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Nonimmigrant Petition Based On Blanket L Petition I-129S - Official Federal Forms
| Nonimmigrant Petition Based On Blanket L Petition Form. This is a national form and can be used in US Citizenship And Immigration Services . |
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OMB No. 1615-0010; Expires 03/31/2013 Department of Homeland Security U.S. Citizenship and Immigration Services Form I-129S, Nonimmigrant Petition Based on Blanket L Petition For USCIS Use Only Returned Date Date Resubmitted START HERE - Please type or print in black ink. Part 1. Information About Employer Receipt Sponsoring Company of Organization's Name Address - ATTN: Date Date Street Number and Name Room/Suite # Relocated Sent Date City or Town State or Province Country Zip/Postal Code Date Relocated Received Date Part 1A. Data Collection Does the petitioner employ 50 or more individuals in the U.S. ? If yes, are more than 50% of those employees in H-1B or L nonimmigrant status? Yes Yes No No Date Petitioner Interviewed on Beneficiary Interviewed on Approved as: Part 2. Information About Employment Manager/executive on Validity Dates: From: Denied (Give reason) Specialized knowledge This alien will be a: a. Manager/Executive b. Specialized knowledge professional Blanket petition approval number: To: Part 3. Information About Employee Action Block Family Name Given Name Middle Name Foreign Address: Street Number and Name Room/Suite # City or Town State or Province Country Zip/Postal Code Date of Birth (mm/dd/yyyy) To Be Completed by Attorney or Representative, if any. Country of Birth Country of Citizenship/Nationality Fill in box if G-28 is attached to represent the petition. ATTY State License # Form I-129S (Rev. 04/01/12) Y Page American LegalNet, Inc. www.FormsWorkFlow.com Part 4. Additional Information About the Employment Address: Street Number and Name Room/Suite # City or Town State or Province Country Zip/Postal Code Date of intended employment and Wage From (mm/dd/yyyy) To (mm/dd/yyyy) Weekly Wage Hours Per Week Title and detailed description of duties to be performed. Give the alien's dates of prior periods of stay in the United States in a work authorized capacity and the type of visa. Give the alien's dates of employment and job duties for the immediate prior 3 years. Summarize the alien's education and other work experience. Form I-129S (Rev. 04/01/12) Y Page American LegalNet, Inc. www.FormsWorkFlow.com Part 5. Signature Read the information on penalties in the instructions before completing this section. I certify, under penalty of perjury under the laws of the United States of America, that this petition and the evidence submitted with it are all true and correct. I am filing this on behalf of an organization, and I certify that I am empowered to do so by that organization. If this petition is to extend a prior petition, I certify that the proposed employment is under the same terms and conditions as in the prior approved petition. I authorize the release of any information from my records, or from the petitioning organizations records that U.S. Citizenship and Immigration Services needs to determine eligibility for the benefit being sought. Signature Print or Type Your Name Date (mm/dd/yyyy) Daytime Telephone Number (with area code) E-Mail Address (If any) NOTE: If you do not completely fill out this form or fail to submit required documents listed in the instructions, the person(s) petitioned may not be found eligible for the requested benefit and this petition may be denied. Part 6. Signature of Person Preparing Form, If Other Than Above Signature of Preparer (Sign below) Print or Type Your Name Date (mm/dd/yyyy) Daytime Telephone Number (with area code) E-Mail Address (If any) Firm Name and Address Form I-129S (Rev. 04/01/12) Y Page American LegalNet, Inc. www.FormsWorkFlow.com
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