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

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

USCIS
Form I-129CW

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

OMB No. 1615-0111
Expires 04/30/2018

For USCIS Use Only
Partial Approval (explain)

Receipt

Action Block

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Classification Approved

Class:
# of Workers:
Job Code:
Priority Number:
Validity Dates: From:
To:

Consulate/POE/PFI Notified

At:

Extension Granted

COS/Extension Granted

► START HERE - Type or print in black ink.

Part 1. Information about the Employer Filing
This Petition

Part 2. Information About This Petition

NOTE: See the Instructions for fee information.

Name of Representative for Employer/Organization

1.

1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)

Basis for Classification (Select only one box):

1.c. Middle Name

Name of Employer/Organization and Address
2.a. Name of Employer/Organization
2.b. In Care Of Name (if any)

2.d.

Apt.

2.a.

New employment (including a duplicate for U.S.
Department of State notification).

2.b.

Continuation of previously approved employment
without change with the same employer.

2.c.

Change in previously approved employment.

2.d.

New concurrent employment.

2.e.

Change of employer.

2.f.

Amended petition.

3.

2.c. Street Number
and Name
Ste.

4.

2.f.

State

2.g. ZIP Code

3.

Federal Employer Identification Number

4.

USCIS Online Account Number (if any)

If you selected Item Number 2.b., 2.c., 2.d., 2.e., or 2.f.,
provide the petition receipt number.
►

Flr.

2.e. City or Town

Requested Nonimmigrant Classification

Prior Petition. If the beneficiary is in the CNMI as a
nonimmigrant and is applying to change and/or extend his
or her status, provide the prior petition or application
receipt number.

►

Form I-129CW 12/23/16 N

Page 1 of 11

Part 2. Information About This Petition
(continued)

3.

Date of Birth (mm/dd/yyyy)

4.

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

Requested Action (Select only one box):
5.a.

Notify the office in Part 4. so the beneficiary can
obtain a visa or be admitted.

5.b.

Change the beneficiary's status and extend their stay
since the beneficiary is in the CNMI in another status
(see the Instructions for limitations). This option is
available only where you select "New Employment"
in Item Number 2.a., above. Select the appropriate
box indicating the type of status change.
Change of Federal Nonimmigrant Status to
CW-1

5.d.
6.

Alien Registration Number (A-Number) (if any)
► A-

6.

Country of Birth

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Initial Grant of CW-1 Status in CNMI

5.c.

5.

Extend the stay of the beneficiary since they now
hold this status.

Amend the stay of the beneficiary since they now
hold this status.

Total number of workers in petition (See instructions
relating to when more than one worker can be included):

7.

Province of Birth

8.

Country of Citizenship or Nationality

If in the CNMI, complete the following:
9.

Date of Last Arrival (mm/dd/yyyy)

10.

Form I-94 Arrival-Departure Record Number
►

11.a. Current Nonimmigrant Status

►

Part 3. Information About the Beneficiaries For
Whom You Are Filing

Provide the requested information below. If you need
additional space to complete this section, use the space provided
in Part 9. Additional Information. If you need additional
space to name each beneficiary included in this petition use
Form I-129CW Classification Supplement.

Beneficiary's Full Name
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name

11.b. Date Status Expires (mm/dd/yyyy)
12.a. Passport Number

12.b. Country Where Passport Was Issued

12.c. Date Passport Issued (mm/dd/yyyy)

12.d. Date Passport Expires (mm/dd/yyyy)

Beneficiary's Current CNMI Address
13.a. Street Number
and Name
13.b.

Apt.

Other Names Used (if any)

13.c. City or Town

Provide all other names the beneficiary has ever used, including
aliases, maiden name, and nicknames. If you need extra space
to complete this section, use the space provided in Part 9.
Additional Information.

13.d. State

Ste.

Flr.

13.e. ZIP Code

2.a. Family Name
(Last Name)
2.b. Given Name
(First Name)
2.c. Middle Name
Form I-129CW 12/23/16 N

Page 2 of 11

6.

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

Are applications by dependents being filed with this
petition?
►

Yes. If yes, how many?
No
7.

