "0",
"dataSource": [{
"Text": "",
"Value": "0",
"Selected": false
}, {
"Text": "1",
"Value": "1",
"Selected": false
}, {
"Text": "2",
"Value": "2",
"Selected": false
}, {
"Text": "3",
"Value": "3",
"Selected": false
}, {
"Text": "4",
"Value": "4",
"Selected": false
}, {
"Text": "5",
"Value": "5",
"Selected": false
}]
});
});
</script>
<div class="d-md-none select-number" id="divPreparerTranslatorbuttons" style="display: none;">
<button type="button" id="btnSelectNumber1" class="select-number-btn">1</button>
<button type="button" id="btnSelectNumber2" class="select-number-btn">2</button>
<button type="button" id="btnSelectNumber3" class="select-number-btn">3</button>
<button type="button" id="btnSelectNumber4" class="select-number-btn">4</button>
<button type="button" id="btnSelectNumber5" class="select-number-btn">5</button>
</div>
</span>
<label data-valmsg-for-id="PreparerCount" data-valmsg-for="PreparerCount" style="display:block;text-align:right;padding-right: 127px;"></label>
</li>
</ul>
</div>
</div>
<div class="clear"></div>
<div id="PreparerTranslatorsDiv" style="display: none;">
<!-- end tree view -->
<div id="PreparerTranslator1">
<div style="margin-left: 30px;" class="mb-4 mt-2 header-style-01 header-style-size-01 prep-trans-head">Preparer/Translator 1</div>
<div style="margin-left: 30px;" class="prep-trans-inputs">
<ul class="float m-0 p-0">
<li class="special-placement-li">
</li>
</ul>
<ul class="float p-0 m-0 disp-innit w-100">
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">First Name</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="firstname-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the full legal first name of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
The first name is also the given name.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="firstname-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">First Name</span>
<span> Enter the full legal first name of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> The first name is also the given name. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="First Name *" class="inputMed clearWhenChangeRadio" id="PreparerFirstName" name="PreparerFirstName" onblur="PreparerFirstNameValidate(1)" placeholder="Required" type="text" value=""
style="font-style: italic;" autocomplete="off"> <label class="field-errormsg" id="PreparerFirstName1_error" data-valmsg-for-id="PreparerFirstName" data-valmsg-for="PreparerFirstName" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">Last Name</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="lastname-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the full legal last name of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
The last name is also the family name or surname. If the preparer or translator has two last names or a hyphenated last name, include both names in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="lastname-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Last Name</span>
<span> Enter the full legal last name of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> The last name is also the family name or surname. If the preparer or translator has two last names or a hyphenated last name, include both names in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="Last Name *" class="inputMed clearWhenChangeRadio" id="PreparerLastName" name="PreparerLastName" onblur="PreparerLastNameValidate(1)" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"> <label class="field-errormsg" id="PreparerLastName1_error" data-valmsg-for-id="PreparerLastName" data-valmsg-for="PreparerLastName" aria-live="polite"></label>
</li>
</ul>
<div class="clear"></div>
<ul class="vertList p-0 m-0 disp-innit w-100">
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01"> Preparer’s/Translator’s Address <span class="d-none d-md-inline-block">(Street Name and Number)</span>
</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="address-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the street name and number of the current address of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
Addresses in Canada or Mexico may be entered in this field. If the address is an apartment, include the apartment number in this field.
<br><br>
If the person does not have a physical address, enter a description of the person’s location, such as “3 miles southwest of Anytown post office near water tower.”
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="address-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Preparer’s/Translator’s Address</span>
<span> Enter the street name and number of the current address of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> Addresses in Canada or Mexico may be entered in this field. If the address is an apartment, include the apartment number in this field. </span>
<span> If the person does not have a physical address, enter a description of the person’s location, such as “3 miles southwest of Anytown post office near water tower.” </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="Preparer’s/Translator’s Address (Street Name and Number) *" class="inputFullWidth clearWhenChangeRadio" id="PreparerAddress" maxlength="150" name="PreparerAddress" onblur="PreparerAddressValidate(1)"
placeholder="Required" style="width: 410px; font-size: 12px; font-style: italic;" type="text" value="" autocomplete="off"> <label class="field-errormsg" id="PreparerAddress1_error" data-valmsg-for-id="PreparerAddress"
data-valmsg-for="PreparerAddress" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<ul class="float p-0 m-0 disp-innit w-100">
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">City</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="city-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the city, town or village of the address of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
If the address is not located in a city or town, enter the name of the village, country, township, reservation, etc., in this field. If the address is in Canada, enter the city and province in this field. If the address is in Mexico, enter the city and state in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="city-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">City</span>
<span> Enter the city, town or village of the address of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> If the address is not located in a city or town, enter the name of the village, country, township, reservation, etc., in this field. If the address is in Canada, enter the city and province in this field. If
the address is in Mexico, enter the city and state in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="City *" class="inputMed clearWhenChangeRadio" id="PreparerCity" name="PreparerCity" onblur="PreparerCityValidate(1)" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"> <label class="field-errormsg" id="PreparerCity1_error" data-valmsg-for-id="PreparerCity" data-valmsg-for="PreparerCity" aria-live="polite"></label>
</li>
<li class="select-style-1 select-style-4 pb-md-0 pb-3 prep-state-input">
<label class="fontsize-sytle-01">State</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="state-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Select the state, territory or country of the preparer or translator’s address from the drop-down list. You may also type the first letter of the abbreviation and use the down arrow to select your state or territory.
<br><br>
If the preparer or translator entered an address from Canada or Mexico, choose the country abbreviation, located at the end of the drop-down list.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="state-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">State</span>
<span> Select the state, territory or country of the preparer or translator’s address from the drop-down list. You may also type the first letter of the abbreviation and use the down arrow to select your state or
territory. </span>
<span> If the preparer or translator entered an address from Canada or Mexico, choose the country abbreviation, located at the end of the drop-down list. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<span title="" class="k-widget k-dropdown k-header" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="PreparerState_listbox" aria-label="State *" aria-live="polite"
aria-disabled="false" aria-busy="false" aria-activedescendant="7ef6e194-bac0-4b41-a0d4-183a897bee95" style=""><span unselectable="on" class="k-dropdown-wrap k-state-default"><span unselectable="on"
class="k-input"><None></span><span unselectable="on" class="k-select" aria-label="select"><span class="k-icon k-i-arrow-60-down"></span></span></span><select aria-label="State *" id="PreparerState"
name="PreparerState" onblur="PreparerStateValidate(1)" data-role="dropdownlist" style="display: none;">
<option value="" selected="selected"><None></option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="District of Columbia">District of Columbia</option>
<option value="Federated States Of Micronesia">Federated States Of Micronesia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Guam">Guam</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Palau">Palau</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="Vermont">Vermont</option>
<option value="Virgin Islands Of The U.S.">Virgin Islands Of The U.S.</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
<option value="Canada">Canada</option>
<option value="Mexico">Mexico</option>
</select></span> <label class="field-errormsg" id="PreparerState1_error" data-valmsg-for-id="PreparerState" data-valmsg-for="PreparerState" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">Zip Code</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="zipcode-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the 5-digit ZIP code of the address of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
If the address the preparer or translator entered is in Canada or Mexico, enter the 5- or 6-digit postal code in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="zipcode-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Zip Code</span>
<span> Enter the 5-digit ZIP code of the address of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> If the address the preparer or translator entered is in Canada or Mexico, enter the 5- or 6-digit postal code in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="Zip Code *" class="inputMed clearWhenChangeRadio" id="PreparerZipCode" name="PreparerZipCode" onblur="PreparerZipCodeValidate(1)" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"> <label class="field-errormsg" id="PreparerZipCode1_error" data-valmsg-for-id="PreparerZipCode" data-valmsg-for="PreparerZipCode" aria-live="polite"></label>
</li>
</ul>
<div class="clear"></div>
</li>
<li class="attest-check">
<input type="hidden" name="AttestChecked">
<input type="checkbox" class="mright5 chk-style-2" id="AttestChecked" name="AttestChecked">
<label for="PTSignature"></label>
<label for="AttestChecked" class="li-sytle-01 f18-l24" id="i-attest-prep" style="width:790px;"> I attest, under penality of perjury, that I have assisted in the completion of this form and that to the best of my knowledge the
information is true and correct<span class="required">*</span>
</label>
<br>
<div class="attest-error-msg"><label class="field-errormsg" id="AttestChecked_error" data-valmsg-for-id="AttestChecked" data-valmsg-for="AttestChecked" aria-live="polite"></label></div>
</li>
</ul>
<div id="line-break" class="d-none d-md-block">
<hr style="background-color:#C4C4C4;height:1.2px;border:0px;">
</div>
<script type="text/javascript">
function eyeSelect(ids, values) {
$(values).toggleClass("fa-eye fa-eye-slash");
var input = $(document.getElementById(ids))
input.attr('type') === 'password' ? input.attr('type', 'text') : input.attr('type', 'password')
}
</script>
</div>
</div>
<div id="PreparerTranslator2">
<div style="margin-left: 30px;" class="mb-4 mt-2 header-style-01 header-style-size-01 prep-trans-head">Preparer/Translator 2</div>
<div style="margin-left: 30px;" class="prep-trans-inputs">
<ul class="float p-0 m-0 disp-innit w-100">
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">First Name</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="firstname-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the full legal first name of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
The first name is also the given name.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="firstname-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">First Name</span>
<span> Enter the full legal first name of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> The first name is also the given name. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="First Name *" class="inputMed clearWhenChangeRadio" id="PreparerFirstName2" name="PreparerFirstName2" onblur="PreparerFirstNameValidate(2)" placeholder="Required" type="text" value=""
style="font-style: italic;" autocomplete="off"> <label class="field-errormsg" id="PreparerFirstName2_error" data-valmsg-for-id="PreparerFirstName2" data-valmsg-for="PreparerFirstName2" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">Last Name</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="lastname-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the full legal last name of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
The last name is also the family name or surname. If the preparer or translator has two last names or a hyphenated last name, include both names in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="lastname-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Last Name</span>
<span> Enter the full legal last name of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> The last name is also the family name or surname. If the preparer or translator has two last names or a hyphenated last name, include both names in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="Last Name *" class="inputMed clearWhenChangeRadio" id="PreparerLastName2" name="PreparerLastName2" onblur="PreparerLastNameValidate(2)" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"> <label class="field-errormsg" id="PreparerLastName2_error" data-valmsg-for-id="PreparerLastName2" data-valmsg-for="PreparerLastName2" aria-live="polite"></label>
</li>
</ul>
<div class="clear"></div>
<ul class="vertList p-0 m-0 disp-innit w-100">
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01"> Preparer’s/Translator’s Address <span class="d-none d-md-inline-block">(Street Name and Number)</span>
</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="address-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the street name and number of the current address of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
Addresses in Canada or Mexico may be entered in this field. If the address is an apartment, include the apartment number in this field.
<br><br>
If the person does not have a physical address, enter a description of the person’s location, such as “3 miles southwest of Anytown post office near water tower.”
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="address-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Preparer’s/Translator’s Address</span>
<span> Enter the street name and number of the current address of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> Addresses in Canada or Mexico may be entered in this field. If the address is an apartment, include the apartment number in this field. </span>
<span> If the person does not have a physical address, enter a description of the person’s location, such as “3 miles southwest of Anytown post office near water tower.” </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="Preparer’s/Translator’s Address (Street Name and Number) *" class="inputFullWidth clearWhenChangeRadio" id="PreparerAddress2" maxlength="150" name="PreparerAddress2" onblur="PreparerAddressValidate(2)"
placeholder="Required" style="width: 410px; font-size: 12px; font-style: italic;" type="text" value="" autocomplete="off"> <label class="field-errormsg" id="PreparerAddress2_error" data-valmsg-for-id="PreparerAddress2"
data-valmsg-for="PreparerAddress2" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<ul class="float p-0 m-0 disp-innit w-100">
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">City</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="city-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the city, town or village of the address of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
If the address is not located in a city or town, enter the name of the village, country, township, reservation, etc., in this field. If the address is in Canada, enter the city and province in this field. If the address is in Mexico, enter the city and state in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="city-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">City</span>
<span> Enter the city, town or village of the address of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> If the address is not located in a city or town, enter the name of the village, country, township, reservation, etc., in this field. If the address is in Canada, enter the city and province in this field. If
the address is in Mexico, enter the city and state in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="City *" class="inputMed clearWhenChangeRadio" id="PreparerCity2" name="PreparerCity2" onblur="PreparerCityValidate(2)" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"> <label class="field-errormsg" id="PreparerCity2_error" data-valmsg-for-id="PreparerCity2" data-valmsg-for="PreparerCity2" aria-live="polite"></label>
</li>
<li class="select-style-1 select-style-4 pb-md-0 pb-3 prep-state-input">
<label class="fontsize-sytle-01">State</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="state-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Select the state, territory or country of the preparer or translator’s address from the drop-down list. You may also type the first letter of the abbreviation and use the down arrow to select your state or territory.
