Fill - Free fillable Jackson State University Permanent Residency Application Packet (Jackson State University) PDF form

PR Application 11/2011

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Jackson State University

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Permanent Residency Application Packet

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Division of International Studies • Jackson State University • Office Complex Unit 1, Box 17103 • Jackson, MS 39217 • USA

Phone: (601) 979-3796 • Fax: (601) 979-3388

E-mail: patricia.a.jernigan@jsums.edu

PERMANENT RESIDENCY OVERVIEW

Permanent Residency, also known as the Green Card, is an immigrant visa status. There are many different paths to

obtaining Permanent Residency, but the Jackson State University can petition for only specific employment-based

categories. The categories of Permanent Residency which are sponsored by the Jackson State University are: EB-1

Outstanding Researcher/Professor, EB-2 Advanced Degree Holders, EB-2 Exceptional Ability in the Science, Arts, or

Business, and EB-3 Professional or Skilled Worker.

TIMING OF FILING – PLAN MORE THAN 1 YEAR IN ADVANCE

Permanent Residency is a lengthy process and many PR applicants hold a status such as H-1B while filing for

Permanent Residency. In some situations, it is best to begin the PR process soon after hiring a new faculty member.

For teaching faculty and instructors, there is an 18-month window after the initial job offer to be able to use the

Special Handling option with the Department of Labor. The Special Handling process is detailed in the Labor

Certification section of the PR Application. Depending on the type of application process and the applicant’s country

of origin, an applicant for Permanent Residency can wait months or years after the I-140 approval for final approval of

Permanent Residency. At times, there are backlogs for some countries and certain categories of petitions for filing the

I-485 change-of-status to Permanent Residency application with USCIS. More information about backlogs can be

found in the Visa Bulletin: http://travel.state.gov/visa/frvi/bulletin/bulletin_1360.html . In general, EB-1 categories

are given the highest priority for adjudication of Permanent Residency. EB-2 applications are given second highest

priority. EB-3 categories have the longest wait time for adjudication.

At the very least, the Division of International Studies recommends that departments and employees begin the

Permanent Residency process at least 2 years in advance of the last date of employment eligibility available to the

international employee, especially for employees in H-1B status. An international employee who is in H-1B status

may extend beyond the normal 6-year maximum for H-1B status if the H-1B holder has had a Labor Certification

application or a PR application pending for at least one calendar year.

IMPORTANT NOTE ABOUT J-VISA HOLDERS AND 2-YEAR HOME RESIDENCY REQUIREMENT

If the PR applicant is currently in the U.S. in J-Visa status or has previously held J-Visa status, the international

employee may be subject to the 212(e) two year home residency requirement. Many J-Visa programs require the

individual to complete a two-year home residency requirement [212(e) Rule] in the J-Visa holder’s home country. It is

sometimes possible for the J-Visa holder to get a waiver of the two-year home residency requirement through the

Department of State, but the waiver must be granted before the Division of International Studies can process the

Permanent Residency application.

More information about the waiver requirements and processes are on the U.S. Department of State website:

http://travel.state.gov/visa/temp/info/info_1296.html . It is important to note that once a waiver of the 212(e) two-year

home residency requirement has been recommended by the Department of State, the J-Visa holder’s DS-2019 and J-

program can no longer be transferred or extended; so the waiver should not be sought unless PR support is guaranteed.

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PERMANENT RESIDENCY CATEGORIES SPONSORED BY THE JACKSON STATE UNIVERSITY

EB-1 OUTSTANDING PROFESSORS AND RESEARCHERS CATEGORY

The EB-1 Outstanding Professor/Researcher category is an excellent option for any international faculty member or

researcher who has many years of experience in the field and is either tenured or in a tenure-track/ permanent position.

This category is at the highest level of categories and is given the highest priority for processing by US Citizenship

and Immigration Services. Not all professors or researchers will qualify to file for Permanent Residency under the

EB-1 Outstanding Professor/Researcher category. New faculty or researchers who have not completed at least 3 years

of post-doctoral full-time instruction or research cannot be considered for this category of sponsorship.

EB-1 Applications do not require Labor Certification by the Department of Labor. All proof of eligibility must be

shown by the international applicant. This means that there is a lot less work on the part of the department.

Departments will only have to submit the Enclosure A forms from this application packet, a support letter, and the I-

140 filing fee for an EB-1 Outstanding Professor/ Researcher Petition.

Basic Requirements - EB-1 Outstanding Professor/Researcher petitions must meet three basic requirements:

1. The applicant must be recognized internationally as outstanding in teaching or research in the academic area;

2. The applicant must have at least 3 years of experience in teaching or research in the academic area;

3. The position the applicant holds must be either a tenured or tenure-track position (for professors) or a

permanent position (for researchers).

Establishing Eligibility - An EB-1 applicant can establish eligibility as an outstanding professor or researcher by

developing and submitting documentation in at least two (preferably three) of the categories listed below:

• Receipt of major prizes or awards for outstanding achievement in the field of endeavor;

• Membership in associations in the academic field which require their members to demonstrate outstanding

achievements to become a member (not just a due-paying association);

• Published material in professional publications written by others about the alien's

work in the academic field (i.e. in-text citations of the applicant’s work or research). Such evidence should

include title, date, and author of the publication and any necessary translations;

• Participation, either on a panel or individually, as a judge of the work of others in

the same or allied academic field (such as a reviewer for an academic journal);

• Original scientific, scholarly, or business-related contributions in the field (as shown by letters of

attestation and support from colleagues and other experts in the field; letters should be accompanied by CV’s

or Resumes);

• Authorship of scholarly books or articles (in scholarly journals with international circulation) in the academic

field.

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PERMANENT RESIDENCY CATEGORIES (Continued)

EB-2 ALIENS OF EXCEPTIONAL ABILITY IN THE SCIENCES, ARTS, OR BUSINESS CATEGORY

The EB-2 Aliens of Exceptional Ability in the Sciences, Arts, or Business category is an excellent option for any

international instructor, researcher, or professional staff member who has many years of experience in the field but

may not hold a Master’s or Ph.D. degree. This category is rarely used by the Jackson State University.

EB-2 Applications require Labor Certification by the Department of Labor. In addition to the evidence of eligibility

as an EB-2 Alien of Exception Ability that must be shown by the international applicant, the Department will have to

follow the recruitment guidelines for proper Labor Certification. Departments will also have to submit the Enclosure

A forms from this application packet, a support letter, and the I-140 filing fee.

Establishing Eligibility - An EB-2 applicant can establish eligibility as an alien of exceptional ability in the sciences,

arts, or business by developing and submitting documentation in at least three (preferably four) of the categories listed

below:

• An official academic record showing that the applicant has a degree, diploma, certificate, or similar award

from an institution of learning relating to the area of exceptional ability;

• Evidence in the form of letters from current or former employers showing that the applicant has at least ten

years of full-time experience in the occupation;

• A license to practice the profession or certification for a particular profession or occupation;

• Evidence that the applicant has either commanded a salary or other remuneration for services, as shown by

contracts or letters of employment, which demonstrates exceptional ability;

• Membership in professional associations;

• Evidence of recognition for achievements and significant contributions to the industry or field by peers,

governmental entities, or professional or business organizations.

EB-2 HOLDERS OF ADVANCED DEGREES CATEGORY

The EB-2 Holders of Advanced Degrees category is an excellent option for any new faculty member or researcher.

EB-2 Applications require Labor Certification by the Department of Labor. Most of the work for this petition must be

done by the department. The Department will have to follow the recruitment guidelines for proper Labor

Certification. Departments will also have to submit the Enclosure A forms from this application packet, a support

letter, and the I-140 filing fee.

Basic Requirements - EB-2 Holder of Advanced Degrees petitions must meet three basic requirements:

1. Applicant must be a member of the academic profession;

2. Applicant must hold an advanced degree (a post-baccalaureate degree such as a Master’s, Ph.D., or equivalent);

3. The position must require an advanced degree as a minimum requirement.

EB-3 PROFESSIONALS CATEGORY

The EB-3 Professionals category is meant for any professional position that requires a minimum of a Bachelor’s

degree. This is the category used most often for full-time, permanent support staff members.

EB-3 Applications require Labor Certification by the Department of Labor. Most of the work for the support of this

petition must be done by the department. The Department will have to follow the recruitment guidelines for proper

Labor Certification. Departments will also have to submit the Enclosure A forms from this application packet, a

support letter, and the I-140 filing fee.

Basic Requirements - EB-3 Professionals petitions must meet two basic requirements:

1. The applicant must hold at least a bachelor’s degree or foreign equivalent;

2. The position must require a bachelor’s degree as a minimum requirement.

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PROCESSING STEPS

STEP 1: HUMAN RESOURCES APPROVAL

To begin the Permanent Residency process, the employee’s department must contact Human Resources to request that

the University sponsor a Permanent Residency petition on the employee’s behalf. Academic Departments must get

both the approval of the Dean of their School as well as the approval of the Vice-President for Academic Affairs for

the support of a Permanent Residency petition.

Human Resources must check to see that the employee is in a permanent position at the university. If the position is

not permanent or if the funding for the position is from grants or outside funds, HR may not approve the sponsorship.

When HR approves the request to sponsor Permanent Residency, they will contact the Division of International

Studies.

STEP 2: MEETING WITH DIVISION OF INTERNATIONAL STUDIES

After the Division of International Studies has received approval from HR to proceed with the Permanent Residency

application, a meeting between the Division of International Studies, the international employee, and the department

will be set.

During this meeting, the Division of International Studies will look at options for filing the Permanent Residency. the

Division of International Studies must decide whether labor certification is required or if the Permanent Residency

application can be filed in the Outstanding Professor/Researcher category which is exempt from labor certification.

Besides establishing which type of filing of Permanent Residency will be done, the meeting is important to go over the

requirements and necessary documentation with both the department and the international applicant.

STEP 3: SUBMITTING ENCLOSURE A & B FORMS TO THE DIVISION OF INTERNATIONAL STUDIES

After the meeting with the Division of International Studies, the department will be asked to submit the Enclosure A

Application section of the Permanent Residency Application. The Enclosure A forms will help set the formal job

title, requirements, duties, and pay. With this information, Division of International Studies will work with the

department to establish an appropriate recruitment plan if labor certification is necessary.

Also, the international applicant will be asked to complete and submit all documentation and forms from the

Enclosure B Section of the Permanent Residency Application. With both labor certification cases and with EB-1

Outstanding Professor/Researcher cases, the Enclosure B information is necessary before any part of the Permanent

Residency case may be filed.

STEP 4: FILING LABOR CERTIFICATION (IF FILING IN EITHER EB-2 OR EB-3 CATEGORIES)

If the Division of International Studies determines that the best option for filing is either EB-2 Advanced Degree

Holders category, EB-2 Exceptional Ability in the Science, Arts, or Business category, or EB-3 Professional or Skilled

Worker category, labor certification will be required. Labor certification is a process by which the Jackson State

University submits to the Department of Labor specific information about both the job-requirements as well as the

advertising and search process that the department used to fill the position which the international employee holds.

For the EB-2 and EB-3 categories, the Jackson State University must have the Department of Labor’s approval before

the I-140 Petition can be sent to USCIS.

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For the Department of Labor recruitment requirements, see the Labor Certification Process section on pages 7 and 8

of the Permanent Residency Packet.

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STEP 5: FILING I-140 PETITION WITH U.S. CITIZENSHIP AND IMMIGRATION SERVICES

Once the Division of International Studies has received either all the documentation for the support of an EB-1

petition for Outstanding Researcher/Professor or the labor certification approval from the US Department of Labor for

an EB-2 or EB-3 petition, the Jackson State University can file the I-140 Petition for Alien Worker. The I-140 is the

main petition of support for the international employee’s Permanent Residency, though the international employee

must file several other applications to complete the Permanent Residency process.

DEPARTMENT RESPONSIBILITIES: The department’s primary responsibility in preparing the I-140 Petition is

that it must pay the I-140 filing fee of $580, as the I-140 is a petition supported by the Jackson State University.

Departments have the option of Premium Processing for expedited service for an additional fee of $1225. Payment

MUST be processed through JSU Financial Services using the Request for Payment form (included in Enclosure A

section). The Department of Labor has determined that it is illegal to have an international employee pay for

University sponsored employment petitions, even if the employee is to be reimbursed for the expenses. All other

filing fees associated with the Permanent Residency are the responsibility of the international applicant.

The only other responsibility for preparing the I-140 is that the department must write the letter of support for the

international employee. However, the Division of International Studies will assist the international employee in

finalizing the other documents.

EMPLOYEE RESPONSIBILITIES: The international employee must submit the following basic documents:

 Curriculum Vita/ Resume which includes current address, home country address, statement of work history, and list of publications

 Copy of all university-level academic degrees, diplomas, and transcripts/mark sheets.

- Diplomas and transcripts/mark sheets do not have to be originals

- On the back of each photocopy, sign a statement that says “This is a true photocopy and originals are available upon request.”

- Documents not in English must be translated. The Division of International Studies will assist in translating the document.

- Degrees issued by non-U.S. institutions will have to have a foreign credential evaluation.

 Copy of Passport Identification Pages (Full-page photocopies ONLY. Do not cut the photocopy to the shape of the passport)

 Copies of I-94 Card (FRONT AND BACK)

 Copies of current/ most recent Visa Stamp

 Copies of all previous I-20’s, DS-2019’s, IAP-66’s, and H-1B or H-4 I-797 Approval Notices

 Proof of I-612 waiver of 212(e) Two-Year Home Residency Requirement if currently or previously on J-Visa

Additionally, international applicants who are filing in the EB-1 Outstanding Professor/Researcher or EB-2 Aliens of

Exceptional Ability in the Sciences, Arts, or Business categories must submit significant evidence of their

qualifications, detailed in the Enclosure B section of the Permanent Residency application.

STEP 6: INTERNATIONAL EMPLOYEE FILES FINAL PAPERWORK FOR PR-STATUS

The I-140 Petition for Alien Worker is not the final application for Permanent Residency. It is just the University’s

support of an international employee. Basically, an I-140 approval gives an international employee a valid reason for

being able to apply for a Green Card. Without the University’s approved support, the international employee would

have no legal reason for being able to apply for Permanent Residency.

After the Jackson State University files the I-140 in support of an international applicant for Permanent Residency, the

international employee has two choices for completing the Permanent Residency Process. The first choice is to file

for an adjustment of status to Permanent Residency from within the United States by using the form I-485 Application

to Register Permanent Residence or Adjust Status. The other choice is to process Permanent Residency at a U.S.

