Form I-140 - Immigrant Petition For Alien Worker Page 3
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4
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6Part 4. Processing Information (continued)
Are any other petition(s) or application(s) being filed with
4.
If you provided a United States address in Part 3, provide the
this Form I-140?
person's foreign address:
Yes
No
2.a.
Street Number
If you answered "Yes," check any applicable boxes:
and Name
Form I-485
2.b. Apt.
Ste.
Flr.
Form I-131
2.c. City or Town
Form I-765
2.d. Postal Code
Other-Attach an explanation
2.e. Province
5.
Is the person for whom you are filing in removal
proceedings?
Yes - Attach an explanation
No
Country
2.f.
Has any immigrant visa petition ever been filed by or on
6.
If the person's native alphabet is other than Roman letters, write
behalf of this person?
the person's foreign name and address in the native alphabet:
Yes - Attach an explanation
No
3.a. Family Name
(Last Name)
7.
Is the petition being filed without an original labor
3.b. Given Name
certification because the original labor certification was
(First Name)
previously submitted in support of another Form I-140?
3.c. Middle Name
Yes - Attach an explanation
No
8.
If the petition is being filed without an original labor
Mailing Address
certification, are you requesting that USCIS request a
Street Number
duplicate labor certification from the Department of Labor?
3.d.
and Name
Yes - Attach an explanation
No
3.e. Apt.
Ste.
Flr.
If you answered "Yes" to any of questions 4 through 8,
provide the case number, office location, date of decision,
3.f.
City or Town
and disposition of the decision on a separate sheet of paper.
3.g. Postal Code
3.h. Province
3.i.
Country
Part 5. Additional Information About the Petitioner
Type of petitioner (Select only one box):
Current Number of U.S. Employees
2.c.
1.a.
Employer
1.b.
Self
2.d.
Gross Annual Income
1.c.
Other (Explain, e.g., Permanent Resident, U.S. citizen
Net Annual Income
2.e.
or any other person filing on behalf of the alien)
NAICS Code
2.f.
If a company, give the following:
2.g.
Labor Certification DOL/ETA Case Number
Type of Business
2.a.
2.b. Date Established (mm/dd/yyyy)
Form I-140 03/05/13 N
Page 3 of 6
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