1.  Full legal name of U.S. employer:

2.  Name and title of official who will sign forms: 

3.  Address of U.S. employer (principal place of business):

4.  Employer’s Website:

5.  Name of employers’ contact person: 

6.  Telephone number of employer's contact person:

7.  Fax number of employer's contact person:

8.  E-mail of the employer’s contact person:

9.  Federal employer ID number (IRS tax number )

10. Year U.S. business formed:

11. Current number of employees (U.S. only):

12. Address of U.S. employer where alien will work (if different than above) :

13. Nature of employers’ business activity:

14. Full legal name of foreign affiliate:

15. Address of foreign affiliate:

16. Name of prospective employee:

17. E-mail of prospective employee:

18. Title of U.S. position offered:

19. Salary of U.S. position offered:

WE MAY NEED TO REQUEST ADDITIONAL INFORMATION AND DOCUMENTATION AS WE PROCEED WITH YOUR CASE.