<br><br>
If the preparer or translator entered an address from Canada or Mexico, choose the country abbreviation, located at the end of the drop-down list.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="state-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">State</span>
<span> Select the state, territory or country of the preparer or translator’s address from the drop-down list. You may also type the first letter of the abbreviation and use the down arrow to select your state or
territory. </span>
<span> If the preparer or translator entered an address from Canada or Mexico, choose the country abbreviation, located at the end of the drop-down list. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<span title="" class="k-widget k-dropdown k-header" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="PreparerState2_listbox" aria-label="State *" aria-live="polite"
aria-disabled="false" aria-busy="false" aria-activedescendant="92f51c26-1075-44ff-a657-2bcbd5ec63ef" style=""><span unselectable="on" class="k-dropdown-wrap k-state-default"><span unselectable="on"
class="k-input"><None></span><span unselectable="on" class="k-select" aria-label="select"><span class="k-icon k-i-arrow-60-down"></span></span></span><select aria-label="State *" id="PreparerState2"
name="PreparerState2" onblur="PreparerStateValidate(2)" data-role="dropdownlist" style="display: none;">
<option value="" selected="selected"><None></option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="District of Columbia">District of Columbia</option>
<option value="Federated States Of Micronesia">Federated States Of Micronesia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Guam">Guam</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Palau">Palau</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="Vermont">Vermont</option>
<option value="Virgin Islands Of The U.S.">Virgin Islands Of The U.S.</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
<option value="Canada">Canada</option>
<option value="Mexico">Mexico</option>
</select></span> <label class="field-errormsg" id="PreparerState2_error" data-valmsg-for-id="PreparerState2" data-valmsg-for="PreparerState2" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">Zip Code</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="zipcode-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the 5-digit ZIP code of the address of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
If the address the preparer or translator entered is in Canada or Mexico, enter the 5- or 6-digit postal code in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="zipcode-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Zip Code</span>
<span> Enter the 5-digit ZIP code of the address of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> If the address the preparer or translator entered is in Canada or Mexico, enter the 5- or 6-digit postal code in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="Zip Code *" class="inputMed clearWhenChangeRadio" id="PreparerZipCode2" name="PreparerZipCode2" onblur="PreparerZipCodeValidate(2)" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"> <label class="field-errormsg" id="PreparerZipCode2_error" data-valmsg-for-id="PreparerZipCode2" data-valmsg-for="PreparerZipCode2" aria-live="polite"></label>
</li>
</ul>
<div class="clear"></div>
</li>
<li class="attest-check">
<input type="hidden" name="AttestChecked2">
<input type="checkbox" class="mright5 chk-style-2" id="AttestChecked2" name="AttestChecked2">
<label for="PTSignature"></label>
<label for="AttestChecked2" class="li-sytle-01 f18-l24" id="i-attest-prep" style="width:790px;"> I attest, under penality of perjury, that I have assisted in the completion of this form and that to the best of my knowledge the
information is true and correct<span class="required">*</span>
</label>
<br>
<div class="attest-error-msg"><label class="field-errormsg" id="AttestChecked2_error" data-valmsg-for-id="AttestChecked2" data-valmsg-for="AttestChecked2" aria-live="polite"></label></div>
</li>
</ul>
<div id="line-break" class="d-none d-md-block">
<hr style="background-color:#C4C4C4;height:1.2px;border:0px;">
</div>
<script type="text/javascript">
function eyeSelect(ids, values) {
$(values).toggleClass("fa-eye fa-eye-slash");
var input = $(document.getElementById(ids))
input.attr('type') === 'password' ? input.attr('type', 'text') : input.attr('type', 'password')
}
</script>
</div>
</div>
<div id="PreparerTranslator3">
<div style="margin-left: 30px;" class="mb-4 mt-2 header-style-01 header-style-size-01 prep-trans-head">Preparer/Translator 3</div>
<div style="margin-left: 30px;" class="prep-trans-inputs">
<ul class="float p-0 m-0 disp-innit w-100">
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">First Name</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="firstname-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the full legal first name of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
The first name is also the given name.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="firstname-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">First Name</span>
<span> Enter the full legal first name of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> The first name is also the given name. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="First Name *" class="inputMed clearWhenChangeRadio" id="PreparerFirstName3" name="PreparerFirstName3" onblur="PreparerFirstNameValidate(3)" placeholder="Required" type="text" value=""
style="font-style: italic;" autocomplete="off"> <label class="field-errormsg" id="PreparerFirstName3_error" data-valmsg-for-id="PreparerFirstName3" data-valmsg-for="PreparerFirstName3" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">Last Name</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="lastname-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the full legal last name of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
The last name is also the family name or surname. If the preparer or translator has two last names or a hyphenated last name, include both names in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="lastname-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Last Name</span>
<span> Enter the full legal last name of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> The last name is also the family name or surname. If the preparer or translator has two last names or a hyphenated last name, include both names in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="Last Name *" class="inputMed clearWhenChangeRadio" id="PreparerLastName3" name="PreparerLastName3" onblur="PreparerLastNameValidate(3)" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"> <label class="field-errormsg" id="PreparerLastName3_error" data-valmsg-for-id="PreparerLastName3" data-valmsg-for="PreparerLastName3" aria-live="polite"></label>
</li>
</ul>
<div class="clear"></div>
<ul class="vertList p-0 m-0 disp-innit w-100">
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01"> Preparer’s/Translator’s Address <span class="d-none d-md-inline-block">(Street Name and Number)</span>
</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="address-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the street name and number of the current address of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
Addresses in Canada or Mexico may be entered in this field. If the address is an apartment, include the apartment number in this field.
<br><br>
If the person does not have a physical address, enter a description of the person’s location, such as “3 miles southwest of Anytown post office near water tower.”
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="address-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Preparer’s/Translator’s Address</span>
<span> Enter the street name and number of the current address of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> Addresses in Canada or Mexico may be entered in this field. If the address is an apartment, include the apartment number in this field. </span>
<span> If the person does not have a physical address, enter a description of the person’s location, such as “3 miles southwest of Anytown post office near water tower.” </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="Preparer’s/Translator’s Address (Street Name and Number) *" class="inputFullWidth clearWhenChangeRadio" id="PreparerAddress3" maxlength="150" name="PreparerAddress3" onblur="PreparerAddressValidate(3)"
placeholder="Required" style="width: 410px; font-size: 12px; font-style: italic;" type="text" value="" autocomplete="off"> <label class="field-errormsg" id="PreparerAddress3_error" data-valmsg-for-id="PreparerAddress3"
data-valmsg-for="PreparerAddress3" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<ul class="float p-0 m-0 disp-innit w-100">
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">City</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="city-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the city, town or village of the address of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
If the address is not located in a city or town, enter the name of the village, country, township, reservation, etc., in this field. If the address is in Canada, enter the city and province in this field. If the address is in Mexico, enter the city and state in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="city-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">City</span>
<span> Enter the city, town or village of the address of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> If the address is not located in a city or town, enter the name of the village, country, township, reservation, etc., in this field. If the address is in Canada, enter the city and province in this field. If
the address is in Mexico, enter the city and state in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="City *" class="inputMed clearWhenChangeRadio" id="PreparerCity3" name="PreparerCity3" onblur="PreparerCityValidate(3)" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"> <label class="field-errormsg" id="PreparerCity3_error" data-valmsg-for-id="PreparerCity3" data-valmsg-for="PreparerCity3" aria-live="polite"></label>
</li>
<li class="select-style-1 select-style-4 pb-md-0 pb-3 prep-state-input">
<label class="fontsize-sytle-01">State</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="state-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Select the state, territory or country of the preparer or translator’s address from the drop-down list. You may also type the first letter of the abbreviation and use the down arrow to select your state or territory.
<br><br>
If the preparer or translator entered an address from Canada or Mexico, choose the country abbreviation, located at the end of the drop-down list.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="state-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">State</span>
<span> Select the state, territory or country of the preparer or translator’s address from the drop-down list. You may also type the first letter of the abbreviation and use the down arrow to select your state or
territory. </span>
<span> If the preparer or translator entered an address from Canada or Mexico, choose the country abbreviation, located at the end of the drop-down list. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<span title="" class="k-widget k-dropdown k-header" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="PreparerState3_listbox" aria-label="State *" aria-live="polite"
aria-disabled="false" aria-busy="false" aria-activedescendant="f54f8264-90b6-42b8-ba5c-55b89330741c" style=""><span unselectable="on" class="k-dropdown-wrap k-state-default"><span unselectable="on"
class="k-input"><None></span><span unselectable="on" class="k-select" aria-label="select"><span class="k-icon k-i-arrow-60-down"></span></span></span><select aria-label="State *" id="PreparerState3"
name="PreparerState3" onblur="PreparerStateValidate(3)" data-role="dropdownlist" style="display: none;">
<option value="" selected="selected"><None></option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="District of Columbia">District of Columbia</option>
<option value="Federated States Of Micronesia">Federated States Of Micronesia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Guam">Guam</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Palau">Palau</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="Vermont">Vermont</option>
<option value="Virgin Islands Of The U.S.">Virgin Islands Of The U.S.</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
<option value="Canada">Canada</option>
<option value="Mexico">Mexico</option>
</select></span> <label class="field-errormsg" id="PreparerState3_error" data-valmsg-for-id="PreparerState3" data-valmsg-for="PreparerState3" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">Zip Code</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="zipcode-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the 5-digit ZIP code of the address of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
If the address the preparer or translator entered is in Canada or Mexico, enter the 5- or 6-digit postal code in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="zipcode-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Zip Code</span>
<span> Enter the 5-digit ZIP code of the address of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> If the address the preparer or translator entered is in Canada or Mexico, enter the 5- or 6-digit postal code in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="Zip Code *" class="inputMed clearWhenChangeRadio" id="PreparerZipCode3" name="PreparerZipCode3" onblur="PreparerZipCodeValidate(3)" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"> <label class="field-errormsg" id="PreparerZipCode3_error" data-valmsg-for-id="PreparerZipCode3" data-valmsg-for="PreparerZipCode3" aria-live="polite"></label>
</li>
</ul>
<div class="clear"></div>
</li>
<li class="attest-check">
<input type="hidden" name="AttestChecked3">
<input type="checkbox" class="mright5 chk-style-2" id="AttestChecked3" name="AttestChecked3">
<label for="PTSignature"></label>
<label for="AttestChecked3" class="li-sytle-01 f18-l24" id="i-attest-prep" style="width:790px;"> I attest, under penality of perjury, that I have assisted in the completion of this form and that to the best of my knowledge the
information is true and correct<span class="required">*</span>
</label>
<br>
<div class="attest-error-msg"><label class="field-errormsg" id="AttestChecked3_error" data-valmsg-for-id="AttestChecked3" data-valmsg-for="AttestChecked3" aria-live="polite"></label></div>
</li>
</ul>
<div id="line-break" class="d-none d-md-block">
<hr style="background-color:#C4C4C4;height:1.2px;border:0px;">
</div>
<script type="text/javascript">
function eyeSelect(ids, values) {
$(values).toggleClass("fa-eye fa-eye-slash");
var input = $(document.getElementById(ids))
input.attr('type') === 'password' ? input.attr('type', 'text') : input.attr('type', 'password')
}
</script>
</div>
</div>
<div id="PreparerTranslator4">
<div style="margin-left: 30px;" class="mb-4 mt-2 header-style-01 header-style-size-01 prep-trans-head">Preparer/Translator 4</div>
<div style="margin-left: 30px;" class="prep-trans-inputs">
<ul class="float p-0 m-0 disp-innit w-100">
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">First Name</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="firstname-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the full legal first name of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
The first name is also the given name.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="firstname-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">First Name</span>
<span> Enter the full legal first name of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> The first name is also the given name. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="First Name *" class="inputMed clearWhenChangeRadio" id="PreparerFirstName4" name="PreparerFirstName4" onblur="PreparerFirstNameValidate(4)" placeholder="Required" type="text" value=""
style="font-style: italic;" autocomplete="off"> <label class="field-errormsg" id="PreparerFirstName4_error" data-valmsg-for-id="PreparerFirstName4" data-valmsg-for="PreparerFirstName4" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">Last Name</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="lastname-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the full legal last name of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
The last name is also the family name or surname. If the preparer or translator has two last names or a hyphenated last name, include both names in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="lastname-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Last Name</span>
<span> Enter the full legal last name of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> The last name is also the family name or surname. If the preparer or translator has two last names or a hyphenated last name, include both names in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="Last Name *" class="inputMed clearWhenChangeRadio" id="PreparerLastName4" name="PreparerLastName4" onblur="PreparerLastNameValidate(4)" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"> <label class="field-errormsg" id="PreparerLastName4_error" data-valmsg-for-id="PreparerLastName4" data-valmsg-for="PreparerLastName4" aria-live="polite"></label>
</li>
</ul>
<div class="clear"></div>
<ul class="vertList p-0 m-0 disp-innit w-100">
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01"> Preparer’s/Translator’s Address <span class="d-none d-md-inline-block">(Street Name and Number)</span>
</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="address-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the street name and number of the current address of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
Addresses in Canada or Mexico may be entered in this field. If the address is an apartment, include the apartment number in this field.
<br><br>
If the person does not have a physical address, enter a description of the person’s location, such as “3 miles southwest of Anytown post office near water tower.”
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="address-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Preparer’s/Translator’s Address</span>
<span> Enter the street name and number of the current address of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> Addresses in Canada or Mexico may be entered in this field. If the address is an apartment, include the apartment number in this field. </span>
<span> If the person does not have a physical address, enter a description of the person’s location, such as “3 miles southwest of Anytown post office near water tower.” </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="Preparer’s/Translator’s Address (Street Name and Number) *" class="inputFullWidth clearWhenChangeRadio" id="PreparerAddress4" maxlength="150" name="PreparerAddress4" onblur="PreparerAddressValidate(4)"
placeholder="Required" style="width: 410px; font-size: 12px; font-style: italic;" type="text" value="" autocomplete="off"> <label class="field-errormsg" id="PreparerAddress4_error" data-valmsg-for-id="PreparerAddress4"
data-valmsg-for="PreparerAddress4" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<ul class="float p-0 m-0 disp-innit w-100">
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">City</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="city-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the city, town or village of the address of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
If the address is not located in a city or town, enter the name of the village, country, township, reservation, etc., in this field. If the address is in Canada, enter the city and province in this field. If the address is in Mexico, enter the city and state in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="city-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">City</span>
<span> Enter the city, town or village of the address of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> If the address is not located in a city or town, enter the name of the village, country, township, reservation, etc., in this field. If the address is in Canada, enter the city and province in this field. If
the address is in Mexico, enter the city and state in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="City *" class="inputMed clearWhenChangeRadio" id="PreparerCity4" name="PreparerCity4" onblur="PreparerCityValidate(4)" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"> <label class="field-errormsg" id="PreparerCity4_error" data-valmsg-for-id="PreparerCity4" data-valmsg-for="PreparerCity4" aria-live="polite"></label>
</li>
<li class="select-style-1 select-style-4 pb-md-0 pb-3 prep-state-input">
<label class="fontsize-sytle-01">State</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="state-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Select the state, territory or country of the preparer or translator’s address from the drop-down list. You may also type the first letter of the abbreviation and use the down arrow to select your state or territory.
