Form I-129CW Petition for CNMI-Only Nonimmigrant Transition Worker

OMB No. 1615-0111; Expires 04/30/2016

Form I-129CW, Petition for a CNMI-Only
Nonimmigrant Transitional Worker

Department of Homeland Security
U.S. Citizenship and Immigration Services

For USCIS Use Only

START HERE - Type or print in black ink.

Part 1. Information About the Employer Filing This Petition

Receipt

1. Name of Representative for Employer/Organization
a. Family Name (Last Name)
b. Given Name (First Name)
c. Middle Name
2. Telephone Number (include area
code, no spaces or dashes):
3. Name of Employer/Organization and Address
a. Name of Employer/Organization:

b. C/O (In Care Of):

Class:
# of Workers:

c. Street Number and Name

Job Code:
Priority Number:

d. Suite/Apartment Number

Validity Dates: From:
To:

e. City or Town

Classification Approved
f. State

g. Zip Code

h. Postal Code

Consulate/POE/PFI Notified
At
Extension Granted
COS/Extension Granted

i. Province

Partial Approval (explain)

j. Country
Action Block
4. E-Mail Address (if any):

5. Federal Employer Identification Number:

Part 2. Information About This Petition (See instructions for fee
information)
1. Requested Nonimmigrant Classification
(Write classification symbol):

Form I-129CW 04/04/13 Y Page 1

Part 2. Information About This Petition (See instructions for fee information) (Continued)
2. Basis for Classification (Check one):
a. New employment (including a duplicate for U.S. Department of State notification).
b. Continuation of previously approved employment without change with the same employer.
c. Change in previously approved employment.
d. New concurrent employment.
e. Change of employer.
f. Amended petition.
3. If you checked Box 2b, 2c, 2d, 2e, or 2f, give the petition receipt number.
4. Prior Petition. If the beneficiary is in the CNMI as a nonimmigrant and
is applying to change and/or extend his or her status, give the prior
petition or application receipt number:
5. Requested Action (Check one):
a. Notify the office in Part 4 so the person(s) can obtain a visa or be admitted.
b. Change the person(s) status and extend their stay since the person(s) are all now in the CNMI in another status (see
instructions for limitations). This option is available only where you check "New Employment" in Item 2, above. Check
the appropriate box indicating the type of status change.
1. Initial Grant of CW-1 status in CNMI
2. Change of Federal nonimmigrant status to CW-1
c. Extend the stay of the person(s) since they now hold this status.
d. Amend the stay of the person(s) since they now hold this status.
6. Total number of workers in petition (See instructions relating to when more than one worker can be
included):

Part 3. Information About the Persons For Whom You Are Filing (Complete the blocks below. Use the
continuation sheet to name each person included in this petition.)
1. Complete the following information about the person being filed:
a.Family Name (Last Name)

b. Given Name (First Name)

c. Full Middle Name

d. All Other Names Used (include maiden name and names from all previous marriages)

e. Date of Birth (mm/dd/yyyy)

f. U.S. Social Security Number (if any)

g. A-Number (if any)

h. Country of Birth

i. Province of Birth

j. Country of Citizenship

Form I-129CW 04/04/13 Y Page 2

Part 3. Information About the Persons For Whom You Are Filing (Complete the blocks below. Use the
continuation sheet to name each person included in this petition.) (Continued)
2. If in the CNMI, Complete the following:
a. Date of Last Arrival
(mm/dd/yyyy)

b. I-94 Number (Arrival-Departure Document)

d. Date Status Expires
(mm/dd/yyyy)

e. Passport Number

c. Current Nonimmigrant Status

f. Date Passport Issued
(mm/dd/yyyy)

g. Date Passport Expires
(mm/dd/yyyy)

h. Current CNMI Address

Part 4. Processing Information
1. If the person named in Part 3 is outside the CNMI, or a requested extension of stay, or change of status cannot be granted, give
the U.S. consulate or inspection facility you want notified if this petition is approved.
a. Type of Office (Check one):

Consulate

Pre-flight inspection

Port of Entry

c. U.S. State or Foreign Country

b. Office Address (City)

d. Person's Foreign Address

2. Does each person in this petition have a valid passport?
Not required to have passport

No - write a brief explanation in Part 8.

Yes

3. Are you filing any other petitions with this one?

No

Yes - How many?

4. Are applications for replacement/initial I-94s being filed with this petition?

No

Yes - How many?

5. Are applications by dependents being filed with this petition?

No

Yes - How many?

6. Is any person in this petition in removal proceedings?

No

Yes - explain in Part 8

7. Have you ever filed an immigrant petition for any person in this petition?

No

Yes - explain in Part 8

8. If you indicated you were filing a new petition in Part 2, has any person in this petition:
a. Ever been given the classification you are now requesting?

No

Yes - explain in Part 8

b. Ever been denied the classification you are now requesting?

