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H-1B Questionnaire and Checklist

H-1B Questionnaire & Checklist
  • Family Name:  

  • Given Name:  

  • Middle Name:  

  • Or, if an entertainment group, give group name:  

  • Date of Birth:  

  • Town of Birth:  

  • City of Birth:  

  • Province/State of Birth:  

  • Country of Birth:  

  • Social Security Number (if any):  

  • INS AA@ Number:  

  • Date of last arrival in the United States:  

  • AI-94@ Number:  

  • Current Nonimmigrant Status:  

  • Expiration Date:  

  • Passport Number:  

  • Date of Issuance:  

  • Expiration Date:  

  • Name of Person who was under H or L visa previously or currently:  

  • Date of granted H or L visa:  

  • Date of entry:  

  • Date of Departure:  

  • Current Mobile Phone Number in the US:  

  • Current Work Phone Number in the US:  

  • Current Home Phone Number in the US:  

  • Email:  

  • Address in the US:  

  • Foreign (overseas) Street Address:  

  • Foreign (overseas) City:  

  • Foreign (overseas) Province.State:  

  • Foreign (overseas) Country:  

  • Address where the US embassy/ consulate is located for you to have the visa application interview: City:  

  • Address where the US embassy/ consulate is located for you to have the visa application interview: Country:  

  • Highest education level (bachelor/ master/ PHD):  

  • Name of the school(s):  

  • Degree: (Bachelor/Master/ PHD):  

  • Field of study:  

  • Major:  

  • Year of Graduation:  

  • Address of the Universities:  

  • Evaluation Done?:  

  • Current Employer Name:  

  • Employer's Address:  

  • Current Job Title:  

  • Period of Employment:  

  • Job Duties:  

  • Name of dependents (spouse and children under 21) who need to be filed for H-4 status:  

  • Relationship:  

  • Date of last entry:  

  • Current status in the US:  

  • Start Date:  

  • Expiration Date:  

  • Passport Number:  

  • Issuance Date:  

  • Expiration Date:  

  • Address in the US:  

  • Street Address Overseas:  

  • City:  

  • State/Province:  

  • Country:  

  • Family Name of Indivdual Petitioning Employer:  

  • Given Name:  

  • Middle Name:  

  • Organization/Company Name of Petitioning Employer:  

  • Address: Attn:  

  • Street Number:  

  • City:  

  • State:  

  • Country:  

  • Zip:  

  • IRS Tax #:  

  • Gross Income:  

  • Net Income:  

  • Phone Number:  

  • Fax Number:  

  • Total number of current employees:  

  • Year of establishment:  

  • Type of the business:  

  • NAME and TITLE of the personnel who will sign the documents on the company's behalf:  

  • Job Title:  

  • Job Duties in Detail:  

  • Minimum Education Requirement:  

  • Minimum Experience Requirement:  

  • Special Skills Requirement (if any):  

  • Where the person(s) will work if different from the employer's business place:  

  • Is this a full-time position?:  

  • If no, give number of hours per week:  

  • Wages:  

  • Per Hour, Per Week or Per Year?:  

  • Other Compensation: Value Per Week:  

  • Explain:  

  • Dates of Intended Employment:  

  • Type of Emploer ( US citizen/permanent resident, Organization or Other):  

  • If Other, please explain:  

  • Number of Workers Alien Will Supervise:  


  • Please enter the security code below: