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 		Office of Human Resources
OFFICE OF HUMAN RESOURCES
TEL NO:(818) 677-2101
FAX NO: (818) 677-7863
MAIL DROP: 8229
New Employee Sign-In Form
UN 165 Mon to Fri - 8:00 am to 5:00pm

Department must complete and print this form, and send wth the new employee to the
Office of Human Resources, University Hall 165.
Employees may not perform any work and will not receive a Pay Warrant until the SIGN-IN PROCESS has been completed.

Employee Information:
CSUN ID: (State Only) Last Name: First Name: M.I.
Date of Employment: Supervisor Name: Email: Extension:
Department ID: (State Only) Department:  

>>
Appointment Type: (Check One)
Staff Graduate Assistant ISA/ISA-Work-Study
       Job Codes:1150/1151/1152/1153		 Student Assistant/Student Assistant Work-Study
       Job Codes: 1870/1871/1872
Part-Time Faculty Teaching Associate Resident Assistant
       (For Student Housing Only)
       Job Code: 1869		 Bridge Student Assistant
       Job Code: 1874
Tenure-Track Faculty    NRA Student Assistant
       Job Code: 1868

Background Check - Sensitive Position: Please indicate if the employee hired into one of these classifications will be working a position designated as "sensitive," which would require completion of the background check. (Check One):
Yes No    

SUPERVISOR'S SIGNATURE:_________________________________ DATE:_____________________

IMMIGRATION REFORM & CONTROL ACT (IRCA)

REQUIRED EMPLOYMENT DOCUMENTS

**As governed by the Immigration Reform and Control Act (IRCA) of November 6, 1986. Verification of work authorization status is mandated by the Immigration Reform and Control Act before every prospective employee can begin work. The following typical documents are acceptable for the purposes of the federal employment verification procedures. These lists are not intended to be exhaustive.

List of Acceptable Documents: Bring 1 from column A only, OR 1 from column B AND 1 from column C.

EMPLOYEES MUST PRESENT ORIGINAL DOCUMENTS - COPIES OR EXPIRED DOCUMENTS ARE NOT ACCEPTABLE.

LIST A: | OR | LIST B: | AND | LIST C:
(Documents that establish both Identity and Employment Eligibility) (Documents that establish Identity) (Documents that establish Employment Eligibility)
1. U.S. Passport or U.S. Passport Card
2. Permanent Resident Card or Alien Registration Receipt Card (Form I-551)
3. Foreign Passport that contains a temporary I-551 stamp or temporary I-551 stamp printed notation on a machine-readable immigrant Visa
4. Employment Authorization Document that contains a photograph (Form I-766)
5. For a nonimmigrant alien authorized to work for a specific employer because of his or her status:
  • Foreign Passport; and
  • Form I–94 or Form I-94A that has the following:
    1. The same name as the passport; and
    2. An endorsement of the alien's nonimmigrant status as long as that period of endorsement has not yet expired and the proposed employment is not in conflict with any restrictions or limitations indentified on the form.
6. Passport from the Federated States of Micronesia (FSM) of the Republic of the Marshall Islands (RMI) with Form I-94 or Form I-94A indicating nonimmigrant admission under the Compact of Free Association Between the United States and the FSM or RMI
1. Driver's License or ID Card issued by a State or outlying possession of the United States, provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address
2. ID Card issued by federal, state, or local government agencies, provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address
3. School ID Card with a photograph
4. Voter Registration Card
5. US Military card or draft record
6. Military dependent's ID Card
7. US Coast Guard Merchant Mariner Card
8. Native American Tribal document
9. Driver's License issued by a Canadian government authority
For persons under age 18 who are unable to present a document listed above:
10. School record or report card
11. Clinic, doctor, or hospital record
12. Day-care or nursery school record
1.

Social Security Account Number card, unless the card includes one of the following restrictions:

  1. NOT VALID FOR EMPLOYMENT
  2. VALID FOR WORK ONLY WITH INS AUTHORIZATION
  3. VALID FOR WORK ONLY WITH DHS AUTHORIZATION
2. Certification of birth abroad issued by the Department of State. (Form FS-545)
3. Certification of Report of Birth issues by the Department of State (Form DS-1350)
4. Original or certified copy of a birth certificate, issued by a State, county, municipal authority or Territory of the United States, bearing an official seal
5. Native American tribal document
6. US Citizen ID Card (Form I-197)
7. ID Card for the Use of Resident Citizen in the United States. (Form I-179)
8. Employment Authorization document issued by the Department of Homeland Security
 
 
 
OHRS 20-56 (Revised 07/31/2015)