Employee Record Review Form - Uscis

a. Employer ID:

b. Case Number:

_[pre-filled]__

Employee Record Review Form

c. Employee Name: :

d. Employee SSN:

_[pre-filled]__

e. Employee Address on I-9:

f. Alternate Address (if different from address on I-9):

g. Employee Phone:

h. Employee file contains: (check all that apply.)

___ Form I-9

___ Copy of system response --> number of responses

___ TNC notice

___ Referral letter to SSA

___ Referral letter to DHS

___ Copies of documents used for verification (Please specify, e.g., driver’s license, current passport, permanent resident card, etc.)

___ Other (Please specify)

i. Current work authorization status:

If there is a reason to believe this is incorrect, please explain:

_[pre-filled]__

j. Reviewer: _

___________________

k. Review Date: __________________

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Parent category: Business