H-1b Specialty Occupations Biographical Information Form

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H-1B Specialty Occupations Biographical Information Form
Used for CCSU Employment-Based Immigration Petitions
Name:
_________________________________________________________________
First name
Middle initial
Last/Surname name
Gender:
Date of Birth (please write out, i.e. June 5, 1965):
Phone Number:
Current U.S. Address:
Overseas Address:
E-mail Address:
City of Birth:
_________________________________________________________________
Province of Birth:
_________________________________________________________________
Country of Birth:
_________________________________________________________________
Legal Permanent Resident of (country in which you permanently reside): _________________________
U.S. Social Security Number (if any):
___________________________________________________
Passport Number:
_________________________________________________________________
Country of Issue:
_________________________________________________________________
Date of Issue:
_________________________________________________________________
Expiration Date:
_________________________________________________________________
Date of Last Entry to the U.S.: __________________________________________________________
I-94 Number (small white card in passport): _________________________________________________
Current U.S. Immigration Status (F-1, J-1, H-1B):_____________________________________________
Expiration Date of Current Status: (e.g. June 5, 1965): _________________________________________

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