Form I-140 - Immigrant Petition For Alien Worker Page 4

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Part 5. Additional Information About the Petitioner (continued)
2.h. Labor Certification DOL/ETA Filing Date
If an individual, give following:
3.a. Occupation
(mm/dd/yyyy)
2.i.
Labor Certification Expiration Date
Annual Income
3.b.
(mm/dd/yyyy)
Part 6. Basic Information About the Proposed Employment
1.
Job Title
6.
Is this a permanent position?
Yes
No
-
7.
Is this a new position?
Yes
No
SOC Code
2.
3.
Nontechnical Description of Job
Wages:
per
8.
$
(Specify hour, week, month, or year)
Address where the person will work if different from address in
Part 1.
Street Number
9.a.
and Name
9.b. Apt.
Ste.
Flr.
4.
Is this a full-time position?
Yes
No
9.c. City or Town
If the answer to Number 4 is "No," how many hours per
5.
week for the position?
9.d. State
9.e. Zip Code
Part 7. Information on Spouse and All Children of the Person for Whom You Are Filing
List husband/wife and all children related to the individual for whom the petition is being filed. Also, note if the individual will be
applying for a visa abroad or for adjustment of status as the dependent of the individual for whom the petition is filed. Provide an
attachment of additional family members, if needed.
Person 1
Person 2
1.a. Family Name
2.a. Family Name
(Last Name)
(Last Name)
1.b. Given Name
2.b. Given Name
(First Name)
(First Name)
1.c. Middle Name
2.c. Middle Name
1.d. Date of Birth
(mm/dd/yyyy)
2.d. Date of Birth
(mm/dd/yyyy)
1.e. Country of Birth
2.e. Country of Birth
1.f.
Relationship
2.f.
Relationship
1.g. Applying for Adjustment of Status?
Yes
No
2.g. Applying for Adjustment of Status?
Yes
No
1.h. Applying for Visa Abroad?
Yes
No
2.h. Applying for Visa Abroad?
Yes
No
Form I-140 03/05/13 N
Page 4 of 6

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