Form I-129 - Petition For A Nonimmigrant Worker - Department Of Homeland Security

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Petition for a Nonimmigrant Worker
USCIS
Form I-129
Department of Homeland Security
OMB No. 1615-0009
U.S. Citizenship and Immigration Services
Expires 10/31/2016
Partial Approval (explain)
Receipt
Action Block
For
USCIS
Use
Only
Class:
Classification Approved
No. of Workers:
Consulate/POE/PFI Notified
Job Code:
At:
Validity Dates:
Extension Granted
From:
COS/Extension Granted
To:
START HERE - Type or print in black ink.
Part 1. Petitioner Information
If you are an individual filing this petition, complete Item Number 1. If you are a company or an organization filing this petition,
complete Item Number 2.
1.
Legal Name of Individual Petitioner
Family Name (last name)
Given Name (first name)
Middle Name
2.
Company or Organization Name
3. Mailing Address of Individual, Company or Organization
In Care Of Name
Street Number and Name
Apt.
Ste.
Flr. Number
City or Town
State
ZIP Code
Province
Postal Code
Country
4.
Contact Information
Daytime Telephone Number
Mobile Telephone Number
Email Address (if any)
5. Other Information
Individual IRS Tax Number
U.S. Social Security Number (if any)
Federal Employer Identification Number (FEIN)
Form I-129 08/13/15 Y
Page 1 of 36

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