WD Letter 70-07, Attachment 3 - Workforce Solutions



EMPLOYMENT ELIGIBILITY VERIFICATION CERTIFICATE

Employer Name:      

Employer Address:      

     

     

Job Posting #      

ATTENTION EMPLOYER: This certificate is issued in compliance with the Immigration and Nationality Act (Pub. L. 82-414), as amended by the Immigration Reform and Control Act of 1986 (Pub. L. 99-603), and pursuant to the authority of 8 C.F.R. §274a.6. You are not required to verify the individual’s identity or employment eligibility, but must retain this certificate in lieu of Form I-9. You must have the individual sign the attestation on this certificate in your presence in the space provided below. This certificate is invalid if not completed. Do not accept certificates that have been altered or machine copied. If you detect errors on this certificate and wish to have it corrected, please contact the Texas Workforce Center at the telephone number shown below.

In response to your request for a       , we referred the individual listed below,

Occupation

whose eligibility for employment in the United States was verified by this office prior to his or her referral.

|Name |Birth Date |Social Security Number (if available) |

|      |      |      |

Expiration of employment (if applicable):      

Restrictions, Conditions, Limitations (if any):      

Document Title:       Texas Workforce Center:      

Issuing Authority:       Phone Number:      

Document ID Number:       Address:      

Expiration Date, if any:            

     

Document Title:      

Issuing Authority:      

Document ID Number:      

Expiration Date, if any:      

I certify that this document is in compliance with the requirements of the Immigration and Nationality Act §274A(b) concerning verification of the identity and employment eligibility of the individual referred, and I have determined that, to the best of my knowledge, the individual is authorized to work in the United States.

Signature of Texas Workforce Commission Staff Date

I attest under penalty of perjury that I am the individual named on this certificate and that I am a United States citizen or national or alien authorized for employment in the United States.

Signature of Hired Individual Date

Counterfeiting, falsification, unauthorized issuance, or alteration of this certification constitutes a violation of federal law pursuant to Title 18 U.S.C. §1546.

Rev. 02/09

-----------------------

Tom Pauken, Chairman

Ronald G. Congleton

Commissioner Representing Labor

Andres Alcantar

Commissioner Representing the Public

Larry E. Temple

Executive Director

101 E. 15th Street • Austin, Texas 78778-0001 • (512) 463-2222 • Relay Texas: 800-735-2989 (TDD) 800-735-2988 (Voice) •

Equal Opportunity Employer / Services

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download