ASSOCIATE: Please Do Not Complete This Form. Please Forward This Form to Your Retail

KELLY SERVICES, INC. AGENT AUTHORIZATION FORM
FOR LIZ CLAIBORNE INCRETAIL SALES EXECUTIVES

ASSOCIATE: Please do not complete this form. Please forward this form to your Retail SalesExecutive.

RETAIL SALES EXECUTIVE: After signing and dating this Agent Authorization Form, Please see the instruction for completing Section 2 of the Federal I-9 Form.

Note: The Retail SalesExecutive will be acting as Kelly’s Authorized Agent for I-9 purposes and will act as the Employer for completion of Section 2 of the I-9 Form.

All employers (authorized agents) must ensure each new employee hired in the U.S. completes an I-9 form on or before the time of hire. As a part of this requirement, Kelly Services, Inc. must ensure the new employee’s documents are reviewed and recorded on Section 2 of the I-9 form.

We have asked you, the Retail SalesExecutive, to complete Section 2 of the I-9 as an “Authorized Agent” of Kelly Services, Inc. After the employee completes Section 1 of the I-9 Form, please review it to make sure it is complete. Please refer to the I-9 Guidelines document for further clarification. Then examine the documents presented to you by the employee. Write all required document information in the appropriate portions of Section 2, the “Employer Certification”. Please refer to the I-9 Guidelines document for further clarification. Sign and date the form.

Once reviewed and approved, please place the original I-9 form and all hiring documents in anenvelope along with this Agent Authorization form and send to Kelly Management Services, 999 W. Big Beaver Rd.,Troy, MI48084.

In summary, the packet you return to Kelly Management
1) Kelly Employment Application/Agreement
2) Federal I-9 Form
3) Retail SalesExecutive’s Agent Authorization Form
4) Kelly Background Screening Disclosure
5) Kelly Release and Consent for Drug Screening / Services must include:
6) Kelly Work Opportunity Form
7) Kelly Pre-Screening Notice (Form 8850)
8) Federal W-4 Form
9) Direct Deposit Form / Chase Payroll Card Form

I hereby attest that I read the above and the attached instructions for completing the I-9 and accept responsibility as an Authorized Agent of Kelly Services, Inc. for the sole purpose of completing the I-9 form.

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Retail Sales Executive’s SignatureDate

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Retail Sales Executive’s Printed NameTitle

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Telephone NumberEmployee Name

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Address of Retail Sales ExecutiveEmployee SSN:

Liz Claiborne Inc Agent Authorization