<br><br>
If the preparer or translator entered an address from Canada or Mexico, choose the country abbreviation, located at the end of the drop-down list.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="state-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">State</span>
<span> Select the state, territory or country of the preparer or translator’s address from the drop-down list. You may also type the first letter of the abbreviation and use the down arrow to select your state or
territory. </span>
<span> If the preparer or translator entered an address from Canada or Mexico, choose the country abbreviation, located at the end of the drop-down list. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<span title="" class="k-widget k-dropdown k-header" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="PreparerState4_listbox" aria-label="State *" aria-live="polite"
aria-disabled="false" aria-busy="false" aria-activedescendant="c10958e9-4ee4-4431-87e8-a66a9fe6b742" style=""><span unselectable="on" class="k-dropdown-wrap k-state-default"><span unselectable="on"
class="k-input"><None></span><span unselectable="on" class="k-select" aria-label="select"><span class="k-icon k-i-arrow-60-down"></span></span></span><select aria-label="State *" id="PreparerState4"
name="PreparerState4" onblur="PreparerStateValidate(4)" data-role="dropdownlist" style="display: none;">
<option value="" selected="selected"><None></option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="District of Columbia">District of Columbia</option>
<option value="Federated States Of Micronesia">Federated States Of Micronesia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Guam">Guam</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Palau">Palau</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="Vermont">Vermont</option>
<option value="Virgin Islands Of The U.S.">Virgin Islands Of The U.S.</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
<option value="Canada">Canada</option>
<option value="Mexico">Mexico</option>
</select></span> <label class="field-errormsg" id="PreparerState4_error" data-valmsg-for-id="PreparerState4" data-valmsg-for="PreparerState4" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">Zip Code</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="zipcode-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the 5-digit ZIP code of the address of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
If the address the preparer or translator entered is in Canada or Mexico, enter the 5- or 6-digit postal code in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="zipcode-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Zip Code</span>
<span> Enter the 5-digit ZIP code of the address of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> If the address the preparer or translator entered is in Canada or Mexico, enter the 5- or 6-digit postal code in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="Zip Code *" class="inputMed clearWhenChangeRadio" id="PreparerZipCode4" name="PreparerZipCode4" onblur="PreparerZipCodeValidate(4)" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"> <label class="field-errormsg" id="PreparerZipCode4_error" data-valmsg-for-id="PreparerZipCode4" data-valmsg-for="PreparerZipCode4" aria-live="polite"></label>
</li>
</ul>
<div class="clear"></div>
</li>
<li class="attest-check">
<input type="hidden" name="AttestChecked4">
<input type="checkbox" class="mright5 chk-style-2" id="AttestChecked4" name="AttestChecked4">
<label for="PTSignature"></label>
<label for="AttestChecked4" class="li-sytle-01 f18-l24" id="i-attest-prep" style="width:790px;"> I attest, under penality of perjury, that I have assisted in the completion of this form and that to the best of my knowledge the
information is true and correct<span class="required">*</span>
</label>
<br>
<div class="attest-error-msg"><label class="field-errormsg" id="AttestChecked4_error" data-valmsg-for-id="AttestChecked4" data-valmsg-for="AttestChecked4" aria-live="polite"></label></div>
</li>
</ul>
<div id="line-break" class="d-none d-md-block">
<hr style="background-color:#C4C4C4;height:1.2px;border:0px;">
</div>
<script type="text/javascript">
function eyeSelect(ids, values) {
$(values).toggleClass("fa-eye fa-eye-slash");
var input = $(document.getElementById(ids))
input.attr('type') === 'password' ? input.attr('type', 'text') : input.attr('type', 'password')
}
</script>
</div>
</div>
<div id="PreparerTranslator5">
<div style="margin-left: 30px;" class="mb-4 mt-2 header-style-01 header-style-size-01 prep-trans-head">Preparer/Translator 5</div>
<div style="margin-left: 30px;" class="prep-trans-inputs">
<ul class="float p-0 m-0 disp-innit w-100">
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">First Name</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="firstname-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the full legal first name of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
The first name is also the given name.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="firstname-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">First Name</span>
<span> Enter the full legal first name of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> The first name is also the given name. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="First Name *" class="inputMed clearWhenChangeRadio" id="PreparerFirstName5" name="PreparerFirstName5" onblur="PreparerFirstNameValidate(5)" placeholder="Required" type="text" value=""
style="font-style: italic;" autocomplete="off"> <label class="field-errormsg" id="PreparerFirstName5_error" data-valmsg-for-id="PreparerFirstName5" data-valmsg-for="PreparerFirstName5" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">Last Name</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="lastname-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the full legal last name of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
The last name is also the family name or surname. If the preparer or translator has two last names or a hyphenated last name, include both names in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="lastname-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Last Name</span>
<span> Enter the full legal last name of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> The last name is also the family name or surname. If the preparer or translator has two last names or a hyphenated last name, include both names in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="Last Name *" class="inputMed clearWhenChangeRadio" id="PreparerLastName5" name="PreparerLastName5" onblur="PreparerLastNameValidate(5)" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"> <label class="field-errormsg" id="PreparerLastName5_error" data-valmsg-for-id="PreparerLastName5" data-valmsg-for="PreparerLastName5" aria-live="polite"></label>
</li>
</ul>
<div class="clear"></div>
<ul class="vertList p-0 m-0 disp-innit w-100">
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01"> Preparer’s/Translator’s Address <span class="d-none d-md-inline-block">(Street Name and Number)</span>
</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="address-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the street name and number of the current address of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
Addresses in Canada or Mexico may be entered in this field. If the address is an apartment, include the apartment number in this field.
<br><br>
If the person does not have a physical address, enter a description of the person’s location, such as “3 miles southwest of Anytown post office near water tower.”
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="address-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Preparer’s/Translator’s Address</span>
<span> Enter the street name and number of the current address of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> Addresses in Canada or Mexico may be entered in this field. If the address is an apartment, include the apartment number in this field. </span>
<span> If the person does not have a physical address, enter a description of the person’s location, such as “3 miles southwest of Anytown post office near water tower.” </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="Preparer’s/Translator’s Address (Street Name and Number) *" class="inputFullWidth clearWhenChangeRadio" id="PreparerAddress5" maxlength="150" name="PreparerAddress5" onblur="PreparerAddressValidate(5)"
placeholder="Required" style="width: 410px; font-size: 12px; font-style: italic;" type="text" value="" autocomplete="off"> <label class="field-errormsg" id="PreparerAddress5_error" data-valmsg-for-id="PreparerAddress5"
data-valmsg-for="PreparerAddress5" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<ul class="float p-0 m-0 disp-innit w-100">
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">City</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="city-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the city, town or village of the address of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
If the address is not located in a city or town, enter the name of the village, country, township, reservation, etc., in this field. If the address is in Canada, enter the city and province in this field. If the address is in Mexico, enter the city and state in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="city-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">City</span>
<span> Enter the city, town or village of the address of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> If the address is not located in a city or town, enter the name of the village, country, township, reservation, etc., in this field. If the address is in Canada, enter the city and province in this field. If
the address is in Mexico, enter the city and state in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="City *" class="inputMed clearWhenChangeRadio" id="PreparerCity5" name="PreparerCity5" onblur="PreparerCityValidate(5)" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"> <label class="field-errormsg" id="PreparerCity5_error" data-valmsg-for-id="PreparerCity5" data-valmsg-for="PreparerCity5" aria-live="polite"></label>
</li>
<li class="select-style-1 select-style-4 pb-md-0 pb-3 prep-state-input">
<label class="fontsize-sytle-01">State</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="state-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Select the state, territory or country of the preparer or translator’s address from the drop-down list. You may also type the first letter of the abbreviation and use the down arrow to select your state or territory.
<br><br>
If the preparer or translator entered an address from Canada or Mexico, choose the country abbreviation, located at the end of the drop-down list.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="state-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">State</span>
<span> Select the state, territory or country of the preparer or translator’s address from the drop-down list. You may also type the first letter of the abbreviation and use the down arrow to select your state or
territory. </span>
<span> If the preparer or translator entered an address from Canada or Mexico, choose the country abbreviation, located at the end of the drop-down list. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<span title="" class="k-widget k-dropdown k-header" unselectable="on" role="listbox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-owns="PreparerState5_listbox" aria-label="State *" aria-live="polite"
aria-disabled="false" aria-busy="false" aria-activedescendant="e9bf4d96-b147-4956-98ca-10b8c02d5fe0" style=""><span unselectable="on" class="k-dropdown-wrap k-state-default"><span unselectable="on"
class="k-input"><None></span><span unselectable="on" class="k-select" aria-label="select"><span class="k-icon k-i-arrow-60-down"></span></span></span><select aria-label="State *" id="PreparerState5"
name="PreparerState5" onblur="PreparerStateValidate(5)" data-role="dropdownlist" style="display: none;">
<option value="" selected="selected"><None></option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="District of Columbia">District of Columbia</option>
<option value="Federated States Of Micronesia">Federated States Of Micronesia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Guam">Guam</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Palau">Palau</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="Vermont">Vermont</option>
<option value="Virgin Islands Of The U.S.">Virgin Islands Of The U.S.</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
<option value="Canada">Canada</option>
<option value="Mexico">Mexico</option>
</select></span> <label class="field-errormsg" id="PreparerState5_error" data-valmsg-for-id="PreparerState5" data-valmsg-for="PreparerState5" aria-live="polite"></label>
</li>
<li class="pb-md-0 pb-3">
<label class="fontsize-sytle-01">Zip Code</label>
<span class="required">*</span>
<a class="tooltip" href="#" tabindex="0">
<img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="zipcode-tooltip-description" class="tipIcon mb-1">
<span class="classic" style="font-size: 12px;">
Enter the 5-digit ZIP code of the address of the person who helped the employee in preparing or translating Section 1 in this field.
<br><br>
If the address the preparer or translator entered is in Canada or Mexico, enter the 5- or 6-digit postal code in this field.
</span>
</a>
<span class="pop opacity-100 d-inline d-md-none" tabindex="0"><img src="/Content/tracker/images/icon-info.png" width="17" height="17" alt="zipcode-tooltip-description" class="tipIcon"></span>
<div class="d-md-none">
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content">
<p class="popup-txt" tabindex="0">
<span class="pop-title">Zip Code</span>
<span> Enter the 5-digit ZIP code of the address of the person who helped the employee in preparing or translating Section 1 in this field. </span>
<span> If the address the preparer or translator entered is in Canada or Mexico, enter the 5- or 6-digit postal code in this field. </span>
</p>
<a href="#" class="close-sec" aria-label="close" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
<input aria-label="Zip Code *" class="inputMed clearWhenChangeRadio" id="PreparerZipCode5" name="PreparerZipCode5" onblur="PreparerZipCodeValidate(5)" placeholder="Required" type="text" value="" style="font-style: italic;"
autocomplete="off"> <label class="field-errormsg" id="PreparerZipCode5_error" data-valmsg-for-id="PreparerZipCode5" data-valmsg-for="PreparerZipCode5" aria-live="polite"></label>
</li>
</ul>
<div class="clear"></div>
</li>
<li class="attest-check">
<input type="hidden" name="AttestChecked5">
<input type="checkbox" class="mright5 chk-style-2" id="AttestChecked5" name="AttestChecked5">
<label for="PTSignature"></label>
<label for="AttestChecked5" class="li-sytle-01 f18-l24" id="i-attest-prep" style="width:790px;"> I attest, under penality of perjury, that I have assisted in the completion of this form and that to the best of my knowledge the
information is true and correct<span class="required">*</span>
</label>
<br>
<div class="attest-error-msg"><label class="field-errormsg" id="AttestChecked5_error" data-valmsg-for-id="AttestChecked5" data-valmsg-for="AttestChecked5" aria-live="polite"></label></div>
</li>
</ul>
<div id="line-break" class="d-none d-md-block">
<hr style="background-color:#C4C4C4;height:1.2px;border:0px;">
</div>
<script type="text/javascript">
function eyeSelect(ids, values) {
$(values).toggleClass("fa-eye fa-eye-slash");
var input = $(document.getElementById(ids))
input.attr('type') === 'password' ? input.attr('type', 'text') : input.attr('type', 'password')
}
</script>
</div>
</div>
</div>
<div class="clear"></div>
<ul class="float d-none d-md-block px-0">
<li>
<div class="newUI-moduleLabel-2">
<div>4</div>
</div>
</li>
<li style="width: 740px" class="font-size-12">
<p role="heading" aria-level="3">Click “<strong>Sign Form I-9 Electronically</strong>” to complete the electronic signature.</p>
<input type="button" value="Sign Form I-9 Electronically" class="btn-style-3 btn-style-section1-1 btnNotLoadpage btn-size-9" mobile-responsive="desktop" id="save-and-validate-remoteaccess">
<div class="clear"></div>
</li>
</ul>
<div class="clear d-none d-md-block" style="height: 10px;"></div>
<div style="display: none" class="alert-box-section1-1 divUnder18">
<p class="alert-text-section1-1"> For employees under age 18 that cannot produce a List A or List B document type in Section 2, enter 'INDIVIDUAL UNDER AGE 18' in the Employee Name field and have the parent or legal guardian complete
and sign the Preparer and/or Translator Certification. </p>
</div>
</div>
<script type="text/javascript">
function eyeSelect(ids, values) {
$(values).toggleClass("fa-eye fa-eye-slash");
var input = $(document.getElementById(ids))
input.attr('type') === 'password' ? input.attr('type', 'text') : input.attr('type', 'password')
}
</script>
<div class="clear"></div>
<span id="forceValidationButton" style="display: none;">Validate</span>
</fieldset>
</div>
<!-- end modContent-->
<div class="clear"></div>
</div>
<div class="backWhite" style="display: none;color: red" id="divError">
<table style="width:100%">
<tbody>
<tr>
<td>
<div id="divSummaryLabel" style="float: left; height: 99px; width: 22%;">
<div class="box-module backWhite" style="height: 100%; margin: 0px; padding: 0px;">
<h1 style="margin: 10px !important;">Validation Summary</h1>
</div>
</div>
<div style="float: right; width: 77%;height: 100%;" id="divSummaryError">
<div id="divValidationError" class="box-module backWhite" style="height: 100%; margin: 0px; padding: 0px;">
<h2 style="margin: 10px;float: left; color:#004b79;">Must be fixed before saving</h2>
<h2 style="margin: 10px;float: right; color: red;">Data not saved</h2>
<div class="clear"></div>
<div id="divErrorMsg" style="margin: 10px;"></div>
<br>
</div>
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div>
<div style="display: none; color: red;margin-top:5px;" id="divError">
<div id="divSummaryLabel" style="float: left; height: 100%; width: 22%;">
<div class="newUI-BorderDiv backWhite" style="height: 100%; margin: 0px; padding: 0px;">
<h1 style="margin: 10px;">Validation Summary</h1>
</div>
</div>
<div style="float: right; width: 77%;" id="divSummaryError">
<div id="divValidationError" class="newUI-BorderDiv backWhite" style="margin:0px; display:none;padding:10px;">
<h2 style="float: left;" class="mustbefixed">Must be fixed before saving</h2>
<h2 style="float: right; color: red;">Data not saved</h2>
<div class="clear"></div>
<!--
Spans within the "divErrorMsg" element are to support usage by the
PowWow mobile app, indicating where a validation should be displayed.
Refer to comments in FormI9Section1Controller for details.
-->
<div id="divErrorMsg"></div>
</div>
</div>
<div class="clear"></div>
</div>
</div>
</div>
<br>
<div class="alert-box-section1-1 d-none d-md-block" style="margin-bottom: 10px; margin-right: 10px;">
<p class="alert-text-section1-1"> Warning IMPORTANT: Section 1 Cannot Be Signed Until All Curable Errors Are Corrected. Edit this section to address all curable errors as listed in the Form I-9 Validation Alerts box. </p>
</div>
</div>
<div class="row d-md-none copyright-mitr w-100 mx-0 pt-2 pb-4 bg-white" role="contentinfo">
<div class="col-auto">
<p><b>Tracker I-9 Complete</b></p>
<div class="copy-right"> Copyright 2007-2022 Tracker Corp<span class="px-1"><b>.</b></span>All Rights Reserved<span class="px-1"><b>.</b></span><span class="pop opacity-100 d-inline d-md-none" aria-label="click here to read privacy policy"
tabindex="0">Privacy Policy</span>
<div>
<div class="overlay_form" style="display:none">
<div class="popup-logo" style="background-image: url("https://wwwcdn2.i9complete.com/Content/ClientSettings/C516/S1_Logo_Horz_RGB_BLK.jpg");"></div>
<div class="popup-content" tabindex="0">
<div class="privacy-policy">
<h2>Tracker Corp Privacy Policy</h2>
<p>This Privacy Policy governs the manner in which Tracker Corp collects, uses, maintains and discloses information collected from users (each, a "User") of the Tracker I-9 website ("Site"). This privacy policy applies to the Site and
all products and services offered by Tracker Corp.</p>
<p><b>Personal identification information</b></p>
<p>We may collect personally identification information from Users in a variety of ways, including, but not limited to, when Users visit our site, register on the site, fill out a form, and in connection with other activities,
services, features or resources we make available on our Site. We will collect personal identification information from Users only if they voluntarily submit such information to us. Users can always refuse to supply personally
identification information, with the understanding that it may prevent them from engaging in certain Site related activities.</p>
<p><b>Non-personal identification information</b></p>
<p>We may collect non-personal identification information about Users whenever they interact with our Site. Non-personal identification information may include the browser name, the type of computer and technical information about
Users means of connection to our Site, such as the operating system and the Internet service providers utilized and other similar information.</p>
<p><b>Web browser cookies</b></p>
<p>Our Site may use "cookies" to enhance User experience. User's web browser places cookies on their hard drive for record-keeping purposes and sometimes to track information about them. User may choose to set their web browser to
refuse cookies, or to alert you when cookies are being sent. If they do so, note that some parts of the Site may not function properly.</p>
<p><b>How we use collected information</b></p>
<p>Tracker Corp may use the information Users provide about themselves only to record I-9 and E-Verify related information. We do not share this information with outside parties except to the extent necessary to provide the service.
