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ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which document(s) an employee may present to establish employment authorization and identity. The refusal to hire or continue to employ an individual because the documentation presented has a future expiration date may also constitute illegal discrimination. Section 1. Employee Information and Attestation (Employees must complete and sign Section 1 of Form I-9 no later than the first day of employment, but not before accepting a job offer.) (To view I-9 instructions and Spanish versions, click here) Cruz

Last Name (Family Name)

Michael

First Name (Given Name)

N/A

Middle Initial

N/A

Other Last Names Used

2814 66th

Address (Street Number and Name)

N/A

Apartment

Lubbock

City or Town

TX

State

79413

Zip Code

07/17/1987

Date of Birth

458854465

U.S. Social Security Number

*************@*****.***

E-mail Address

806-***-****

Telephone Number

1. A citizen of the United States

2. A noncitizen national of the United States

3. A lawful permanent resident (Alien Registration Number/USCIS Number): N/A Type: N/A 4. An alien authorized to work until (expiration date, if applicable) N/A Not Applicable Aliens authorized to work must provide only one of the following document numbers to complete Form I-9: An Alien Registration Number/USCIS Number OR Form I-94 Admission Number OR Foreign Passport Number. OR

OR

1. Alien Registration Number/USCIS Number: N/A Type: N/A 2. Form I-94 Admission Number: N/A

3. Foreign Passport Number: N/A Country of Issuance: N/A Digitally Signed by Michael Cruz on Nov-28-2022 1:03:12 PM EST Signature of Employee:

11/28/2022

Date (month/day/year)

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