Michael A. Pezzuto

Attorney at Law

 

(805) 604-9555

Labor  Certification  Questionnaire

This questionnaire should be filled out completely and accurately.  If you do not understand a question or have any other problem regarding any of the items, please feel free to call (805) 604-9555 or

email us your question(s).

1. The name of the alien:

Tel No.:

E-mail address:

2. U.S. current address of alien:

Social Security No.:

3. Foreign address of alien:

4. Date of Birth:

Place of Birth:

5. Present Nationality or Country of Citizenship:

6. Status in the U.S.A.:                                               

Expiration Date:

Address:

Name of person within the company who will be the contact person for coordination of the recruitment phase and newspaper ad approval:

Full Name:

E-mail:

8. Telephone of employer (area code and number):

9. Fax No.:

10. Does employer have a Web page?

11. If the address where the alien will work is different from item # 7(A), give address:

12. Annual sales or income of employer’s organization:

Note:  A copy of the employer’s federal income tax return or annual report must be submitted to the Immigration & Naturalization Service when an immigrant petition is filed.

(b) Total number of employees in the employer’s organization:

 (c) Employer’s Federal Tax Identification No.:

(d) Date business established:

 13. Give brief non-technical description of the nature of the employer’s business or activity:

14. How many other employees will the alien supervise?

15. Give number of employees at the place where the alien will work:

16. Exact job title of the job being offered to the alien:

 17.  (a) Total basic hours per week that the alien will work:

(b) Work schedule hours from:

 (c) Total overtime hours per week that the alien will work:

18. What is the basic rate of pay per hour, week, or month:

19. List Licenses: (Professional, Journeymen, etc.):

20.What is the occupational title of the person who will be the alien’s immediate supervisor:

21. Full name and title of person signing the job offer for the alien:

Name:

Title:

Tel No:

Fax No:

E-mail:

22. Are there Multiple Openings:

How Many:

IF THE BUSINESS IS A RESTAURANT:

(a)  What are the business hours?

(b)  How many days are you open per week?

Name those days:

Seating capacity:

SUMMARY OF ALIEN WORKER’S EDUCATIONAL QUALIFICATIONS:

(Attach photocopies of degree and transcripts)

Can you produce your degree?

Can you produce your transcripts?

Have you ever had your foreign educational awards evaluated by a professional U.S. credentials evaluator?

1. Name and address of school, college or university attended:

Field of study: Degree/Diploma or Certificate obtained:

Academic years: From(Mo./Yr.):

Yo (Mo./Yr.):

4. Qualifications and skills you possess

(Please include proficiency with computer languages, use of equipment, tools and/or machines; and/or experience with special procedures and or techniques):

5.  If you had a prior H-1B visa, how many years did you work on it?

What dates: From: 

To:

6. Have you been out of the country for 12 months since you last had an H-1B visa?

SUMMARY OF THE ALIEN WORKER’S EMPLOYMENT EXPERIENCE

Can you produce prior employment letters to back up your experience?

(These letters must be on business letterhead; state your job title, job duties, and dates of employment.)

Prior work experience. (relating to the work you are applying for via a U.S. work visa or Alien Labor Certification) :

1. Name and address of employer:

Job title:

Type of business:

Employment dates: From (Mo./Yr.):

To (Mo./Yr.):

Number of hours per week:

Please describe in detail the job duties including the use of tools, machines or equipment, computer technology software, programs, languages:  

If necessary, could you obtain a letter from this employer verifying your work experience?

(a) Gross:

Net:

a.m. to

p.m.

2. Name and address of school, college or university attended:

Field of study: Degree/Diploma or Certificate obtained:

Academic years: From(Mo./Yr.):

Yo (Mo./Yr.):

3. Name and address of school, college or university attended:

Field of study: Degree/Diploma or Certificate obtained:

Academic years: From(Mo./Yr.):

Yo (Mo./Yr.):

2. Name and address of employer:

Job title:

Type of business:

Employment dates: From (Mo./Yr.):

To (Mo./Yr.):

Number of hours per week:

Please describe in detail the job duties including the use of tools, machines or equipment, computer technology software, programs, languages:  

If necessary, could you obtain a letter from this employer verifying your work experience?

3. Name and address of employer:

Job title:

Type of business:

Employment dates: From (Mo./Yr.):

To (Mo./Yr.):

Number of hours per week:

Please describe in detail the job duties including the use of tools, machines or equipment, computer technology software, programs, languages:  

If necessary, could you obtain a letter from this employer verifying your work experience?

7. Name of the employer (i.e., full name of the organization):