Review and Verification. To be completed and stoned by employer. Exam MI one document from List A OR examine one document horn List Et and one from List C, as listed on the reverse of this form, and record the title, number and expiration date, if any, of the document(s) List A Document title- Issui

r Review and Verification. To be completed and signed by employer. Examine one document from list A OR examine one document from List B and one from List C, as listed on the reverse of this form, and record the title, number and capitol/on date, a any. of the document(s) List A Document lilt Issuin