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Part I.Contact Information Name of applicant
Address
City, State or Province, Country, Zip/Postal Code
Date of birth
Place of birth
Nationality/Nationalities
Social Security Number (if any)
Alien Number (if any)
If you are in the United States, please provide the following information: a. Date of arrival b. I-94 # c. Current nonimmigrant status d. Date current status expires e. Daytime phone number with area code
Title of your currently held position
Name of the applicant's current employer
Address of the applicant's current employer
Please describe the duties of your present position
Highest level of education: a. Name of school b. Major/Subject c. Degree completed d. Date the degree was earned
Other relevant experience and education (please attach a CV/Resume). Please provide verification of relevant employment in the U.S. and abroad, including exact dates of hire, job title, job duties, location within organization, number and type of employee(s) supervised.
Please provide names, ages and relationships of accompanying family members a. Name b. Age c. Relationship
Part II. Information about the proposed position
Title of position offered to the applicant a. Principal owner/investor/trader b. Manager c. Supervisor d. Executive e. Specialist f. Other
Description of duties of the position. Please highlight: a. Managerial or executive functions b. Special or unique duties c. Functions that are required to “direct and develop” the investment d. Minimum requirements to perform the job
Please explain why an American could not perform this position?
Annual U.S. salary and benefit package: a. Salary b. Allowances/Benefits c. Total
Is the applicant filling a new position? YesNo
Name of person in the U.S. being replaced on this position
If not a replacement, is this an increase of staff? YesNo
Is the applicant renewing a previous E visa? If so, when and where was the visa issued?
Have you ever worked in the United States without work permission? If so, please explain on a seperate page.
Part III Information About U.S. Enterprise, Business or Company
Type of business enterprise: a. Corporation b. Privately owned c. Branch / Liaison Office/ Agency d. Joint Venture with an American Individual or Firm e. Partnership f. A subsidiary company g. Other Address of Headquarters. Please include telephone and fax numbers
Date the enterprise was established
IRS Tax #
Address of Subsidiaries and Branch Offices. Please include telephone and fax numbers
What is the nature of the business? a. General trades b. Imports to U.S c. Exports from U.S. d. Manufacturing e. Retail Sales f. Services /Technology
Please describe fully the services, production, or other activity provided above.
Name and address of foreign parent business. Pease provide telephone and fax number
If the U.S. enterprise is majority-owned by an individual, please provide the following information: a. Name of principal individual owner b. Permanent address c. Percentage of ownership d. What are the sources of the principal individual owner (in the U.S. and abroad) What are the amounts of the principal individual owner (in the U.S. and abroad) e. Please provide the names, nationalities, and percentages of ownership of each of the other individual owners of the U.S. enterprise. If any are Legal Permanent Residents of the United States (“green card” holders), note “LPR” under nationality: f. What is the percentage of the U.S. enterprise over which the investor has direct operational control? If there is a difference between the percentage of ownership and the percentage of control, please explain. g. Has the ownership of the U.S. enterprise changed since its establishment? Please indicate: YesNo If so, please explain how.
If the U.S. enterprise is majority-owned by a foreign corporation, please provide the following information: a. Principal corporate owner b. Total assets in U.S. dollars c. Date and place of incorporation d. Percentage of U.S. enterprise owned e. General nature of parent firm f. Please list the names, nationality, and percentage of ownership of the principal stockholders of the parent corporation:
If the U.S. enterprise is owned jointly with a U.S. corporation, please list the name and percentage ownership of the U.S. partner: a. Has the ownership of the U.S. enterprise changed since its establishment? Please indicate: YesNo If so, please explain how.
Please provide evidence of the ownership by submitting copies of stock certificates, the joint venture/partnership agreement or other evidence with supporting documents.
Please attach the most recent financial statement for the fiscal or calendar year that includes information about: a. Total assets of U.S. business, including current cash and historical cost b. Total liabilities c. Owner’s equity d. Total annual operating income
What type are the personnel in the U.S.? a. Nationals of treaty country: Managerial/Executive type of U.S. visa (if any) Specialized Essentials type of U.S. visa (if any) All other employees type of U.S. visa (if any)
b. U.S. Citizens and Legal Permanent Residents Managerial/Executive type of U.S. visa (if any) Specialized Essentials type of U.S. visa (if any) All other employees
c. Other (third country nationals) Managerial/Executive type of U.S. visa (if any) Specialized Essentials type of U.S. visa (if any) All other employees type of U.S. visa (if any)
d. TOTAL: Managerial/Executive Specialized Essentials All other employees
Part IV – Treaty Trader Applicants
Please describe the nature of trade. What goods, monies, or services are traded between the U.S. enterprise and the treaty country?
To answer the following question: A. For trade in merchandise, exports and imports, please refer to shipment and sale of goods across international boundaries B. For trade in services and technology, exports and imports, please refer to the sale of services by treaty-county nationals to nationals of the U.S .and other countries
What was the Gross International Trade of the U.S. Enterprise for: A. Imports from treaty country to U.S. business. Please provide: the dollar value number of transactions percent of total trade
B. Exports from U.S. business to treaty country the dollar value number of transactions percent of total trade
C. Imports from third country to U.S. businesses the dollar value number of transactions percent of total trade
D. Exports from U.S. to third countries the dollar value number of transactions percent of total trade
E. Domestic U.S. production/manufacturing the dollar value number of transactions percent of total trade
Is the information provided in the question above: a. for the calendar year b. for the fiscal year
Volume of trade. What is the volume of the U.S. – treaty country trade in non monetary terms? (number of shipments, services rendered that did not result in actual transfer of goods?
Part V – Information About Proposed Investment
If you are an individual investor, please provide the following information: a. What is your country of residence? b. What is your immigration status in the U.S c. What is the percent of your ownership?
Please choose one of the following to describe the type of investment: a. Creation of a new business. Please describe the business. b. Purchase of an existing business. Please provide the purchase price c. Continuation of an existing business d. Please provide the Fair Market Value of the business
Total investment from abroad made in the United States for the year. A. Please provide the date and the amount of your initial investment Amount: Date: a. Cash: b. Inventory: c. Equipment: d. Premises: e. Other(describe): f. Total:
B. Total cumulative investment: a. Cash: b. Inventory: c. Equipment: d. Premises: e. Other(describe): f. Total:
The information provided above is for a. for the calendar year b. for the fiscal year
What were the sources of investment capital (e.g., cash from foreign sources, foreign bank loans, sale of stock or other personal property)? Please provide information regarding how U.S. bank loans have been secured (mortgage debt, commercial loan secured by the assets of the enterprise itself, personal loan secured by applicant’s own assets): a. Foreign capital investment b. Foreign bank loans c. U.S. bank loans d. U.S. joint venture capitals e. Personal funds f. Corporate funds g. Stocks h. Debenture i. Bonds j. Other (please explain)
If the U.S. enterprise is an investment by a corporation, please provide the following information: Name of corporation: Address of corporate headquarter(s) Total assets: Date and place of incorporation Percentage of U.S. enterprise owned General nature of parent firm
If the U.S. enterprise is a joint venture by a foreign corporation and a U.S. corporation, please provide the following information about the joint corporate owner. Name of U.S. corporation Address of corporate headquarters Percentage of ownership General nature of parent firm
Part VI – Enterprise Details
Application type (please check one): a. This petition is based on an investment in a commercial enterprise in a targeted employment area for which the required amount of capital invested has been adjusted downward YesNo b. This petition is based on an investment in a commercial enterprise in an area for which the required amount of capital invested has been adjusted upward. YesNo c. This petition is based on an investment in a commercial enterprise that is not in either a targeted area or in an upward adjusted area. YesNo
Employment creation information Please provide the number of the full –time employees in the enterprise in the U.S. (excluding you, your spouse, sons and daughters) as follow: a. When you made your initial investment b. Now c. Difference d. How many of these new jobs were created by your investment? e. How many additional new jobs will be created by your additional investment?
