Fillable I-129s Form I-129S

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I-129s Form I-129S

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The I-129s Form I-129S form is 8 pages long and contains:

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Country of origin: US
File type: PDF

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U.S. Citizenship and Immigration Services (USCIS) is an office of the U.S. Branch of Homeland Security (DHS) that oversees the nation's naturalization and migration framework. It is a successor to the Immigration and Naturalization Service (INS), which was disintegrated by the Homeland Security Act of 2002 and supplanted by three segments inside the DHS: USCIS, Immigration and Customs Enforcement (ICE), and Customs and Border Protection (CBP).

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Form I-129S 06/02/16 N
Page 1 of 8
To be completed by an
attorney or accredited
representative (if any).
Validity Dates
START HERE - Type or print in black ink.►
Relocated Received
For Government Use Only
Action Block
Relocated Sent
Fee Receipt
ResubmittedReceived
Denial Reason
Manager/Executive
Specialized Knowledge
Professional
Beneficiary Interviewed on:
Part 1. Information About The Employer
(Petitioner)
Nonimmigrant Petition Based on Blanket L Petition
Department of Homeland Security
U.S. Citizenship and Immigration Services
USCIS
Form I-129S
OMB No. 1615-0010
Expires 06/30/2018
Approval Date:
Name of the Petitioner
Petitioner's Mailing Address
If you answered "No" to Item Number 3., provide the
sponsoring company's or organization's physical address
in Item Numbers 4.a. - 4.e.
3. Is this mailing address the same as the physical location
of the sponsoring company or organization?
Yes No
7.
Web site Address (if any)8.
Email Address (if any)
6. Fax Number
5. Daytime Telephone Number
Petitioner's Contact Information
1.
Attorney State Bar Number
(if applicable)
Attorney or Accredited Representative
USCIS Online Account Number (if any)
Select this box if
Form G-28 is
attached.
Approved as:
From:
To:
9.
Are more than 50 percent of the petitioner's employees in
H-1B, L-1A, or L-1B nonimmigrant status?
10.
Does the petitioner employ 50 or more individuals in the
United States?
Petitioner's Employees in the United States
If you answered "Yes" to Item Number 9., complete
Item Number 10.
Petitioner's Physical Address
NoYes
Yes No
Street Number
and Name
2.a. In Care Of Name (if any)
2.b.
2.c. Ste. Flr.Apt.
2.d. City or Town
2.e. State 2.f. ZIP Code
4.b. Ste. Flr.Apt.
4.c. City or Town
4.d. State 4.e. ZIP Code
4.a. Street Number
and Name
Form I-129S 06/02/16 N
Page 2 of 8
Part 3. Information About the Beneficiary
Alien Registration Number (A-Number) (if any)1.
►
A-
Provide the following information about the beneficiary.
Beneficiary's Full Name
Other Names Used
4.b.
4.c.
4.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
List all other names the beneficiary has ever used, including
aliases, maiden name, and names from all previous marriages.
If you need extra space to complete this section, use the space
provided in Part 10. Additional Information.
5.b.
5.c.
5.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Beneficiary's Foreign Mailing Address
City or Town6.d.
6.e.
6.g.
Province
Country
6.f. Postal Code
Street Number and Name or PO Box6.b.
6.c. Ste. Flr.Apt.
6.a. In Care Of Name (if any)
7. Is this mailing address also where the beneficiary
physically resides?
If you answered "No" to Item Number 7., provide the
beneficiary's physical address in Item Numbers 8.a. - 8.f.
Part 2. Information About the Proposed Position
and Prior Employment Periods in the United
States
The beneficiary will work as a:
Manager or Executive (L-1A)1.a.
Specialized Knowledge Professional (L-1B)1.b.
Dates of Proposed Employment
Provide the beneficiary's dates of proposed employment.
Start Date (mm/dd/yyyy)
2.b. End Date (mm/dd/yyyy)
2.a.
Prior Periods of Stay in the United States
3.a.
To (mm/dd/yyyy)3.b.
From (mm/dd/yyyy)
If the beneficiary was previously in the United States, provide
the dates of the beneficiary's prior periods of stay for the last
seven years in a work-authorized capacity and indicate the
beneficiary's immigration status and visa category (for example,
H-1B, O-1) during the period of stay. If you need extra space to
complete this section, use the space provided in Part 10.
Additional Information.
Period of Stay 1
6. Nonimmigrant Status During Period of Stay
5.a.
To (mm/dd/yyyy)5.b.
From (mm/dd/yyyy)
4. Nonimmigrant Status During Period of Stay
Period of Stay 2
2. USCIS Online Account Number (if any)
►
►
U.S. Social Security Number (if any)3.
Yes No
Form I-129S 06/02/16 N
Page 3 of 8
Country of Citizenship or Nationality14.
Provide the receipt number for the Blanket L petition
upon which this petition is based.
1.
►
Proposed Job Title and Duties
Provide the job title and duties the beneficiary will perform.
Also indicate the percentage of time the beneficiary will spend
performing the duties on a daily basis. If you need extra space