</p>
<p><b>How we protect your information</b></p>
<p>We adopt appropriate data collection, storage and processing practices and security measures to protect against unauthorized access, alteration, disclosure or destruction of your personal information, username, password,
transaction information and data stored on our Site.</p>
<p>Sensitive and private data exchange between the Site and its Users happens over a SSL secured communication channel and is encrypted and protected with digital signatures. Our Site is also in compliance with PCI vulnerability
standards in order to create as secure of an environment as possible for Users.</p>
<p><b>Sharing your personal information</b></p>
<p>Any information collected from Users on this Site falls will not be disclosed without consent, with the exception of the E-Verify website and WebFax utility (when applicable), unless in response to court order, subpoena, or
government investigation. We do not sell, trade, or rent Users personal identification information to others.</p>
<p><b>Third party websites</b></p>
<p>Users may find links to other content on our Site. We do not control the content or links that appear on these sites and are not responsible for the practices employed by websites linked to or from our Site. With the exception of
the E-Verify website and WebFax utility, no information is shared with third party vendors. In addition, these sites or services, including their content and links, may be constantly changing. These sites and services may have their
own privacy policies and customer service policies. Browsing and interaction on any other website, including websites which have a link to our Site, is subject to that website's own terms and policies.</p>
<p><b>Changes to this privacy policy</b></p>
<p>Tracker Corp has the discretion to update this privacy policy at any time. When we do, we will revise the updated date at the bottom of this page. We encourage Users to frequently check this page for any changes to stay informed
about how we are helping to protect the personal information we collect. You acknowledge and agree that it is your responsibility to review this privacy policy periodically and become aware of modifications.</p>
<p><b>Your acceptance of these terms</b></p>
<p>By using this Site, you signify your acceptance of this policy. If you do not agree to this policy, please do not use our Site. Your continued use of the Site following the posting of changes to this policy will be deemed your
acceptance of those changes.</p>
<p><b>Contacting us</b></p>
<p>If you have any questions about this Privacy Policy, the practices of this Site, or your dealings with this Site, please contact us at:</p>
<p><b>Tracker Corp</b></p>
<a href="mailto:support@trackercorp.com">Support@TrackerCorp.com</a>
<a href="tel:+866.TRKR.911">866.TRKR.911</a>
</div>
</div>
<div class="fixed-close">
<a href="#" class="close-sec" tabindex="-1">
<span class="close" tabindex="0">
<span class="stylecalibritext">
<img src="/Content/images/FormI9-Responsive/cross-icon.svg" alt="close">
</span>
</span>
</a>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="row justify-content-between d-md-none footer-sticky-fixed" id="sticky-footer">
<div class="col-auto pre-btn"><button type="button" class="btn btn-secondary" data-enchanter="previous" tabindex="0">Back</button></div>
<div class="col-auto next-btn" id="div-stepper-btn">
<button type="button" class="btn btn-primary" data-enchanter="next" tabindex="0">I understand</button>
<button type="button" class="btn-style-3 btn-style-section1-1 btnNotLoadpage btn-size-9 d-none" data-enchanter="finish" mobile-responsive="mobile" tabindex="0">Sign Form I-9 Electronically</button>
</div>
</div>
<input name="I94ExpiresCheckbox" type="hidden" value="false"><input name="ListAReceiptProvided" type="hidden" value="false"><input name="ListBReceiptProvided" type="hidden" value="false"><input name="ListCReceiptProvided" type="hidden"
value="false">
</form>Text Content
SORRY, YOUR BROWSER DON'T SUPPORT JAVASCRIPT, PLEASE SETUP YOUR BROWSER TO
SUPPORT JAVASCRIPT AND TRY AGAIN.
General Info Need Help?
USCIS Form I-9
Department of Homeland Security
U.S. Citizenship and Immigration Services
Download I-9 Instructions in
English Español
Unauthorized access, use, or modification of this system or of data contained
herein, or in transit to/from this system, may constitute a violation of section
1030 of title 18 of the U.S. Code and other criminal laws.
Have a question or need to contact us? Call us
541-206-1327 Or email us:
MeganP@Sentinelone.com If you experience any technical issues completing this
Form I-9, contact your hiring manager or HR representative.
IMPORTANT
Changes made within the page will be lost. Are you sure you want to start over ?
Yes No
IMPORTANT
Yes No
SKIP FOR NOW
Are you sure you want to complete this task later? Any information entered on
this page will not be saved. Verify your email address and click Yes to confirm
and receive a reminder email.
Email Address:*
Yes
No
Tracker I-9 Complete
Copyright 2007-2022 Tracker Corp.All Rights Reserved.Privacy Policy
TRACKER CORP PRIVACY POLICY
This Privacy Policy governs the manner in which Tracker Corp collects, uses,
maintains and discloses information collected from users (each, a "User") of the
Tracker I-9 website ("Site"). This privacy policy applies to the Site and all
products and services offered by Tracker Corp.
Personal identification information
We may collect personally identification information from Users in a variety of
ways, including, but not limited to, when Users visit our site, register on the
site, fill out a form, and in connection with other activities, services,
features or resources we make available on our Site. We will collect personal
identification information from Users only if they voluntarily submit such
information to us. Users can always refuse to supply personally identification
information, with the understanding that it may prevent them from engaging in
certain Site related activities.
Non-personal identification information
We may collect non-personal identification information about Users whenever they
interact with our Site. Non-personal identification information may include the
browser name, the type of computer and technical information about Users means
of connection to our Site, such as the operating system and the Internet service
providers utilized and other similar information.
Web browser cookies
Our Site may use "cookies" to enhance User experience. User's web browser places
cookies on their hard drive for record-keeping purposes and sometimes to track
information about them. User may choose to set their web browser to refuse
cookies, or to alert you when cookies are being sent. If they do so, note that
some parts of the Site may not function properly.
How we use collected information
Tracker Corp may use the information Users provide about themselves only to
record I-9 and E-Verify related information. We do not share this information
with outside parties except to the extent necessary to provide the service.
How we protect your information
We adopt appropriate data collection, storage and processing practices and
security measures to protect against unauthorized access, alteration, disclosure
or destruction of your personal information, username, password, transaction
information and data stored on our Site.
Sensitive and private data exchange between the Site and its Users happens over
a SSL secured communication channel and is encrypted and protected with digital
signatures. Our Site is also in compliance with PCI vulnerability standards in
order to create as secure of an environment as possible for Users.
Sharing your personal information
Any information collected from Users on this Site falls will not be disclosed
without consent, with the exception of the E-Verify website and WebFax utility
(when applicable), unless in response to court order, subpoena, or government
investigation. We do not sell, trade, or rent Users personal identification
information to others.
Third party websites
Users may find links to other content on our Site. We do not control the content
or links that appear on these sites and are not responsible for the practices
employed by websites linked to or from our Site. With the exception of the
E-Verify website and WebFax utility, no information is shared with third party
vendors. In addition, these sites or services, including their content and
links, may be constantly changing. These sites and services may have their own
privacy policies and customer service policies. Browsing and interaction on any
other website, including websites which have a link to our Site, is subject to
that website's own terms and policies.
Changes to this privacy policy
Tracker Corp has the discretion to update this privacy policy at any time. When
we do, we will revise the updated date at the bottom of this page. We encourage
Users to frequently check this page for any changes to stay informed about how
we are helping to protect the personal information we collect. You acknowledge
and agree that it is your responsibility to review this privacy policy
periodically and become aware of modifications.
Your acceptance of these terms
By using this Site, you signify your acceptance of this policy. If you do not
agree to this policy, please do not use our Site. Your continued use of the Site
following the posting of changes to this policy will be deemed your acceptance
of those changes.
Contacting us
If you have any questions about this Privacy Policy, the practices of this Site,
or your dealings with this Site, please contact us at:
Tracker Corp
Support@TrackerCorp.com 866.TRKR.911
Progression
PROGRESSION
* Complete Section 1
02/09/2021
* Identify Authorized Representative Due:
02/12/2021
* Form I-9 Next Steps
EMPLOYMENT ELIGIBILITY VERIFICATION
USCIS Form I-9
Employment Eligibility Verification
Department of Homeland Security
U.S. Citizenship and Immigration Services
Form I-9 Section 1: Employee Information and Attestation
I-9 Instructions: English | Español
Employees must complete and sign Section 1 of Form I-9 no later than the first
day of employment, but not before accepting a job offer.
Anti-Discrimination Notice It is illegal to discriminate against
work-authorized individuals. Employers CANNOT specify which document(s) an
employee may present to establish employment authorization and identity.The
refusal to hire or continue to employ an individual because the documentation
presented has a future expiration date may also constitute illegal
discrimination.
For more information, call the Immigrant and Employee Rights Section (IER) at in
the Department of Justice's Civil Rights Division at 1-800-255-7688 (employees),
1-800-255-8155 (employers), or 1-800-237-2515 (TTY), or visit
https://www.justice.gov/crt/immigrant-and-employee-rights-section.
Anti-Discrimination Notice
It is illegal to discriminate against
work-authorized individuals. Employers CANNOT specify which document(s) an
employee may present to establish employment authorization and identity.The
refusal to hire or continue to employ an individual because the documentation
presented has a future expiration date may also constitute illegal
discrimination.
For more information, call the Immigrant and Employee Rights Section (IER) at in
the Department of Justice's Civil Rights Division at 1-800-255-7688 (employees),
1-800-255-8155 (employers), or 1-800-237-2515 (TTY), or visit
https://www.justice.gov/crt/immigrant-and-employee-rights-section.
Alert: Employees under age 18 require special handling and cannot complete
Section 1 online. Close this web page and contact your HR representative to
complete the Form I-9 in person.
Employee Name and Identification
EMPLOYEE NAME AND IDENTIFICATION
* First Name (Given Name):* Enter your full legal first name.Your first name is
your given name.
Some examples of correctly entered first names include Jessica, John-Paul,
Tae Young, D’Shaun, Mai.
If you only have one name, enter it in the Last Name field, then enter
“Unknown” in this field. You may not enter “Unknown” in both this field and
the Last Name field.
First Name (Given Name) Enter your full legal first name.Your first name is
your given name. Some examples of correctly entered first names include
Jessica, John-Paul, Tae Young, D’Shaun, Mai. If you only have one name, enter
it in the Last Name field, then enter “Unknown” in this field. You may not
enter “Unknown” in both this field and the Last Name field.
* Middle Initial:* Your middle initial your second given name, or your middle
name, if any. If you do not have a middle intial, enter N/A in this field.
Middle Initial Your middle initial your second given name, or your middle
name, if any. If you do not have a middle intial, enter N/A in this field.
* Last Name (Family Name):* Enter your full legal last name. Your last name is
your family name or surname. If you have two last names or a hyphen-ated last
name, include both names in this field.
Examples of correctly entered last names include De La Cruz, O’Neill, Garcia
Lopez, Smith-Johnson, Nguyen.
If you only have one name, enter it in this field, then enter “Unknown” in
the First Name field. You may not enter “Unknown” in both this field and the
First Name field.
Last Name (Family Name) Enter your full legal last name. Your last name is
your family name or surname. If you have two last names or a hyphen-ated last
name, include both names in this field. Examples of correctly entered last
names include De La Cruz, O’Neill, Garcia Lopez, Smith-Johnson, Nguyen. If
you only have one name, enter it in this field, then enter “Unknown” in the
First Name field. You may not enter “Unknown” in both this field and the
First Name field.
* Other Last Names Used:* Provide all other last names used, if any, such as
maiden name. Enter N/A if you have not used other last names.
For example, if you legally changed your last name from Smith to Jones, you
should enter the name Smith in this field.
Other Last Names Used Provide all other last names used, if any, such as
maiden name. Enter N/A if you have not used other last names. For example, if
you legally changed your last name from Smith to Jones, you should enter the
name Smith in this field.
* U.S. Social Security Number: Providing your Social Security number is
voluntary on Form I-9 unless your employer participates in E-Verify.
If your employer participates in E-Verify and:
1. You have been issued a Social Security number, you must provide it in this
field; or
2. You have applied for, but have not yet received a Social Security number,
leave this field blank until you receive a Social Security number.
U.S. Social Security Number Providing your Social Security number is
voluntary on Form I-9 unless your employer participates in E-Verify. If your
employer participates in E-Verify and:
1. You have been issued a Social Security number, you must provide it in this
field; or
2. You have applied for, but have not yet received a Social Security number,
leave this field blank until you receive a Social Security number.
(###-##-####)
* Date of Birth:* Enter your date of birth as a 2-digit month, 2-digit day, and
4-digit year (mm/dd/yyyy). For example, enter January 8, 1980 as 01/08/1980.
Date of Birth Enter your date of birth as a 2-digit month, 2-digit day, and
4-digit year (mm/dd/yyyy). For example, enter January 8, 1980 as 01/08/1980.
(mm/dd/yyyy)
Employee Address and Contact Information
EMPLOYEE ADDRESS AND CONTACT INFORMATION
* Address(Street Number and Name):* Enter the street name and number of the
current address of your residence. If you are a border commuter from Canada
or Mexico, you may enter your Canada or Mexico address in this field.
If your residence does not have a physical address, enter a description of
the location of your residence, such as “3 miles southwest of Anytown post
office near water tower.”
Address(Street Number and Name) Enter the street name and number of the
current address of your residence. If you are a border commuter from Canada
or Mexico, you may enter your Canada or Mexico address in this field. If your
residence does not have a physical address, enter a description of the
location of your residence, such as “3 miles southwest of Anytown post office
near water tower.”
* Apt. Number:* Enter the number(s) or letter(s) that identify(ies) your
apartment. If you do not live in an apartment, enter N/A.
Apt. Number Enter the number(s) or letter(s) that identify(ies) your
apartment. If you do not live in an apartment, enter N/A.
* City or Town:* Enter your city, town or village in this field.
If your residence is not located in a city, town or village, enter your
country, township, reservation, etc., in this field. If you are a border
commuter from Canada, enter your city and province in this field. If you are
a border commuter from Mexico, enter your city and state in this field.
City or Town Enter your city, town or village in this field. If your
residence is not located in a city, town or village, enter your country,
township, reservation, etc., in this field. If you are a border commuter from
Canada, enter your city and province in this field. If you are a border
commuter from Mexico, enter your city and state in this field.
* State:* Select the abbreviation of your state or territory from the drop-down
list. You may also type the first letter of the abbreviation and use the down
arrow to select your state or territory.
If you are a border commuter from Canada or Mexico, you should choose your
country abbreviation, located at the end of the drop-down list.
State Select the abbreviation of your state or territory from the drop-down
list. You may also type the first letter of the abbreviation and use the down
arrow to select your state or territory. If you are a border commuter from
Canada or Mexico, you should choose your country abbreviation, located at the
end of the drop-down list.
<None>
* Zip Code:* Enter your 5-digit ZIP code in this field.
If you are a border commuter from Canada or Mexico, enter your 5- or 6-digit
postal code in this field.
Zip Code Enter your 5-digit ZIP code in this field. If you are a border
commuter from Canada or Mexico, enter your 5- or 6-digit postal code in this
field.
* Employee's Telephone Number:* Providing your telephone number is optional for
Form I-9. Enter only the numbers of your 9- or 10-digit telephone number.
Enter N/A if you do not enter your telephone number.
