Heartland

Order Summary

Detail	Price/Application	# of Applications	Total
WOTC Application	$299	1	$299

Payment Information

Name on Card

Credit Card Number

Security Code

Expiration Date

Billing Address

Street Address

City

State

ZIP Code

Save my billing information

I agree to the WOTC Application Terms of Service and authorize GetHired to process my credit card for a total cost of $299. I understand that I will receive a credit against future application fees if the employee quits or is terminated within 120 hours of the start date and/or if GetHired is unsuccessful in securing WOTC certification from the required state Workforce Agency.

Please read instructions carefully before completing Form I-9

The employee uploaded the following documents:

List A - US Passport

Please note to be compliant you should physically examine all documents used in completing the I-9. See here for more information on accepted document.

Click here to preview the I-9 form completed by the employee.

List A - Establish Both Identity and Employment Authorization

Document Title

Issuing Authority

Document Number

Expiry Date(if any)

This document has no expiration date

Additional Information

Use this space to notate any additional information required for Form I-9, such as:

Employment authorization extensions for Temporary Protected Status benediciaries, F-1 OPT STEM students, CAP-GAP, H-1B and H-2A employees continuing employment with the same employer or changing employers, and other nonimmigrant categories that may receive extensions of stay.
Addtional document(s) that certain nonimmigrant employees may present that cannot be entered in thw drop-downs provided
Discrepancies that E-Verify employers must notate when participating in the IMAGE program
Employee termination dates and form retention dates
E-Verify case number, which may also be entered in the margin or attached as a separate sheet per E-Verify requirements and your chosen business process
Any other comments or notations necessary for the employer's business process

You may leave this field blank if the employee's circumstance do not require additional notations. Please limit to 80 words or less.

Additional Information is too long

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 date of employment:

*The following section is pre-filled with the information provided in the company setting section. Please verify the information for accuracy before adding your signature.

First Name

Last Name

Title 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

Verification Date

Signature

Signature is required

By signing and clicking [Save], you agree that your electronic signature is legally binding, and complies with our Terms of Service.

1. What type of interview would you like to schedule?

Virtual Phone In-person

2. How long should interview be scheduled for?

3. Review your schedule and add additional times if needed:

to

Please provide the following information to create your GoodHire account.

Background checks are provided by our partner GoodHire. For legal compliance, GoodHire must confirm that you are ordering background checks for employment purposes on behalf of a valid business.

Click "Create GoodHire Account" below to send your company information to GoodHire and start this process. (You’ll only have to do this once.)

Important: Look out for an email from support@goodhire.com to finish setting up your account.

Company Name:
Phone:
Address:
City:
State:
Zip:
Industry:
Number of Employees:
Federal Tax ID:
State of Incorporation:
Requestor First Name:
Requestor Last Name:
Requestor Email:

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