Country of Issuance: N/A

*. Foreign Passport Number: N/A

OR

2. Form I-94 Admission Number: N/A

OR

1. Alien Registration Number/USCIS Number: N/A

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. Some aliens may write "N/A" in the expiration date field. (See instructions) 4. An alien authorized to work until (expiration date, if applicable, mm/dd/yyyy) N/A 3. A lawful permanent resident (Alien Registration Number/USCIS Number) N/A 2. A noncitizen national of the United States (See instructions) N/A 1. A citizen of the United States

Employment Eligibility Verification USCIS

Form I-9

Department of Homeland Security OMB No. 1615-0047

U.S. Citizenship and Immigration Services Expires 10/31/2022 START HERE: Read instructions carefully before completing this form. The instructions must be available, either in paper or electronically, during completion of this form. Employers are liable for errors in the completion of this form. 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.) Last Name (Family Name)

Birdwell

First Name (Given Name)

Thomas

Middle Initial

A

Other Last Names Used (if any)

N/A

Address (Street Number and Name)

605 S Roy Reynolds Dr

Apt. Number

N/A

City or Town

Harker Heights

State

TX

ZIP Code

76548

Date of Birth (mm/dd/yyyy)

U.S. Social Security Number

5790

Employee's E-mail Address

adx6o2@r.postjobfree.com

Employee's Telephone Number

N/A

I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in connection with the completion of this form.

I attest, under penalty of perjury, that I am (check one of the following boxes): QR Code - Section 1

Do Not Write in This Space

Signature of Employee Today's Date (mm/dd/yyyy)

02/11/2023 13:12:23 PST

Preparer and/or Translator Certification (check one): I did not use a preparer or translator. A preparer(s) and/or translator(s) assisted the employee in completing Section 1.

(Fields below must be completed and signed when preparers and/or translators assist an employee in completing Section 1.) I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct.

Signature of Preparer or Translator Today's Date (mm/dd/yyyy) Last Name (Family Name)

First Name (Given Name)

Address (Street Number and Name)

City or Town

State

ZIP Code

Employer Completes Next Page

Employment Eligibility Verification USCIS

Form I-9 10/21/2019 Page 1 of 2

Employment Eligibility Verification USCIS

Form I-9

Department of Homeland Security OMB No. 1615-0047

U.S. Citizenship and Immigration Services Expires 10/31/2022 Section 2. Employer or Authorized Representative Review and Verification

(Employers or their authorized representative must complete and sign Section 2 within 3 business days of the employee's first day of employment. You must physically examine one document from List A OR a combination of one document from List B and one document from List C as listed on the "Lists of Acceptable Documents.")

Employee Info from Section 1: Last Name (Family Name) Birdwell

First Name (Given Name)

Thomas

M.I.

A

Citizenship/Immigration Status

1

List A

Identity and Employment Authorization

OR List B

Identity

AND List C

Employment Authorization

Certification: I attest, under penalty of perjury, that (1) I have examined the document(s) presented by the above-named employee, (2) the above-listed document(s) appear to be genuine and to relate to the employee named, and (3) to the best of my knowledge the employee is authorized to work in the United States.

The employee's first day of employment (mm/dd/yyyy) : 02/10/2023 (See instructions for exemptions) Section 3. Reverification and Rehires (To be completed and signed by employer or authorized representative.) A. New Name (if applicable) B. Date of Rehire (if applicable) Last Name (Family Name) First Name (Given Name) Middle Initial Date (mm/dd/yyyy) C. If the employee's previous grant of employment authorization has expired, provide the information for the document or receipt that establishes continuing employment authorization in the space provided below. Document Title Document Number Expiration Date (if any)(mm/dd/yyyy) I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if the employee presented document(s), the document(s) I have examined appear to be genuine and to relate to the individual. Form I-9 10/21/2019 Page 2 of 2

Document Title

N/A

Issuing Authority

N/A

Document Number

N/A

Expiration Date (if any)(mm/dd/yyyy)

N/A

Document Title

N/A

Issuing Authority

N/A

Document Number

N/A

Expiration Date (if any)(mm/dd/yyyy)

N/A

Document Title

N/A

Issuing Authority

N/A

Document Number

N/A

Expiration Date (if any)(mm/dd/yyyy)

N/A

Document Title

N/A

Document Title

N/A

Issuing Authority

N/A

Issuing Authority

N/A

Document Number

N/A

Document Number

N/A

Expiration Date (if any)(mm/dd/yyyy)

N/A

Expiration Date (if any)(mm/dd/yyyy)

N/A

Additional Information

QR Code - Sections 2 & 3

Do Not Write in This Space

Signature of Employer or Authorized Representative Today's Date(mm/dd/yyyy) Title of Employer or Authorized Representative Last Name of Employer or Authorized Representative First Name of Employer or Authorized Representative Employer's Business or Organization Name

Employer's Business or Organization Address (Street Number and Name) City or Town

State

ZIP Code

Signature of Employer or Authorized Representative Today's Date (mm/dd/yyyy) Name of Employer or Authorized Representative

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