Immigrant Petition For Alien Worker 140 I
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Form I-140 01/17/17 N Page 1 of 6
For
USCIS
Use
Only
Immigrant Petition for Alien Worker
Department of Homeland Security
U.S. Citizenship and Immigration Services
USCIS
Form I-140
OMB No. 1615-0015
Expires 04/30/2018
START HERE - Type or print in black ink.►
Part 1. Information About the Person or Organization Filing This Petition (If an individual is filing,
use numbers 1.a. - 1.c. If a Company or Organization is filing, use number 2).
Other Information
U.S. Social Security Number (if any)4.
IRS Tax Number 3.
►
Mailing Address
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
Company or Organization Name2.
►
5.a.
In Care of Name
Street Number
and Name
5.b.
5.c. Apt. Flr.Ste.
5.d. City or Town
5.g. Postal Code
5.h. Province
5.i. Country
5.e. State 5.f. Zip Code
A professional (at a minimum, possessing a
bachelor's degree or a foreign degree equivalent to a
U.S. bachelor's degree).
1.e.
A skilled worker (requiring at least 2 years of
specialized training or experience).
1.f.
Any other worker (requiring less than 2 years of
training or experience).
1.g.
(Reserved)
1.h.
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).
1.i.
Check below if this petition is being filed:
To amend a previously filed petition.
2.a.
Previous Petition Receipt Number:
For the Schedule A, Group I or II designation.
2.b.
►
Part 2. Petition Type
This petition is being filed for: (Select only one box):
An alien of extraordinary ability.
1.a.
An outstanding professor or researcher.
1.b.
A multinational executive or manager.
1.c.
A member of the professions holding an advanced
degree or an alien of exceptional ability (who is NOT
seeking a National Interest Waiver).
1.d.
203(b)(1)(A) Alien of
Extraordinary Ability
Certification
203(b)(1)(B) Outstanding
Professor or Researcher
203(b)(1)(C) Multinational
Executive or Manager
203(b)(2) Member of Professions with
Advanced Degree/Exceptional Ability
203(b)(3)(A)(i) Skilled Worker
203(b)(3)(A)(ii) Professional
203(b)(3)(A)(iii) Other Worker
National Interest Waiver (NIW)
Schedule A, Group I
Schedule A, Group II
Priority Date Consulate
Remarks
Action BlockFee Stamp
Classification
must be 9 digits; no dashes
must be 9 digits; no dashes
(USPS ZIP Code Lookup)
Form I-140 01/17/17 N Page 2 of 6
Part 3. Information About the Person for Whom You Are Filing
Mailing Address
6. City/Town/Village of Birth
Other Information
Country of Nationality10.
9. Country of Citizenship
5. Date of Birth (mm/dd/yyyy) ►
E-mail Address (if any)3.
Alien Registration Number (A-Number)11.
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
4.
( )
-Daytime Phone Number
►A-
Street Number
and Name
2.b.
2.c. Apt. Flr.Ste.
2.d. City or Town
2.g. Postal Code
2.h. Province
2.i. Country
2.e. State 2.f. Zip Code
In Care of Name
2.a.
If in the United States, please provide the following
(complete all sections, as applicable):
13. Date of Arrival (mm/dd/yyyy) ►
U.S. Social Security Number (if any)12.
►
Current Nonimmigrant Status15.
I-94 Arrival-Departure Record Number:14.a.
►(mm/dd/yyyy)
Date Status Expires:16.
►
Part 4. Processing Information
Complete the following for the person named in Part 3:
(Check one)
Alien will apply for a visa abroad at a U.S. Embassy
or consulate at:
1.a.
Alien is in the United States and will apply for
adjustment of status to that of lawful permanent
resident.
1.b.
City or Town
Country
Alien's country of current residence or, if now in the
United States, last country of permanent residence
abroad.
8.
7. State/Province of Birth
Country of Birth
Passport Number14.b.
Travel Document Number14.c.
14.d. Country of Issuance for Passport or Travel Document
14.e. Expiration Date for Passport or Travel Document
(mm/dd/yyyy) ►
must be 9 digits; no dashes
Form I-140 01/17/17 N Page 3 of 6
Part 4. Processing Information (continued)
If you provided a United States address in Part 3, provide the
person's foreign address:
If the person's native alphabet is other than Roman letters, write
the person's foreign name and address in the native alphabet:
Mailing Address
Are any other petition(s) or application(s) being filed with
this Form I-140?
4.
If you answered "Yes," check any applicable boxes:
Yes No
Form I-485
Form I-131
Form I-765
Other-Attach an explanation
3.a. Family Name
(Last Name)
3.b. Given Name
(First Name)
3.c. Middle Name
Street Number
and Name
2.a.
2.b. Apt. Flr.Ste.
2.c. City or Town
2.d. Postal Code
2.e. Province
2.f. Country
Street Number
and Name
3.d.
3.e. Apt. Flr.Ste.
3.f. City or Town
3.g. Postal Code
3.h. Province
3.i. Country
Is the petition being filed without an original labor
certification because the original labor certification was
previously submitted in support of another Form I-140?
7.
Yes - Attach an explanation No
Is the person for whom you are filing in removal
proceedings? NoYes - Attach an explanation
5.
NoYes - Attach an explanation
Has any immigrant visa petition ever been filed by or on
behalf of this person?
6.
If you answered "Yes" to any of questions 4 through 8,
provide the case number, office location, date of decision,
and disposition of the decision on a separate sheet of paper.
If the petition is being filed without an original labor
certification, are you requesting that USCIS request a
duplicate labor certification from the Department of Labor?
8.
Yes - Attach an explanation No
Part 5. Additional Information About the Petitioner
Type of petitioner (Select only one box):
1.a. Employer
Self1.b.