to complete this section, use the space provided in Part 10.
Additional Information.
7. Job Title
Duties Performed on a Daily Basis8.
Primary Worksite
9. If you are seeking L-1B specialized knowledge
professional status for the beneficiary, will the beneficiary
work primarily offsite (at a worksite of a company or
organization other than the petitioner or its affiliate,
branch, subsidiary, or parent company)?
Yes No
If you need extra space to complete this section, use the space
provided in Part 10. Additional Information.
If you answered "Yes" to Item Number 9., describe how
and who will control and supervise the beneficiary's work
and why the placement is not labor for hire in Item
Numbers 10.a. - 11.
Country of Birth13.
City or Town8.c.
8.d.
8.f.
Province
Country
8.e. Postal Code
Street Number
and Name
8.a.
8.b. Ste. Flr.Apt.
Beneficiary's Foreign Physical Address
Other Information About the Beneficiary
FemaleMaleGender
9.
10.
11. City or Town of Birth
Date of Birth (mm/dd/yyyy)
12. Province or State of Birth
Part 4. Information About Proposed United
States Employment
2. Are you filing Form I-129, Petition for a Nonimmigrant
Worker, with this petition?
Yes No
Wages and Hours of Proposed Employment
4.
Beneficiary's Hours Per Week5.
Beneficiary's Wages Per Year
Provide the wages per year the beneficiary will receive and the
number of hours the beneficiary will work per week for the
proposed employment. Also describe any other compensation
the beneficiary will receive, including dollar value (if
applicable).
Other Compensation6.
Street Number
and Name
3.a.
3.b. Ste. Flr.Apt.
3.c. City or Town
3.d. State 3.e. ZIP Code
Proposed Employment Address for the Beneficiary
10.b. Nature of Supervision and Control of the Beneficiary's
Work
Supervisor's Name10.a.
$
Part 3. Information About the Beneficiary
(continued)
Form I-129S 06/02/16 N
Page 4 of 8
Part 4. Information About Proposed United
States Employment (continued)
Describe the reasons why the placement of the beneficiary
at this worksite is not an arrangement to provide labor for
hire. Also include a description of how the beneficiary's
duties at this worksite relate to your need for the
specialized knowledge he or she possesses.
11.
Part 5. Information About Foreign Employment
Qualifying Foreign Position
Indicate the type of qualifying position the beneficiary was
employed in while working for the qualifying foreign employer.
Manager 1.a.
1.c. Specialized Knowledge Professional
Executive1.b.
Provide information for each qualifying foreign employer for
whom the beneficiary worked during the required one
continuous year out of three years. If you need extra space to
complete this section, use the space provided in Part 10.
Additional Information.
Qualifying Foreign Employer Name and Address
Provide the name and address for the qualifying foreign
employer for whom the beneficiary worked.
Foreign Employer Name
2.
Other Information About the Beneficiary's Foreign
Employment
Provide the beneficiary's job titles, dates of foreign
employment, and the duties of the jobs the beneficiary
performed during the required one continuous year out of three
years. Also provide the yearly wage the beneficiary received
and the number of hours the beneficiary worked per week.
4.
Job 1
Job Title
5.a.
End Date (mm/dd/yyyy)5.b.
6.
Start Date (mm/dd/yyyy)
Job Duties
7.
Hours Worked Per Week8.
Wages Earned Per Year $
9.
Job 2
Job Title
10.a.
End Date (mm/dd/yyyy)10.b.
Start Date (mm/dd/yyyy)
11. Job Duties
Mailing Address
Street Number
and Name
3.a.
3.b. Ste. Flr.Apt.
3.c. City or Town
3.d.
Postal Code
3.e.
3.f. Country
Province
12.
Hours Worked Per Week13.
Wages Earned Per Year $
Form I-129S 06/02/16 N
Page 5 of 8
Part 6. Certification Regarding the Release of
Controlled Technology or Technical Data to
Foreign Persons in the United States
Select Item Number 1. or 2., as appropriate.
With respect to the technology or technical data the petitioner
will release or otherwise provide access to the beneficiary, the
petitioner certifies that it has reviewed the Export
Administration Regulations (EAR) and the International
Traffic in Arms Regulations (ITAR) and has determined that:
A license is not required from either the U.S.
Department of Commerce or the U.S. Department of
State to release such technology or technical data to
the foreign person; or
1.
A license is required from the U.S. Department of
Commerce and/or the U.S. Department of State to
release such technology or technical data to the
beneficiary AND the petitioner will prevent access to
the controlled technology or technical data by the
beneficiary until and unless the petitioner has
received the required license or other authorization to
release it to the beneficiary.
2.
Part 7. Statement, Contact Information,
Declaration, 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.
NOTE: Read the Penalties section of the Form I-129S
Instructions before completing this part.
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.a.
Petitioner's or Authorized Signatory's Statement
Authorized Signatory's Contact Information