Employee's Telephone Number Providing your telephone number is optional for
Form I-9. Enter only the numbers of your 9- or 10-digit telephone number.
Enter N/A if you do not enter your telephone number.
(###-###-####)
Not Applicable (N/A)
* Employee's Email Address:* Providing your e-mail address is optional on Form
I-9. To enter your e-mail address, use this format: name@site.domain. One
reason the Department of Homeland Security (DHS) may e-mail you is if your
employer uses E-Verify and DHS learns of a potential mismatch between the
information provided and the information in government records. This e-mail
would contain information on how to begin to resolve the potential mismatch.
Enter N/A if you do not enter your e-mail address. You may use either your
personal or work e-mail address in this field.
Employee's Email Address Providing your e-mail address is optional on Form
I-9. To enter your e-mail address, use this format: name@site.domain. One
reason the Department of Homeland Security (DHS) may e-mail you is if your
employer uses E-Verify and DHS learns of a potential mismatch between the
information provided and the information in government records. This e-mail
would contain information on how to begin to resolve the potential mismatch.
Enter N/A if you do not enter your e-mail address. You may use either your
personal or work e-mail address in this field.
Employee Employment Status
EMPLOYEE EMPLOYMENT STATUS
Section 2 Document(s) do not match the Employment Status type in Section 1.
Important Note
I am aware that federal law provides for imprisonment and/or fines for false
statements or use of false documents in connection with the completion of this
form.
I am aware that federal law provides for imprisonment and/or fines for false
statements or use of false documents in connection with the completion of this
form.
I attest, under penalty of perjury, that I am (check one of the following):*
* 1. A citizen of the United States Select this status if it applies to you. If
you select this option, the rest of the fields in this area will contain N/A.
A citizen of the United States Select this status if it applies to you. If
you select this option, the rest of the fields in this area will contain N/A.
* 2. A noncitizen national of the United States (see instructions) Select this
status if it applies to you. If you select this option, the rest of the
fields in this area will contain N/A.
A noncitizen national of the United States is an individual born in American
Samoa, certain former citizens of the former Trust Territory of the Pacific
Islands, and certain children of noncitizen nationals born abroad.
A noncitizen national of the United States Select this status if it applies
to you. If you select this option, the rest of the fields in this area will
contain N/A. A noncitizen national of the United States is an individual 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 Select this status if it applies to you. If
you select this option, the fields associated with the alien authorized to
work status will contain N/A.
A lawful permanent resident is an individual 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. This term includes conditional
residents.
If you select this option, you must enter either your Alien Registration
Number or USCIS Number in the field provided. At this time, the USCIS Number
is the same as the A-number without the “A” prefix.
Asylees and refugees should not select this status, but should instead select
“An alien authorized to work.”
A lawful permanent resident Select this status if it applies to you. If you
select this option, the fields associated with the alien authorized to work
status will contain N/A. A lawful permanent resident is an individual 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. This
term includes conditional residents. If you select this option, you must
enter either your Alien Registration Number or USCIS Number in the field
provided. At this time, the USCIS Number is the same as the A-number without
the “A” prefix. Asylees and refugees should not select this status, but
should instead select “An alien authorized to work.”
If you are a lawful permanent resident, please provide your Alien
Registration Number/USCIS Number. *
Alien Registration Number/USCIS Number Lawful permanent residents must enter
their 7- to 9-digit Alien Registration Number or USCIS Number here. For
numbers with fewer than nine digits, add leading zero(s). For example, a
number of "1234567" should be entered as "001234567". At this time, the USCIS
Number is the same as the A-number without the “A” prefix. To do so, enter
the number in the space provided, then select either Alien Registration
Number or USCIS Number from the drop-down. If you select Alien Registration
Number from the drop-down, an “A” will appear before the number you entered.
Alien Registration Number/USCIS Number: * Lawful permanent residents must
enter their 7- to 9-digit Alien Registration Number or USCIS Number here. For
numbers with fewer than nine digits, add leading zero(s). For example, a
number of "1234567" should be entered as "001234567".
At this time, the USCIS Number is the same as the A-number without the “A”
prefix. To do so, enter the number in the space provided, then select either
Alien Registration Number or USCIS Number from the drop-down. If you select
Alien Registration Number from the drop-down, an “A” will appear before the
number you entered.
Alien Registration Number USCIS Number
A
(###-###-###)
<Select One>
* 4. An alien authorized to work Select this status if it applies to you. If
you select this option, the fields associated with the lawful permanent
resident status will contain N/A.
An alien authorized to work is an individual who is not a citizen or national
of the United States, or a lawful permanent resident, but is authorized to
work in the United States.
If you select this option, you must enter the expiration date of your
employment authorization, if any, and either the Alien Registration
Number/USCIS Number or the Form I-94 Admission Number in the fields below.
An alien authorized to work Select this status if it applies to you. If you
select this option, the fields associated with the lawful permanent resident
status will contain N/A. An alien authorized to work is an individual who is
not a citizen or national of the United States, or a lawful permanent
resident, but is authorized to work in the United States. If you select this
option, you must enter the expiration date of your employment authorization,
if any, and either the Alien Registration Number/USCIS Number or the Form
I-94 Admission Number in the fields below.
If you are an alien authorized to work, please provide the following
additional information.
1
Date authorized to work until * If you select this option, enter the date
that your employment authorization expires, if any, in this field.
In most cases, your employment authorization expiration date is on the
document(s) evidencing your employment authorization. In some cases, your
employment authorization document may have been automatically extended; in
these cases, you should enter the expiration date of the automatic extension
in this field.
Refugees, asylees and certain citizens of the Federated States of Micronesia,
the Republic of the Marshall Islands, or Palau, and other foreign nationals
whose employment authorization does not expires should select the N/A
checkbox. Some aliens may check the N/A Checkbox. Hover over the for
instructions.
N/A (Not Applicable)
Some aliens may check the N/A Checkbox If you select this option, enter the
date that your employment authorization expires, if any, in this field.
In most cases, your employment authorization expiration date is on the
document(s) evidencing your employment authorization. In some cases, your
employment authorization document may have been automatically extended; in
these cases, you should enter the expiration date of the automatic extension
in this field.
Refugees, asylees and certain citizens of the Federated States of Micronesia,
the Republic of the Marshall Islands, or Palau, and other foreign nationals
whose employment authorization does not expires should select the N/A
checkbox.
2
Aliens authorized to work must provide only one of the following document
numbers to complete Form I-9: An Alien Registration Number/USCIS Number OR
Form I-94 Admission Number OR Foreign Passport Number. *
Alien Registration Number/USCIS Number: Enter your 7- to 9-digit Alien
Registration Number (A-Number)/USCIS Number, if any, in this field. To do so,
enter the number in the space provided, then select either Alien Registration
Number or USCIS Number from the drop-down. If you select Alien Registration
Number from the drop-down, an “A” will appear before the number you entered.
Currently, the USCIS number is the same as the Alien number without the “A”
prefix. If you do not provide an Alien Registration Number/USCIS Number,
enter either a Form I-94 Admission Number or Foreign Passport Number in the
fields provided. This field will then be populated with N/A.
Aliens authorized to work must enter one of the following to complete Section
1:
1. Alien Registration Number (A-Number)/USCIS Number or
2. Form I-94 Admission Number or
3. Foreign Passport Number and the Country of Issuance.
Alien Registration Number/USCIS Number Enter your 7- to 9-digit Alien
Registration Number (A-Number)/USCIS Number, if any, in this field. To do so,
enter the number in the space provided, then select either Alien Registration
Number or USCIS Number from the drop-down. If you select Alien Registration
Number from the drop-down, an “A” will appear before the number you entered.
Currently, the USCIS number is the same as the Alien number without the “A”
prefix. If you do not provide an Alien Registration Number/USCIS Number,
enter either a Form I-94 Admission Number or Foreign Passport Number in the
fields provided. This field will then be populated with N/A. Aliens
authorized to work must enter one of the following to complete Section 1:
1. Alien Registration Number (A-Number)/USCIS Number or
2. Form I-94 Admission Number or
3. Foreign Passport Number and the Country of Issuance.
OR
Alien Registration Number USCIS Number
A
(###-###-###)
<Select One>
Form I-94 Admission Number: Enter your 11-digit I-94 admission number or 9
digits followed by one letter followed by one digit (e.g. #########A#) in
this field. If you do not provide an I-94 Admission Number, enter either an
Alien Registration Number/USCIS Number or a Foreign Passport number in the
fields provided. This field will then be populated with N/A.
Aliens authorized to work must enter one of the following to complete Section
1:
1. Alien Registration Number (A-Number) /USCIS Number or
2. Form I-94 Admission Number or
3. Foreign Passport Number and the Country of Issuance.
Form I-94 Admission Number Enter your 11-digit I-94 admission number or 9
digits followed by one letter followed by one digit (e.g. #########A#) in
this field. If you do not provide an I-94 Admission Number, enter either an
Alien Registration Number/USCIS Number or a Foreign Passport number in the
fields provided. This field will then be populated with N/A. Aliens
authorized to work must enter one of the following to complete Section 1:
1. Alien Registration Number (A-Number) /USCIS Number or
2. Form I-94 Admission Number or
3. Foreign Passport Number and the Country of Issuance.
OR
Foreign Passport Number: Enter your 6- to 12-digit alpha numeric Foreign
Passport Number in this field. For numbers with fewer than 6-digits, add a
leading zero(s). For example, a number of "A1234" should be entered as
"0A1234." If you do not provide a Foreign Passport number, enter either your
Alien Number/USCIS Number or your I-94 Admission Number in the fields
provided. This field will then be populated with N/A.
Aliens authorized to work must enter one of the following to complete Section
1:
1. Alien Registration Number (A-Number)/USCIS Number or
2. Form I-94 Admission Number or
3. Foreign Passport Number and the Country of Issuance.
Foreign Passport Number Enter your Foreign Passport Number in this field. If
you do not provide a foreign passport number, enter either your Alien
Number/USCIS Number or your I-94 admission number in the fields provided.
This field will then be populated with N/A. Aliens authorized to work must
enter one of the following to complete Section 1:
1. Alien Registration Number (A-Number)/USCIS Number or
2. Form I-94 Admission Number or
3. Foreign Passport Number and the Country of Issuance.
Issuing Country:* If you entered your foreign passport number in the Foreign
Passport Number field, select the country of issuance of the foreign passport
you used to enter the United States from the drop-down list provided. You may
also type the first letter of the country and use the down arrow to select
your country of issuance.
If you entered an Alien Registration Number/USCIS Number or I-94 admission
number, or you entered N/A in the Foreign Passport Number field, this field
will contain N/A.
Issuing Country If you entered your foreign passport number in the Foreign
Passport Number field, select the country of issuance of the foreign passport
you used to enter the United States from the drop-down list provided. You may
also type the first letter of the country and use the down arrow to select
your country of issuance. If you entered an Alien Registration Number/USCIS
Number or I-94 admission number, or you entered N/A in the Foreign Passport
Number field, this field will contain N/A.
<None>
I Do Not Have My Documents Available At This Time Your employer has requested
that you select and enter your identity and work authorization document
information at this time. If you do not have access to these documents, click
the link to skip this step. You must still present these documents to your
employer for examination when you begin work. Click to Select Employment
Verification Documents
Employment Verification Documents (The Employee must present one document from
List A OR one document from List B and List C).
Use the drop-down menu to select a document from List A or one from List B and
C. Then, enter the respective document number(s) and
expiration date(s).
*
Document Type
* List A
SelectSelect
* List B
SelectSelect
* List C
SelectSelect
I Do Not Have My Documents Available At This Time Your employer has requested
that you select and enter your identity and work authorization document
information at this time. If you do not have access to these documents, click
the link to skip this step. You must still present these documents to your
employer for examination when you begin work.
EMPLOYMENT VERIFICATION DOCUMENTS (THE EMPLOYEE MUST PRESENT ONE DOCUMENT FROM
LIST A OR ONE DOCUMENT FROM LIST B AND LIST C)
Switch to Classic View Switch to New View
Reset
Use the drop-down menu to select a document from List A or one from List B and
C. Then, enter the respective document number(s) and expiration date(s). Click
the (i) button for more information about a specific document.
List A:
List B:
List C:
1
Select Employee Document Type
List A (Both Identity & Employment Eligibility) List B (Identity) and& List C
(Employment Authorization)
List A document information form
2
Select the List A document provided by the Employee and provide the document
details:
List A
Document Type:
<Select One> *
Attachment:
Attachment Attachment.
Take picture
Foreign Passport I-94 Document A-Number/USCIS Number:* * Enter the 7- to 9-digit
Alien Registration Number (A-Number)/USCIS Number, in this field. The
A-Number/USCIS Number can be found on the face of the EAD Card (Form I-766). For
numbers with fewer than nine digits, add leading zero(s). For example, a number
of "1234567" should be entered as "001234567". Issuing Authority:*
Issuing Authority
* Issuing Authority:*
Issuing Authority
<None> AFGHANISTAN ÅLAND ISLANDS ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA
ANGUILLA ANTARCTICA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA
AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE
BENIN BERMUDA BHUTAN BOLIVIA, PLURINATIONAL STATE OF BOSNIA AND HERZEGOVINA
BOTSWANA BOUVET ISLAND BRAZIL BRITISH INDIAN OCEAN TERRITORY BRUNEI DARUSSALAM
BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CAPE VERDE CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS (KEELING)
ISLANDS COLOMBIA COMOROS CONGO CONGO, DEMOCRATIC REPUBLIC OF THE COOK ISLANDS
COSTA RICA CÔTE D'IVOIRE CROATIA CUBA CYPRUS CZECH REPUBLIC DENMARK DJIBOUTI
DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA
ESTONIA ESWATINI ETHIOPIA FALKLAND ISLANDS (MALVINAS) FAROE ISLANDS FEDERATED
STATES OF MICRONESIA FIJI FINLAND FRANCE FRENCH GUIANA FRENCH POLYNESIA FRENCH
SOUTHERN TERRITORIES GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE
GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUERNSEY GUINEA GUINEA-BISSAU GUYANA
HAITI HEARD ISLAND AND MCDONALD ISLANDS HOLY SEE (VATICAN CITY STATE) HONDURAS
HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN, ISLAMIC REPUBLIC OF IRAQ IRELAND
ISLE OF MAN ISRAEL ITALY JAMAICA JAPAN JERSEY JORDAN KAZAKHSTAN KENYA KIRIBATI
KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA, REPUBLIC OF KOSOVO KUWAIT
KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA
LIBYAN ARAB JAMAHIRIYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAO MACEDONIA, NORTH
MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARTINIQUE MAURITANIA MAURITIUS
MAYOTTE MEXICO MOLDOVA, REPUBLIC OF MONACO MONGOLIA MONTENEGRO MONTSERRAT
MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NETHERLANDS ANTILLES
NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTHERN
MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PALESTINIAN TERRITORY, OCCUPIED
PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL
PUERTO RICO QATAR Republic of the Marshall Islands (RMI) RÉUNION ROMANIA RUSSIAN
FEDERATION RWANDA SAINT BARTHÉLEMY SAINT HELENA, ASCENSION AND TRISTAN DA CUNHA
SAINT KITTS AND NEVIS SAINT LUCIA SAINT MARTIN (FRENCH PART) SAINT PIERRE AND
MIQUELON SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE
SAUDI ARABIA SENEGAL SERBIA SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA
SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH GEORGIA AND THE SOUTH SANDWICH
ISLANDS SPAIN SRI LANKA STATELESS SUDAN SURINAME SVALBARD AND JAN MAYEN SWEDEN
SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN TAJIKISTAN TANZANIA, UNITED REPUBLIC OF
THAILAND TIMOR-LESTE TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY
TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES
UNITED KINGDOM UNITED STATES MINOR OUTLYING ISLANDS URUGUAY UZBEKISTAN VANUATU
VENEZUELA, BOLIVARIAN REPUBLIC OF VIET NAM VIRGIN ISLANDS (BRITISH) VIRGIN
ISLANDS (U.S.) WALLIS AND FUTUNA WESTERN SAHARA YEMEN ZAMBIA ZIMBABWE *
Issuing Authority:*
Issuing Authority
<Select One> USCIS DOJ INS * Issuing Authority:*
Issuing Authority
Issuing Authority:*
Issuing Authority
U.S. Department of Homeland Security * Passport I-94 Card Number:* Document
#:*
Document
*
Passport I-94 Expires:*
Expires Enter the expiration date of the document you selected.
