H-1b Prospective Employee Information Form printable pdf download

H-1b Prospective Employee Information Form

H-1B PROSPECTIVE EMPLOYEE INFORMATION FORM

(To be completed by prospective employee only)

1. Name

______________________________________________________________________________

(Surname)

(First)

(Middle)

2. ____________________________________________________________________________

Address:

(Street)

(City)

(State)

(Zip)

2. Date of Birth (mo/day/year)____________ 3. Country of birth_____________

4. Country of Citizenship ____________________ 5. Male/Female_____________

6. Social Security #__________________ 7. Alien Reg. # (if any)________________

8. Valid Passport? Y

If yes, expiration date________ Passport #_______________

9. Has an immigration petition ever been filed for you?

If yes, give details on the back of this form.

10. Have you had H-1B status in the past 7 years? Y

11. Have you ever been denied H-1B status previously?

If you are currently in the United States:

12.

Date of last arrival (mo/day/year)_______________

13.

I-94 number (11 digits)_________________________

14.

Current non-immigrant status (e.g. F-1, J-1)_______________

If you have ever been in the J-1 or J-2 status, please provide dates and photocopies of

previous IAP-66’s. If you are subject to the 2 year home residency requirement you must

have already received a waiver before we can proceed with this application.

15.

Expiration of current status (mo/day/year)________________

H-1b Prospective Employee Information Form