OMB No. 1615-0015; Exp. 12/31/09
Form I-140, Immigrant
Department of Homeland Security
Petition for Alien Worker
U.S. Citizenship and Immigration Services
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For USCIS Use Only
Returned
Receipt
Part 1. Information About the Person or Organization Filing this Petition.
If
an individual is filing, use the top name line. Organizations should use the second line.
Family Name (Last Name)
Given Name (First Name)
Full Middle Name
Date
Company or Organization Name
Date
Resubmitted
Address: (Street Number and Name)
Suite No.
Date
Attn:
Date
Reloc Sent
City
State/Province
Date
Country
Zip/Postal Code
Date
IRS Tax No.
U.S. Social Security No. (if any)
E-Mail Address (if any)
Reloc Rec'd
Part 2. Petition Type
Date
This petition is being filed for: (Check one)
Date
a.
An alien of extraordinary ability
b.
An outstanding professor or researcher
Classification:
203(b)(1)(A) Alien of Extraordinary
c.
A multinational executive or manager
Ability
d.
A member of the professions holding an advanced degree or an alien of exceptional
203(b)(1)(B) Outstanding Professor or
ability (who is NOT seeking a National Interest Waiver)
Researcher
203(b)(1)(C) Multinational Executive or
e.
A professional (at a minimum, possessing a bachelor's degree or a foreign degree
Manager
equivalent to a U.S. bachelor's degree) or a skilled worker (requiring at least two years of
specialized training or experience)
203(b)(2) Member of Professions w/Adv.
Degree or Exceptional Ability
f.
(Reserved)
203(b)(3)(A)(i) Skilled Worker
g.
Any other worker (requiring less than two years of training or experience)
203(b)(3)(A)(ii) Professional
h.
Soviet Scientist
203(b)(3)(A)(iii) Other Worker
i.
An alien applying for a National Interest Waiver (who IS a member of the professions
holding an advanced degree or an alien of exceptional ability)
Certification:
National Interest Waiver (NIW)
Part 3. Information About the Person For Whom You Are Filing
Schedule A, Group I
Family Name (Last Name)
Given Name (First Name)
Full Middle Name
Schedule A, Group II
Priority Date
Consulate
Address: (Street Number and Name)
Apt. No.
Concurrent Filing:
C/O: (In Care Of)
I-485 filed concurrently
City
State/Province
Remarks
Country
Zip/Postal Code
E-Mail Address (if any)
Daytime Phone # (with area/country codes)
Date of Birth (mm/dd/yyyy)
Action Block
State/Province of Birth
Country of Birth
City/Town/Village of Birth
Country of Nationality/Citizenship
A-Number (if any)
U.S. Social Security # (if any)
To Be Completed by
Attorney or Representative, if any.
Date of Arrival (mm/dd/yyyy)
I-94 # (Arrival/Departure Document)
If
Fill in box if G-28 is attached
to represent the applicant.
in
the
Current Nonimmigrant Status
Date Status Expires (mm/dd/yyyy)
ATTY State License #
U.S.
Form I-140 (Rev. 06/12/09) Y