Saint Ambrose University

H1B Employment Based Application

Intake Form

Instructions

In order to help your candidate obtain the most appropriate visa to come to SAU, both the applicant and the sponsoring department must complete this form and return it to the International Student Services at SAU.

Visa status affects the type of employment and length of stay permitted, permission for a spouse to work, and liability for income taxes.

Issuance of a visa may take weeks or months.  If the candidate is already in the U.S. , you should be aware that applications for a transfer of visa sponsorship or for a change of immigration status may take several months to be processed by the US government, and it may not be possible to receive an SAU salary until the application is approved.  If the candidate is outside the country approval will be necessary before the candidate enters the country and begins to work.

Application for an H1B work visa often takes several months. An application can be expedited for an additional fee of $1000 and a response should be received within 15 days.

Please attach all appropriate documentation.

TO BE COMPLETED BY THE SPONSORING DEPARTMENT AT SAU

Please attach letter of position offer, position description, position contract and  one letter of support from department sponsor.

Date:____________________________

Department:_______________________ Contact:______________________________

Contact Phone:__________________ Contact Email:___________________________

Premium Processing is Requested ($1000): Yes_______ No:________

Check made out to the USCIS is attached: Yes_____ No:_______

Position Information

Candidate legal name:___________________________________________________

Position Title at SAU:____________________________________________________

Brief Description of responsibilities at SAU:__________________________________

________________________________________________________________________

Minimum requirements of position (degree and experience):____________________

________________________________________________________________________

Anticipated Starting Date:_____________________End Date:__________________

Address of Actual Work Site (Main Campus, ACCEL, Satellite sites):

______________________________________________________________________

Financial Information

The funding information will appear on a visa certificate and will be a determining factor in whether a visa is actually issued by the US government. It is, therefore, important that this information be accurate. The University may be held liable for statements made about scholarships, benefits, and salaries etc.

Salary:_________________________

Additional Benefits (Insurance, housing, tuition remission):_____________________

Signature Dean of College: ______________________________ Date:_____________

TO BE COMPLETED BY THE FOREIGN NATIONAL

Personal Data

Full Name_______________________________________________________________

(As it appears on passport)  family/last              given/first                      middle

Current Residing Address:________________________________________________

Permanent Address Outside the U.S.________________________________________

Email Address:_________________________Phone:___________________________

Date of birth____________ Place of birth _________________________ Male __Female__                                              Month/Date/Year                       City                 Country

Citizenship Country____________ Legal Permanent Residence Country__________                                                         (Attach proof of such residence if not your citizenship 

Passport number______________Date Issued____________Date Expires__________

(Attach copies of passport ID pages)

US Social Security Number (if applicable):___________________________________

US Immigration Information

Current Visa Status (if applicable):_________________ Expiration Date:___________

If F1, have you applied for OPT ? Yes_____ No_____ End Date: _________________

Is Applicant subject to 212(e) two-year home residency requirement:_____________

Sponsoring Institution for Current Status:___________________________________

Are you currently in the U.S. __yes  __no   If yes, latest date of arrival:___________

If yes, please indicate:

__ I will be leaving the U.S. and returning before I begin my appointment at SAU

            Give destination and travel dates:_______________________________________

__ I am requesting a transfer or extension of my current visa status

__ I am requesting a change of visa status to:_______________________

(Attach a photocopy of all previous visa documents including visas, passport id pages, Form I-94, DS2019 forms,  I-20 forms, H-1B approval notices, etc.)

If no, please complete:

            At which U.S. consulate/embassy will you apply for your visa?_______________

            Proposed port of entry:_____________________________

All applicants must complete:

Have you ever been in the U.S. in any visa class other than tourist?  __yes  __no

If yes, please complete this section.  Begin with your most recent visa class and work backwards chronologically.

Visa Classification      Begin and end dates of status      Purpose of stay and location                                                                                                               (institution if appropriate)

  ________                       ____________________________________________________

________________________________________________________________________

Have you ever filed, or has anyone ever filed for you, an application for permanent

resident (green card) status?  __yes  __no

If you answered yes, please attach a separate sheet and explain (give dates and places of filing, name of person who filed, relationship of that person to you, final decision on application, current status of application.)

Position in home country:  Check appropriate category

__Graduate Student  __Researcher  __Physician  __Professor/Teacher 

__Other (specify): _______________________

Academic degrees and years awarded_______________________________________

_______________________________________________________________________                        (Attach copies of diploma(s), certificates, transcripts and your curriculum vitae)

Date of previous affiliation with SAU, if any__________________________________

Means of Support While in the US . (in US dollars Please)                                                                       (attach proof of financial support if not paid by SAU 

__St. Ambrose University                      Amount in U.S. $___________________________

__Personal Funds                                 Amount in U.S. $___________________________

__U.S. Government Agency                 Amount in U.S. $___________________________

(name of organization/gov’t agency) _________________________

__Your Government                             Amount in U.S. $___________________________

__Other(Specify)_____________        Amount in U.S. $___________________________

Family Information

Please complete this section for any family members who will travel with you to the U.S. or who will arrive later to join you.  If your family will travel to the U.S. separately, a visa document will be prepared to allow them to enter the U.S. Only your spouse and minor children (under age 21) may be included as family members.

Name of family member     Date of birth     City & Country of birth     Citizenship     Relationship

________ Family will travel to the U.S. with me  _________Family will arrive later. 

Expected arrival date___________

If your family is already in the U.S. with you, please attach copies of passport data and expiration pages, I-94 cards, and Social Security cards, if applicable.

Applicant Signature__________________________________Date_____________________

Check List

The appropriate supporting documentation must be attached to prepare the employment-based petition. 

______                        Intake form

______            Check in the amount of $185 (I-129 filing fee), payable to US Bureau of Citizenship & Immigration Services (or USCIS); (May forward check separately.)

______            Check in the amount of $195 (I-539 filing fee), payable to US Bureau of Citizenship & Immigration Services (USCIS) (applicable only when dependents are currently in the U.S. and will be included in the petition – Do not include if dependents and employee are Not in the U.S.); department discretion whether department or employee responsible for paying this fee (May forward check separately.)

______            Check in the amount of $500 payable to the USCIS for fraud prevention. (May forward check separately.)

______            Check in the amount of $1,000 (optional – contact International Student Services to confirm if appropriate for employee’s circumstance) (Premium Processing form I-907 filing fee), payable to US Bureau of Citizenship & Immigration Services.   NOTE:  For this optional fee, the BCIS will process the petition (both employee & dependents) within 15 days (as opposed to regular processing which is 45 to 120 days).   Department discretion whether department or employee responsible for paying this fee (May forward check separately.)

                        Employment Offer Letter signed by Department Chair or designated hiring                                   authority

_______          Copy of passport pages including:  ID page, and most recent visa stamp for employee and each dependent family member included in petition

_______          Copy of most recent I-94 Admission/Departure Record, front and back sides, for employee and each dependent family member included in petition

_______          Copy of marriage license (with English translation if applicable) if spouse is included in petition, and birth certificates (with English translation if applicable) if children are included in petition.    NOTE:  Only include this information if the dependents are in the U.S. during petition application.  Do not include if dependents are abroad while H1B is being processed.

________        Copy of all SEVIS I-20 forms, front and back (applicable if employee and or dependent are in F1/F2 status)

_______          Copy of Employment Authorization card (EAD card) for J2 dependent (if applicable), front and back

_______          Copy of Employment Authorization card (EAD/ OPT card) (also known as Optional Practical Training card) for F1 employee (if applicable), front and back

_______          Copy of all SEVIS DS-2019 forms (applicable if employee or dependent is currently in J1 or J2 status)

_______          Documentation of J1 waiver (I-612) or satisfaction of Section 212(e) two-year home residency requirement (if applicable – please check with International Student Services if questions)

                        Copy of all recent Form I-797 Approval Notices for employee and each                                       dependent family member (if applicable only if employee and/or dependent is                                    transferring employment to St. Ambrose University from another employer)

                        Copy of TOFEL certification of language proficiency (if applicable) or other                                 English evaluation 

                        Copy of CV/Resume

                        Copy of degree(s), with English translation(s) (if applicable)

                        Copy of foreign credential evaluation (if applicable)

                        One letter of reference from department

_______          Copy of most recent paystub for new hire ONLY if transferring his/her H1B from a previous employer

______            Copy of I-485 Receipt Notice (if applicable)

Thanks to the University of Iowa for their help with this.