Instructions For Form I-9 - Employment Eligibility Verification - Department Of Homeland Security Page 11

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Full name of List B Document
Abbreviations
Individual under age 18 endorsement by parent or guardian
Individual under Age 18
Special placement endorsement for persons with disabilities
Special Placement
Receipt for the application to replace a lost, stolen or
damaged Driver's License issued by a State or outlying
Receipt: Replacement driver's license
possession of the United States
Receipt for the application to replace a lost, stolen or
damaged ID card issued by a State or outlying possession of
Receipt: Replacement ID card
the United States
Receipt for the application to replace a lost, stolen or
damaged ID card issued by federal, state, or local
Receipt: Replacement Gov't ID
government agencies or entities
Receipt for the application to replace a lost, stolen or
Receipt: Replacement School ID
damaged School ID card with photograph
Receipt for the application to replace a lost, stolen or
Receipt: Replacement Voter reg. card
damaged Voter's registration card
Receipt for the application to replace a lost, stolen or
Receipt: Replacement U.S. Military card
damaged U.S. Military card
Receipt for the application to replace a lost, stolen or
Receipt: Replacement U.S. Military dep. card
damaged Military dependent's ID card
Receipt for the application to replace a lost, stolen or
Receipt: Replacement Military draft
damaged U.S. Military draft record
record
Receipt for the application to replace a lost, stolen or
Receipt: Replacement Merchant Mariner card
damaged U.S. Coast Guard Merchant Mariner Card
Receipt for the application to replace a lost, stolen or
damaged Driver's license issued by a Canadian government
Receipt: Replacement Canadian DL
authority
Receipt for the application to replace a lost, stolen or
Receipt: Replacement Native American
damaged Native American tribal document
tribal doc
Receipt for the application to replace a lost, stolen or
Receipt: Replacement School record
damaged School record (for persons under age 18 who are
(under age 18)
unable to present a document listed above)
Receipt for the application to replace a lost, stolen or
Receipt: Replacement Report card
damaged Report card (for persons under age 18 who are
(under age 18)
unable to present a document listed above)
Receipt for the application to replace a lost, stolen or
Receipt: Replacement Clinic record
damaged Clinic record (for persons under age 18 who are
(under age 18)
unable to present a document listed above)
Receipt for the application to replace a lost, stolen or
Receipt: Replacement Doctor record
damaged Doctor record (for persons under age 18 who are
(under age 18)
unable to present a document listed above)
Receipt for the application to replace a lost, stolen or
Receipt: Replacement Hospital record
damaged Hospital record (for persons under age 18 who are
(under age 18)
unable to present a document listed above)
Receipt for the application to replace a lost, stolen or
Receipt: Replacement Day-care record
damaged Day-care record (for persons under age 18 who
(under age 18)
are unable to present a document listed above)
Receipt for the application to replace a lost, stolen or
Receipt: Replacement Nursery school record
damaged Nursery school record (for persons under age 18
(under age 18)
who are unable to present a document listed above)
Issuing Authority: Enter the issuing authority of the List B document or receipt. The issuing authority is the entity that
issued the document. If the employee presented a document that is issued by a state agency, include the state as part of
the issuing authority.
Document Number: Enter the document number, if any, of the List B document or receipt exactly as it appears on the
document. If the document does not contain a number, enter N/A in this field.
Expiration Date (if any) (mm/dd/yyyy): Enter the expiration date, if any, of the List B document. The document is not
acceptable if it has already expired. If the document does not contain an expiration date, enter N/A in this field. For a
receipt, enter the expiration date of the receipt validity period as described in the Receipt section above.
Form I-9 Instructions 07/17/17 N
Page 10 of 15

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