HR Immigration Document

HR IMMIGRATION DOCUMENT

Applicant Personal Information

Position Information

Immigration and Work Authorization

Citizen of:   Country of Birth:

Immigration status (select all that apply): U.S. Citizen Lawful Permanent Resident Authorized to work (non-immigrant) Other

Are you currently authorized to work in the country of employment? Yes No

Do you require employer sponsorship now or in the future? Yes No

Documents Presented

Provide original documents or acceptable combinations that establish identity and employment authorization. For each document presented include issuing authority, document number, and expiration date.

Previous Immigration History

Have you ever been denied a visa, denied admission, removed, deported, or otherwise subject to immigration proceedings? Yes No

Authorization to Verify and Release Information

I authorize the employer, its agents and legal representatives to verify any and all information provided in this document, to obtain copies of immigration or employment authorization documentation, and to consult with legal counsel or government agencies as necessary to confirm my eligibility to work. I acknowledge that the employer may retain copies of my documents in personnel records for compliance and auditing purposes.

I consent to release of information to prospective sponsors, government authorities, or verifying parties where disclosure is required by law or necessary for adjudication of immigration or work authorization matters.

I authorize the employer to contact my current and former employers and educational institutions for employment verification and background checks related to immigration and employment eligibility. I understand that such verification may include dates of employment, job titles, duties, performance, and reason for separation.

Applicant initial to acknowledge authorization:

Employment History

Education

References

Legal Disclosures

At-Will Employment: Nothing in this document creates an employment contract or guarantees employment. Employment with the employer is at-will, meaning either the employer or the employee may terminate the employment relationship at any time, with or without cause or notice, unless otherwise expressly agreed in a separate written agreement.

Equal Opportunity: The employer is an equal opportunity employer and makes employment decisions on the basis of merit and business needs. The employer prohibits discrimination and harassment on the basis of national origin, citizenship status, immigration status, or any other protected characteristic under applicable law.

Applicant Certification and Acknowledgment

I certify that all information provided on this form is true, complete, and correct to the best of my knowledge. I understand that providing false or misleading information or failing to disclose relevant immigration history may result in withdrawal of an offer or termination of employment. I further acknowledge that I will provide original documentation to establish identity and employment authorization as required by the employer and applicable law.

I authorize the release of information necessary to verify my eligibility to work, including release of immigration documentation or copies thereof to government agencies if required by law or regulation. I understand that the employer will retain a copy of any documents provided for verification and compliance purposes.

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