Part 3. Information About the Beneficiary
Wages and Hours of Proposed Employment
(continued)
Provide the wages per year the beneficiary will receive and the
number of hours the beneficiary will work per week for the
Beneficiary's Foreign Physical Address
proposed employment. Also describe any other compensation
8.a.
Street Number
the beneficiary will receive, including dollar value (if
and Name
applicable).
8.b.
Apt.
Ste.
Flr.
4.
Beneficiary's Wages Per Year
$
8.c.
City or Town
5.
Beneficiary's Hours Per Week
8.d.
Province
6.
Other Compensation
8.e. Postal Code
8.f.
Country
Proposed Job Title and Duties
Provide the job title and duties the beneficiary will perform.
Other Information About the Beneficiary
Also indicate the percentage of time the beneficiary will spend
performing the duties on a daily basis. If you need extra space
9.
Date of Birth (mm/dd/yyyy)
to complete this section, use the space provided in Part 10.
Additional Information.
10.
Gender
Male
Female
7.
Job Title
11.
City or Town of Birth
8.
Duties Performed on a Daily Basis
12.
Province or State of Birth
13.
Country of Birth
Primary Worksite
14.
Country of Citizenship or Nationality
If you need extra space to complete this section, use the space
provided in Part 10. Additional Information.
9.
If you are seeking L-1B specialized knowledge
professional status for the beneficiary, will the beneficiary
Part 4. Information About Proposed United
work primarily offsite (at a worksite of a company or
States Employment
organization other than the petitioner or its affiliate,
branch, subsidiary, or parent company)?
1.
Provide the receipt number for the Blanket L petition
Yes
No
upon which this petition is based.
►
If you answered "Yes" to Item Number 9., describe how
and who will control and supervise the beneficiary's work
2.
Are you filing Form I-129, Petition for a Nonimmigrant
and why the placement is not labor for hire in Item
Worker, with this petition?
Yes
No
Numbers 10.a. - 11.
10.a.
Supervisor's Name
Proposed Employment Address for the Beneficiary
3.a.
Street Number
and Name
10.b. Nature of Supervision and Control of the Beneficiary's
Work
3.b.
Apt.
Ste.
Flr.
3.c. City or Town
3.d. State
3.e. ZIP Code
Form I-129S 06/02/16 N
Page 3 of 8