Employment Authorization EAD Renewal

EMPLOYMENT AUTHORIZATION EAD RENEWAL AGREEMENT

This Employment Authorization EAD Renewal Agreement is entered into by and between Applicant Name: , Applicant Address: , Date of Birth: , Alien Registration Number: (collectively, "Applicant"), and Employer Name: , Employer Address: (collectively, "Employer").

RECITALS

WHEREAS, Applicant previously received an Employment Authorization Document and seeks renewal of employment authorization to continue lawful employment; and

WHEREAS, Employer is willing to continue to employ Applicant conditioned on Applicant's renewal application and compliance with the requirements set forth in this Agreement; and

WHEREAS, the parties desire to set forth their respective representations, attestations, and certifications in connection with the renewal of Applicant's Employment Authorization.

NOW, THEREFORE, in consideration of the mutual covenants contained herein and other good and valuable consideration, the receipt and sufficiency of which are acknowledged, the parties agree as follows:

1. DEFINITIONS

For purposes of this Agreement, the following terms shall have the meanings set forth below: "Application" means the Applicant's submission seeking renewal of employment authorization; "EAD" means the Employment Authorization Document issued to the Applicant; "Authorized Period" means the period of employment authorization reflected on any valid EAD issued to Applicant.

2. APPLICANT REPRESENTATIONS AND CERTIFICATIONS

Applicant represents and warrants that all statements, supporting documents, and attestations furnished in connection with the Application are true, complete, and correct under penalty of perjury. Applicant certifies continued eligibility for employment authorization and acknowledges the obligation to promptly notify Employer of any material change in status that affects authorization to work.

Applicant attests to the following (check all that apply):

Adjustment of status beneficiary    Asylee/Refugee derivative    Other:

3. DOCUMENTS SUBMITTED

Applicant has submitted or will submit to Employer and to any authorized processing agent the following documents in support of the Application (check all that apply):

Copy of current EAD card    Passport or travel document    Birth certificate or identity document

If other supporting documents are provided, describe:

4. EMPLOYER ATTESTATION

Employer attests that it has reviewed the copies of Applicant's documentation presented for renewal and that Employer will not continue employment beyond the Authorized Period unless and until Applicant demonstrates valid employment authorization. Employer further agrees to maintain copies of documentation provided and make such copies available for inspection by authorized officials if legally required.

5. FEES, COSTS AND RESPONSIBILITIES

Applicant is responsible for payment of any fees, costs, or charges associated with filing the Application unless otherwise agreed in writing. Employer is not obligated to pay such fees except where a separate written agreement exists. Neither party shall misrepresent financial responsibility to a processing authority.

6. AUTHORIZATION TO SHARE INFORMATION

Applicant authorizes Employer to receive confirmation of Applicant's employment authorization status from relevant authorities and to maintain records of such confirmation. Applicant may withdraw such authorization in writing, but withdrawal shall not affect disclosures made prior to receipt of written withdrawal.

7. NOTICES

All notices required or permitted under this Agreement shall be in writing and delivered to the addresses set forth below or to such other address as a party may designate in writing. Notices shall be deemed given upon personal delivery or three (3) business days after deposit in the mail with postage prepaid.

8. REPRESENTATIONS REGARDING PENALTIES

Applicant understands that willful misrepresentation of material facts in connection with the Application may subject Applicant to civil or criminal penalties under applicable law. Applicant certifies under penalty of perjury that the information provided is true and correct.

9. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

This Agreement shall be governed by and construed in accordance with the laws of the state of execution without regard to choice-of-law principles. This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements and understandings, oral or written. If any provision of this Agreement is found to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.

10. AMENDMENT; WAIVER; COUNTERPARTS

No amendment or modification of this Agreement shall be effective unless in writing and signed by both parties. The failure of either party to enforce any provision of this Agreement shall not constitute a waiver of future enforcement of that or any other provision. This Agreement may be executed in counterparts, each of which shall be deemed an original, and all of which together shall constitute one and the same instrument.

11. ADDITIONAL INFORMATION

The parties acknowledge that they have read and understand this Agreement and that the person signing below on behalf of each party is duly authorized to enter into this Agreement on behalf of that party.

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