No

Yes - explain in Part 8

No

Yes - explain in Part 8

9. Have you ever previously filed a petition for this person?

Form I-129CW 04/04/13 Y Page 3

Part 5. Basic Information About the Proposed Employment and Employer (Attach Form I-129 CW Supplement)
1.

Job Title

2.

Nontechnical Job Description

3.

Reserved for future use.

4.

Reserved for future use.

5.

Address where the person(s) will work if different from address in Part 1. (Street Number and Name, City/Town, State, Zip Code)

6.

Is this a full-time position?
Yes - Wages per week or per year: $

No - Hours per week:
7.

Other Compensation (Explain)

8.

Dates of intended employment (mm/dd/yyyy):

9.

Type of Petitioner - Check one:
a. Business

b. Organization

From:

To:

c. Other - write a brief explanation in Part 8.

10. Type of Business

11. Year Established

12. Current Number of Employees

13. Gross Annual Income

14. Net Annual Income

Form I-129CW 04/04/13 Y Page 4

Part 6. Signature (Read the information on penalties in the instructions before completing this section.)
I certify, under penalty of perjury under the laws of the United States of America, that this petition and the evidence submitted with it
is all true and correct. If filing this on behalf of an organization, I certify that I am empowered to do so by that organization. If this
petition is to extend a prior petition, I certify that the proposed employment is under the same terms and conditions as stated in the
prior approved petition. I authorize the release of any information from my records, or from the petitioning organization's records that
U.S. Citizenship and Immigration Services needs to determine eligibility for the benefit being sought.
Signature of Petitioner

Daytime Phone Number (include Area/
Country Code):

Printed Name of Petitioner

Date (mm/dd/yyyy)

NOTE: If you do not completely fill out this form and the required supplement, or fail to submit required documents listed in the
instructions, the beneficiary may not be found eligible for the requested benefit and this petition may be denied.

Part 7. Signature of Person Preparing Form, If Other Than Above
I declare that I prepared this petition at the request of the above person and it is based on all information of which I have any
knowledge.
Signature of Preparer

Day time Phone Number (include Area/
Country Code, no spaces or dashes):

Printed Name of Preparer

Date (mm/dd/yyyy)

Firm Name and Address

Form I-129CW 04/04/13 Y Page 5

Part 8. Explanation (Provide on the space below the Question Number with your answers.)

Form I-129CW 04/04/13 Y Page 6

Attachment - 1
Attach to Form I-129CW when more than one person is included in the petition. (List each person separately. Do not include
the person you named on Form I-129CW.)
Family Name (Last Name)

Given Name (First Name)

Full Middle Name

Date of Birth (mm/dd/yyyy)

U.S. Social Security Number (if any)

A-Number (if any)

Address in the CNMI (Complete Address)

Foreign Address (Complete Address)

Country of Birth

Date of Arrival
(mm/dd/yyyy)

IF
IN
THE
CNMI

Country of Citizenship

I-94 # (Arrival-Departure Document)

Country Where Passport Issued

Current Nonimmigrant Status Date Status Expires
(mm/dd/yyyy)

Date Passport Expires Date Started With Group
(mm/dd/yyyy)

(mm/dd/yyyy)

Family Name (Last Name)

Given Name (First Name)

Full Middle Name

Date of Birth (mm/dd/yyyy)

U.S. Social Security Number (if any)

A-Number (if any)

Address in the CNMI (Complete Address)

Foreign Address (Complete Address)

Country of Birth

Date of Arrival

(mm/dd/yyyy)

IF
IN
THE
CNMI

Country of Citizenship

I-94 # (Arrival-Departure Document)

Country Where Passport Issued

Current Nonimmigrant Status Date Status Expires
(mm/dd/yyyy)

Date Passport Expires Date Started With Group
(mm/dd/yyyy)

(mm/dd/yyyy)

Form I-129CW 04/04/13 Y Page 7

Attachment - 1
Attach to Form I-129CW when more than one person is included in the petition. (List each person separately. Do not include
the person you named on Form I-129CW.)
Family Name (Last Name)

Given Name (First Name)

Full Middle Name

Date of Birth (mm/dd/yyyy)

U.S. Social Security Number (if any)

A-Number (if any)

Address in the CNMI (Complete Address)

Foreign Address (Complete Address)

Country of Birth

Date of Arrival

(mm/dd/yyyy)

IF
IN
THE
CNMI

Country of Citizenship

I-94 # (Arrival-Departure Document)

Country Where Passport Issued

Current Nonimmigrant Status Date Status Expires
(mm/dd/yyyy)

Date Passport Expires Date Started With Group
(mm/dd/yyyy)

(mm/dd/yyyy)

Family Name (Last Name)

Given Name (First Name)

Full Middle Name

Date of Birth (mm/dd/yyyy)

U.S. Social Security Number (if any)

A-Number (if any)

Address in the CNMI (Complete Address)

Foreign Address (Complete Address)

