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) H-1B Cover Letter from Provost (sample here) 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: $1,410 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 Attorney Question 1: Is the employer represented by an attorney or agent in the filing of this application? Yes No Sponsoring department name Sponsoring department email Beneficiary Information Beneficiary name: Beneficiary title: Attorney or agent's name (First, Last) Attorney address Address: City: State: Zip code: Country: Attorney phone number Law firm/business address Law firm/business FEIN State Bar number (only if attorney) Name of highest court where attorney is in good standing (only if attorney) State of highest court where attorney is in good standing (only if attorney) - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming 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 Street number and name: City or town: State: Zip code: Will the beneficiary work for you off-site at another company or organization’s location? Yes No Beneficiary duties Describe the proposed duties of the employee. Is this a full time position? Yes No List wages and unit. If other compensation will be provided, please explain. List dates of intended employment. From: Year Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 to: Year Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 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 No 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 No Wage The beneficiary will be paid the higher of the prevailing or actual wage at any and all off-site locations. Yes No Ownership Does any beneficiary in this petition have ownership interest in the petitioning organization? Yes No 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 UploadsPlease upload the following documents. H-1B Cover Letter from Provost Files must be less than 50 MB.Allowed file types: gif jpg jpeg png pdf doc docx. Job offer letter Files must be less than 50 MB.Allowed file types: gif jpg jpeg png pdf doc docx. Recruitment report 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.