Form I-129 - Petition For A Nonimmigrant Worker - Department Of Homeland Security Page 11

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Trade Agreement Supplement to Form I-129
USCIS
Form I-129
Department of Homeland Security
OMB No. 1615-0009
U.S. Citizenship and Immigration Services
Expires 10/31/2016
1.
Name of the Petitioner
2. Name of the Beneficiary
3. Employer is a (select only one box):
4. If Foreign Employer, Name the Foreign Country
U.S. Employer
Foreign Employer
Section 1. Information About Requested Extension or Change (See instructions attached to this form.)
1. This is a request for Free Trade status based on (select only one box):
a.
Free Trade, Canada (TN1)
d.
Free Trade, Singapore (H-1B1)
b.
Free Trade, Mexico (TN2)
e.
Free Trade, Other
c.
Free Trade, Chile (H-1B1)
f.
A sixth consecutive request for Free Trade, Chile or
Singapore (H-1B1)
Section 2. Petitioner's Declaration, Signature, and Contact Information (Read the information on
penalties in the instructions before completing this section.)
Copies of any documents submitted are exact photocopies of unaltered, original documents, and I understand that, as the petitioner, I
may be required to submit original documents to U.S. Citizenship and Immigration Services (USCIS) at a later date.
I authorize the release of any information from my records, or from the petitioning organization's records that USCIS needs to
determine eligibility for the immigration benefit sought. I recognize the authority of USCIS to conduct audits of this petition using
publicly available open source information. I also recognize that any supporting evidence submitted in support of this petition may be
verified by USCIS through any means determined appropriate by USCIS, including but not limited to, on-site compliance reviews.
I certify, under penalty of perjury, that I have reviewed this petition and that all of the information contained on the petition, including
all responses to specific questions, and in the supporting documents, is complete, true, and correct.
I am filing this petition on behalf of an organization and I certify that I am authorized to do so by the organization.
1.
Name of Petitioner
Family Name (last name)
Given Name (first name)
2.
Signature and Date
Signature of Petitioner
Date of Signature
(mm/dd/yyyy)
3.
Petitioner's Contact Information
Daytime Telephone Number
Mobile Telephone Number
Email Address (if any)
Form I-129 08/13/15 Y
Trade Agreement Supplement
Page 11 of 36

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