Other (Explain, e.g., Permanent Resident, U.S. citizen
or any other person filing on behalf of the alien)
1.c.
If a company, give the following:
Type of Business2.a.
2.b. Date Established (mm/dd/yyyy) ►
Current Number of U.S. Employees2.c.
Gross Annual Income2.d.
Net Annual Income2.e.
NAICS Code2.f.
Labor Certification DOL/ETA Case Number2.g.
►
Form I-140 01/17/17 N Page 4 of 6
Part 5. Additional Information About the Petitioner (continued)
2.i. Labor Certification Expiration Date
(mm/dd/yyyy) ►
If an individual, give following:
3.a. Occupation
Annual Income3.b.
Part 6. Basic Information About the Proposed Employment
1. Job Title
SOC Code2. ►-
Nontechnical Description of Job3.
2.h. Labor Certification DOL/ETA Filing Date
(mm/dd/yyyy) ►
Address where the person will work if different from address in
Part 1.
Street Number
and Name
9.a.
9.b. Apt. Flr.Ste.
9.c. City or Town
9.d. State 9.e. Zip Code
Is this a full-time position?
If the answer to Number 4 is "No," how many hours per
week for the position?
5.
NoYes4.
7. Is this a new position? NoYes
Wages:8. $per
(Specify hour, week, month, or year)
Part 7. Information on Spouse and All Children of the Person for Whom You Are Filing
List husband/wife and all children related to the individual for whom the petition is being filed. Also, note if the individual will be
applying for a visa abroad or for adjustment of status as the dependent of the individual for whom the petition is filed. Provide an
attachment of additional family members, if needed.
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
1.d. Date of Birth (mm/dd/yyyy) ►
1.e. Country of Birth
Relationship1.f.
1.g. Applying for Adjustment of Status? No
Yes
1.h. Applying for Visa Abroad? NoYes
Person 1 Person 2
2.g. Applying for Adjustment of Status? NoYes
2.h. Applying for Visa Abroad? NoYes
2.a. Family Name
(Last Name)
2.b. Given Name
(First Name)
2.c. Middle Name
2.d. Date of Birth (mm/dd/yyyy) ►
2.e. Country of Birth
Relationship2.f.
6. Is this a permanent position? NoYes
Form I-140 01/17/17 N Page 5 of 6
Part 7. Information on Spouse and All Children of the Person for Whom You Are Filing (continued)
Person 3 Person 5
Yes NoApplying for Visa Abroad?6.h.
Yes No6.g. Applying for Adjustment of Status?
6.f. Relationship
6.e. Country of Birth
6.d. Date of Birth (mm/dd/yyyy) ►
Middle Name
6.c.
Given Name
(First Name)
6.b.
Family Name
(Last Name)
6.a.
Person 6
5.a. Family Name
(Last Name)
5.b. Given Name
(First Name)
5.c. Middle Name
►(mm/dd/yyyy)Date of Birth 5.d.
Country of Birth 5.e.
Yes
Relationship
5.f.
Applying for Adjustment of Status?5.g. NoYes
5.h. Applying for Visa Abroad? NoYes
NoApplying for Visa Abroad?4.h.
Yes No4.g. Applying for Adjustment of Status?
4.f. Relationship
4.e. Country of Birth
4.d. Date of Birth (mm/dd/yyyy) ►
Middle Name
4.c.
Given Name
(First Name)
4.b.
Family Name
(Last Name)
4.a.
Person 4
3.a. Family Name
(Last Name)
3.b. Given Name
(First Name)
3.c. Middle Name
►(mm/dd/yyyy)Date of Birth 3.d.
Country of Birth 3.e.
Relationship
3.f.
Applying for Adjustment of Status?3.g. NoYes
3.h. Applying for Visa Abroad? NoYes
Part 8. Signature of Petitioner
I certify, under penalty of perjury under the laws of the United States
of America, that this petition and the evidence submitted with it are all
true and correct. I authorize U.S. Citizenship and Immigration Services
(USCIS) to release to other government agencies any information from
my USCIS records, if USCIS determines that such action is necessary
to determine eligibility for the benefit sought.
1.a. Signature of Petitioner
1.b. Date of Signature (mm/dd/yyyy) ►
2.
Mobile Phone Number
( )
-3.
NOTE: If you do not fully complete this form or fail to submit
the required documents listed in the instructions, a final decision
on your petition may be delayed or the petition may be denied.
E-mail Address (if any)4.
Job Title of Position with Petitioning Employer, If the
Petition Is Being Filed by an Employer
5.
( )
-Daytime Phone Number
Form I-140 01/17/17 N Page 6 of 6
Preparer's Mailing Address
7.a. Signature
of Preparer
7.b. Date of Signature (mm/dd/yyyy) ►
Declaration
To be completed by all preparers, including attorneys and
authorized representatives: I declare that I prepared this petition
at the request of the petitioner, that it is based on all the
information of which I have knowledge, and that the information
is true to the best of my knowledge.
Part 9. Signature of Person Preparing This Petition, If Other Than the Petitioner
Preparer's Full Name
Provide the following information concerning the preparer:
2.a. Preparer's Family Name (Last Name)
2.b. Preparer's Given Name (First Name)
3. Preparer's Business or Organization Name
Yes No
Attorney or Representative: In the event of a Request for
Evidence (RFE), may USCIS contact you by e-mail?
1.
Preparer's Contact Information
Preparer's E-mail Address (if any)5.
4. Preparer's Daytime Phone Number Extension
( )
-
Street Number
and Name
6.a.
6.b. Apt. Flr.Ste.
6.c. City or Town
6.f. Postal Code
6.g. Province
6.h. Country
6.d. State 6.e. Zip Code
