Form I-140 05/09/18 Page 1 of 9
For
USCIS
Use
Only
Immigrant Petition for Alien Workers
Department of Homeland Security
U.S. Citizenship and Immigration Services
USCIS
Form I-140
OMB No. 1615-0015
Expires 05/31/2020
START HERE - Type or print in black ink.
203(b)(1)(A) Alien of
Extraordinary Ability
Certification
203(b)(1)(B) Outstanding
Professor or Researcher
203(b)(1)(C) Multinational
Executive or Manager
203(b)(2) Member of Professions with
Advanced Degree/Exceptional Ability
203(b)(3)(A)(i) Skilled Worker
203(b)(3)(A)(ii) Professional
203(b)(3)(A)(iii) Other Worker
National Interest Waiver (NIW)
Schedule A, Group I
Schedule A, Group II
Priority Date Consulate
Remarks
Action BlockFee Stamp
Classification
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.
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
Company or Organization Name2.
To be completed
by an Attorney
or Accredited
Representative (if any).
Select this box if
Form G-28 or
Form G-28I is
attached.
Attorney State Bar Number
(if applicable)
Attorney or Accredited Representative
USCIS Online Account Number (if any)
Other Information
U.S. Social Security Number (SSN) (if any)5.
IRS Employer Identification Number (EIN)4.
USCIS Online Account Number (if any)6.
Mailing Address
3.a. In Care Of Name
Street Number
and Name
3.b.
3.c.
3.d. City or Town
3.h.
Postal Code
3.i. Country
3.e.
State
3.f.
ZIP Code
Ste. Flr.Apt.
3.g.
Province
Part 2. Petition Type
A professional (at a minimum, possessing a
bachelor's degree or a foreign degree equivalent
to a U.S. bachelor's degree).
1.e.
This petition is being filed for (select only one box):
An alien of extraordinary ability.
1.a.
An outstanding professor or researcher.
1.b.
A multinational executive or manager.
1.c.
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.d.
Any other worker (requiring less than two years of
training or experience).
1.g.
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).
A skilled worker (requiring at least two years of
specialized training or experience).
1.f.
(USPS ZIP Code Lookup)
Form I-140 05/09/18 Page 2 of 9
Part 2. Petition Type (continued)
This petition is being filed (select only one box):
To amend a previously filed petition.2.a.
Previous Petition Receipt Number
For the Schedule A, Group I or II designation.2.b.
Part 3. Information About the Person for Whom
You Are Filing
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
Mailing Address
Street Number
and Name
2.b.
2.c.
2.d. City or Town
2.g.
2.h.
Province
2.i. Country
2.e.
State
2.f.
ZIP Code
In Care Of Name
2.a.
Ste. Flr.Apt.
Postal Code
Other Information
Date of Birth (mm/dd/yyyy)3.
4.
6.
City/Town/Village of Birth
Country of Birth
7. Country of Citizenship or Nationality
Alien Registration Number (A-Number) (if any)8.
A-
U.S. SSN (if any)9.
Information About His or Her Last Arrival in the
United States
If the person for whom you are filing is in the United States,
provide the following information.
10.
Date of Last Arrival (mm/dd/yyyy)
Form I-94 Arrival-Departure Record Number
11.b.
Status on Form I-94 (for example, class of admission, or
paroled, if paroled)
11.c.
Expiration Date of Authorized Stay Shown on Form I-94
(mm/dd/yyyy)
11.a.
Passport Number12.
Travel Document Number13.
14. Country of Issuance for Passport or Travel Document
15. Expiration Date for Passport or Travel Document
(mm/dd/yyyy)
Part 4. Processing Information
Provide the following information for the person named in
Part 3. (select only one box):
Alien will apply for a visa abroad at a U.S. Embassy
or U.S. Consulate at:
1.a.
1.b.
1.c.
City or Town
Country
5.
State or Province of Birth
Alien is in the United States and will apply for
adjustment of status to that of lawful permanent
resident.
2.a.
Form I-140 05/09/18 Page 3 of 9
Part 4. Processing Information (continued)
2.b. Alien's current country of residence or, if now in the
United States, last country of permanent residence abroad.
If you provided a United States address in Part 3., provide the
person's foreign address in Item Numbers 3.a. - 3.f.:
Street Number
and Name
3.a.
3.b.
3.c. City or Town
3.d.
3.e.
Province
3.f. Country
Postal Code
Ste. Flr.Apt.
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)
4.c. Middle Name
Mailing Address
Street Number
and Name
5.b.
5.c.
5.d. City or Town
5.e.
Postal Code
5.f.
5.g. Country
Province
Ste. Flr.Apt.
In Care Of Name
5.a.
6.b. If you answered “Yes” to Item Number 6.a., select all
applicable boxes:
Form I-485
Form I-131
Form I-765
Other (Provide an explanation in Part 11. Additional
Information.)
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?
9.
Yes No
Is the person for whom you are filing in removal
proceedings?
NoYes
7.
NoYes
Has any immigrant visa petition ever been filed by or on
behalf of this person?
8.
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)?
10.
Yes No
Part 5. Additional Information About the
Petitioner
Type of petitioner (select only one box):
1.a. Employer
Self1.b.
Other (For example, Lawful Permanent Resident,
U.S. citizen or any other person filing on behalf of
the alien)
1.c.
If a company or an organization is filing this petition, provide
the following information:
Type of Business2.
3. Date Established (mm/dd/yyyy)
Current Number of U.S. Employees4.
Gross Annual Income5.
$
Net Annual Income6. $
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.
Are you filing any other petitions or applications with this
Form I-140?
6.a.
Yes No
NAICS Code7.
Labor Certification DOL Case Number8.
Form I-140 05/09/18 Page 4 of 9
Part 5. Additional Information About the
Petitioner (continued)
10. Labor Certification Expiration Date (mm/dd/yyyy)
If an individual is filing this petition, provide the following
information.
11. Occupation
Annual Income12.
$
Part 6. Basic Information About the Proposed
Employment
1. Job Title
SOC Code2.
-
Nontechnical Job Description3.
Is this a full-time position?
If the answer to Item Number 4. is "No," how many
hours per week for the position?
5.
NoYes4.
7. Is this a new position? NoYes
6. Is this a permanent position?
NoYes
Part 7. Information About the Spouse and All
Children of the Person for Whom You Are Filing
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.
Person 1
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
2. Date of Birth (mm/dd/yyyy)
3. Country of Birth
Relationship4.
5. Is he or she applying for adjustment of status?
Yes No
6. Is he or she applying for a visa abroad?
Wages (Specify hour, week, month, or year):8.
$ per
9. Labor Certification DOL Filing Date (mm/dd/yyyy)
For Item Numbers 9.a. - 9.e., provide the address where the
person will work if different from the address provided in Part 1.
Street Number
and Name
9.a.
9.b.
9.c. City or Town
9.d.
State
9.e.
ZIP Code
Worksite Location
Ste. Flr.Apt.
11.
12.
Relationship10.
Is he or she applying for a visa abroad?
Is he or she applying for adjustment of status?
Person 2
7.a. Family Name
(Last Name)
7.b. Given Name
(First Name)
7.c. Middle Name
8. Date of Birth (mm/dd/yyyy)
9. Country of Birth
Yes No
Yes No
Yes No
Form I-140 05/09/18 Page 5 of 9
Part 7. Information About Spouse and All
Children of the Person for Whom You Are Filing
(continued)
Person 3
13.a. Family Name
(Last Name)
13.b. Given Name
(First Name)
13.c. Middle Name
17.
18.
14. Date of Birth (mm/dd/yyyy)
15. Country of Birth
Relationship16.
Is he or she applying for a visa abroad?
Is he or she applying for adjustment of status?
Person 4
19.a. Family Name
(Last Name)
19.b. Given Name
(First Name)
19.c. Middle Name
20. Date of Birth (mm/dd/yyyy)
Person 5
25.a. Family Name
(Last Name)
25.b. Given Name
(First Name)
25.c. Middle Name
29.
26. Date of Birth (mm/dd/yyyy)
27. Country of Birth
Relationship28.
Is he or she applying for adjustment of status?
30. Is he or she applying for a visa abroad?
Person 6
31.a. Family Name
(Last Name)
31.b. Given Name
(First Name)
31.c. Middle Name
35.
32. Date of Birth (mm/dd/yyyy)
33. Country of Birth
Relationship34.
Is he or she applying for adjustment of status?
36. Is he or she applying for a visa abroad?
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
23.
21. Country of Birth
Relationship22.
Is he or she applying for adjustment of status?
NoYes
24. Is he or she applying for a visa abroad?
NoYes
Form I-140 05/09/18 Page 6 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.
The interpreter named in Part 9. has read to me every
question and instruction on this petition and my answer
to every question in
1.b.
,
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 Statement
a language in which I am fluent. I understood all of
this information as interpreted.
At my request, the preparer named in Part 10.,
2.
prepared this petition for me based only upon
information I provided or authorized.
,
Authorized Signatory's Contact Information
3.a. Authorized Signatory's Family Name (Last Name)
3.b. Authorized Signatory's Given Name (First Name)
Authorized Signatory's Title4.
7.
Authorized Signatory's Email Address (if any)
Authorized Signatory's Mobile Telephone Number (if any)6.
Authorized Signatory's Daytime Telephone Number5.
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 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 Signature8.a.
8.b. Date of Signature (mm/dd/yyyy)
Petitioner's or Authorized Signatory's Signature
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
Interpreter's Full Name
1.a. Interpreter's Family Name (Last Name)
1.b. Interpreter's Given Name (First Name)
Interpreter's Business or Organization Name (if any)2.
Provide the following information about the interpreter.
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.
Form I-140 05/09/18 Page 7 of 9
Part 9. Interpreter's Contact Information,
Certification, and Signature (continued)
Interpreter's Mailing Address
3.c. City or Town
3.d. State 3.e. ZIP Code
3.f.
Postal Code3.g.
Province
3.h. Country
Street Number
and Name
3.a.
3.b.
Ste. Flr.Apt.
Interpreter's Daytime Telephone Number
6.
4.
Interpreter's Email Address (if any)
Interpreter's Contact Information
Interpreter's Mobile Telephone Number5.
Interpreter's Certification
I certify, under penalty of perjury, that:
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.
,I am fluent in English and
Part 10. Contact Information, Declaration, and
Signature of the Person Preparing this Petition,
if Other Than the Authorized Individual
Preparer's Full Name
Provide the following information about the preparer.
1.a. Preparer's Family Name (Last Name)
1.b. Preparer's Given Name (First Name)
Preparer's Business or Organization (if any)2.
Preparer's Mailing Address
3.c. City or Town
3.d. State 3.e. ZIP Code
3.f.
Postal Code3.g.
Province
3.h. Country
Street Number
and Name
3.a.
3.b.
Ste. Flr.Apt.
Preparer's Contact Information
Preparer's Daytime Telephone Number
6.
4.
Preparer's Email Address (if any)
Preparer's Mobile Telephone Number (if any)5.
Interpreter's Signature7.a.
7.b.
Interpreter's Signature
Date of Signature (mm/dd/yyyy)
Form I-140 05/09/18 Page 8 of 9
Preparer's Statement
extends does not extend beyond the
preparation of this application.
I am not an attorney or accredited representative but
have prepared this petition on behalf of the petitioner
and with the petitioner's consent.
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.
7.a.
7.b.
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
Preparer's Signature8.a.
8.b. Date of Signature (mm/dd/yyyy)
Part 10. Contact Information, Declaration, and
Signature of the Person Preparing this Petition,
if Other Than the Authorized Individual
(continued)
I am an attorney or accredited representative and my
representation of the petitioner in this case
Form I-140 05/09/18 Page 9 of 9
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.
3.d.
1.a Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
3.a. 3.b. 3.c.Page Number Part Number Item Number
IRS EIN 2.
4.d.
4.a. 4.b. 4.c.Page Number Part Number Item Number
5.d.
5.a. 5.b. 5.c.Page Number Part Number Item Number
Item NumberPart NumberPage Number 7.c.7.b.7.a.
7.d.
6.d.
6.a. 6.b. 6.c.Page Number Part Number Item Number