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H1 Hiring Dept (University of Saint Thomas)

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H-1B Request Form
(Completed by Hiring Department)
Office of International Students & Scholars
oiss@stthomas.edu, Tel: 651-962-6650, Fax: 651-962-6655
1 of 2
Type of Petition (select one):
□ Initial Employment (first time working at St. Thomas in H-1B status)
□ Extension- Continuation of previously approved H-1B employment without substantial changes
□ Amendment- Substantial change in previously approved H-1B employment
□ Concurrent Employment- Will continue at another place of employment and will work simultaneously at St.
Thomas
Employee (Beneficiary Information):
Name (Last, First, Middle Initial):
Email address:
Is employee currently in the U.S.? YES □ or NO □
Hiring Department/ Supervisor Information:
Hiring Department: Contact Information:
Name of Supervisor: Supervisor Title:
Supervisor Phone #: Supervisor Email Address:
Departmental Index number*:
Position Information:
Requested Employment Dates (not to exceed three
years): _____________ to _____________
Wages/Year:
Position Description (non-technical):
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H-1B Conditions Acceptance
The Department understands that (please initial):
____ The employment of the H-1B nonimmigrant will not adversely affect the working conditions of employees
similarly employed in the area.
____ The salary being paid to the above-named employee is at least the actual wage being paid to all other individuals
with similar experience and qualifications for the specific employment in question or the prevailing wage level for the
occupation, whichever is higher.
____ A notice of filing will be sent to you and will be posted for 10 working days in at least two conspicuous locations
where the H-1B nonimmigrant will be employed. One location will be in Human Resources, Aquinas.
____ The vacation time, sick leave and other benefits offered to this employee are equivalent to that offered to other
U.S. workers in the same classification.
____ Any change in employment or material change in working conditions must be reported to OISS immediately. This
includes changes in responsibilities, such as reassignment of duties, changes in salary or if the employee is assigned to a
position at a new location.
____ The H-1 may not receive payment from any source other than St. Thomas payroll unless under
concurrent H from other employer.
____ If the department terminates this employment before the expiration of the H-1B status, the department is
required to report this immediately to OISS and is responsible for the reasonable transportation costs of returning the
employee to their home country.
____ *I allow OISS to charge our departmental index number for the required H-1B fees for the petition including filing
and shipping fees.
Signature
As Department Head, I understand the conditions as stated above and will comply with all requirements.
Signature: __________________________________________________Date: ____________________________
Signature of VP or President’s Cabinet member: __________________________________________________
I-129 Export Compliance
Questionnaire and Cert.
Office of International Students & Scholars
oiss@stthomas.edu, Tel: 651-962-6650, Fax: 651-962-6655
1 of 2
When completing a visa application for a foreign national (the “visa beneficiary”) who will perform services for St.
Thomas, the University is required to determine whether an export control license is required for the visa beneficiary
under U.S. export control regulations. This questionnaire and certification is designed to assist the University in making
this determination.
Before the visa application will be filed, this certification must be completed and signed by the visa beneficiary’s sponsor
within the University (typically the department chair), reviewed and signed by the responsible dean, and returned to OISS.
Sponsors are expected to take the steps necessary to accurately complete this Questionnaire and Certification. If you have
questions about U.S. export control regulations, please contact the Office of General Counsel.
Beneficiary Information:
Name (Surname, First, Middle):
Country of Citizenship: Country of Legal Permanent Residence:
Any additional Countries of Citizenship or Legal Permanent Residence:
University of St. Thomas Job Title:
College/School: Hiring Department:
Export-Controlled Technology, Services and Information
Please check the appropriate boxes below:
Will the visa beneficiary participate or be likely to participate in research at the University that involves hardware,
software or technical data contained in the U.S. Munitions List (available at
https://www.pmddtc.state.gov/regulations_laws/documents/official_itar/ITAR_Part_121.pdf)?
□ No □ Yes
Will the visa beneficiary participate in or be likely to participate in research at the University that involves
commodities, software or technologies contained in the Commerce Control List (available at
http://www.bis.doc.gov/index.php/regulations/commerce-control-list-ccl), other than computers or software?
□ No □ Yes
Will the visa beneficiary have access to or be likely to have access to high-speed computing equipment or work on
encryption source code while at the University of St. Thomas? (High speed computing equipment includes, for
example, a computer with an Applied Peak Performance equal to or greater than 0.75 Weighted Terraflops.)
□ No □ Yes
2 of 2
Does any other person in the visa beneficiary’s department at the University of St. Thomas currently or regularly
have access to or engage in research or services involving export-controlled technology or information, including
but not limited to information or data used to provide defense services such as training and technical assistance?
□ No □ Yes
Export Controls Restrictions
As a foreign national, the visa beneficiary may be restricted under U.S. export controls regulations from participating in
research, providing services or receiving information of the type described in the section above. Even if you answered
“No” to each of the questions above, it is important to be aware of these restrictions and to carefully consider whether
export controls are implicated when the visa beneficiary participates in research and scholarly activities.
Certification
By signing below, I affirm that I am familiar with the job duties and other particulars of employment of the visa beneficiary
identified above, and that to the best of my knowledge, information and belief, the information contained in this
Questionnaire and Certification is accurate.
Hiring Department
Signature
Printed Name and Title
Date
Prevailing Wage Worksheet
Office of International Students & Scholars
oiss@stthomas.edu, Tel: 651-962-6650, Fax: 651-962-6655
1 of 2
This form should be completed based on information for the position, not the individual. This information is required for
OISS to obtain the prevailing wage from the U.S. Department of Labor.
Position Information
Position Title:
Full-Time
□
OR Part-Time*
□
If PT, # of hours of work/week:
*Complete PT certification sheet.
Is position eligible for overtime? Yes □ OR No □
Hourly work schedule: _________ to _________
This position is a □ 12-month appointment / □ 9-month appointment.
Title of worker’s immediate supervisor:
Description of the duties to be performed (may use technical terms):
Minimum degree required: Bachelors □ Masters □ Doctorate/PhD □ Other □ (specify JD, MD, etc.)
Major fields of study required:
Is a second U.S. diploma/degree required? Yes □ OR No □
Is employment experience required? Yes □ OR No □ If yes, specify the # of months/years required:
Is training or professional license for the job required (this not does include on-the-job training, but a special training
program)?: Yes □ OR No □ If yes, please specify:
Does the position include supervisory (non-student) duties? Yes
□
OR No□
If yes, indicate the # and level of employees being supervised:
2 of 2
Will travel be required in order to perform the job duties? Yes
□
OR No
□
If yes, provide details of travel (location, frequency and nature):
Address Where Person Will Work:
Street: City:
State: County: Zip Code:
Will work be performed at multiple worksites? Yes
□ OR No □
If yes, please attach to this form a list of complete addresses of all anticipated worksites. You do not need to list
additional on- campus worksites, only those that are off- campus.
Statement of Actual Wage
Office of International Students & Scholars
oiss@stthomas.edu, Tel: 651-962-6650, Fax: 651-962-6655
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H-1B Employee’s Name (Last, First, Middle):
Position Title: Salary:
Department:
In
order to process this H-1B application, we must determine the actual wage being paid to all other individuals with
similar experience and qualifications at the place of employment. Please provide the necessary information for all
employees in your department who are similar to the H-1B in the terms specified below:
□ No one in this unit is similar to the prospective H-1 in terms of education, experience and job responsibilities.
□ Individuals in the positions listed below are similar to the prospective H-1B nonimmigrant in terms of all of the
following- Same degree, same or related major field, same amount of post-graduation work experience, similar
duties and responsibility, even if job title is different. Include U.S. workers and nonimmigrants in the assessment,
but not the individual to whom the H-1B application pertains.
Position Title (no names):
Salary:
Statement of Working Conditions
I certify that employing this H-1B nonimmigrant will not adversely affect the working conditions of workers similarly
employed in the area of intended employment in regards to such matters as hours, vacation periods and fringe benefits.
In the event that a complaint is filed, I will be able to show that the working conditions are similar to working conditions
which preceded the employment of the H-1B nonimmigrant.
Signature of Department Head or Director: ___________________________________ Date:_________________
Pri
nt Name and Title: __________________________________________________________________________
H-1B Part-Time Certification
Office of International Students & Scholars
oiss@stthomas.edu, Tel: 651-962-6650, Fax: 651-962-6655
1 of 1
Only complete this form if position is part-time
An H-1B worker may be employed part-time provided the Labor Condition Application (LCA) and H-1B petition state that
the H-1B worker will work only part-time. For part-time positions, an employer must always express the prevailing wage
as an hourly wage, even if the worker is paid a salary.
An employer may not sponsor an H-1B worker for full-time employment and then only pay him or her for part-time
employment.
A change from full-time to part-time is considered a material change that requires the employer to file an
amended petition.
• DOL regulations required employers to keep records of “hours worked each day and each week” for all part-time
H-1B employees regardless of whether or not the part-time employee is paid a fixed salary.
• Employer is required to keep such hourly records for its H-1B part-time salaried employees, even if it does not for
other part-time workers.
This requirement places an additional burden on employers who hire part-time salaried employees for whose hours are
not necessarily tracked. Departments who do not already keep records of hours worked for such employees face the
choice of implementing a system to track hours worked by their part-time salaried H-1Bs or deciding not to do H-1B
petitions for part-timers and adjuncts.
When hiring an H-1B for less than full-time the department agrees to keep track of all hours worked for this part-time
employee and to have this written information available to give to the Department of Labor in case of an audit.
Name of Part-time Employee: ______________________________________________
Department Chair Signature: _______________________________________________
Date: _____________________________________
H-1B Hiring Department Checklist
Office of International Students & Scholars
oiss@stthomas.edu, Tel: 651-962-6650, Fax: 651-962-6655
Please submit one copy (no staples please) of the items below to OISS:
Beneficiary Forms and Supporting Documents:
□ Please refer to the H-1B worker’s checklist
Hiring Department Forms:
□ H-1B request form- completed by hiring department
□ Prevailing wage worksheet
□ Statement of actual wage
□ Export control questionnaire and certification
□ Supplemental documents
□ Position description or posting
□ Employment letter (samples available on the OISS website)
Application Fees:
□ OISS will request these checks from Accounts Payable for the necessary H-
1B fees and will charge the departmental index accordingly. Checks take 2
weeks to process and this may delay sending the H-1B petition.
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Completed 26 July 2020

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