Employment Eligibility Notice

EMPLOYMENT ELIGIBILITY NOTICE AND AGREEMENT

RECITALS

WHEREAS, Employer Name: (the "Employer") desires to verify the employment eligibility of the individual identified below for lawful employment in the United States; and

WHEREAS, Employee Name: (the "Employee" or "Applicant") has been offered or is seeking employment for the position of Title: ;

WHEREAS, the parties agree that eligibility documentation must be presented and verified prior to continued employment and that this Notice sets forth the process, timeline and legal terms governing that verification.

SCOPE OF VERIFICATION (SCOPE OF WORK)

The Employer will review original documentation presented by the Employee to establish identity and authorization to work. The Employer may copy documentation for recordkeeping in accordance with law. The Employee authorizes the Employer to make any necessary inquiries to confirm eligibility as permitted by law.

REQUIRED DOCUMENTATION

The Employee must present acceptable original documents establishing identity and employment authorization. Acceptable documents include, but are not limited to, any of the following categories. Indicate which document(s) are provided at time of presentation:

Documentation Deadline: . The Employee must present required documentation no later than the date shown above. Failure to provide acceptable documentation by the deadline may result in rescission of the offer or termination of employment consistent with law.

PAYMENT TERMS

The parties acknowledge the following compensation arrangements for employment while verification is pending and if employment is accepted:

If verification fails or the Employee cannot provide required documentation within the applicable period, the Employer may withhold payment or rescind compensation consistent with applicable wage and employment laws. Any dispute regarding payment shall be governed by the Governing Law provision below.

TERM AND TERMINATION

Employment Start Date: . Expected End Date (if applicable): .

Termination for Cause: Employer may terminate employment immediately if the Employee willfully provides false documentation, fails to present required documentation by the deadline, or otherwise engages in conduct that disqualifies eligibility to work under applicable law.

CONFIDENTIALITY

All documentation and information provided for verification shall be treated as confidential personnel records. The Employer will maintain documentation and any copies only as permitted or required by law, and will restrict access to those with a legitimate business need. The Employee authorizes limited disclosure to third parties where required to confirm eligibility or to comply with legal obligations.

GOVERNING LAW

This Notice and Agreement shall be governed by and construed in accordance with the laws of the State of without regard to conflict of laws principles.

ENTIRE AGREEMENT

This Notice and Agreement, including any attachments and acknowledgments of documentation, constitutes the entire agreement between the parties with respect to employment eligibility verification and supersedes all prior discussions and agreements, whether oral or written, on that subject.

EMPLOYER CONTACT INFORMATION

EMPLOYEE ACKNOWLEDGMENT

By signing below, the Employee acknowledges receipt of this Employment Eligibility Notice and Agreement, understands the documentation requirements, and certifies that the information and documents provided are true, complete and not misleading. The Employee further acknowledges that falsification or failure to provide required documentation may result in rescission of employment or termination.

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