Investor Visa Checklist
INFORMATION ABOUT U.S. OPERATIONS
Copies of passports of majority shareholders from treaty country Articles of Incorporation and certificate from state Bylaws Stock certificates Certificate of Officers Business license Certificate of Qualification of Foreign Business Partnership agreement or Joint Venture agreement Receipts for equipment, supplies Bank account statements showing capitalization Loan agreements, if any Copies of advertisements, press releases, etc., about new office Trade references Licenses, if required for type of business or profession Copies of telephone bills re: international calls to treaty country Sample contracts with customers/clients; invoices re transactions Letters of credit Business plan re: projected revenues, costs, staffing Letters from chambers of commerce, trade commissioners, home office re amount of initial investment as “substantial” and reasonable for start up of this type of business Lease or deed to office/facility space Trade or professional association memberships Awards, certificates PR releases Marketing brochures/firm résumé Photos of facilities, products, etc. Organizational chart re: employees; projected organization Customer/supplier list Relevant patents, trademarks, copyrights, if any Statistics re: volume and amount of trade between U.S. and treaty country (past performance and projected)
INFORMATION ABOUT RELATED OPERATIONS ABROAD
[Same as above] Recent annual report, and/or tax return
INFORMATION ABOUT PROPOSED POSITION
Job description (Highlight managerial or executive functions or special or unique duties or those functions that are required to “direct and develop” the investment.) Minimum requirements to perform the job Why could an American not do this position?
INFORMATION ABOUT APPLICANT
CV/Resume Copies of diplomas, degrees and relevant transcripts Verification of relevant employment in U.S. and abroad: Exact dates of hire; job title, job duties, location within organization, number, type of employees supervised. Optional: information about employer, recommendation about alien’s performance. Membership in trade or professional societies Articles written about or by alien Awards or commendations received Number and type of employees supervised before and in future
GENERAL INFORMATION
All documents in a foreign language must be translated. The translator must certify under oath that the translator is competent to translate into English. Notarized translations are preferred.
Referral Source How did you find our website?*
Your Questions or Comments Your privacy is important to us! By clicking the Submit button, you acknowledge that we collect the information you provide in this form only to assess your options for immigration. We will not sell your information to third-parties or disclose it without your consent unless authorized by law or if you hire us as your attorney and the services we provide for you require us to give your information to third-parties. You also acknowledge that an attorney-client relationship is not established until you speak directly with the attorney in person or over the phone to confirm such relationship.
PART A. U.S. IMMIGRATION ISSUES
What immigration Services do you Require? Spousal sponsorshipFamily SponsorshipSelf PetitionAdjustment of StatusWork VisaStudent VisaInvestor VisaTravel Document / Advance ParoleEmployment Authorization CardCitizenshipAsylumOther If “Other”, please provide type of service required
PART. B PERSONAL INFORMATION
First Name Middle Name Family Name Other name used (including maiden name) Date of Birth Date Month Year Nationality Citizenship (country) Place of birth Town Province/State Country Phone number Email Age Salutation MrMrsOther U.S. Social Security no. Home phone Business phone E-mail address Fax number Cell/Alternative phone Current residence address Address in the United States where you will reside (if not currently in the U.S.) Present occupation EmployedStudentRetiredUnemployedOther If “other” please explain PART C. PLEASE COMPLETE IF YOU ARE CURRENTLY OUTSIDE OF THE U.S. (if not applicable skip this part)
Full name, address and phone number(s) of contact person or organization in the U.S List all countries you have entered in the last 10 years (give the year of each visit) List all countries that ever issued you a passport: Have you ever lost a passport or had one stolen? List all Professional, Social and Charitable Organizations to which you belong(ed) or contribute(ed) or with which you work(ed): Do you have any specialized skills or training, including firearms, explosives, nuclear, biological, or chemical experience? If yes then please explain Have you ever performed military service? If "Yes" please list: Country, Branch of Service, Rank, Position, Military Specialty, Dates of Service Have you ever been in an armed conflict, either as a participant or victim? If "Yes" please explain: Have you ever been a victim to domestic or other physical/mental abuse? If "Yes" please provide complete details, including dates of arrests, etc: How long do you intend to stay in the United States? Have you ever been refused a U.S. Visa? If Yes: When Where What type of visa Have you ever been issued a U.S. Visa? If Yes: When Where What type of visa Have you ever been in the United States? If Yes: When For how long Do you intend to work in the United States? Do you intend to study in the United States? Has your U.S. Visa ever been canceled or revoked? Have you ever been refused admission to the United States? Has anyone ever filed an immigrant visa petition on your behalf? If answered "Yes" to the three questions above, please explain below:
Are any of the following persons in the U.S., or do they have U.S. Legal Permanent Residence or U.S. Citizenship (please indicate that person's status in the U.S.: i.e., U.S. legal permanent resident, U.S. citizen, visiting, studying, working, etc.)? Husband / Wife YesNo Status Fiancé / Fiancée YesNo Status Father / Mother YesNo Status Son / Daughter YesNo Status Brother / Sister YesNo Status
Have you attended a U.S. public elementary school on student (F) status or a public secondary school after November 30, 1996 without reimbursing the school?