Authorized Signatory's Daytime Telephone Number5.
Authorized Signatory's Email Address (if any)7.
Authorized Signatory's Mobile Telephone Number (if any)6.
The interpreter named in Part 7. has read to me every
question and instruction on this petition, and my
answer to every question, in
1.b.
,
a language in which I am fluent. I understand all of
this information as interpreted.
3.b.
4.
3.a. Authorized Signatory's Family Name (Last Name)
Authorized Signatory's Given Name (First Name)
Authorized Signatory's Title
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. Photocopied, faxed, or scanned copies of
Form I-129S that I will submit to any other Federal agency,
including U.S. Department of State and U.S. Customs and
Border Protection (CBP), are exact copies of this unaltered,
original Form I-129S.
2.
At my request, the preparer named in Part 9.,
prepared this petition for me based only upon
information I provided or authorized.
,
I authorize the release of any information from my records, or
from the petitioning organization's records, that USCIS needs 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.
Petitioner's Statement Regarding the Interpreter
Petitioner's Statement Regarding the Preparer
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.
Form I-129S 06/02/16 N
Page 6 of 8
Part 8. Interpreter's Contact Information,
Certification, and Signature
Provide the following information about the interpreter.
Interpreter's Full Name
Interpreter's Business or Organization Name (if any)2.
Interpreter's Given Name (First Name)1.b.
Interpreter's Family Name (Last Name)1.a.
Interpreter's Mailing Address
3.c. City or Town
3.d. State 3.e. ZIP Code
3.f.
Postal Code
Street Number
and Name
3.a.
3.b. Ste. Flr.Apt.
3.g.
3.h. Country
Province
Interpreter's Signature
Date of Signature (mm/dd/yyyy)7.b.
Interpreter's Signature7.a.
Part 9. Contact Information, Declaration, and
Signature of the Person Preparing this Petition, if
Other Than the Petitioner
Provide the following information about the preparer.
Preparer's Full Name
Preparer's Given Name (First Name)1.b.
1.a. Preparer's Family Name (Last Name)
2. Preparer's Business or Organization Name (if any)
NOTE: If applicable, provide the name of your accredited
organization recognized by the Board of Immigration Appeals
(BIA).
Interpreter's Certification
I am fluent in English and
which is the same language provided in Part 7., 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.
I certify that:
,
Petitioner's or Authorized Signatory's Signature
Date of Signature (mm/dd/yyyy)8.b.
Petitioner's Signature8.a.
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.
Interpreter's Daytime Telephone Number
4.
Interpreter's Email Address (if any)6.
Interpreter's Contact Information
Interpreter's Mobile Telephone Number (if any)5.
Part 7. Statement, Contact Information,
Declaration, and Signature of the Petitioner or
Authorized Signatory (continued)
Form I-129S 06/02/16 N
Page 7 of 8
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 petition 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)
Part 9. Contact Information, Declaration, and
Signature of the Person Preparing this Petition, if
Other Than the Petitioner (continued)
Preparer's Contact Information
Preparer's Mobile Telephone Number (if any)5.
Preparer's Daytime Telephone Number4.
Preparer's Email Address (if any)6.
Preparer's Mailing Address
3.c. City or Town
3.d. State 3.e. ZIP Code
3.f.
Postal Code
Street Number
and Name
3.a.
3.b. Ste. Flr.Apt.
3.g.
3.h. Country
Province
Preparer's Statement
I am not an attorney or accredited representative but
have prepared this petition on behalf of the petitioner
and with the petitioner's consent.
I am an attorney or accredited representative and my
representation of the petitioner in this case
does not extend beyond the
7.a.
7.b.
preparation of this petition.
NOTE: If you are an attorney or accredited
representative whose representation extends beyond
preparation of this petition, you must submit a
completed Form G-28, Notice of Entry of
Appearance as Attorney or Accredited
Representative, or G-28I, Notice of Entry of
Appearance as Attorney In Matters Outside the
Geographical Confines of the United States, with this
petition.
extends
Form I-129S 06/02/16 N
Page 8 of 8
Part 10. 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. Include the beneficiary's 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.
Beneficiary's A-Number (if any)
►
A-
3.a.
2.
Page Number 3.b. Part Number 3.c. Item Number
3.d.
5.a.
Page Number
Part Number Item Number
5.d.
Part NumberPage Number
Item Number
1.b.
1.c.
1.a. Beneficiary's Family Name (Last Name)
Beneficiary's Given Name (First Name)
Beneficiary's Middle Name
5.c.5.b.
6.c.6.b.6.a.
6.d.
Page Number Part Number Item Number4.c.4.b.
4.d.
4.a.
Part NumberPage Number Item Number7.c.7.b.7.a.
7.d.
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I-129s Form I-129S

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Completed 6 November 2019

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