A document is not acceptable if it has already expired. An unexpired document
includes a document where the expiration date shown on the face of a document
has been automatically extended, such as for individuals with Temporary
Protected Status.
If the document does not have an expiration date, select N/A.
* Enter the expiration date of the document you selected.
A document is not acceptable if it has already expired. An unexpired document
includes a document where the expiration date shown on the face of a document
has been automatically extended, such as for individuals with Temporary
Protected Status.
If the document does not have an expiration date, select N/A.
Not Applicable (N/A)
Temporary I-551 Stamp I-551 Printed Notation on a MRIV
Issuing Authority
I-94 Issuing Authority:* I-20 Issuing Authority:* Issuing Authority:*
Issuing Authority
<Select One> U.S. Customs and Border Protection USCIS <Select One> U.S.
Citizenship and Immigration Services U.S. Customs and Border Protection <Select
One> U.S. Citizenship and Immigration Services DOJ Immigration and
Naturalization Services U.S. Department of State * I-94 Document #:* I-20
Document #:* Temporary I-551 Document #:* Form I-797C Receipt Number :*
Document
* I-94 Expires:* Temporary I-551 Expires:*
Expires
*
N/A (Not Applicable)
Additional Documents:* Temporary I-551 Type*
*
Certain Foreign National employees may need to present additional documents in
support of their List A document in order complete the employment eligibility
verification process. Use this drop-down menu to select the Additional Documents
option that pertains to the Foreign employee. Then, enter the respective
document number(s) and expiration date(s).
List A:
Take picture
DS-2019 Issuing Authority:* I-20 Issuing Authority:* U.S. Immigration and
Customs Enforcement US DOJ INS * DS-2019 Document #:* I-20 Document #:*
Document Enter the Form I-20 number (Student and Exchange Visitor Number - SEVIS
Number). SEVIS Numbers must start with a letter followed by 10-11 numbers.
* Enter the Form I-20 number (Student and Exchange Visitor Number - SEVIS
Number). SEVIS Numbers must start with a letter followed by 10-11 numbers. H-1B
Filing Date:* H2A Filling Date:* Extension Filing Date:* * Reverification Due
Date:*
Reverification Due Date
* DS-2019 Expires:* I-20 Expires:* H2A Expires:*
Expiry Date Enter the work authorization end date from the Form I-20 as the
expiry date.
* Enter the work authorization end date from the Form I-20 as the expiry date
Attachment
According to USCIS, an acceptable receipt is not issued for the selected
Document Type. Since receipts are not issued for this document, the receipt
checkbox is disabled. Employee presented an acceptable receipt in lieu
of an original document in List A If an employee is unable to present a required
document, the employee can present an acceptable receipt in lieu of an original
document (see Handbook for Employer, M-274 for additional USCIS guidance)
If the employee provides an acceptable receipt, you should:
• Check the receipt checkbox and confirm the correct List Document (A, B or C)
is selected
• Enter the document number (if any) in the Document Number field
• Enter the last day that the receipt is valid in the ‘Expires’ date field.
Typically, receipts are valid for 90 days from the start date or, in the case of
reverification, within 90 days from the date employment authorization expires.
• Advise the employee to present the original document before the receipt
expires.
When the employee provides the original document, you should:
• Uncheck the receipt checkbox
• Update the Issuing Authority, Expires date, and any other document information
as necessary based upon the information in the new original document
• Save and resign Section 2
Employee presented an acceptable receipt in lieu
of an original document in List C If an employee is unable to present a required
document, the employee can present an acceptable receipt in lieu of an original
document (see Handbook for Employer, M-274 for additional USCIS guidance)
If the employee provides an acceptable receipt, you should:
• Check the receipt checkbox and confirm the correct List Document (A, B or C)
is selected
• Enter the document number (if any) in the Document Number field
• Enter the last day that the receipt is valid in the ‘Expires’ date field.
Typically, receipts are valid for 90 days from the start date or, in the case of
reverification, within 90 days from the date employment authorization expires.
• Advise the employee to present the original document before the receipt
validity period expires.
When the employee provides the original document, you should:
• Uncheck the receipt checkbox
• Update the Issuing Authority, Expires date, and any other document information
as necessary based upon the information in the new original document
• Save and electronically amend Section 2
The Authorized to Work Until Date in Section 1 does not match the Employment
Authorization Document expiration date in Section 2.
Section 1 Authorized to Work Until Date:
Section 2 Employment Authorization
Document expiration date: Section 2 Reverification Due Date:
Please verify that you entered the correct expiration date for the Employment
Authorization Document presented by the employee.
Was the correct date entered in Section 2?
Form I-9 rules state the employment authorization expiration date provided by
your employee in Section 1 may not match the document expiration date recorded
under List A or List C in Section 2. The earlier date must be used to determine
when reverification is necessary.
Based upon the information provided by the employee in Section 1 and the
documents presented for completion of Section 2, this employee has temporary
work authorization until . The system will track this date for reverification.
Consider asking the employee if they misentered their Authorized to Work Until
Date in Section 1. If the Section 1 date is incorrect, ask the employee to
update the date value and complete the Form I-9 amendment process.
Click Save/Validate Section 2 to Continue.
The Section 2 Employment Authorization Date must be corrected Please click Okay
to close this message, carefully inspect the Employment Authorization Document,
and enter the correct Employment Authorization Document expiration date. Then
click the Save/Validate button to proceed.
Click Okay to Continue.
List B document information form
2
Select the List B document provided by the Employee and provide the document
details: List B Document Type:
<Select One> *
Attachment:*
Attachment Attachment.
Take picture
Driver license/ID:* <None> *
State:* <None> *
Document Title:*
Document Title
Issuing Authority:*
Issuing Authority
<Select One> <None> Alabama Alaska America Samoa Arizona Arkansas California
Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii
Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland
Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada
New Hampshire New Jersey New Mexico New York North Carolina North Dakota
Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode
Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands
Of The U.S. Virginia Washington West Virginia Wisconsin Wyoming * Document
#:*
Document
*
Expires:*
Expires
*
Enter the expiration date of the document you selected.
A document is not acceptable if it has already expired. An unexpired document
includes a document where the expiration date shown on the face of a document
has been automatically extended, such as for individuals with Temporary
Protected Status.
If the document does not have an expiration date, select N/A.
Not Applicable (N/A)
Auto-Extended Document
COVID-19 Receipt List B documents that expired on or after March 1, 2020 should
be treated as an acceptable receipt per DHS policy changes adopted as a response
to the COVID-19 pandemic. Within 90 days after DHS’s termination of this
temporary policy, the employee will be required to present a valid unexpired
document. Note: Per DHS guidelines, it is best if the employee can present the
replacement of the actual document that was expired, but if necessary, the
employee may choose to present a different List A or List B document or
documents and record the new document information in the Additional Information
Field.
Attachment * Not a document
According to USCIS, an acceptable receipt is not issued for the selected
Document Type. Since receipts are not issued for this document, the receipt
checkbox is disabled. Employee presented an acceptable receipt in lieu
of an original document in List B If an employee is unable to present a required
document, the employee can present an acceptable receipt in lieu of an original
document (see Handbook for Employer, M-274 for additional USCIS guidance)
If the employee provides an acceptable receipt, you should:
• Check the receipt checkbox and confirm the correct List Document (A, B or C)
is selected
• Enter the document number (if any) in the Document Number field
• Enter the last day that the receipt is valid in the ‘Expires’ date field.
Typically, receipts are valid for 90 days from the start date or, in the case of
reverification, within 90 days from the date employment authorization expires.
• Advise the employee to present the original document before the receipt
validity period expires.
When the employee provides the original document, you should:
• Uncheck the receipt checkbox
• Update the Issuing Authority, Expires date, and any other document information
as necessary based upon the information in the new original document
• Save and electronically amend Section 2
Employee presented an acceptable receipt in lieu
of an original document in List C If an employee is unable to present a required
document, the employee can present an acceptable receipt in lieu of an original
document (see Handbook for Employer, M-274 for additional USCIS guidance)
If the employee provides an acceptable receipt, you should:
• Check the receipt checkbox and confirm the correct List Document (A, B or C)
is selected
• Enter the document number (if any) in the Document Number field
• Enter the last day that the receipt is valid in the ‘Expires’ date field.
Typically, receipts are valid for 90 days from the start date or, in the case of
reverification, within 90 days from the date employment authorization expires.
• Advise the employee to present the original document before the receipt
validity period expires.
When the employee provides the original document, you should:
• Uncheck the receipt checkbox
• Update the Issuing Authority, Expires date, and any other document information
as necessary based upon the information in the new original document
• Save and electronically amend Section 2
List C document information form
3
Select the List C document provided by the Employee and provide the document
details: List C Document Type:
Document Type
<Select One> *
Attachment:*
Attachment Attachment.
Take picture
Document Title:*
Document Title Enter the Document Title of the DHS Employment Authorization
Document.
* Enter the Document Title of the DHS Employment Authorization Document. Issuing
Authority:*
Issuing Authority
* Issuing Authority:*
Issuing Authority
Social Security Administration U.S Dept. of Health and Human Services Social
Security Board Dept. of Health, Education, and Welfare * Document#:*
Document
* Expires:*
Expires
*
Enter the expiration date of the document you selected.
A document is not acceptable if it has already expired. An unexpired document
includes a document where the expiration date shown on the face of a document
has been automatically extended, such as for individuals with Temporary
Protected Status.
If the document does not have an expiration date, select N/A.
Not Applicable (N/A)
Attachment:
According to USCIS, an acceptable receipt is not issued for the selected
Document Type. Since receipts are not issued for this document, the receipt
checkbox is disabled. Employee presented an acceptable receipt in lieu
of an original document in List C If an employee is unable to present a required
document, the employee can present an acceptable receipt in lieu of an original
document (see Handbook for Employer, M-274 for additional USCIS guidance)
If the employee provides an acceptable receipt, you should:
• Check the receipt checkbox and confirm the correct List Document (A, B or C)
is selected
• Enter the document number (if any) in the Document Number field
• Enter the last day that the receipt is valid in the ‘Expires’ date field.
Typically, receipts are valid for 90 days from the start date or, in the case of
reverification, within 90 days from the date employment authorization expires.
• Advise the employee to present the original document before the receipt
validity period expires.
When the employee provides the original document, you should:
• Uncheck the receipt checkbox
• Update the Issuing Authority, Expires date, and any other document information
as necessary based upon the information in the new original document
• Save and electronically amend Section 2
Employee presented an acceptable receipt in lieu
of an original document in List C If an employee is unable to present a required
document, the employee can present an acceptable receipt in lieu of an original
document (see Handbook for Employer, M-274 for additional USCIS guidance)
If the employee provides an acceptable receipt, you should:
• Check the receipt checkbox and confirm the correct List Document (A, B or C)
is selected
• Enter the document number (if any) in the Document Number field
• Enter the last day that the receipt is valid in the ‘Expires’ date field.
Typically, receipts are valid for 90 days from the start date or, in the case of
reverification, within 90 days from the date employment authorization expires.
• Advise the employee to present the original document before the receipt
validity period expires.
When the employee provides the original document, you should:
• Uncheck the receipt checkbox
• Update the Issuing Authority, Expires date, and any other document information
as necessary based upon the information in the new original document
• Save and electronically amend Section 2
Additional Information Additional Information
Use this space to notate any additional information that you wish to appear in
Section 2 of the Form I-9, such as:
• Employment authorization extensions for Temporary Protected Status
beneficiaries, F-1 OPT STEM students, CAP-GAP, H-1B and H-2A employees
continuing employment with the same employer or changing employers, and other
nonimmigrant categories that may receive extensions of stay.
• Additional document(s) that certain nonimmigrant employees may present that
cannot be entered fields provided.
• Discrepancies that E-Verify employers must notate when participating in the
IMAGE program.
• Any other comments or notations necessary for the employer’s business process.
You may leave this field blank if the employee’s circumstances do not require
additional notations.
Additional Information Additional Information
Use this space to notate any additional information that you wish to appear in
Section 2 of the Form I-9, such as:
• Employment authorization extensions for Temporary Protected Status
beneficiaries, F-1 OPT STEM students, CAP-GAP, H-1B and H-2A employees
continuing employment with the same employer or changing employers, and other
nonimmigrant categories that may receive extensions of stay.
• Additional document(s) that certain nonimmigrant employees may present that
cannot be entered fields provided.
• Discrepancies that E-Verify employers must notate when participating in the
IMAGE program.
• Any other comments or notations necessary for the employer’s business process.
You may leave this field blank if the employee’s circumstances do not require
additional notations.
IMPORTANT: A copy of both the front and back of the document must be retained
with the employee's I-9 record, or in the case of a U.S. Passport, copy the
Passport ID page and Passport Barcode page. The photocopies must be of
sufficient quality to allow for verification of the photo and written
information.
Provide an Electronic Signature
PROVIDE AN ELECTRONIC SIGNATURE
The employee is under the age of 18 and cannot produce a List A or List B
document type for Section 2. 'INDIVIDUAL UNDER AGE 18' will automatically appear
in the 'Print Employee Name' field and the parent or legal guardian must
complete the Preparer and/or Translator Certification.
ALERT: The individual who completes the Preparer and/or Translator Certification
must be present with you when you present original identity and work
authorization documents to your employer or its representative for verification
as required by law. Contact your employer if you cannot meet these requirements
for any reason. Click to view a list of Acceptable Documents.
***IMPORTANT: YOU ARE SIGNING A U.S. GOVERNMENT FORM***
I am aware that federal law provides for imprisonment and/or fines for false
statements or use of false documents in connection with the completion of this
form.
* 1
* Enter your legal name as your electronic signature: Employee Name (First,
Middle Initial, and Last) *
* 2
* Select the box next to “ I agree” to acknowledge that you have read and
accept the fact that you are signing a U.S. Government Form and that you are
aware that federal law provides for imprisonment and/or fines for false
statements or use of false documents in connection with the completion of
this Form.
I agree * After completing Section 1, click the “I Agree” checkbox and then
click the Sign Section 1 button below
By signing this form, you attest under penalty of perjury (28 U.S.C. §1746)
that the information you provided; the citizenship or immigration status you
selected; and all information and documentation you provide to your employer,
is complete, true and correct, and you are aware that you may face severe
penalties provided by law and may be subject to criminal prosecution for
knowingly or willfully making false statements or using false documentation
when completing this form.
