H-1b Intake Form Work Authorization Form Page 2
Download a blank fillable H-1b Intake Form Work Authorization Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete H-1b Intake Form Work Authorization Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3If you are currently in the U.S., please complete the following:
Date of most recent arrival in U.S.: __________________________ I-94#:_____________________________________
Current immigration status: ___________ Expiration date of current immigration status: __________________________
U.S V
H
ISA
ISTORY
If you are currently in the U.S., or have previously been in the U.S. in any status other than B-1/WB (business visitor) or
B-2/WT (tourist), please summarize your study and/or employment since your first arrival in the U.S. (attach an additional
page if you need more space). Additionally please list your prior periods of stay in H-1B status; please only list the periods
that you were physically present in the U.S. including entry and exit stamps
Visa status
Period of Stay
Name and location of institution (school) or employer
_________
___________________________
___________________________________________________
_________
___________________________
___________________________________________________
_________
___________________________
___________________________________________________
_________
___________________________
___________________________________________________
Have you ever been granted the H-1B visa classification?
No
Yes – please answer questions below
- Please provide your first entry date into the U.S. in H-1B status: ____________________
Have you ever been denied the H-1B visa classification?
No
Yes – please attach explanation on separate sheet
Are you currently in removal (deportation) proceedings?
No
Yes – please attach explanation on separate sheet
Do you have a petition for U.S. permanent residence pending?
No
Yes – please answer questions below:
- On what basis was the application filed? (National interest waiver, marriage, etc.): _________________________
- Do you have a current employment authorization card (EAD)?
No
Yes – please attach a copy
If yes, did you use the EAD?
No
Yes
- Do you have an Advance Parole travel document?
No
Yes – please attach a copy
If yes, have you used the Advance Parole?
No
Yes
Do you now hold, or have you ever held, J visa status (J-1 or J-2)?
No
Yes – If yes, please answer questions below:
- Have you ever received direct funding from the Fulbright Commission?
No
Yes
- Have you ever been subject to the 2-year home country residence requirement?
No
Yes
Unsure
- Have you received a waiver, a recommendation for a waiver, or an advisory opinion regarding this requirement?
No
Yes – attach copy
Have you ever been denied a visa (including tourist visa)?
No
Yes – please attach explanation on separate sheet
Have you ever violated the terms of a U.S. visa or been unlawfully present in the U.S.?
No
Yes – please attach explanation on separate sheet
F
I
AMILY
NFORMATION
Are you married?
No
Yes – will your spouse require H-4 (dependent) status?
No
Yes
Do you have any children who will require H-4 status*?
No
Yes – How many? __________
*children must be under 21 years of age to qualify as H-4 dependent
If any family members are or have previously been in H-1 or H-4 status inside the U.S., please provide the following:
Name (Family, Given)
Period of stay (in H classification)
______________________________________________
from: ________________ to: __________________
______________________________________________
from: ________________ to: __________________
______________________________________________
from: ________________ to: __________________
H Intake Part 2 – Applicant (01/2015)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal