H-1B QUESTIONNAIRE FOR EMPLOYEE
Please type your answers into the right column
Please answer all questions. Please put “Not Applicable” if question is not applicable to you.
BIOGRAPHICAL DATA REGARDING EMPLOYEE
Full name (First, middle, underline last name):
Any other names used:
Foreign address:
(Please put your current address here)
U.S. address (if any):
Home telephone number:
Work telephone number:
Email address:
Date of birth:
City, State and Country of birth:
Social security number (if any):
Country of Nationality:
Alien registration number (if any):
The U.S. consulate (city and country) you would apply for
your visa through, even if you do not plan to apply for your
visa at this time:
(Please put name of City and Country of US Consulate
where you will go for visa stamping. For example, if you are
working and staying in Bangalore then you should fill it
“Chennai, India”)
Passport number and expiration date:
If you are in the U.S. and plan to travel internationally over
the next 4 months, provide the dates of intended departure
and return:
If in the U.S. when did you arrive, in what status, when
does the status expire:
(provide this information from your I-94 card)
Have you been refused/denied of a non-immigrant visa:
Have you ever filed an application for permanent residency
status (either adjustment of status or through the
Consulate):
Have you ever been arrested or convicted of a crime in or
outside the U.S.:
Have you ever violated your status in the U.S.:
(If yes, please provide details)
Were you ever refused a U.S. visa? If yes, provide detailsDate, Visa
All prior periods of H or L stay in the last seven years (list
dates):
First:
Middle:
LAST NAME:
Have you acquired a U.S. Master’s degree or higher
education degree from a U.S. institution?
Name of University?
Accreditation status of University?
Whether the University is "for profit" or not "non profit"?
Whether it is public or private University?
Educational details (MS/BS and field of study)
(Put all your university education)
Number of years of experience
(Job title, Duration, Company name and place)
Do you wish to seek change of status or consular process?
Are applications for spouse/ children to be filed with your H-1B?
_____ Yes. If yes, complete the below table
_____ If no, answer the following:
1) □ I am not married
2) □ My spouse is not in the U.S.
3) □ My spouse would like to continue with her independent immigration status
BIOGRAPHICAL DATA FOR EMPLOYEE’S SPOUSE
Full name of spouse (underline last name):
Date of birth:
City and Country of birth:
Social security number (if any):
Country of Nationality:
Alien registration number (if any):
Passport number and expiration date:
If you are in the U.S. and plan to travel internationally over
the next 4 months, provide the dates of intended departure
and return:
Have you been refused/denied of a non-immigrant visa:
Have you ever filed an application for permanent residency
status (either adjustment of status or through the
Consulate):
Have you ever been arrested or convicted of a crime in or
outside the U.S.:
List all prior periods of H or L stay in the last seven years
(list dates):
Complete this if spouse/ child is in the U.S. and seeking
change or extension of status
BIOGRAPHICAL DATA FOR CHILD ONE
Full name of child (underline last name):
Date of birth:
City and Country of birth:
Social security number (if any):
Country of Nationality:
Alien registration number (if any):
Passport number and expiration date:
If you are in the U.S. and plan to travel internationally over
the next 4 months, provide the dates of intended departure
and return:
Have you been refused or denied of a non-immigrant visa:
Have you ever filed an application for permanent
residency status (either adjustment of status or through
the Consulate):
Have you ever been arrested or convicted of a crime in or
outside the U.S.:
List all prior periods of H or L stay in the last seven years
(list dates):
Note: Provide above information for each additional child.
Required Documents – please provide the following documents along with the completed questionnaire:
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Copy of academic diplomas and transcripts.
Copy of foreign education evaluation (for foreign degrees), if available.
Copy of all letters confirming previous work experience, if available.
Detailed and updated resume.
Copy of current I-94 card, front and back, including those for all accompanying family members.
Copy of passport (all pages including blank pages)
Copy of all previously issued USCIS Approval Notices (I-797 Notice of Action).
Copy of EAD card (if any).
Copy of all I-20s, front and back (if previously in F-1 status), and EAD (Employment Authorization Document), if applicable.
Copy of pay-stubs for the past 3 months, if you are in the U.S. in a work-authorized status or dependent of work-authorized
beneficiary such has H, L or TN status.
 Marriage certificate and birth certificate of children, if filing for H-4
I certify that the information I have provided herein is true and accurate. I have carefully read this questionnaire, and
I certify the information is true and complete.
__________________________
Candidate's signature
Date:______________________