If anyone other than the employee completes Section 1, both the employee and
the preparer or translator should complete their respective areas of Section
1, then sign Section 1. If the employee is a minor (individual under age 18)
or a person with a disability (who is placed in employment by a nonprofit
organization, association or as part of a rehabilitation program) who cannot
present an identity document, refer to the section of the Form I-9
instructions titled “Signature of the Employee” for more information.
I agree After completing Section 1, click the “I Agree” checkbox and then
click the Sign Section 1 button below By signing this form, you attest under
penalty of perjury (28 U.S.C. §1746) that the information you provided; the
citizenship or immigration status you selected; and all information and
documentation you provide to your employer, is complete, true and correct,
and you are aware that you may face severe penalties provided by law and may
be subject to criminal prosecution for knowingly or willfully making false
statements or using false documentation when completing this form. If anyone
other than the employee completes Section 1, both the employee and the
preparer or translator should complete their respective areas of Section 1,
then sign Section 1. If the employee is a minor (individual under age 18) or
a person with a disability (who is placed in employment by a nonprofit
organization, association or as part of a rehabilitation program) who cannot
present an identity document, refer to the section of the Form I-9
instructions titled “Signature of the Employee” for more information.
* 3
* Preparer and/or Translator Certification (select one):* Select the number of
preparers and/or translators you used to complete the form if any. If you are
the employee and you did not use a preparer or translator, you must select
the first option marked “I did not use a preparer or translator.”
If one or more preparers or translators assist the employee in completing
Section 1, the preparer or translator must select the second box marked “A
preparer(s) and/or translator(s) assisted the employee in completing Section
1” and complete the rest of the fields below.
The preparer and/or translator also must select the number of Certification
areas needed from the dropdown provided. There is no limit to the number of
preparers and/or translators that can be used, however each additional
preparer and/or translator must complete and sign a separate Certification
area. When more than 5 preparer/translator certification are required, the
Supplement for Section 1 Preparer and/or Translator must be printed and
preparer/translator 6 and beyond must complete the certification on paper.
Parents or legal guardians attesting to the identity of minors (individuals
under 18) and individuals attesting to the identity of certain employees with
disabilities must complete this section.
Preparer and/or Translator Certification Select the number of preparers
and/or translators you used to complete the form if any. If you are the
employee and you did not use a preparer or translator, you must select the
first option marked “I did not use a preparer or translator.” If one or more
preparers or translators assist the employee in completing Section 1, the
preparer or translator must select the second box marked “A preparer(s)
and/or translator(s) assisted the employee in completing Section 1” and
complete the rest of the fields below. The preparer and/or translator also
must select the number of Certification areas needed from the dropdown
provided. There is no limit to the number of preparers and/or translators
that can be used, however each additional preparer and/or translator must
complete and sign a separate Certification area. When more than 5
preparer/translator certification are required, the Supplement for Section 1
Preparer and/or Translator must be printed and preparer/translator 6 and
beyond must complete the certification on paper. Parents or legal guardians
attesting to the identity of minors (individuals under 18) and individuals
attesting to the identity of certain employees with disabilities must
complete this section.
* I did not use a preparer or translator If you are the employee and you did
not use a preparer or translator, you must select this box “I did not use a
preparer or translator.”
I did not use a preparer or translator If you are the employee and you did
not use a preparer or translator, you must select this box “I did not use a
preparer or translator.”
* A preparer(s) and/or translator(s) assisted the employee in completing
Section 1 If one or more preparers or translators assist the employee in
completing Section 1, the preparer or translator must select this box “A
preparer(s) and/or translator(s) assisted the employee in completing Section
1.” The preparer and/or translator also must select the number of
Certification areas needed from the dropdown provided. If this box is
selected, the preparer or translator must complete the rest of the fields
below.
A preparer(s) and/or translator(s) assisted the employee in completing
Section 1 If one or more preparers or translators assist the employee in
completing Section 1, the preparer or translator must select this box “A
preparer(s) and/or translator(s) assisted the employee in completing Section
1.” The preparer and/or translator also must select the number of
Certification areas needed from the dropdown provided. If this box is
selected, the preparer or translator must complete the rest of the fields
below.
How Many?*
1 2 3 4 5
Preparer/Translator 1
*
* First Name * Enter the full legal first name of the person who helped the
employee in preparing or translating Section 1 in this field.
The first name is also the given name.
First Name Enter the full legal first name of the person who helped the
employee in preparing or translating Section 1 in this field. The first name
is also the given name.
* Last Name * Enter the full legal last name of the person who helped the
employee in preparing or translating Section 1 in this field.
The last name is also the family name or surname. If the preparer or
translator has two last names or a hyphenated last name, include both names
in this field.
Last Name Enter the full legal last name of the person who helped the
employee in preparing or translating Section 1 in this field. The last name
is also the family name or surname. If the preparer or translator has two
last names or a hyphenated last name, include both names in this field.
* Preparer’s/Translator’s Address (Street Name and Number) * Enter the street
name and number of the current address of the person who helped the employee
in preparing or translating Section 1 in this field.
Addresses in Canada or Mexico may be entered in this field. If the address is
an apartment, include the apartment number in this field.
If the person does not have a physical address, enter a description of the
person’s location, such as “3 miles southwest of Anytown post office near
water tower.”
Preparer’s/Translator’s Address Enter the street name and number of the
current address of the person who helped the employee in preparing or
translating Section 1 in this field. Addresses in Canada or Mexico may be
entered in this field. If the address is an apartment, include the apartment
number in this field. If the person does not have a physical address, enter a
description of the person’s location, such as “3 miles southwest of Anytown
post office near water tower.”
* * City * Enter the city, town or village of the address of the person who
helped the employee in preparing or translating Section 1 in this field.
If the address is not located in a city or town, enter the name of the
village, country, township, reservation, etc., in this field. If the
address is in Canada, enter the city and province in this field. If the
address is in Mexico, enter the city and state in this field.
City Enter the city, town or village of the address of the person who
helped the employee in preparing or translating Section 1 in this field. If
the address is not located in a city or town, enter the name of the
village, country, township, reservation, etc., in this field. If the
address is in Canada, enter the city and province in this field. If the
address is in Mexico, enter the city and state in this field.
* State * Select the state, territory or country of the preparer or
translator’s address from the drop-down list. You may also type the first
letter of the abbreviation and use the down arrow to select your state or
territory.
If the preparer or translator entered an address from Canada or Mexico,
choose the country abbreviation, located at the end of the drop-down list.
State Select the state, territory or country of the preparer or
translator’s address from the drop-down list. You may also type the first
letter of the abbreviation and use the down arrow to select your state or
territory. If the preparer or translator entered an address from Canada or
Mexico, choose the country abbreviation, located at the end of the
drop-down list.
<None><None>AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict
of ColumbiaFederated States Of
MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall
IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew
HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern
Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode
IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin Islands Of
The U.S.VirginiaWashingtonWest VirginiaWisconsinWyomingCanadaMexico
* Zip Code * Enter the 5-digit ZIP code of the address of the person who
helped the employee in preparing or translating Section 1 in this field.
If the address the preparer or translator entered is in Canada or Mexico,
enter the 5- or 6-digit postal code in this field.
Zip Code Enter the 5-digit ZIP code of the address of the person who helped
the employee in preparing or translating Section 1 in this field. If the
address the preparer or translator entered is in Canada or Mexico, enter
the 5- or 6-digit postal code in this field.
* I attest, under penality of perjury, that I have assisted in the completion
of this form and that to the best of my knowledge the information is true and
correct*
--------------------------------------------------------------------------------
Preparer/Translator 2
* First Name * Enter the full legal first name of the person who helped the
employee in preparing or translating Section 1 in this field.
The first name is also the given name.
First Name Enter the full legal first name of the person who helped the
employee in preparing or translating Section 1 in this field. The first name
is also the given name.
* Last Name * Enter the full legal last name of the person who helped the
employee in preparing or translating Section 1 in this field.
The last name is also the family name or surname. If the preparer or
translator has two last names or a hyphenated last name, include both names
in this field.
Last Name Enter the full legal last name of the person who helped the
employee in preparing or translating Section 1 in this field. The last name
is also the family name or surname. If the preparer or translator has two
last names or a hyphenated last name, include both names in this field.
* Preparer’s/Translator’s Address (Street Name and Number) * Enter the street
name and number of the current address of the person who helped the employee
in preparing or translating Section 1 in this field.
Addresses in Canada or Mexico may be entered in this field. If the address is
an apartment, include the apartment number in this field.
If the person does not have a physical address, enter a description of the
person’s location, such as “3 miles southwest of Anytown post office near
water tower.”
Preparer’s/Translator’s Address Enter the street name and number of the
current address of the person who helped the employee in preparing or
translating Section 1 in this field. Addresses in Canada or Mexico may be
entered in this field. If the address is an apartment, include the apartment
number in this field. If the person does not have a physical address, enter a
description of the person’s location, such as “3 miles southwest of Anytown
post office near water tower.”
* * City * Enter the city, town or village of the address of the person who
helped the employee in preparing or translating Section 1 in this field.
If the address is not located in a city or town, enter the name of the
village, country, township, reservation, etc., in this field. If the
address is in Canada, enter the city and province in this field. If the
address is in Mexico, enter the city and state in this field.
City Enter the city, town or village of the address of the person who
helped the employee in preparing or translating Section 1 in this field. If
the address is not located in a city or town, enter the name of the
village, country, township, reservation, etc., in this field. If the
address is in Canada, enter the city and province in this field. If the
address is in Mexico, enter the city and state in this field.
* State * Select the state, territory or country of the preparer or
translator’s address from the drop-down list. You may also type the first
letter of the abbreviation and use the down arrow to select your state or
territory.
If the preparer or translator entered an address from Canada or Mexico,
choose the country abbreviation, located at the end of the drop-down list.
State Select the state, territory or country of the preparer or
translator’s address from the drop-down list. You may also type the first
letter of the abbreviation and use the down arrow to select your state or
territory. If the preparer or translator entered an address from Canada or
Mexico, choose the country abbreviation, located at the end of the
drop-down list.
<None><None>AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict
of ColumbiaFederated States Of
MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall
IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew
HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern
Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode
IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin Islands Of
The U.S.VirginiaWashingtonWest VirginiaWisconsinWyomingCanadaMexico
* Zip Code * Enter the 5-digit ZIP code of the address of the person who
helped the employee in preparing or translating Section 1 in this field.
If the address the preparer or translator entered is in Canada or Mexico,
enter the 5- or 6-digit postal code in this field.
Zip Code Enter the 5-digit ZIP code of the address of the person who helped
the employee in preparing or translating Section 1 in this field. If the
address the preparer or translator entered is in Canada or Mexico, enter
the 5- or 6-digit postal code in this field.
* I attest, under penality of perjury, that I have assisted in the completion
of this form and that to the best of my knowledge the information is true and
correct*
--------------------------------------------------------------------------------
Preparer/Translator 3
* First Name * Enter the full legal first name of the person who helped the
employee in preparing or translating Section 1 in this field.
The first name is also the given name.
First Name Enter the full legal first name of the person who helped the
employee in preparing or translating Section 1 in this field. The first name
is also the given name.
* Last Name * Enter the full legal last name of the person who helped the
employee in preparing or translating Section 1 in this field.
The last name is also the family name or surname. If the preparer or
translator has two last names or a hyphenated last name, include both names
in this field.
Last Name Enter the full legal last name of the person who helped the
employee in preparing or translating Section 1 in this field. The last name
is also the family name or surname. If the preparer or translator has two
last names or a hyphenated last name, include both names in this field.
* Preparer’s/Translator’s Address (Street Name and Number) * Enter the street
name and number of the current address of the person who helped the employee
in preparing or translating Section 1 in this field.
Addresses in Canada or Mexico may be entered in this field. If the address is
an apartment, include the apartment number in this field.
If the person does not have a physical address, enter a description of the
person’s location, such as “3 miles southwest of Anytown post office near
water tower.”
Preparer’s/Translator’s Address Enter the street name and number of the
current address of the person who helped the employee in preparing or
translating Section 1 in this field. Addresses in Canada or Mexico may be
entered in this field. If the address is an apartment, include the apartment
number in this field. If the person does not have a physical address, enter a
description of the person’s location, such as “3 miles southwest of Anytown
post office near water tower.”
* * City * Enter the city, town or village of the address of the person who
helped the employee in preparing or translating Section 1 in this field.
If the address is not located in a city or town, enter the name of the
village, country, township, reservation, etc., in this field. If the
address is in Canada, enter the city and province in this field. If the
address is in Mexico, enter the city and state in this field.
City Enter the city, town or village of the address of the person who
helped the employee in preparing or translating Section 1 in this field. If
the address is not located in a city or town, enter the name of the
village, country, township, reservation, etc., in this field. If the
address is in Canada, enter the city and province in this field. If the
address is in Mexico, enter the city and state in this field.
* State * Select the state, territory or country of the preparer or
translator’s address from the drop-down list. You may also type the first
letter of the abbreviation and use the down arrow to select your state or
territory.
If the preparer or translator entered an address from Canada or Mexico,
choose the country abbreviation, located at the end of the drop-down list.
State Select the state, territory or country of the preparer or
translator’s address from the drop-down list. You may also type the first
letter of the abbreviation and use the down arrow to select your state or
territory. If the preparer or translator entered an address from Canada or
Mexico, choose the country abbreviation, located at the end of the
drop-down list.
<None><None>AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict
of ColumbiaFederated States Of
MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall
IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew
HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern
Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode
IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin Islands Of
The U.S.VirginiaWashingtonWest VirginiaWisconsinWyomingCanadaMexico
* Zip Code * Enter the 5-digit ZIP code of the address of the person who
helped the employee in preparing or translating Section 1 in this field.
If the address the preparer or translator entered is in Canada or Mexico,
enter the 5- or 6-digit postal code in this field.
Zip Code Enter the 5-digit ZIP code of the address of the person who helped
the employee in preparing or translating Section 1 in this field. If the
address the preparer or translator entered is in Canada or Mexico, enter
the 5- or 6-digit postal code in this field.
* I attest, under penality of perjury, that I have assisted in the completion
of this form and that to the best of my knowledge the information is true and
correct*
--------------------------------------------------------------------------------
Preparer/Translator 4
* First Name * Enter the full legal first name of the person who helped the
employee in preparing or translating Section 1 in this field.
The first name is also the given name.
First Name Enter the full legal first name of the person who helped the
employee in preparing or translating Section 1 in this field. The first name
is also the given name.
* Last Name * Enter the full legal last name of the person who helped the
employee in preparing or translating Section 1 in this field.
The last name is also the family name or surname. If the preparer or
translator has two last names or a hyphenated last name, include both names
in this field.
Last Name Enter the full legal last name of the person who helped the
employee in preparing or translating Section 1 in this field. The last name
is also the family name or surname. If the preparer or translator has two
last names or a hyphenated last name, include both names in this field.
* Preparer’s/Translator’s Address (Street Name and Number) * Enter the street
name and number of the current address of the person who helped the employee
in preparing or translating Section 1 in this field.
Addresses in Canada or Mexico may be entered in this field. If the address is
an apartment, include the apartment number in this field.
If the person does not have a physical address, enter a description of the
person’s location, such as “3 miles southwest of Anytown post office near
water tower.”
Preparer’s/Translator’s Address Enter the street name and number of the
current address of the person who helped the employee in preparing or
translating Section 1 in this field. Addresses in Canada or Mexico may be
entered in this field. If the address is an apartment, include the apartment
number in this field. If the person does not have a physical address, enter a
description of the person’s location, such as “3 miles southwest of Anytown
post office near water tower.”