Consulate or Embassy through Consular Processing, which involves traveling abroad for an interview in order to

obtain Permanent Residency.

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While the Division of International Studies does not prefer one method over the other, the I-485 Adjustment of Status

is the most common processing method and allows the international applicant to apply for a Green Card from within

the United States. More information about the adjustment of status process can be found in the “I-485 Adjustment of

Status” section. More information about Consular Processing can be found at www.uscis.gov.

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I-485 ADJUSTMENT OF STATUS: FINAL STEP TO OBTAINING PR-STATUS IN THE U.S.

To adjust status to Permanent Residency within the United States, the international employee must file the Form I-

485, Application to Register Permanent Residence or Adjust Status. Before being able to apply for adjustment of

status, the applicant’s priority date (based on the I-140 Receipt Date or the PERM filing date with the Department of

Labor) must be current. The current priority dates can be found in the Visa Bulletin:

http://travel.state.gov/visa/frvi/bulletin/bulletin_1360.html. If the employee is not from a country on the backlog list

or is not in an application status that is backlogged by the USCIS, it may be possible for the applicant to file the I-485

Adjustment of Status application concurrently with the University’s I-140 Petition. Otherwise, the applicant must

wait until the I-140 is approved and the priority date is current before filing the I-485.

In general, the following documents and forms are necessary to be able to adjust status to Permanent Residency. The

details are available under the Forms Section at http://www.uscis.gov/portal/site/uscis:

 Form I-485 for Applicant and for each dependent family member

 Form I-485 filing fees for Applicant and for each dependent family member

 Copy of I-140 approval notice (not needed if concurrently filing I-485 and I-140).

 Proof of waiver or completion of 212(e) 2-Year Home Residency Requirement if currently/ previously on J-Visa and changing status in U.S.

 Form G-325A Biographic Information for Applicant and Each Family Member (4 pages each)

 Form I-134 Affidavit of Support, notarized and completed by main applicant for any dependent family members

 Form I-693 medical exam and Form I-693 supplement for applicant and each dependent family member, completed and sealed by a

Designated Civil Surgeon (Civil Surgeons can be found under I-693 in the forms section at www.uscis.gov )

 Letter of support from the academic department (see sample letter in Enclosure A Section for the Department)

 Two passport style photos for applicant and each dependent family member

 Biometrics fee for applicant and each dependent family member over 14 years old (USCIS will send notification for fingerprint appointment)

 Copy of birth certificates for applicant and each dependent family member, with English translation if not in English

 Copy of marriage certificate with translation if not in English

 Copy of divorce or death certificates from previous marriages with translation if not in English

 Copy of all passports held by applicant and dependents (include introductory page and any and all stamped pages)

 Copies of I-94 Card (FRONT AND BACK) and current/ most recent Visa Stamp

 Copies of all previous I-20’s, DS-2019’s, IAP-66’s, and I-797 Approval Notices

 Copies of transcripts for anyone who studied in the U.S. as an F-1 or J-1 student

APPLYING FOR TEMPORARY WORK AUTHORIZATION BASED ON PENDING I-485

While waiting for the adjudication of an I-485 application to adjust status, it is possible for the applicant (and any

dependent family members for whom I-485s have also been filed) to apply for an Employment Authorization Card

(EAD Card). To obtain the EAD Card, the applicant must submit the form I-765 along with the appropriate filing fee

and documentation of the I-485 application. In general, the EAD Card is only authorized for one year at a time.

TRAVEL AUTHORIZATION WHILE PENDING ADJUSTMENT OF STATUS TO PR

Individuals who travel internationally may want to apply for Advanced Parole using the Form I-131. Advanced Parole

allows the individual who has filed the I-485 to travel and reenter the United States without the need for a new visa.

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Advanced Parole is not necessary for H-1B Visa Holders since their visa is a dual-intent visa-type, but it is necessary

for any other visa-type to make sure that their I-485 petition is not cancelled due to abandonment of the petition.

NOTE: The Jackson State University requires that anyone who travels and reenters the U.S. on Advanced Parole have

an EAD Employment Eligibility Card to be eligible to work at the Jackson State University.

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LABOR CERTIFICATION PROCESS

There are two separate processes for Labor Certification. The Special Handling Process is an option for any employee

whose position requires classroom teaching. Otherwise, the Regular Labor Certification process must be used for any

other professional position.

SPECIAL HANDLING PROCESS – ONLY FOR TEACHING FACULTY AND INSTRUCTORS

The Special Handling Process for Labor Certification is a great option for a Department which wishes to support any

international teaching faculty or instructors for Permanent Residency. The process requires much less work and

documentation than the standard Labor Certification Process.

The Special Handling Process still requires that the department follow the basic steps for supporting Permanent

Residency. This means the Department must first get Human Resources approval to support the position for

Permanent Residency.

Also, Departments must submit the Enclosure A form of the Permanent Residency Packet and the proposed

advertisement and recruitment plan to the Division of International Studies for review before placing any ads. If

experience is required for the position, the international applicant must have had that experience before being hired by

the Jackson State University. Experience gained while working for the Jackson State University cannot be used to

satisfy minimum experience requirements unless that experience was gained in a substantially different position.

Basic Requirements – To be eligible for Special Handling processing, the job position and job search must meet the

following requirements set by the U.S. Department of Labor:

• Position must involve classroom teaching;

• Allows Jackson State University to pick the most qualified candidate (not just the only qualified candidate);

• Department must advertise the position in the print version of The Chronicle of Higher Education or the

equivalent publication for the profession. Online ads will not be accepted. The ad must appear in at least one

edition, and the ad must list teaching in the job requirements;

• Department must do an internal posting of the position for ten business days- following Department of Labor

specifications (posting notice will be provided by Division of International Studies);

• Department must accept applications for 30 days following publication of ad;

• The search committee must write report detailing recruitment efforts, including location of ads, screening

processes, list of all applicants and non-selection reasons and statement explaining why the chosen candidate

is the best for the position (a sample of the recruitment report is included in the Enclosure A section);

• The University must file the PERM labor application within 18 months of position selection (the selection

date is the date the search committee made the recommendation to hire, not the date of job-offer).

Once the Department has completed all of the Special Handling recruitment requirements, they must submit all

evidence of advertising and recruitment efforts to the Division of International Studies.

To be submitted by the Department upon completion of the search:

 Original copy of the print advertisement or the official tear sheet from the Chronicle of Higher Education or

equivalent publication

 The internal posting notice of job availability, signed and dated by Department Head that shows the location of

the posting of the notice and the dates of posting (must be ten business days, not ten calendar days)

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 A signed Recruitment Report from the head of the search committee which outlines the recruitment steps taken

(advertising methods, advertising dates, number of total applicants, number of applicants/ candidates, number who

were interviewed, reason for non-selection, and reason for selection of the international employee)

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Permanent Residency Enclosure A Form: For the Department

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Division of International Studies • Jackson State University • Office Complex Unit 1, Box 17103 • Jackson, MS 39217 • USA

Phone: (601) 979-3796 • Fax: (601) 979-3388

Email: patricia.a.jernigan@jsums.edu

Please submit the following information. Be sure to type or print clearly.

It is very important that you read the following carefully and not sign anything unless you are in total agreement.

PART 1: POSITION DESCRIPTION. TO BE COMPLETED BY DEPARTMENT CHAIR

- PLEASE ENTER INFORMATION ABOUT POSITION REQUIREMENTS, NOT PROSPECTIVE EMPLOYEE’S QUALIFICATIONS

- ATTACH THE OFFICIAL HUMAN RESOURCES JOB DESCRIPTION, WEB POSTING, AND ANY PROPOSED ADVERTISEMENTS

Hiring Department/ Unit: ____________________________________________________________________________________________________

School/ Division: __________________________________________________________________________________________________________

Primary Worksite Address : _______________________________________________________________________________________________

(where work is to be performed)

_______________________________________________________________________________________________

Position Title : ____________________________________________________________________________________________________________

Position’s minimum degree requirement: ________________________________ Field(s) of study: _____________________________________

Position’s minimum required training and experience (other than that which would or could have been obtained during the normal course of the degree

program listed above). Please specify field of experience and quantify required training and experience in months or years:

_____________________________________________________________________________________________________________________

___________________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________

List any alternate fields of study or alternate areas of experience that are acceptable:

_____________________________________________________________________________________________________________________

List minimum requirements for applicants from alternate fields of study or alternate areas of experience:

_____________________________________________________________________________________________________________________

Description of basic job duties

_____________________________________________________________________________________________________________________

Are the job’s requirements normal for the occupation?  Yes or  No (If “No,” department must justify business necessity for non-normal requirements)

Is knowledge of a foreign language required to perform the basic job duties?  Yes or  No (If “Yes,” department must justify language requirement)

List any other specific job skills or other job requirements:

_____________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

Will the international applicant hold multiple occupations or will the job position require a combination of work sites and duties?  Yes or  No

If “Yes,” please provide details of other occupations, work sites, or duties:

_____________________________________________________________________________________________________________________

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Permanent Residency Enclosure A Form: For the Department

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PART 1: POSITION DESCRIPTION (CONTINUED)

Proposed Position Salary: _____________________________________________________________________________________________________

Hours/ Range of hours per week:  Per year or  Per nine months

There are no additions or deductions from each pay period, nor overtime. (Check if true)

Benefits: (Check all that apply)

 Position includes NO additional compensation or benefits

 Position includes standard Jackson State University employee benefits

 Position includes additional compensation (specify): _____________________________________________________________________________

with an estimated dollar value of (per year): ____________________________________________________________________________________

Number of employees applicant will supervise (other than students): ____________________________________________________________________

Occupational title of person who will be employee’s immediate supervisor: _______________________________________________________________

Supervisor’s name: ______________________________________ : ________________________________ : ________________________________

Family Name (Last) Given Name (First) Middle Name (if any)

Supervisor’s E-mail address: ___________________________________________________________________________________________________

Supervisor’s Phone Number: ___________________________________________________________________________________________________

Supervisor’s Fax Number: _____________________________________________________________________________________________________

PART 2: PROSPECTIVE EMPLOYEE CONTACT INFORMATION

Prospective PR employee name: ______________________________ : ________________________________ : ________________________

Family Name (Last) Given Name (First) Middle Name (if any)

U.S. Social Security # (if any): _______________________________________

Current Mailing Address : _____________________________________________________________________________________________________

_____________________________________________________________________________________________________

E-mail address: ___________________________________________________________________________

Phone Number (with country and city code): _______________________________________________________________________________________

Fax Number (with country and city code): ________________________________________________________________________________________

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Permanent Residency Enclosure A Form: For the Department

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PART 3: LEGALLY BINDING EMPLOYER ATTESTATIONS

From 18 U.S.C. § 2, 1001 & 18 U.S.C. § 1546 and 1621

By signing below, I attest that the above information is true and that the Jackson State University will comply with the following

statements as required by US Department of Labor.

1) That the offered wage equals or exceeds the prevailing wage and I will pay at least the prevailing wage (Prevailing wage is set by

Department of Labor);

2) That the wage is not based on commissions, bonuses or other incentives, unless a guaranteed wage is paid on a weekly, bi-weekly, or

monthly basis that equals or exceeds the prevailing wage;

3) That there are enough funds available to pay the wage or salary offered to the employee;

4) That the department will be able to place the international employee on the payroll on or before the date of the international employee’s

proposed entrance into the United States;

5) The job opportunity does not involve unlawful discrimination by race, creed, color, national origin, age, sex, religion, handicap, or

citizenship;

6) The job opportunity is no:

a) Vacant because the former occupant is on strike or is being locked out in the course of a labor dispute involving a work

stoppage; or

b) At issue in a labor dispute involving a work stoppage.

7) The job opportunity’s terms, conditions, and occupational environment are not contrary to Federal, state, or local laws;

8) The job opportunity has been and is clearly open to any U.S. worker;

9) The U.S. workers who applied for the job opportunity were rejected for lawful job-related reasons;

10) The job opportunity is for full-time, permanent employment for an employer other than the international applicant.

Required Signatures:

Department Chair Name: ___________________________ : ____________________________ : ___________________

Family Name (Last) Given Name (First) Middle Name (if any)

Department Chair Signature: Date: ________________________________________

Dean’s Signature: Date: ________________________________________

LEGAL NOTES AND COMPLIANCE

Any employer or alien, or their agent or attorney, who knowingly and willingly furnishes any false information in the preparation

of the Department of Labor ETA Form 9089 Labor Certification and any supporting documentation, or aids, abets, or counsels

another to do so is committing a federal offense, punishable by fine or imprisonment up to five years or both (18 U.S.C. § 2, 1001).

Other penalties as well to fraud or misuse of the immigration document and to perjury with respect to the ETA Form 9089 Labor

Certification (18 U.S.C. § 1546, 1621).

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After completion of parts 1, 2, and 3, return to:

Division of International Studies

Jackson State University

Office Complex Unit 1, Box 17103

Jackson, MS 39217

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Jackson State University

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Permanent Residency Enclosure B Form: For the Applicant

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Division of International Studies • Jackson State University • Office Complex Unit 1, Box 17103 • Jackson, MS 39217 • USA

Phone: (601) 979-3796 • Fax: (601) 979-3388

E-mail: patricia.a.jernigan@jsums.edu

Please submit all of the following information. Be sure to type or print clearly

DO NOT STAPLE ANY DOCUMENTS TOGETHER

PERMANENT RESIDENCY APPLICANT DEMOGRAPHIC INFORMATION

NAME AND RESIDENCE INFORMATION:

Full Name (as it appears in your passport): ____________________________ : ____________________________ : _________________________

Family Name (Surname) Given Name (First) Middle Name (if any)

All other names used : _________________________________________________________________________________________________________

(Include maiden name and names from all previous marriages)

Residential Address Inside the U.S. : _________________________________________________________________________________________

_________________________________________________________________________________________

Residential Address Outside of the U.S. : _______________________________________________________________________________________

______________________________________________________________________________________

_________________________________________________________________________________________

Work Phone Number: ________________________________________ Home Phone Number:_________________________________________

E-mail address: _____________________________________________ Fax Number: _________________________________________________

Place of Birth (required): _______________________ : ________________________________________ : _______________________________

City Province/ State Country

Residence Information (required): ______________________________________ :____________________________________________________

Country of Citizenship Country of Permanent Residence

Date of Birth (Month/ Day/ Year): ________________________________________ Gender :_______________________________________

PR Application 11/2011

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US VISA HISTORY INFORMATION:

Please list all time in the US in non-immigrant visa status. If more space is needed, please attach a separate page for your visa history.

1. Immigration Status (i.e. F-1, J-1, H-4): ____________ Dates of Stay (Month/ Day/ Year): ___________________ through ___________________

2. Immigration Status (i.e. F-1, J-1, H-4): ____________ Dates of Stay (Month/ Day/ Year): ___________________ through ___________________

3. Immigration Status (i.e. F-1, J-1, H-4): ____________ Dates of Stay (Month/ Day/ Year): ___________________ through ___________________

Have you ever been in the United States on a J Visa (J-1 or J-2)? 

YES or

 NO.

Are you subject to the 212(e), Two-Year Home Residency Requirement (only possible if currently or previously on J-Visa)? 

YES or

 NO.

If subject to 212(e), Two-Year Home Residency Requirement what is your current status? (Please Check One)

 Applied for waiver

 Received waiver (Please Include Proof of Waiver)

 Completed requirement in home country

 None of the above

Do you have any other pending immigrant petitions (Permanent Residency Applications)? 

YES or

 NO.

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Jackson State University

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Permanent Residency Enclosure B Form: For the Applicant

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IMMIGRATION INFORMATION

Passport # : _________________________________________________ Passport Country: ______________________________________________

Passport Issue Date (Month/ Day/ Year): _________________________________________

Passport Expiry Date (Month/ Day/ Year): ________________________________________

[Please note that passports must be renewed at least 6 months prior to their expiration date]

U.S. Social Security # (if any): _______________________________________

A # (Alien number is listed on EAD Cards, OPT Cards, and on any I-140 or I-485 Notices) : _________________________________________________

Which U.S. Consulate or Embassy is closest to your place of residence in your home country?

City (outside of the U.S.): ________________________________ Country: _______________________________

Current Non-Immigrant Visa Status (i.e. F-1, J-1, H-1B) : _____________

Date Current Visa Status Expires (Month/ Day/ Year): __________________________________________________

Date of Last Arrival (Stamped on I-94 Card) (Month/ Day/ Year): ________________________________________

I-94 # (Eleven Digit Number at Top of White Card in Passport): _______________________________________

JACKSON STATE UNIVERSITY POSITION INFORMATION

(Please provide contact information about your intended employer at the Jackson State University)

JSU Academic Department: _________________________________________ Supervisor’s Name_________________________________________

Supervisor’s Phone Number: ________________________________________ E-mail address: ___________________________________________

EDUCATION BACKGROUND

PR Application 11/2011

14

EDUCATION:

Highest Level of Education Achieved: ___________________________ Major field of study/concentration: __________________________________

Year of Degree Completion/Graduation: ________________Name of Institution from which Degree was received: _____________________________

Address of Institution: _________________________________________________________________________________________________________

_________________________________________________________________________________________________________

FAMILY INFORMATION: LIST INFO FOR SPOUSE AND EACH CHILD (EVEN U.S. BORN DEPENDENTS)

NAME (First/ Middle/ Last) Relationship Date of Birth (mm/dd/yyyy) Country of Birth

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Jackson State University

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Permanent Residency Enclosure B Form: For the Applicant

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WORK HISTORY

PR Application 11/2011

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List all jobs held during the past three years. Also list any other experiences that meet job requirements.

Use multiple pages if necessary.

Job 1:

Employer Name: ___________________________________________ Type of Business: _______________________________________________

Address of Employer: _________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Supervisor’s Name: _________________________________________ Business Phone Number: _________________________________________

Employment Start Date (Month/ Day/ Year): ________________________ Employment End Date (Month/ Day/ Year): ________________________

Number of Hours Worked Per Week: ___________________________Job Title: ________________________________________________________

Job Description (include duties performed, use of tools, machines, equipment, computers programs, skills, qualifications, certifications, licenses, etc.)

___________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

Job 2:

Employer Name: ___________________________________________ Type of Business:________________________________________________

Address of Employer: _________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Supervisor’s Name: _________________________________________ Business Phone Number:__________________________________________

Employment Start Date (Month/ Day/ Year): ________________________ Employment End Date (Month/ Day/ Year): ________________________

Number of Hours Worked Per Week: __________________________________Job Title: ________________________________________

Job Description (include duties performed, use of tools, machines, equipment, computers programs, skills, qualifications, certifications, licenses, etc.)

________________________________________________________________________________________________________________________

PERMANENT RESIDENCY PROCESSING & CONCURRENT PROCESSING

Please indicate your preference for obtaining your final approval of Permanent Residency

 I will file an I-485 for myself and all dependent family members to change status and obtain a Green Card from within the United States

 I will process my Permanent Residency by Consular Processing and will travel abroad to a U.S. Consulate or Embassy to become a Permanent Resident

Will you be filing any forms for concurrent processing with the University’s I-140 (i.e. simultaneous filing)?



YES or

 NO.

If yes, indicate which forms you will be concurrently filing:  I-485,  I-765 EAD Card Application, and/or  I-131 Advanced Parole Document

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Jackson State University

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Permanent Residency Enclosure B Form: For the Applicant

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BASIC SUPPORTING DOCUMENTATION – REQUIRED OF ALL PR APPLICANTS

PR Application 11/2011

16

PLEASE INCLUDE THE FOLLOWING SUPPORTING DOCUMENTS AND RETURN TO THE DIVISION OF INTERNATIONAL STUDIES.

**DO NOT STAPLE ANY DOCUMENTS TOGETHER**

 Curriculum Vita/ Resume which includes current address, home country address, statement of work history, and list of publications

 Copy of all university-level academic degrees, diplomas, and transcripts/mark sheets.

- Diplomas and transcripts/mark sheets do not have to be originals

- On the back of each photocopy, sign a statement that says “This is a true photocopy and originals are available upon request.”

- Documents not in English must be translated by someone competent to do so (See attached translation certificate on last page of PR Packet)

- Degrees or documents issued by non-U.S. institutions will have to have a foreign credential evaluation processed by the Division of International

Studies

 Copy of Passport Identification Pages (Full-page photocopies ONLY. Do not cut the photocopy to the shape of the passport)

 Copies of I-94 Card (FRONT AND BACK)

 Copies of current/ most recent Visa Stamp

 Copies of all previous I-20’s, DS-2019’s, IAP-66’s, and H-1B or H-4 I-797 Approval Notices

 Proof of I-612 waiver of 212(e) Two-Year Home Residency Requirement if currently or previously on J-Visa

EVIDENCE OF EB-1 OUTSTANDING PROFESSOR AND RESEARCHER

PLEASE INCLUDE THE FOLLOWING SUPPORTING DOCUMENTS AND RETURN TO DIVISION OF INTERNATIONAL STUDIES.

**DO NOT STAPLE ANY DOCUMENTS TOGETHER**

An EB-1 applicant can establish eligibility as an outstanding professor or researcher by developing and submitting documentation in at least two

(preferably three) of the categories listed below:

• Receipt of major prizes or awards for outstanding achievement in the field of endeavor;

• Membership in associations in the academic field which require their members to demonstrate outstanding achievements to become a member;

• Published material in professional publications written by others about the alien's

work in the academic field. Such evidence should include title, date, and author of the publication and any necessary translations;

• Participation, either on a panel or individually, as a judge of the work of others in

the same or allied academic field;

• Original scientific, scholarly, or business-related contributions in the field (as shown by letters of attestation and support from colleagues and

other experts in the field; letters should be accompanied by CV’s or Resumes);

• Authorship of scholarly books or articles (in scholarly journals with international circulation) in the academic field.

EB-1 applications do not require Labor Certification by the Department of Labor.

EVIDENCE OF EB-2 ALIENS OF EXCEPTIONAL ABILITY IN THE SCIENCES, ARTS, OR BUSINESS

PLEASE INCLUDE THE FOLLOWING SUPPORTING DOCUMENTS AND RETURN TO DIVISION OF INTERNATIONAL STUDIES.

**DO NOT STAPLE ANY DOCUMENTS TOGETHER**

An EB-2 applicant can establish eligibility as an alien of exceptional ability in the sciences, arts, or business or advanced degree by developing and

submitting documentation in at least three (preferably four) of the categories listed below:

• An official academic record showing that the applicant has a degree, diploma, certificate, or similar award from an institution of learning relating

to the area of exceptional ability;

• Evidence in the form of letters from current or former employers showing that the applicant has at least ten years of full-time experience in the

occupation;

• A license to practice the profession or certification for a particular profession or occupation;

• Evidence that the applicant has either commanded a salary or other remuneration for services, as shown by contracts or letters of employment,

which demonstrates exceptional ability;

• Membership in professional associations;

• Evidence of recognition for achievements and significant contributions to the industry or field by peers, governmental entities, or professional or

business organizations.

EB-2 applications require Labor Certification by the Department of Labor.

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Jackson State University

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Permanent Residency Enclosure B Form: For the Applicant

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PR Application 11/2011

17

EVIDENCE OF EB-2 ADVANCED DEGREE HOLDER

PLEASE INCLUDE THE FOLLOWING SUPPORTING DOCUMENTS AND RETURN TO DIVISION OF INTERNATIONAL STUDIES.

**DO NOT STAPLE ANY DOCUMENTS TOGETHER**

An EB-2 applicant can establish eligibility as an alien with an advanced degree by submitting the documentation listed below:

• An official academic record showing that the applicant has an advanced degree, diploma, certificate, or similar award from an institution of

learning relating to the profession;

EB-2 applications require Labor Certification by the Department of Labor.

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Fillable Jackson State University Permanent Residency Application Packet (Jackson State University)

Fill Online, Printable, Fillable, Blank Jackson State University Permanent Residency Application Packet (Jackson State University) Form

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