Have you ever been afflicted with a communicable disease of public health significance or a dangerous physical or mental disorder?
PART D. SPONSOR OR PETITIONER (if not applicable skip this part)
Please complete this part if you are a Sponsor or Petitioner of a person seeking immigration benefits. I am sponsoring HusbandWifeParentBrotherSisterChild Are you related by adoption? Has your relative ever been to the United States? Is your relative currently in the United States? Are you applying for an advance parole document for a person who is outside the U.S.? Will your relative apply for adjustment of status? Address in the U.S. where your relative intends to live: If you are a U.S. citizen, how did you acquire your citizenship (birth in the U.S., Naturalization, parents)? Have you obtained a certificate of citizenship in your name? Certificate number Date, Place of issuance If you are a lawful permanent resident alien, complete the following: Date Place of Adjustment of Status How did you gain permanent resident status (Marriage to a U.S. citizen or lawful permanent resident, through adoption)? If filing for your husband or wife, provide last address at which you lived together: Street Address Unit Number City state/province Zip Country From (month/year) To (month/year) Have you ever filed a petition for any foreign national before? If you answered "Yes" to the above question provide the following: Name Place Date Date of filing Results Are you, or any person you are sponsoring, now in exclusion, deportation, removal or recission proceedings? If "Yes" Name of DHS office: If you applying for an advance parole document (permission to travel to the U.S.) for a person who is outside the United States, provide the following information about this person: Current legal name (as shown on the passport or I-94 departure card): First name Middle name Family name Date of Birth Month Day Year Country Citizenship Current address Date of intended departure Expected length of trip
PART E. FAMILY INFORMATION
Name of Father First Name Middle Name Last Name Father's date of birth Month Day Year Father’s place of birth Town Province/State Country Father’s current residence address: Is Father deceased? If yes, what year? Name of Mother First Name Middle Name Family Name Maiden Name Mother’s date of birth Month Day Year Mother's place of birth Town Province/State Country Mother’s current residence address Is Mother deceased? If yes, what year? Were any of your grandparents born in the United States? If yes, where?
