Work Visa Questionnaire

INDIVIDUAL OR COMPANY SPONSORING THIS PETITION

Name of Individual Petitioner

First

Middle

Last

Company or Organization Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email

EIN Number

Social Security Number (SSN)

Type of Business

Date Business Established

Current Number of Employees in the US

Gross Annual Income

Net Annual Income

Name of Officer Who Will Sign the Petition

First

Middle

Last

Title of Officer Who Will Sign the Petition

TYPE OF PETITION

Requested Visa Classification

Is the Petitioner an H1B Dependent Employer?

Has the Petitioner Ever Been Found to be a Willful Violator?

Does the Petitioner Employ 50 or More Individuals in the US?

Are More Than 50 Percent of those Employees in H1B, L1B, or L1B Nonimmigrant Status?

BENEFICIARY OF THIS PETITION

Name

First

Middle

Last

Other Names Used 1

First

Middle

Last

Other Names Used 2

First

Middle

Last

Date of Birth

Place of Birth (City / State / Country)

Country of Citizenship or Nationality

Sex

Social Security Number (SSN)

Alien Number (USCIS Number or A#)

Is the beneficiary currently in the US?

Date of Last Arrival

Passport Number

Date Passport Issued

Date Passport Expires

Passport Country of Issuance

Current Nonimmigrant Status

I94 Number

Date Status Expires

SEVIS Number, if any

EAD Number, if any

Address

Address Line 1

Address Line 2

City

State

Zip Code

Location of US Embassy (City and Country) Where the Beneficiary Wishes to Apply for the Visa

Foreign Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Has the Beneficiary Ever Been in Removal Proceedings?

Has the Petitioner Ever Filed an Immigrant Petition for the Beneficiary?

Has the Beneficiary Ever Been a J1 or J2 Visa Holder?

If so, you must provide copies of all DS-2019 forms, IAP-66 forms, J1/J2 visa stamps, and a copy of the passport containing the J1/J2 visa stamps.

Has the Beneficiary Ever Been a H1B Visa Holder?

If so, you must provide copies of all I-94 cards, I-797 forms, H1B visa stamps, a copy of the passport containing the H1B visa stamps, and any other documents issued by USCIS.

Does the Beneficiary Have an Ownership Interest in the Petitioning Organization?

Information About the Proposed Employment

Job Title

Work Address

Address Line 1

Address Line 2

City

State

Zip Code

Is this a Full Time Position

Hours Per Week

Proposed Annual Wage

Proposed Hourly Wage

Other Compensation (Explain)

Proposed Start Date

Proposed End Date

Is a license from either the US Department of Commerce or the US Department of State required by the Petitioner to release any technology or access to technical data to the Beneficiary?

Enter the Information of the Person Submitting This Questionnaire

Name *

Email *

Work Visa Questionnaire

For Employment Based NonImmigrant Petitions

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