Is any beneficiary in this petition in removal proceedings?
Yes. If yes, explain in Part 9. Additional
Information.
No

Consulate
Pre-flight Inspection

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8.

Port of Entry

1.b. Office Address (City)

Have you ever filed an immigrant petition for any
beneficiary in this petition?
Yes. If yes, explain in Part 9. Additional
Information.
No

1.c. U.S. State or Foreign Country

If you indicated you were filing a new petition in Part 2., has
any beneficiary in this petition:

Beneficiary's Foreign Address

9.

2.a. Street Number
and Name
2.b.

Apt.

Ste.

Yes. If yes, explain in Part 9. Additional
Information.
No

Flr.

2.c. City or Town
2.d. State
2.f.

Province

10.

2.e. ZIP Code

3.

4.

11.

No. If no, type or print a brief explanation in Part 9.
Additional Information.

Part 5. Basic Information About the Proposed
Employment and Employer

Not Required to Have Passport

NOTE: Attach Form I-129CW Classification Supplement for
each beneficiary you are petitioning for.

Are you filing any other petitions with this one?
Yes. If yes, how many?

►

No
5.

Have you ever previously filed a petition for this
beneficiary?
Yes. If yes, explain in Part 9. Additional
Information.
No

Does each beneficiary in this petition have a valid passport?
Yes

Ever been denied the classification you are now
requesting?
Yes. If yes, explain in Part 9. Additional
Information.
No

2.g. Postal Code
2.h. Country

Ever been given the classification you are now
requesting?

Are applications for replacement/initial Form I-94's being
filed with this petition?
Yes. If yes, how many?

1.

Job Title

2.

SOC Code (if known)

3.

Nontechnical Job Description

►

-

►

No

Form I-129CW 12/23/16 N

Page 3 of 11

Part 5. Basic Information About the Proposed
Employment and Employer (continued)
Address where the beneficiary will work if different from
address in Part 1.
4.a. Street Number
and Name
4.b.

Apt.

Ste.

Flr.

5.

NOTE: Read the Penalties section of the Form I-129CW
Instructions before completing this part. You, the petitioner,
must file Form I-129CW while in the United States.

Petitioner's or Authorized Signatory's Statement

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4.c. City or Town
4.d. State

Part 6. Statement, Contact Information,
Declaration, Certification, and Signature of the
Petitioner or Authorized Signatory

NOTE: Select the box for either Item Number 1.a. or 1.b.
If applicable, select the box for Item Number 2.

4.e. ZIP Code

Is this a full-time position?

1.a.

I can read and understand English, and I have read
and understand every question and instruction on this
petition and my answer to every question.

1.b.

The interpreter named in Part 7. has read to me every
question and instruction on this petition and my
answer to every question in

Yes - Wages per week or per year:
$

No - Hours per week:
6.

Other Compensation (Explain)

a language in which I am fluent. I understood all of
this information as interpreted.

2.

7.b. Date To (mm/dd/yyyy)
8.

Type of Petitioner (Select only one box):
Business

Organization

Other (Type or print a brief explanation in Part 9.
Additional Information.)
9.

Type of Business

10.

Year Established

11.

Current Number of Employees

12.

Gross Annual Income

13.

Net Annual Income

Form I-129CW 12/23/16 N

At my request, the preparer named in Part 8.,
,

prepared this petition for me based only upon
information I provided or authorized.

Dates of Intended Employment

7.a. Date From (mm/dd/yyyy)

,

Petitioner's or Authorized Signatory's Contact
Information

3.a. Authorized Signatory's Family Name (Last Name)
3.b. Authorized Signatory's Given Name (First Name)
4.

Authorized Signatory's Title

5.

Authorized Signatory's Daytime Telephone Number

6.

Authorized Signatory's Mobile Telephone Number (if any)

7.

Authorized Signatory's Email Address (if any)

Page 4 of 11

Part 6. Statement, Contact Information,
Declaration, Certification, and Signature of the
Petitioner or Authorized Signatory (continued)
Petitioner's or Authorized Signatory's Declaration
and Certification
Copies of any documents submitted are exact photocopies of
unaltered, original documents, and I understand that, as the
petitioner, I may be required to submit original documents to
USCIS at a later date.

Part 7. Interpreter's Contact Information,
Certification, and Signature
Provide the following information about the interpreter.

Interpreter's Full Name
1.a. Interpreter's Family Name (Last Name)

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I authorize the release of any information from my records, or
from the petitioning organization's records, to USCIS or other
entities and persons where necessary to determine eligibility for
the immigration benefit sought or where authorized by law. I
recognize the authority of USCIS to conduct audits of this
petition using publicly available open source information. I
also recognize that any supporting evidence submitted in
support of this petition may be verified by USCIS through any
means determined appropriate by USCIS, including but not
limited to, on-site compliance reviews.

If filing this petition on behalf of an organization, I certify that I
am authorized to do so by the organization.
I understand that USCIS may require me to appear for an
appointment to take my biometrics (fingerprints, photograph,
and/or signature) and, at that time, if I am required to provide
biometrics, I will be required to sign an oath reaffirming that:
1) I reviewed and understood all of the information
contained in, and submitted with, my petition; and

2) All of this information was complete, true, and correct
at the time of filing.
I certify, under penalty of perjury, that I have reviewed this
petition, I understand all of the information contained in, and
submitted with, my petition, and all of this information is
complete, true, and correct.

Petitioner's or Authorized Signatory's Signature
8.a. Petitioner's Signature

8.b. Date of Signature (mm/dd/yyyy)
NOTE TO ALL PETITIONERS AND AUTHORIZED
SIGNATORIES: If you do not completely fill out this petition
or fail to submit required documents listed in the Instructions,
USCIS may delay a decision on or deny your petition.

Form I-129CW 12/23/16 N

1.b. Interpreter's Given Name (First Name)
2.

Interpreter's Business or Organization Name (if any)

Interpreter's Mailing Address

3.a. Street Number
and Name
3.b.

Apt.

Ste.

Flr.

3.c. City or Town
3.d. State
3.f.

3.e. ZIP Code

Province

3.g. Postal Code
3.h. Country

Interpreter's Contact Information

4.

Interpreter's Daytime Telephone Number

5.

Interpreter's Mobile Telephone Number (if any)

6.

Interpreter's Email Address (if any)

Interpreter's Certification
I certify, under penalty of perjury, that:
I am fluent in English and

,

which is the same language specified in Part 6., Item Number
1.b., and I have read to this petitioner or the authorized
signatory in the identified language every question and
instruction on this petition and his or her answer to every
question. The petitioner or authorized signatory informed me
that he or she understands every instruction, question, and
answer on the petition, including the Petitioner's or
Authorized Signatory's Declaration and Certification, and
has verified the accuracy of every answer.
Page 5 of 11

Part 7. Interpreter's Contact Information,
Certification, and Signature (continued)

Preparer's Statement
7.a.

I am not an attorney or accredited representative but
have prepared this petition on behalf of the petitioner
and with the petitioner's consent.

7.b.

I am an attorney or accredited representative and my
representation of the petitioner in this case
extends
does not extend beyond the
preparation of this petition.

Interpreter's Signature
7.a. Interpreter's Signature

7.b. Date of Signature (mm/dd/yyyy)

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Part 8. Contact Information, Declaration, and
Signature of the Person Preparing This Petition,
if Other Than the Petitioner

NOTE: If you are an attorney or accredited
representative, you may need to submit a completed
Form G-28, Notice of Entry of Appearance as
Attorney or Accredited Representative, with this
petition.

Provide the following information about the preparer.

Preparer's Certification

Preparer's Full Name

By my signature, I certify, under penalty of perjury, that I
prepared this petition at the request of the petitioner or
authorized signatory. The petitioner has reviewed this
completed petition, including the Petitioner's or Authorized
Signatory's Declaration and Certification, and informed me
that all of this information in the form and in the supporting
documents is complete, true, and correct.

1.a. Preparer's Family Name (Last Name)
1.b. Preparer's Given Name (First Name)
2.

Preparer's Business or Organization Name (if any)

Preparer's Signature

8.a. Preparer's Signature

Preparer's Mailing Address
3.a. Street Number
and Name
3.b.

Apt.

Ste.

8.b. Date of Signature (mm/dd/yyyy)

Flr.

3.c. City or Town
3.d. State
3.f.

3.e. ZIP Code

Province

3.g. Postal Code
3.h. Country

Preparer's Contact Information
4.

Preparer's Daytime Telephone Number

5.

Preparer's Mobile Telephone Number (if any)

6.

Preparer's Email Address (if any)

Form I-129CW 12/23/16 N

Page 6 of 11

5.a. Page Number

Part 9. Additional Information
If you need extra space to provide any additional information
within this petition, use the space below. If you need more
space than what is provided, you may make copies of this page
to complete and file with this petition or attach a separate sheet
of paper. Type or print your name and A-Number (if any) at the
top of each sheet; indicate the Page Number, Part Number,
and Item Number to which your answer refers; and sign and
date each sheet.

5.b. Part Number

5.c. Item Number

5.d.

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1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)

1.c. Middle Name
2.

A-Number (if any) ► A-

3.a. Page Number
3.d.

4.a. Page Number

3.b. Part Number

3.c. Item Number

6.a. Page Number

6.b. Part Number

6.c. Item Number

7.b. Part Number

7.c. Item Number

6.d.

4.b. Part Number

4.d.

Form I-129CW 12/23/16 N

4.c. Item Number

7.a. Page Number
7.d.

Page 7 of 11

Part 11. Employer Attestation

Part 10. Accommodations for Individuals With
Disabilities and/or Impairments

Employer Attestation

NOTE: Read the information in the Form I-129CW
Instructions before completing this part.

There are no qualified U.S. workers available to fill the position
offered by the above named petitioning employer.

1.

Name of Employer or Organization Filing Petition:

The above named petitioning employer is doing business as
defined in the regulations at 8 CFR 214.2(w)(1)(ii).

2.

Name of Person for Whom You Are Filing:

The above named petitioning employer is a legitimate business
as defined in the regulations at 8 CFR 214.2(w)(1)(vi).

3.

Are you, the petitioning employer, requesting an
accommodation because of the beneficiary's disabilities
and/or impairments?

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.

Yes

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No

If you answered “Yes” to Item Number 3., select any
applicable in Item Numbers 4.a. - 4.c. and provide an answer.
4.a.

4.b.

4.c.

The beneficiary is deaf or hard of hearing and
requests the following accommodation. (If they are
requesting a sign-language interpreter, indicate for
which language (for example, American Sign
Language).)
The beneficiary is blind or has low vision and
requests the following accommodation:

The beneficiary has another type of disability and/or
impairment. (Describe the nature of their disability
and/or impairment and the accommodation you are
requesting.)

Form I-129CW 12/23/16 N

The beneficiary meets the qualifications for the position.
The beneficiary, if present in the CNMI, is lawfully present in
the CNMI.
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.
The position falls within the list of occupational categories
designated by the Secretary at 8 CFR 214.2(w)(1)(ix).
Select only one box:
1.a.

Professional, Technical, or Management Occupations

1.b.

Clerical and Sales Occupations

1.c.

Service Occupations

1.d.

Agricultural, Fisheries, Forestry, and Related
Occupations

1.e.

Processing Occupations

1.f.

Machine Trade Occupations

1.g.

Benchwork Occupations

1.h.

Structural Occupations

1.i.

Miscellaneous Occupations

Page 8 of 11

Part 11. Employer Attestation (continued)
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.

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2.

Petitioner's Printed Name

3.

Title

4.

Employer/Organization Name

Employer/Organization's Physical Address
5.a. Street Number
and Name
5.b.

Apt.

Ste.

Flr.

5.c. City or Town
5.d. State

5.e. ZIP Code

Employer/Organization's Contact Information
6.

Daytime Telephone Number

7.

Fax Number (if any)

8.

Email Address (if any)

Petitioner's Signature
9.a. Petitioner's Signature

9.b. Date of Signature (mm/dd/yyyy)

Form I-129CW 12/23/16 N

Page 9 of 11

Form I-129CW Classification Supplement
Department of Homeland Security
U.S. Citizenship and Immigration Services

Attach to Form I-129CW when more than one beneficiary is
included in the petition. (Provide each beneficiary separately.
Do not include the person you named on Form I-129CW.)

Part 1. Information About the Additional
Beneficiary (if applicable)

USCIS
Form I-129CW

OMB No. 1615-0111
Expires 04/30/2018

IF IN THE CNMI
9.

Date of Last Arrival (mm/dd/yyyy)

10.

Form I-94 Arrival-Departure Record Number

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►

11.a. Current Nonimmigrant Status

1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)

11.b. Date Status Expires (mm/dd/yyyy)

1.c. Middle Name

12.a. Passport Number

2.

Date of Birth (mm/dd/yyyy)

3.

U.S. Social Security Number (if any)

12.b. Country Where Passport Issued

►

4.

Alien Registration Number (A-Number) (if any)
► A-

12.c. Date Passport Issued (mm/dd/yyyy)

12.d. Date Passport Expires (mm/dd/yyyy)

Beneficiary's Current CNMI Address
5.a. Street Number
and Name
5.b.

Apt.

Ste.

Flr.

NOTE: Read the information in the Form I-129CW
Instructions before completing this part.

5.c. City or Town
5.d. State

5.e. ZIP Code

Beneficiary's Foreign Address
6.a. Street Number
and Name
6.b.

Apt.

Part 2. Accommodations for Individuals With
Disabilities and/or Impairments

Ste.

Flr.

1.

Name of Employer or Organization Filing Petition

2.

Name of Person For Whom You Are Filing

3.

Are you, the petitioning employer, requesting an
accommodation because of the beneficiary's disabilities
and/or impairments?
Yes
No

6.c. City or Town
6.d. State
6.f.

6.e. ZIP Code

Province

If you answered “Yes” to Item Number 3., select any applicable
box in Item Numbers 4.a. - 4.c. and provide an answer.
4.a.

The beneficiary is deaf or hard of hearing and requests
the following accommodation. (If they are requesting
a sign-language interpreter, indicate for which
language (for example, American Sign Language).)

4.b.

The beneficiary is blind or has low vision and
requests the following accommodation:

6.g. Postal Code
6.h. Country
7.

Country of Birth

8.

Country of Citizenship or Nationality

Form I-129CW 12/23/16 N

Page 10 of 11

Part 2. Accommodations for Individuals With
Disabilities and/or Impairments (continued)
4.c.

The beneficiary has another type of disability and/or
impairment. (Describe the nature of their disability
and/or impairment and the accommodation you are
requesting.)

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.

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Part 3. Employer Attestation
Employer Attestation

There are no qualified U.S. workers available to fill the position
offered by the above named petitioning employer.
The above named petitioning employer is doing business as
defined in the regulations at 8 CFR 214.2(w)(1)(ii).

The above named petitioning employer is a legitimate business
as defined in the regulations at 8 CFR 214.2(w)(1)(vi).

2.

Petitioner's Printed Name

3.

Title

4.

Employer/Organization Name

Employer/Organization's Physical Address

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.a. Street Number
and Name

The beneficiary meets the qualifications for the position.

5.c. City or Town

The beneficiary, if present in the CNMI, is lawfully present in
the CNMI.

5.d. State

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.
The position falls within the list of occupational categories
designated by the Secretary at 8 CFR 214.2(w)(1)(ix).

5.b.

Apt.

Ste.

Flr.

5.e. ZIP Code

Employer/Organization's Contact Information

6.

Daytime Telephone Number

7.

Fax Number (if any)

8.

Email Address (if any)

Select only one box:
1.a.

Professional, Technical, or Management Occupations

1.b.

Clerical and Sales Occupations

1.c.

Service Occupations

1.d.

Agricultural, Fisheries, Forestry, and Related
Occupations

1.e.

Processing Occupations

1.f.

Machine Trade Occupations

1.g.

Benchwork Occupations

1.h.

Structural Occupations

1.i.

Miscellaneous Occupations

Form I-129CW 12/23/16 N

Petitioner's Signature
9.a. Petitioner's Signature

9.b. Date of Signature (mm/dd/yyyy)

Page 11 of 11