* * City * Enter the city, town or village of the address of the person who
helped the employee in preparing or translating Section 1 in this field.
If the address is not located in a city or town, enter the name of the
village, country, township, reservation, etc., in this field. If the
address is in Canada, enter the city and province in this field. If the
address is in Mexico, enter the city and state in this field.
City Enter the city, town or village of the address of the person who
helped the employee in preparing or translating Section 1 in this field. If
the address is not located in a city or town, enter the name of the
village, country, township, reservation, etc., in this field. If the
address is in Canada, enter the city and province in this field. If the
address is in Mexico, enter the city and state in this field.
* State * Select the state, territory or country of the preparer or
translator’s address from the drop-down list. You may also type the first
letter of the abbreviation and use the down arrow to select your state or
territory.
If the preparer or translator entered an address from Canada or Mexico,
choose the country abbreviation, located at the end of the drop-down list.
State Select the state, territory or country of the preparer or
translator’s address from the drop-down list. You may also type the first
letter of the abbreviation and use the down arrow to select your state or
territory. If the preparer or translator entered an address from Canada or
Mexico, choose the country abbreviation, located at the end of the
drop-down list.
<None><None>AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict
of ColumbiaFederated States Of
MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall
IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew
HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern
Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode
IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin Islands Of
The U.S.VirginiaWashingtonWest VirginiaWisconsinWyomingCanadaMexico
* Zip Code * Enter the 5-digit ZIP code of the address of the person who
helped the employee in preparing or translating Section 1 in this field.
If the address the preparer or translator entered is in Canada or Mexico,
enter the 5- or 6-digit postal code in this field.
Zip Code Enter the 5-digit ZIP code of the address of the person who helped
the employee in preparing or translating Section 1 in this field. If the
address the preparer or translator entered is in Canada or Mexico, enter
the 5- or 6-digit postal code in this field.
* I attest, under penality of perjury, that I have assisted in the completion
of this form and that to the best of my knowledge the information is true and
correct*
--------------------------------------------------------------------------------
Preparer/Translator 5
* First Name * Enter the full legal first name of the person who helped the
employee in preparing or translating Section 1 in this field.
The first name is also the given name.
First Name Enter the full legal first name of the person who helped the
employee in preparing or translating Section 1 in this field. The first name
is also the given name.
* Last Name * Enter the full legal last name of the person who helped the
employee in preparing or translating Section 1 in this field.
The last name is also the family name or surname. If the preparer or
translator has two last names or a hyphenated last name, include both names
in this field.
Last Name Enter the full legal last name of the person who helped the
employee in preparing or translating Section 1 in this field. The last name
is also the family name or surname. If the preparer or translator has two
last names or a hyphenated last name, include both names in this field.
* Preparer’s/Translator’s Address (Street Name and Number) * Enter the street
name and number of the current address of the person who helped the employee
in preparing or translating Section 1 in this field.
Addresses in Canada or Mexico may be entered in this field. If the address is
an apartment, include the apartment number in this field.
If the person does not have a physical address, enter a description of the
person’s location, such as “3 miles southwest of Anytown post office near
water tower.”
Preparer’s/Translator’s Address Enter the street name and number of the
current address of the person who helped the employee in preparing or
translating Section 1 in this field. Addresses in Canada or Mexico may be
entered in this field. If the address is an apartment, include the apartment
number in this field. If the person does not have a physical address, enter a
description of the person’s location, such as “3 miles southwest of Anytown
post office near water tower.”
* * City * Enter the city, town or village of the address of the person who
helped the employee in preparing or translating Section 1 in this field.
If the address is not located in a city or town, enter the name of the
village, country, township, reservation, etc., in this field. If the
address is in Canada, enter the city and province in this field. If the
address is in Mexico, enter the city and state in this field.
City Enter the city, town or village of the address of the person who
helped the employee in preparing or translating Section 1 in this field. If
the address is not located in a city or town, enter the name of the
village, country, township, reservation, etc., in this field. If the
address is in Canada, enter the city and province in this field. If the
address is in Mexico, enter the city and state in this field.
* State * Select the state, territory or country of the preparer or
translator’s address from the drop-down list. You may also type the first
letter of the abbreviation and use the down arrow to select your state or
territory.
If the preparer or translator entered an address from Canada or Mexico,
choose the country abbreviation, located at the end of the drop-down list.
State Select the state, territory or country of the preparer or
translator’s address from the drop-down list. You may also type the first
letter of the abbreviation and use the down arrow to select your state or
territory. If the preparer or translator entered an address from Canada or
Mexico, choose the country abbreviation, located at the end of the
drop-down list.
<None><None>AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict
of ColumbiaFederated States Of
MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall
IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew
HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern
Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode
IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin Islands Of
The U.S.VirginiaWashingtonWest VirginiaWisconsinWyomingCanadaMexico
* Zip Code * Enter the 5-digit ZIP code of the address of the person who
helped the employee in preparing or translating Section 1 in this field.
If the address the preparer or translator entered is in Canada or Mexico,
enter the 5- or 6-digit postal code in this field.
Zip Code Enter the 5-digit ZIP code of the address of the person who helped
the employee in preparing or translating Section 1 in this field. If the
address the preparer or translator entered is in Canada or Mexico, enter
the 5- or 6-digit postal code in this field.
* I attest, under penality of perjury, that I have assisted in the completion
of this form and that to the best of my knowledge the information is true and
correct*
--------------------------------------------------------------------------------
* 4
* Click “Sign Form I-9 Electronically” to complete the electronic signature.
For employees under age 18 that cannot produce a List A or List B document type
in Section 2, enter 'INDIVIDUAL UNDER AGE 18' in the Employee Name field and
have the parent or legal guardian complete and sign the Preparer and/or
Translator Certification.
Validate
VALIDATION SUMMARY
MUST BE FIXED BEFORE SAVING
DATA NOT SAVED
VALIDATION SUMMARY
MUST BE FIXED BEFORE SAVING
DATA NOT SAVED
Warning IMPORTANT: Section 1 Cannot Be Signed Until All Curable Errors Are
Corrected. Edit this section to address all curable errors as listed in the Form
I-9 Validation Alerts box.
Tracker I-9 Complete
Copyright 2007-2022 Tracker Corp.All Rights Reserved.Privacy Policy
TRACKER CORP PRIVACY POLICY
This Privacy Policy governs the manner in which Tracker Corp collects, uses,
maintains and discloses information collected from users (each, a "User") of the
Tracker I-9 website ("Site"). This privacy policy applies to the Site and all
products and services offered by Tracker Corp.
Personal identification information
We may collect personally identification information from Users in a variety of
ways, including, but not limited to, when Users visit our site, register on the
site, fill out a form, and in connection with other activities, services,
features or resources we make available on our Site. We will collect personal
identification information from Users only if they voluntarily submit such
information to us. Users can always refuse to supply personally identification
information, with the understanding that it may prevent them from engaging in
certain Site related activities.
Non-personal identification information
We may collect non-personal identification information about Users whenever they
interact with our Site. Non-personal identification information may include the
browser name, the type of computer and technical information about Users means
of connection to our Site, such as the operating system and the Internet service
providers utilized and other similar information.
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Our Site may use "cookies" to enhance User experience. User's web browser places
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some parts of the Site may not function properly.
How we use collected information
Tracker Corp may use the information Users provide about themselves only to
record I-9 and E-Verify related information. We do not share this information
with outside parties except to the extent necessary to provide the service.
How we protect your information
We adopt appropriate data collection, storage and processing practices and
security measures to protect against unauthorized access, alteration, disclosure
or destruction of your personal information, username, password, transaction
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Sharing your personal information
Any information collected from Users on this Site falls will not be disclosed
without consent, with the exception of the E-Verify website and WebFax utility
(when applicable), unless in response to court order, subpoena, or government
investigation. We do not sell, trade, or rent Users personal identification
information to others.
Third party websites
Users may find links to other content on our Site. We do not control the content
or links that appear on these sites and are not responsible for the practices
employed by websites linked to or from our Site. With the exception of the
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vendors. In addition, these sites or services, including their content and
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other website, including websites which have a link to our Site, is subject to
that website's own terms and policies.
Changes to this privacy policy
Tracker Corp has the discretion to update this privacy policy at any time. When
we do, we will revise the updated date at the bottom of this page. We encourage
Users to frequently check this page for any changes to stay informed about how
we are helping to protect the personal information we collect. You acknowledge
and agree that it is your responsibility to review this privacy policy
periodically and become aware of modifications.
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* <None>
* Alabama
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* Utah
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* Virgin Islands Of The U.S.
* Virginia
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No data found.
* <Select One>
* Alien Registration Number
* USCIS Number
No data found.
* <Select One>
* Alien Registration Number
* USCIS Number
No data found.
* <None>
* AFGHANISTAN
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* BOSNIA AND HERZEGOVINA
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* COOK ISLANDS
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* FALKLAND ISLANDS (MALVINAS)
* FAROE ISLANDS
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* FIJI
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* GABON
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* GUAM
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* GUINEA
* GUINEA-BISSAU
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* HOLY SEE (VATICAN CITY STATE)
* HONDURAS
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* HUNGARY
* ICELAND
* INDIA
* INDONESIA
* IRAN, ISLAMIC REPUBLIC OF
* IRAQ
* IRELAND
* ISLE OF MAN
* ISRAEL
* ITALY
* JAMAICA
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* JERSEY
* JORDAN
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* KIRIBATI
* KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF
* KOREA, REPUBLIC OF
* KOSOVO
* KUWAIT
* KYRGYZSTAN
* LAO PEOPLE'S DEMOCRATIC REPUBLIC
* LATVIA
* LEBANON
* LESOTHO
* LIBERIA
* LIBYAN ARAB JAMAHIRIYA
* LIECHTENSTEIN
* LITHUANIA
* LUXEMBOURG
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* MACEDONIA, NORTH
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* MALAYSIA
* MALDIVES
* MALI
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* MAURITIUS
* MAYOTTE
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* MOLDOVA, REPUBLIC OF
* MONACO
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* MONTENEGRO
* MONTSERRAT
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* NAURU
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* NETHERLANDS ANTILLES
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* NORTHERN MARIANA ISLANDS
* NORWAY
* OMAN
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* PANAMA
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* PITCAIRN
* POLAND
* PORTUGAL
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* QATAR
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* RÉUNION
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* TRINIDAD AND TOBAGO
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* TURKMENISTAN
* TURKS AND CAICOS ISLANDS
* TUVALU
* UGANDA
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* UNITED KINGDOM
* UNITED STATES MINOR OUTLYING ISLANDS
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* VANUATU
* VENEZUELA, BOLIVARIAN REPUBLIC OF
* VIET NAM
* VIRGIN ISLANDS (BRITISH)
* VIRGIN ISLANDS (U.S.)
* WALLIS AND FUTUNA
* WESTERN SAHARA
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* ZIMBABWE
No data found.
* <Select One>
No data found.
No data found.
* <Select One>
No data found.
* <None>
* Driver's License
* ID Card
No data found.
* <None>
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* Virgin Islands Of The U.S.
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No data found.
* <Select One>
* Alberta
* British Columbia
* Manitoba
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* Newfoundland and Labrador
* Northwest Territories
* Nova Scotia
* Nunavut
* Ontario
* Prince Edward Island
* Quebec
* Saskatchewan
* Yukon
No data found.
* <Select One>
No data found.
*
* 1
* 2
* 3
* 4
* 5
No data found.
Upload a File
Empty Fields Alert
Empty Fields Alert
The following Section 1 fields are empty:
* Middle Initial
* Other Last Names Used
* Apt. Number
* Employee's Email Address
* Employee's Telephone Number
ALL fields are required. Enter "N/A" for fields that do not apply to you. The
SSN field is optional if your employer does not participate in E-Verify.
Click Continue to enter N/A for the listed fields. Click Cancel to remain on the
Section 1 screen and make changes.
Continue
and enter "N/A" for all empty fields
Cancel
and edit Section 1
* Select
No data found.
* Select
No data found.
* Select
No data found.
Select a Document from List A - OR - one from both List B and C
Select an Additional Document
Auto-Extended Document Alert
AUTO-EXTENDED DOCUMENT ALERT
The document expiration date entered is expired.
If the employee's List B expired on or after March 1, 2020, and the issuing
authority has extended the document expiration date due to COVID-19, then it is
acceptable as a List B document for Form I-9. Check the Auto-Extended Document
checkbox below and enter "COVID-19 EXT" in the Additional Information field.
Otherwise, click cancel to close this message.
Auto-Extended Document Because many areas are under stay-at-home orders due to
COVID-19 and some online renewal services have restrictions, employees may
experience challenges renewing a state driver's license, a state ID card, or
other List B identity document. Considering these circumstances, DHS issued
temporary policy changes regarding expired List B identity documents used to
complete Form I-9. Check this checkbox if the employee's List B document has
been auto-extended. You may also attach a copy of the issuing authority's
webpage or other notice indicating that their documents have been extended. You
can confirm that a state has auto-extended the expiration date of state IDs and
driver's licenses by checking the state Motor Vehicle Administration or
Department of Motor Vehicle's website.
--------------------------------------------------------------------------------
Cancel
Continue
Expiration Date Warning
EXPIRATION DATE WARNING
The List B document expiration date entered is expired. However, due to
temporary changes to DHS policy, the document is still valid.
Has this document been automatically extended by the issuing authority?
--------------------------------------------------------------------------------
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Acceptable Expired Document Alert
ACCEPTABLE EXPIRED DOCUMENT ALERT
If the employee's List B documents expired on or after March 1, 2020 and has not
been automatically extended by the issuing authority, then it may be treated as
a valid receipt. Check the COVID-19 Receipt checkbox below and enter the text
“COVID-19” in the Additional Information field.
Otherwise, click the cancel button to close this message.
COVID-I9 Receipt
--------------------------------------------------------------------------------
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* Alabama
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No data found.
* <None>
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* Oregon
* Palau
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* Puerto Rico
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* Texas
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* Vermont
* Virgin Islands Of The U.S.
* Virginia
* Washington
* West Virginia
* Wisconsin
* Wyoming
* Canada
* Mexico
No data found.
* <None>
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* Delaware
* District of Columbia
* Federated States Of Micronesia
* Florida
* Georgia
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* Palau
* Pennsylvania
* Puerto Rico
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* Tennessee
* Texas
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* Vermont
* Virgin Islands Of The U.S.
* Virginia
* Washington
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* Canada
* Mexico
No data found.
* <None>
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* Federated States Of Micronesia
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* Georgia
* Guam
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* North Carolina
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* Northern Mariana Islands
* Ohio
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* Oregon
* Palau
* Pennsylvania
* Puerto Rico
* Rhode Island
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* South Dakota
* Tennessee
* Texas
* Utah
* Vermont
* Virgin Islands Of The U.S.
* Virginia
* Washington
* West Virginia
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* Canada
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No data found.
* <None>
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* Colorado
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* Federated States Of Micronesia
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* Georgia
* Guam
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* Missouri
* Montana
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* New Hampshire
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* New York
* North Carolina
* North Dakota
* Northern Mariana Islands
* Ohio
* Oklahoma
* Oregon
* Palau
* Pennsylvania
* Puerto Rico
* Rhode Island
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* Virgin Islands Of The U.S.
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* Canada
* Mexico
No data found.