H-1B Visa Data Collection Form - Employer | College of Extended Education & Global Engagement at Cal Poly Humboldt

Instructions

Please fill out and submit the following application, including supporting documents. Please direct the beneficiary (H-1B applicant) to fill out this application.

Department Checklist
Upload the following documents at the end of the application:

Nationally Published Announcement (obtain from HR)

Send the following fees to the Center for International Programs. Each check must be written separately, payable to Department of Homeland Security. Work with your departmental budget analyst to procure these checks.

$500 for Fraud Prevention and Detection
$460 for I-129 petition processing fee
Optional: $2,500 for Premium Processing, if desired (approx. 4 weeks), paid by department or beneficiary

Please note that the sponsoring department will pay for mailing expenses.

Begin Form

Sponsoring department name

Sponsoring department email

Beneficiary Information

Sponsoring Department Information

Department name

Department contact name

Department contact title

Department contact email

Department contact phone

Beneficiary name

Beneficiary job title

Address where beneficiary will work

Will the beneficiary work for you off-site at another company or organization’s location?

Yes

Beneficiary duties

Describe the proposed duties of the employee.

Is this a full time position?

Yes

List wages and unit.

If other compensation will be provided, please explain.

List dates of intended employment. From:

Year

Month

Day

to:

Year

Month

Day

Describe how the nonimmigrant worker fits into the “specialty worker” category (why we didn’t hire U.S. worker)

Describe nonimmigrant present occupation and summarize prior work experience

Off-site

The beneficiary of this petition will be assigned to work at an off-site location for all or part of the period for which H-1B classification is sought.

Yes

Comply

Placement of the beneficiary off-site during the period of employment will comply with the statutory and regulatory requirements of the H-1B nonimmigrant classification.

Yes

Wage

The beneficiary will be paid the higher of the prevailing or actual wage at any and all off-site locations.

Yes

Ownership

Does any beneficiary in this petition have ownership interest in the petitioning organization?

Yes

If yes, please explain.

Certification

Certification regarding the release of controlled technology or technical data to foreign persons in the United States.

A license is not required from either the U.S. Department of Commerce or the U.S. Department of State to release such technology or technical data to the foreign person; or

A license is required from the U.S. Department of Commerce and/or the U.S. Department of State to release such technology or technical data to the beneficiary and the petitioner will prevent access to the controlled technology or technical data by the beneficiary until and unless the petitioner has received the required license or other authorization to release it to the beneficiary.

Document Uploads

Please upload the following documents.

Signed Job offer letter

Files must be less than 50 MB.
Allowed file types: gif jpg jpeg png pdf doc docx.

Nationally published announcement

Files must be less than 50 MB.
Allowed file types: gif jpg jpeg png pdf doc docx.

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H-1B Visa Data Collection Form - Employer