PART F. MARITAL INFORMATION
Marital status MarriedWidowDivorceSeparatedSingle Date of present marriage Number of times of married, including this marriage Spouse’s name First Name Middle Name Last Name Spouse’s date of birth Month Day Year Spouse’s place of birth Town Province/State Country Nationality Citizenship (country) Spouse’s U.S. Social Security Number Place of present marriage Former Spouse First Name Middle Name Last Name Former spouse’s date of birth Month Day Year Former spouse’s citizenship Date/Place of termination of marriage or death List any children, including stepchildren immigrating with you a. Child Name b. Relationship c. Date of birth d. Place of birth City State Country e. Address (if different) f. U.S. Social Security Number g. “A” number (if applicable)
PART G. PRIOR RESIDENCE
Residences last 5 years (Present address first) Street Address unit number City state/province Zip Country From To Last residence outside U.S. of more than one year Street Address unit number City state/province Zip Country From To
PART H. EMPLOYMENT
Current occupation: Employment last five years. Present employment first. Name Address Telephone number Supervisor’s Name From To Current Employer’s Tax Identification Number If you are applying for Employment Authorization Document, complete the following: Have you ever before applied for Employment Authorization Document? If "Yes", Which USCIS Office Dates Results From To Currently I am applying for permission to accept employment: YesNo Currently I am applying for replacement of lost Employment Authorization Document: YesNo Currently I am applying for renewal of my permission to accept employment: YesNo If applying for work visa complete the following Name and address of (prospective) employer: List all jobs held during the last three years. Also, list any other jobs related to the occupation for which you are seeking a work visa (use attachment if necessary): a. Name and address of employer Name of job Kind of business b. Date started and left (month/year) Date Started Date Left c. Describe in detail the duties performed, including the use of tools, machines or equipment:
PART I. EDUCATION
High school? College Degree earned and date earned:
If applying for a work visa or you are currently outside of the United States please complete the detailed information below Names of schools, colleges and universities attended Addresses of schools, colleges and universities attended Addresses of schools, colleges and universities attended A. Field of Study: B. Dates of attendance (month/year) C. Degrees or Certificates Received
PART J. ARRIVAL INFORMATION
Date of first arrival in U.S.: Place of first arrival in the U.S. Date and place of last arrival in U.S.: A. Date B. Place Has a prior visa petition ever been filed? If yes, answer the following. A. Where? B. When? C. Inspected? Without Inspection? Means of travel into U.S.: Status at entry (visitor, student, etc.): Approved? Passport Number: Passport Issue Date Passport expiry date: Passport Issue Place:
PART K. DESTINATION IN U.S. AT TIME OF ADMISSION:
Consulate Where Visa Issued: Visa Validity Dates (month/year) Visa Number Visa Classification: I-94 issue date: Name Exactly as it Appears on I-94: Have you ever filed for Permanent Residence in the U.S.? If yes, please answer the following A. Date and place of filing: B, “A” Number as it appears on Lawful Permanent Residence Card: C. Current Status in the U.S. U.S permanent residentU.S. refugee/asylee statusPermanent resident as a direct result of refugee/asylee statusStudentTemporary Foreign WorkerK-1 Fiancee VisaBusiness VisitorTemporary Protected StatusOther (please provide) Information about your proposed travel (if applicable): Date of intended departure FROM THE U.S. (month, day, year): Expected length of trip: How many trips do you intend to use the travel document: Have you ever before been issued a reentry permit or refugee travel document? If “Yes” Date Issued (month, day, year): Disposition (lost, stolen, other): Since becoming a permanent resident of the United States (or during the past five years, whichever is less) how much total time have you spent outside the United States: Since you became a permanent resident of the United States, have you ever filed a federal income tax return as a nonresident, or failed to file a federal tax return because you consider(ed) yourself to be a nonresident? If “Yes” please explain: Where do you want this travel document sent Number and Street Apt. # City State or Province Zip/Postal Code Country Daytime Telephone # with area/country code):
PART L. BACKGROUND INFORMATION
List ALL present/past membership in groups of any kind: Group name Location (City/State) Received public assistance in U.S. from any source, or likely to in the future? Engaged in prostitution in past 10 years, or likely to in future? Encouraged any alien to enter U.S. illegally? Trafficked in any controlled substance? Been in any way involved in any terrorist activity? Engaged in espionage or intend to once in the U.S.? Been a member of or affiliated with the Communist Party or Nazi government of Germany between March 23, 1933 and May 8, 1945? Engaged in genocide or persecuted any person because of race, religion, national origin or political opinion? Been deported, removed, or excluded from the U.S. or been ordered to do same? Committed fraud in order to obtain entry into the U.S.? Left the U.S. to avoid being drafted into the U.S. Army? Been a J nonimmigrant visitor and not complied with the 2-year foreign requirement or obtained a waiver? Withheld custody of a U.S. citizen child from a person granted custody of the child? Been a polygamist or plan to practice polygamy in the U.S.? Claimed to be a U.S. citizen (in writing or any other way)? Violated or evaded laws prohibiting the export of goods, technology or information from the Unites States? If you answered YES to any of the above, explain fully Have you ever been under immigration proceedings? If you answered "Yes" to the last question, please explain: RemovalDetentionExclusionRecisionVoluntary Departure Withdrawal of Application for Admission What date did you return to your home country?
