H-1B Form

GENERAL INFORMATION FOR:

LAST NAME

FIRST NAME

MIDDLE NAME

Email Address

Telephone

1. Date of birth:

Place of Birth:

2. Social Security #: 

3. Date of Arrival in US (if applicable): 

4. Current Status:

Expiration date of current status:

5. Address outside of US:

6. Address in US:

7. Job Title: ; salary:  per 

8. Job title of to-be immediate supervisor: 

9. Detail description of job duty and theories/tools that may be used:

10. Mininum education/experience required to perform the job:

11. Has Applicant ever been in H status before?  Yes  No

If Yes, please provide exact dates of employment and names of companies with whom employed.

12. Has Applicant ever been in immigration court proceedings?  Yes  No

13. Has an immigration petition ever been filed on behalf of applicant?  Yes  No

14. Has applicant ever been denied H status before?  Yes  No

15. Has applicant's spouse or dependent ever been on H status?  Yes  No

If yes, list exact dates and companies with whom spouse or dependent were on H status.

IF IN THE UNITED STATES PLEASE PROVIDE THESE DOCUMENTS TO ESTABLISH THAT APPLICANT HAS NOT VIOLATED THE TERMS OF HIS/HERE STATUS IN THE UNITED STATES

1) Copy of I-20 (if applicable); 2) Copy of Form I-94 (front and back); 3) Proof of present status

GENERAL INFORMATION ABOUT THE H-1B COMPANY

1. NAME OF BUSINESS & TYPE OF BUSINESS:

2. NATURE OF BUSINESS ACTIVITY:

3. NUMBER OF EMPLOYEES: 

4. GROSS ANNUAL INCOME (Estimate): 

5. NET ANNUAL INCOME: 

6. FEDERAL ID #: 

7. EXACT BUSINESS ADDRESS & TELEPHONE NUMBER:

Address

City

State

Zipcode:

Telephone:

8. YEAR ESTABLISHED: