Form I-129CWR Semiannual Report for CW-1 Workers

Semiannual Report for CW-1 Employers

USCIS
Form I-129CWR

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

OMB No. 1615-0111
Expires xx/xx/20xx

► START HERE - Type or print in black ink.

Part 1. Information about the Employer

Employer's Contact Information

If you are an individual employer or sole proprietor filing this
form, you must complete Item Numbers 1.a. - 2. If you are a
company or an organization filing this petition, complete Item
Number 3. All petitioners should fill out Item Numbers 5. 14.

6.

Daytime Telephone Number

7.

Mobile Telephone Number (if any)

Legal Name of Individual Employer or Sole
Proprietor

8.

Email Address (if any)

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

Provide the following information as applicable:

1.c. Middle Name

9.

Employer Identification Number (EIN)

10.

Individual Taxpayer Identification Number(ITIN)

11.

U.S. Social Security Number (if any)

2.

Taxpayer Identification Numbers

Date of Birth (mm/dd/yyyy)

Employing Company or Organization Name
3.

Name of Employer/Organization

►

12.

Employer Address

USCIS Online Account Number (if any)
►

(USPS ZIP Code Lookup)

4.a. In Care Of Name (if any)

E-Verify Information

4.b. Street Number
and Name
4.c.

Apt.

Ste.

Flr.

13.

Employer's Name as Listed in E-Verify

14.

Employer's E-Verify Company Identification Number or a
Valid E-Verify Client Company Identification Number

4.d. City or Town
4.e. State

4.f.

ZIP Code

4.g. If your place of business does not have a physical address,
provide a description of your location, (for example: “3
miles southwest of Anytown Post Office, near the water
tower”) and provide a map with your petition. If you
need more space to provide your explanation, use the
space provided in Part 10. Additional information.

Part 2. Reporting Information
Reporting Period
1.a. Date From (mm/dd/yyyy)
1.b. Date To (mm/dd/yyyy)
2.

Receipt Number of Approved Form I-129CW Petition
►

3.
5.

Trade Name or "Doing Business As" Name (if applicable)

Form I-129CWR xx/xx/19

Employment and Training Administration (ETA) Case
Number For Temporary Labor Certification (TLC)

Page 1 of 7

7.b. What is the actual wage, per week or per year, currently
paid to this worker?

Part 2. Reporting Information (continued)
4.

Total Number of Workers Approved on the Petition

Wages: $

►
5.

Total Number of Workers on the Approved Petition Who
Are Currently Working For the Employer Named in
Part 1.
►

per

NOTE: The wage frequency reported on this form must
match the frequency reported on the approved petition.
8.a. What are the hours, per week, offered on the approved
Form I-129CW petition?
►

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8.b. What are the actual hours this worker worked per week?

Part 3. Worker Information

Provide the information requested in Item Numbers 1.a. - 4. as
reported on the approved Form I-129CW petition. If the
approved petition included more than one worker, use the
Additional Worker Attachment for Form I-129CWR to
provide the information for each additional worker.

►

9.

What is the current job title of the worker's position?

10.

What are the worker's current job duties? (Provide a
detailed explanation.)

Worker's Information
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)

11.a. Is the worker working at the location in Part 1. Item
Number 3.?
Yes
No

1.c. Middle Name
2.

Date of Birth (mm/dd/yyyy)

3.

U.S. Social Security Number (if any)

11.b. If you answered “No” to Item Number 11.a., provide the
address where the worker will work. If the location has
no address, describe the location where the worker will
work and provide a map with your Form I-129CWR.

►

4.

12.a. Street Number
and Name

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

5.

12.b.

Is the approved worker currently in CW-1 status?
Yes

6.a. Is the approved worker currently working for the
employer named in Part 1.?
Yes

Apt.

Ste.

Flr.

12.c. City or Town

No

12.d. State

12.e. ZIP Code

No

6.b. If you answered “No,” to Item Number 6.a., provide an
explanation about why the worker is not currently
working for the employer named in Part 1.

Part 4. Attestation for Employers of the CNMIOnly Transitional Worker (CW-1) Nonimmigrant
Workers(s)
By virtue of my signature below, I hereby certify that the
following is true and correct:
1.

I am the employer identified in Part 1. of this form with
the approved petition identified in Part 2. to employ a
CW-1 nonimmigrant worker(s) in the Commonwealth of
the Northern Mariana Islands (CNMI);

2.

I attest that I continue to employ the CW-1 worker(s)
under the terms and conditions set forth in the approved
Form I-129CW petition and as declared on this form;

7.a. What was the wage offered, per week or year, on the
approved Form I-129CW petition?
Wages: $

per

NOTE: The wage frequency reported on this form must
match the frequency reported on the approved petition.

Form I-129CWR xx/xx/19

Page 2 of 7

Part 4. Attestation for Employers of the CNMIOnly Transitional Worker (CW-1) Nonimmigrant
Workers(s) (continued)
3.

I attest that I continue to pay the CW-1 worker(s) under
the terms and conditions set forth in the approved Form
I-129CW petition and as declared on this form;

4.

I understand that failure to comply with the semiannual
reporting requirement may be a basis for revocation of the
approved petition or for denial of subsequently filed
petitions;

5.

6.

7.

8.

The interpreter named in Part 6. has read to me every
question and instruction on this petition and my
answer to every question in
,
a language in which I am fluent. I understood all of
this information as interpreted.

2.

At my request, the preparer named in Part 7.,

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I understand that at the time of filing, I am not required to
submit evidence or supporting documentation. However,
DHS or the Department of Labor (DOL) may request
documents that I am required to retain at any point during
the document retention period to ensure compliance with
the terms and conditions of the petition;
I understand that USCIS may revoke or deny my petition
under 8 CFR 214.2(w)(27) if I fail to submit requested
evidence at any point during the document retention
period;
I attest that I will retain evidence and records which
support each statement in this certification for the
required document retention period; and

I attest that I have complied with and am continuing to
comply with all assurances, obligations, and conditions of
employment set forth in the approved Form I-129CW
petition.

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 or retained are true and correct to the best of
my knowledge. If filing on behalf of an employer, I certify that
I am empowered to do so by the employer. I authorize the
release of any information from my records, or from the
employer's records that U.S. Citizenship and Immigration
Services needs to determine eligibility for the benefit sought.

Part 5. Statement, Contact Information,
Certification, and Signature of the Employer or
Authorized Signatory
Employer'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.

1.b.

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.

Form I-129CWR xx/xx/19

,

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

Employer'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)

Employer's or Authorized Signatory's Certification

I authorize the release of any information contained in this form,
in supporting documents, in my USCIS records, and in the
petitioning organization's records, to DHS or DOL or other
entities and persons where necessary to verify the continued
employment and payment of the CW-1 worker(s) under the
terms and conditions of the approved petition or where
authorized by law. I recognize the authority of DHS or DOL to
conduct audits of this form using publicly available open source
information. I also recognize that any supporting evidence
submitted in support of this form may be verified by DHS or
DOL through any means determined appropriate by USCIS,
including but not limited to, on-site compliance reviews.
If filing this form 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
form, I understand all of the information contained in, and
submitted with, my form, and all of this information is
complete, true, and correct.

Page 3 of 7

Interpreter's Contact Information

Part 5. Statement, Contact Information,
Certification, and Signature of the Employer or
Authorized Signatory (continued)

4.

Interpreter's Daytime Telephone Number

Employer's or Authorized Signatory's Signature

5.

Interpreter's Mobile Telephone Number (if any)

6.

Interpreter's Email Address (if any)

8.a. Petitioner's Signature

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

Interpreter's Certification

Part 6. 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.

Interpreter's Business or Organization Name (if any)

I certify, under penalty of perjury, that:

I am fluent in English and
,
which is the same language specified in Part 5., Item Number
1.a., and I have read to this employer or the authorized
signatory in the identified language every question and
instruction on this form and his or her answer to every question.
The employer or authorized signatory informed me that he or
she understands every instruction, question, and answer on the
petition, including the Employer's or Authorized Signatory's
Certification, and has verified the accuracy of every answer.

Interpreter's Signature

7.a. Interpreter's Signature

Interpreter's Mailing Address

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

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

Part 7. Contact Information, Declaration, and
Signature of the Person Preparing This
Certification, if Other Than the Petitioner or
Authorized Signatory

Provide the following information about the preparer.

Province

Preparer's Full Name
3.g. Postal Code

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

3.h. Country
1.b. Preparer's Given Name (First Name)
3.i.

If you are located in the CNMI and your place of business
does not have a physical address, provide a description of
your location (for example: “3 miles southwest of
Anytown Post Office, near the water tower”) and provide
a map with your petition.

Form I-129CWR xx/xx/19

2.

Preparer's Business or Organization Name (if any)

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Part 7. Contact Information, Declaration, and
Signature of the Person Preparing This
Certification, if Other Than the Petitioner or
Authorized Signatory (continued)
Preparer's Mailing Address
3.a. Street Number
and Name
3.b.

Apt.

3.f.

Province

Flr.

3.e. ZIP Code

3.g. Postal Code
3.h. Country

3.i.

7.a.

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

7.b.

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

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Ste.

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

Preparer's Statement

If you are located in the CNMI and your place of business
does not have a physical address, provide a description of
your location (for example: “3 miles southwest of
Anytown Post Office, near the water tower”) and provide
a map with your petition.

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
form.

Preparer's Certification

By my signature, I certify, under penalty of perjury, that I
prepared this form at the request of the employer or authorized
signatory. The employer has reviewed this completed petition,
including the Employer's or Authorized Signatory's
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)

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-129CWR xx/xx/19

Page 5 of 7

5.a. Page Number

Part 8. 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-129CWR xx/xx/19

4.c. Item Number

7.a. Page Number

7.d.

Page 6 of 7

Additional Worker Attachment for Form I-129CWR

USCIS
Form I-129CWR

Department of Homeland Security
U.S. Citizenship and Immigration Services
Complete a separate attachment for each additional worker who
was approved on Form I-129CW. Provide the information
requested in Item Numbers 3.a. - 6. as reported on the approved
Form I-129CW petition. (Do not complete a copy of this
Attachment for the worker you already named in Part 3.)

OMB No. 1615-0111
Expires xx/xx/20xx

9.a. What was the wage offered, per week or year, on the
approved Form I-129CW petition?
Wages: $

per

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In Item Numbers 1.a. - 2., provide the same information as
listed in Part 1. of Form I-129CWR.

NOTE: The wage frequency reported on this form must
match the frequency reported on the approved petition.

9.b. What is the actual wage, per week or per currently paid to
this worker?

Legal Name of Individual Employer or Sole
Proprietor

Wages: $

per

10.a. What are the hours, per week, offered on the approved
Form I-129CW petition?
►

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

10.b. What are the actual hours this worker worked per week?
►

1.c. Middle Name

11.

What is the current job title of the worker's position?

12.

What are the worker's current job duties? (Provide a
detailed explanation.)

Employing Company or Organization Name
2.

Name of Employer/Organization

Worker's Information
3.a. Family Name
(Last Name)
3.b. Given Name
(First Name)

13.a. Is the worker working at the location in Part 1. Item
Number 3. of Form I-129CWR?
Yes
No
13.b. If you answered “No” to Item Number 13.a., provide the
address where the worker will work. If the location has
no address, describe the location where the worker will
work and provide a map with your Form I-129CWR.

3.c. Middle Name
4.

Date of Birth (mm/dd/yyyy)

5.

U.S. Social Security Number (if any)

14.a. Street Number
and Name

►
6.

14.b.

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

7.

Apt.

Ste.

Flr.

14.c. City or Town

Is the approved worker currently in CW-1 status?
Yes

No

8.a. Is the approved worker currently working for the
employer name Item Number 2.?
Yes

No

14.d. State

14.e. ZIP Code

8.b. If you answered “No,” to Item Number 8.a., provide an
explanation about why the worker is not currently
working for the employer named in Item Number 2.

Form I-129CWR xx/xx/19

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