Part M. NATURALIZATION APPLICANTS ONLY (if not applicable, skip to Part N)
How many total days did you spend outside of the United States during the past 5 years? How many trips of more than 24 hours have you taken outside of the U.S. during the past 5 years? List below all the trips of 24 hours or more that you have taken outside of the United States since becoming a Lawful Permanent Resident. Begin with your most recent trip. Date left and returned to the U.S. (month/year)
PART N. ADDITIONAL QUESTIONS
Please list all countries you have travelled to and when Have you ever voted in any Federal, state, or local election in the United States? Have you ever registered to vote in any Federal, state, or local election in the U.S.? Since becoming a Lawful Permanent Resident (Green Card holder), have you ever failed to file a required Federal, state, or local tax return or called yourself a “nonresident” on same? Do you owe any Federal, state, or local taxes that are overdue? Do you have any title of nobility in any foreign country? Have you ever been arrested, cited, or detained by any law enforcement officer (including INS, now BCIS and military officers) for any reason? Have you ever been placed in an alternative sentencing or rehabilitative program (for example: diversion, deferred prosecution, withheld adjudication, deferred adjudication)?
*PLEASE NOTE: If you answered “Yes” to the previous question, but did NOT register with the Selective Service System and you are still under 26 years of age, you must register before you apply for naturalization. If you answered “YES” to the previous question, but did NOT register with the Selective Service System, and you are now 26 years or older, attach a statement explaining why you did not register.
Other, please specify:
Please upload the following documents:
• Passport • Proof of U.S. citizenship or U.S. Permanent Residency • Visa (all prior visas to the U.S.) • Front and back of your I-94 card • Copy of I-797 Approval Notices • Employment authorization documents • Advance Parole documents • Resume • Degrees, transcripts and translations • Birth certificates, and translations (all family members) • Adoption papers (for dependents if applicable) • Marriage certificates and/or divorce decrees (candidate and spouse) • Death certificate (if widowed)
Contact Information
• If unknown – write “unknown” • If not applicable – write “N/A” • If none – write “none” BENEFICIARY PERSONAL INFORMATION Full Name (First, Middle Last) US Social Security Number Any other names used (please include names by previous marriages) Place of birth (city/country) Date of Birth Date of Entry into the U.S. Type of Entry Visa into the U.S. Expiry date of visa MARITAL HISTORY Spouse’s Full Name (First, Middle Last) US Social Security Number Any other names used (please include names by previous marriages) Spouse’s place of birth (city/country) Spouse’s date of birth
FAMILY HISTORY
Father's Full Name
Father's Date of Birth
Father's City and Country of Birth
Father's City and Country of Residence
Mother's Full Name
Mother's Maiden Name
Mother's Date of Birth
Mother's City and Country of Birth
Mother's City and Country of Residence
MARITAL HISTORY Full name of any former Husband or Wife (if none so state). Please include maiden names if any. Date of Birth Date and Place of Marriage Date and Place of Termination of Marriage
RESIDENCE HISTORY Street Name and Number City State or Province Country Dates of Residency (mm/dd/yyyy – mm/dd/yyyy) Please provide your most recent foreign address of more than one (1) year Street Name and Number City State or Province Country Dates of Residency
Please list all employment for the last five (5) years. If none, so state. Employer Name Job Title City State or Province Country Dates of Employment
Please list your Last Occupation Abroad Employer Name Job Title City State or Province Country Dates of Employment
PLEASE ANSWER THE FOLLOWING QUESTIONS
Have you EVER had any problem entering the U.S., obtaining a U.S. visa, or ANY contact with the police in any country? Have you ever been under immigration proceedings? If you have children, even adult children, please provide a list of their names, dates of birth, and countries of birth. What is your current address abroad, if any?
CONTACT INFORMATION
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