Country of Birth

Date of Arrival

(mm/dd/yyyy)

IF
IN
THE
CNMI

Country of Citizenship

I-94 # (Arrival-Departure Document)

Country Where Passport Issued

Current Nonimmigrant Status Date Status Expires
(mm/dd/yyyy)

Date Passport Expires Date Started With Group
(mm/dd/yyyy)

(mm/dd/yyyy)

Form I-129CW 04/04/13 Y Page 8

Attachment - 1
Attach to Form I-129CW when more than one person is included in the petition. (List each person separately. Do not include
the person you named on Form I-129CW.)
Family Name (Last Name)

Given Name (First Name)

Full Middle Name

Date of Birth (mm/dd/yyyy)

U.S. Social Security Number (if any)

A-Number (if any)

Address in the CNMI (Complete Address)

Foreign Address (Complete Address)

Country of Birth

Date of Arrival

(mm/dd/yyyy)

IF
IN
THE
CNMI

Country of Citizenship

I-94 # (Arrival-Departure Document)

Country Where Passport Issued

Current Nonimmigrant Status Date Status Expires
(mm/dd/yyyy)

Date Passport Expires Date Started With Group
(mm/dd/yyyy)

(mm/dd/yyyy)

Family Name (Last Name)

Given Name (First Name)

Full Middle Name

Date of Birth (mm/dd/yyyy)

U.S. Social Security Number (if any)

A-Number (if any)

Address in the CNMI (Complete Address)

Foreign Address (Complete Address)

Country of Birth

Date of Arrival

(mm/dd/yyyy)

IF
IN
THE
CNMI

Country of Citizenship

I-94 # (Arrival-Departure Document)

Country Where Passport Issued

Current Nonimmigrant Status Date Status Expires
(mm/dd/yyyy)

Date Passport Expires Date Started With Group
(mm/dd/yyyy)

(mm/dd/yyyy)

Form I-129CW 04/04/13 Y Page 9

OMB No. 1615-0111; Expires 04/30/2016

CW Classification
Supplement to Form I-129CW

Department of Homeland Security
U.S. Citizenship and Immigration Services

1. Name of employer or organization filing petition:

2. Name of person for whom you are filing:

3. Is the petitioning employer requesting an accommodation to the benefit process on behalf of the
beneficiary because of a disability or impairment? (See instructions for examples of accommodations.)

Yes

No

If you answered "Yes," check the box below that applies:
a. The beneficiary is deaf or hard of hearing and request the following accommodation (if requesting a sign-language
interpreter, indicate for what language (e.g. American Sign Language):
.
b. The beneficiary is blind or sight impaired and request the following accommodation:
.
c. The beneficiary has another type of disability (describe the nature of the disability and accommodation you are requesting):
.

Employer Attestation
1. There are no qualified U.S. workers available to fill the position offered by the above named petitioning employer.
2. The above named petitioning employer is doing business as defined in the regulations at 8 CFR 214.2(w)(1)(ii).
3. The above named petitioning employer is a legitimate business as defined in the regulations at 8 CFR 214.2(w)(1)(vi).
4. The above named petitioning employer is an eligible employer as described in 8 CFR 214.2(w)(4) and will continue to comply
with the requirements for an eligible employer until such time as the employer no longer employs any CW-1 nonimmigrant
worker;
5. The beneficiary meets the qualifications for the position.
6. The beneficiary, if present in the CNMI, is lawfully present in the CNMI.
7. The position is not temporary or seasonal employment, and the above named petitioning employer does not reasonably believe the
position to qualify for any other nonimmigrant worker classification.
8. The position falls within the list of occupational categories designated by the Secretary at 8 CFR 214.2(w)(1)(ix).
Check one:
a. Professional, technical, or management occupations

f. Machine trade occupations

b. Clerical and sales occupations

g. Benchwork occupations

c. Service occupations

h. Structural occupations

d. Agricultural, fisheries, forestry, and related occupations

i. Miscellaneous occupations

e. Processing occupations

Form I-129CW 04/04/13 Y Page 10

Employer Attestation

I certify under penalty of perjury, under the laws of the United States of America, that the contents of this attestation and the evidence
submitted with it are true and correct to the best of my knowledge. If filing on behalf of an organization, I certify that I am empowered
to do so by the organization. If this petition is to extend a prior petition, I certify that the proposed employment is under the same
terms and conditions as stated in the prior approved petition. I authorize the release of any information from my records, or from the
petitioning organization's record that U.S. Citizenship and Immigration Services needs to determine eligibility for the benefit sought.

Signature
Printed Name
Title
Date (mm/dd/yyyy)
Employer/Organization Name
Employer/Organization Street Address
(do not use a post office)
Suite Number
City
State
Zip Code
Daytime Phone Number (with area code)
Fax Number (if any)
E-mail Address (if any)

Form I-129CW 04/04/13 Y Page 11