Form I-140 Immigrant Petition for Alien Workers

Immigrant Petition for Alien Workers

I140-FRM-EXT+SL-OMBReview-03272018

Immigrant Petition for Alien Workers

OMB: 1615-0015

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USCIS
Form I-140

Immigrant Petition for Alien Workers
Department of Homeland Security
U.S. Citizenship and Immigration Services

OMB No. 1615-0015
Expires 04/30/2018

Priority Date Consulate

Fee Stamp

Action Block

For
USCIS
Use
Only
Classification

Certification

203(b)(1)(A) Alien of
Extraordinary Ability

203(b)(2) Member of Professions with
Advanced Degree/Exceptional Ability

National Interest Waiver (NIW)

203(b)(1)(B) Outstanding
Professor or Researcher

203(b)(3)(A)(i) Skilled Worker

Schedule A, Group I

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203(b)(1)(C) Multinational
Executive or Manager

Schedule A, Group II

203(b)(3)(A)(ii) Professional

203(b)(3)(A)(iii) Other Worker

To be completed
by an Attorney
or Accredited
Representative (if any).

Select this box if
Form G-28 or
Form G-28I is
attached.

Remarks

Attorney State Bar Number
(if applicable)

Attorney or Accredited Representative
USCIS Online Account Number (if any)

► START HERE - Type or print in black ink.

Part 1. Information About the Person or
Organization Filing This Petition

If an individual is filing this petition, answer Item Numbers
1.a. - 1.c. If a company or organization is filing this petition,
answer Item Number 2.

Other Information

4.

IRS Employer Identification Number (EIN)
►

5.

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

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

6.

USCIS Online Account Number (if any)
►

1.c. Middle Name
2.

Part 2. Petition Type

Company or Organization Name

This petition is being filed for (select only one box):

Mailing Address

1.a.

An alien of extraordinary ability.

1.b.

An outstanding professor or researcher.

1.c.

A multinational executive or manager.

1.d.

A member of the professions holding an advanced
degree or an alien of exceptional ability (who is
NOT seeking a National Interest Waiver (NIW)).

1.e.

A professional (at a minimum, possessing a
bachelor's degree or a foreign degree equivalent
to a U.S. bachelor's degree).

1.f.

A skilled worker (requiring at least two years of
specialized training or experience).

1.g.

Any other worker (requiring less than two years of
training or experience).

1.h.

An alien applying for an NIW (who IS a member of
the professions holding an advanced degree or an
alien of exceptional ability).

(USPS ZIP Code Lookup)

3.a. In Care Of Name

3.b. Street Number
and Name
3.c.

Apt.

Ste.

Flr.

3.d. City or Town
3.e. State

3.f.

3.g. Province
3.h. Postal Code
3.i.

Country

Form I-140 01/17/17 N

ZIP Code

Page 1 of 9

Part 2. Petition Type (continued)

6.

Country of Birth

7.

Country of Citizenship or Nationality

8.

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

9.

U.S. SSN (if any)

This petition is being filed (select only one box):
2.a.

To amend a previously filed petition.
Previous Petition Receipt Number
►

2.b.

For the Schedule A, Group I or II designation.

Part 3. Information About the Person for Whom
You Are Filing

►

Information About His or Her Last Arrival in the
United States

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

If the person for whom you are filing is in the United States,
provide the following information.

1.c. Middle Name

10.

Date of Last Arrival (mm/dd/yyyy)

11.a. Form I-94 Arrival-Departure Record Number

Mailing Address

►

2.a. In Care Of Name

11.b. Expiration Date of Authorized Stay Shown on Form I-94
(mm/dd/yyyy)

2.b. Street Number
and Name
2.c.

Apt.

11.c. Status on Form I-94 (for example, class of admission, or
paroled, if paroled)

Ste.

Flr.

2.d. City or Town
2.e. State

2.f.

Passport Number

13.

Travel Document Number

14.

Country of Issuance for Passport or Travel Document

15.

Expiration Date for Passport or Travel Document
(mm/dd/yyyy)

ZIP Code

2.g. Province

2.h. Postal Code
2.i.

12.

Country

Other Information
3.

Date of Birth (mm/dd/yyyy)

4.

City/Town/Village of Birth

5.

State or Province of Birth

Part 4. Processing Information
Provide the following information for the person named in
Part 3. (select only one box):
1.a.

Alien will apply for a visa abroad at a U.S. Embassy
or U.S. Consulate at:

1.b. City or Town

1.c. Country

2.a.

Form I-140 01/17/17 N

Alien is in the United States and will apply for
adjustment of status to that of lawful permanent
resident.
Page 2 of 9

Part 4. Processing Information (continued)

6.b. If you answered “Yes” to Item Number 6.a., select all
applicable boxes:

2.b. Alien's current country of residence or, if now in the
United States, last country of permanent residence abroad.

Form I-485
Form I-131
Form I-765

If you provided a United States address in Part 3., provide the
person's foreign address in Item Numbers 3.a. - 3.f.:
3.a. Street Number
and Name
3.b.

Apt.

Ste.

Other (Provide an explanation in Part 11. Additional
Information.)
7.

Flr.

No

8.

Has any immigrant visa petition ever been filed by or on
behalf of this person?
Yes
No

9.

Are you filing this petition without an original labor
certification because the original labor certification was
previously submitted in support of another Form I-140?
Yes
No

10.

If you are filing this petition without an original labor
certification, are you requesting that U.S. Citizenship and
Immigration Services (USCIS) request a duplicate labor
certification from the Department of Labor (DOL)?
Yes
No

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3.c. City or Town
3.d. Province

3.e. Postal Code
3.f.

Is the person for whom you are filing in removal
proceedings?
Yes

Country

If the person's native alphabet is other than Roman letters, type
or print the person's foreign name and address in the native
alphabet in Item Numbers 4.a. - 4.c.:
4.a. Family Name
(Last Name)
4.b. Given Name
(First Name)

Type of petitioner (select only one box):

4.c. Middle Name

1.a.

Employer

1.b.

Self

1.c.

Other (For example, Lawful Permanent Resident,
U.S. citizen or any other person filing on behalf of
the alien)

Part 5. Additional Information About the
Petitioner

Mailing Address

5.a. In Care Of Name

5.b. Street Number
and Name
5.c.

Apt.

Ste.

Flr.

If a company or an organization is filing this petition, provide
the following information:
2.

Type of Business

3.

Date Established (mm/dd/yyyy)

4.

Current Number of U.S. Employees

5.

Gross Annual Income

$

6.

Net Annual Income

$

7.

NAICS Code

8.

Labor Certification DOL Case Number

5.d. City or Town
5.e. Province
5.f.

Postal Code

5.g. Country

If you answer "Yes" to Item Numbers 6.a. - 10., provide the
case number, office location, date of decision, and disposition
of the decision in the space provided in Part 11. Additional
Information.

►

6.a. Are you filing any other petitions or applications with this
Form I-140?
Yes
No

Form I-140 01/17/17 N

Page 3 of 9

Part 5. Additional Information About the
Petitioner (continued)

Part 7. Information About the Spouse and All
Children of the Person for Whom You Are Filing

9.

Labor Certification DOL Filing Date (mm/dd/yyyy)

10.

Labor Certification Expiration Date (mm/dd/yyyy)

For Part 7., provide information on the spouse and all children
related to the individual for whom you are filing this petition.
Also, note if the individual will apply for a visa abroad or
adjustment of status as the dependent of the individual for
whom the petition is filed. If you need extra space to provide
information about additional family members, use the space
provided in Part 11. Additional Information.

If an individual is filing this petition, provide the following
information.
11.

12.

Person 1

Occupation

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

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Annual Income

$

1.c. Middle Name

Part 6. Basic Information About the Proposed
Employment

2.

Date of Birth (mm/dd/yyyy)

1.

3.

Country of Birth

4.

Relationship

5.

Is he or she applying for adjustment of status?
Yes

2.
3.

Job Title

►

SOC Code

-

Nontechnical Job Description

6.

No

Is he or she applying for a visa abroad?

Yes

No

No

Person 2

4.
5.

Is this a full-time position?

Yes

No

If the answer to Item Number 4. is "No," how many
hours per week for the position?

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

7.c. Middle Name

6.

Is this a permanent position?

Yes

No

8.

Date of Birth (mm/dd/yyyy)

7.

Is this a new position?

Yes

No

9.

Country of Birth

8.

Wages (Specify hour, week, month, or year):
10.

Relationship

11.

Is he or she applying for adjustment of status?
Yes

$

per

Worksite Location
For Item Numbers 9.a. - 9.e., provide the address where the
person will work if different from the address provided in Part 1.

Apt.

Is he or she applying for a visa abroad?
Yes

9.a. Street Number
and Name
9.b.

12.

Ste.

No

Flr.

9.c. City or Town
9.d. State

9.e. ZIP Code

Form I-140 01/17/17 N

Page 4 of 9

Part 7. Information About Spouse and All
Children of the Person for Whom You Are Filing
(continued)
Person 3

Person 5
25.a. Family Name
(Last Name)
25.b. Given Name
(First Name)
25.c. Middle Name

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

26.

Date of Birth (mm/dd/yyyy)

27.

Country of Birth

13.c. Middle Name
14.
15.

16.
17.
18.

Date of Birth (mm/dd/yyyy)

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Country of Birth

28.

Relationship

29.

Is he or she applying for adjustment of status?
Yes

30.

Relationship

Is he or she applying for adjustment of status?
Yes
Yes

Is he or she applying for a visa abroad?

No

Person 6

No

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

Is he or she applying for a visa abroad?

Person 4

No

Yes

No

No

31.c. Middle Name

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

32.

Date of Birth (mm/dd/yyyy)

33.

Country of Birth

34.

Relationship

35.

Is he or she applying for adjustment of status?
Yes

19.c. Middle Name
20.
21.

22.

Date of Birth (mm/dd/yyyy)

Country of Birth

36.

Relationship

Is he or she applying for a visa abroad?

Yes

23.
24.

Is he or she applying for adjustment of status?
Yes

No

No

Is he or she applying for a visa abroad?
Yes

Form I-140 01/17/17 N

No

Page 5 of 9

Part 8. Statement, Contact Information,
Declaration, Certification, and Signature of the
Petitioner or Authorized Signatory and Signature
NOTE: Read the Penalties section of the Form I-140
Instructions before completing this part.

Petitioner's or Authorized Signatory's Statement
NOTE: Select the box for either Item Number 1.a. or 1.b. If
applicable, select the box for Item Number 2.
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.

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.
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.

5.

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6.

Authorized Signatory's Mobile Telephone Number (if any)

7.

Authorized Signatory's Email Address (if any)

1.b.

The interpreter named in Part 9. has read to me every
question and instruction on this petition and my answer
to every question in
,

If filing this petition on behalf of an organization, I certify that I
am authorized to do so by the organization.

,

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.

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

2.

At my request, the preparer named in Part 10.,
prepared this petition for me based only upon
information I provided or authorized.

Authorized Signatory's Contact Information

Petitioner's or Authorized Signatory's Signature

8.a. Petitioner's Signature

3.a. Authorized Signatory's Family Name (Last Name)

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

3.b. Authorized Signatory's Given Name (First Name)

4.

Authorized Signatory's Title

Authorized Signatory's Daytime Telephone Number

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.

Part 9. 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)

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

2.

Form I-140 01/17/17 N

Interpreter's Business or Organization Name (if any)

Page 6 of 9

Part 9. Interpreter's Contact Information,
Certification, and Signature (continued)

Part 10. Contact Information, Declaration, and
Signature of the Person Preparing this Petition,
if Other Than the Authorized Individual

Interpreter's Mailing Address

Provide the following information about the preparer.

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

Apt.

Preparer's Full Name

Ste.

Flr.

1.a. Preparer's Family Name (Last Name)

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

1.b. Preparer's Given Name (First Name)

3.e. ZIP Code

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Province

2.

Preparer's Business or Organization (if any)

3.g. Postal Code
3.h. Country

Preparer's Mailing Address

3.a. Street Number
and Name

Interpreter's Contact Information
4.

3.b.

Interpreter's Daytime Telephone Number

Apt.

Ste.

Flr.

3.c. City or Town

5.

6.

Interpreter's Mobile Telephone Number

3.d. State
3.f.

Interpreter's Email Address (if any)

3.e. ZIP Code

Province

3.g. Postal Code
3.h. Country

Interpreter's Certification

I certify, under penalty of perjury, that:
I am fluent in English and

,

which is the same language specified in Part 8., 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.

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)

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

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

Form I-140 01/17/17 N

Page 7 of 9

Part 10. Contact Information, Declaration, and
Signature of the Person Preparing this Petition,
if Other Than the Authorized Individual
(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 application.

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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, or Form
G-28I, Notice of Entry of Appearance as Attorney In Matters
Outside the Geographical Confines of the United States, with
this petition.

Preparer's Certification

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.

Preparer's Signature
8.a. Preparer's Signature

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

Form I-140 01/17/17 N

Page 8 of 9

5.a. Page Number

Part 11. 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.

1.a

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

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1.c. Middle Name
2.

3.a. Page Number

3.d.

►

IRS EIN

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-140 01/17/17 N

4.c. Item Number

7.a. Page Number

7.d.

Page 9 of 9


File Typeapplication/pdf
File TitlePetition for Alien Workers
AuthorUSCIS
File Modified2018-03-27
File Created2018-03-26

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