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Fillable Printable Form I-129CW

Fillable Printable Form I-129CW

Form I-129CW

Form I-129CW

Form I-129CW 12/23/16 N Page 1
Department of Homeland Security
U.S. Citizenship and Immigration Services
OMB No. 1615-0111; Expires 04/30/2018
Action Block
Partial Approval (explain)
For USCIS Use Only
Class:
# of Workers:
Job Code:
Priority Number:
Validity Dates:
From:
To:
Classification Approved
Consulate/POE/PFI Notified
At
Extension Granted
COS/Extension Granted
START HERE - Type or print in black ink.
Part 1. Information About the Employer Filing This Petition
2. Telephone Number (include area
code, no spaces or dashes):
1. Name of Representative for Employer/Organization
3. Name of Employer/Organization and Address
a. Name of Employer/Organization:
Form I-129CW, Petition for a CNMI-Only
Nonimmigrant Transitional Worker
4. E-Mail Address (if any):
5. Federal Employer Identification Number:
b. C/O (In Care Of):
Receipt
Part 2. Information About This Petition (See instructions for fee
information)
1. Requested Nonimmigrant Classification
(Write classification symbol):
a. Family Name (Last Name)
b. Given Name (First Name)
c. Middle Name
c. Street Number and Name
d. Suite/Apartment Number
e. City or Town
f. State g. Zip Code
h. Postal Code
i. Province
j. Country
Form I-129CW 12/23/16 N Page 2
Part 2. Information About This Petition (See instructions for fee information) (Continued)
4. Prior Petition. If the beneficiary is in the CNMI as a nonimmigrant and
is applying to change and/or extend his or her status, give the prior
petition or application receipt number:
2. Basis for Classification
(Check one):
3. If you checked Box 2b, 2c, 2d, 2e, or 2f, give the petition receipt number.
5. Requested Action (Check one):
6. Total number of workers in petition (See instructions relating to when more than one worker can be
included):
a. New employment (including a duplicate for U.S. Department of State notification).
d. New concurrent employment.
e. Change of employer.
f. Amended petition.
c. Change in previously approved employment.
b. Continuation of previously approved employment without change with the same employer.
a. Notify the office in Part 4 so the person(s) can obtain a visa or be admitted.
d. Amend the stay of the person(s) since they now hold this status.
c. Extend the stay of the person(s) since they now hold this status.
b. Change the person(s) status and extend their stay since the person(s) are all now in the CNMI in another status (see
instructions for limitations). This option is available only where you check "New Employment" in Item 2, above. Check
the appropriate box indicating the type of status change.
Part 3. Information About the Persons For Whom You Are Filing (Complete the blocks below. Use the
continuation sheet to name each person included in this petition.)
a. Family Name (Last Name) b. Given Name (First Name) c. Full Middle Name
1. Complete the following information about the person being filed:
e. Date of Birth (mm/dd/yyyy)
j. Country of Citizenship
f. U.S. Social Security Number (if any) g. A-Number (if any)
h. Country of Birth i. Province of Birth
d. All Other Names Used (include maiden name and names from all previous marriages)
1. Initial Grant of CW-1 status in CNMI
2. Change of Federal nonimmigrant status to CW-1
Form I-129CW 12/23/16 N Page 3
Part 3. Information About the Persons For Whom You Are Filing (Complete the blocks below. Use the
continuation sheet to name each person included in this petition.) (Continued)
b. I-94 Number (Arrival-Departure Document)
a. Date of Last Arrival
(mm/dd/yyyy)
h. Current CNMI Address
2. If in the CNMI, Complete the following:
c. Current Nonimmigrant Status
d. Date Status Expires
(mm/dd/yyyy)
e. Passport Number
f. Date Passport Issued
(mm/dd/yyyy)
g. Date Passport Expires
(mm/dd/yyyy)
Part 4. Processing Information
1. If the person named in Part 3 is outside the CNMI, or a requested extension of stay, or change of status cannot be granted, give
the U.S. consulate or inspection facility you want notified if this petition is approved.
a. Type of Office (Check one):
b. Office Address (City)
c. U.S. State or Foreign Country
d. Person's Foreign Address
Consulate Pre-flight inspection Port of Entry
2. Does each person in this petition have a valid passport?
3. Are you filing any other petitions with this one?
4. Are applications for replacement/initial I-94s being filed with this petition?
5. Are applications by dependents being filed with this petition?
6. Is any person in this petition in removal proceedings?
9. Have you ever previously filed a petition for this person?
7. Have you ever filed an immigrant petition for any person in this petition?
8. If you indicated you were filing a new petition in Part 2, has any person in this petition:
a. Ever been given the classification you are now requesting?
b. Ever been denied the classification you are now requesting?
Not required to have passport YesNo - write a brief explanation in Part 8.
Yes - How many?
No
Yes - How many?
No
Yes - How many?No
Yes - explain in Part 8No
Yes - explain in Part 8
No
Yes - explain in Part 8
No Yes - explain in Part 8
No
Yes - explain in Part 8
No
Form I-129CW 12/23/16 N Page 4
1. Job Title
Part 5. Basic Information About the Proposed Employment and Employer (Attach Form I-129 CW Supplement)
2. Nontechnical Job Description
5. Address where the person(s) will work if different from address in Part 1. (Street Number and Name, City/Town, State, Zip Code)
6. Is this a full-time position?
7. Other Compensation (Explain)
3. Reserved for future use. 4. Reserved for future use.
Yes - Wages per week or per year:
No - Hours per week:
8. Dates of intended employment (mm/dd/yyyy):
From: To:
10. Type of Business
11. Year Established 12. Current Number of Employees
9. Type of Petitioner - Check one:
13. Gross Annual Income 14. Net Annual Income
a. Business b. Organization c. Other - write a brief explanation in Part 8.
$
Form I-129CW 12/23/16 N Page 5
I certify, under penalty of perjury under the laws of the United States of America, that this petition and the evidence submitted with it
is all true and correct. If filing this on behalf of an organization, I certify that I am empowered to do so by that organization. If this
petition is to extend a prior petition, I certify that the proposed employment is under the same terms and conditions as stated in the
prior approved petition. I authorize the release of any information from my records, or from the petitioning organization's records that
U.S. Citizenship and Immigration Services needs to determine eligibility for the benefit being sought.
Signature of Petitioner
Date
(mm/dd/yyyy)Printed Name of Petitioner
Daytime Phone Number (include Area/
Country Code):
NOTE: If you do not completely fill out this form and the required supplement, or fail to submit required documents listed in the
instructions, the beneficiary may not be found eligible for the requested benefit and this petition may be denied.
Part 6. Signature (Read the information on penalties in the instructions before completing this section.)
I declare that I prepared this petition at the request of the above person and it is based on all information of which I have any
knowledge.
Part 7. Signature of Person Preparing Form, If Other Than Above
Firm Name and Address
Signature of Preparer
Date (mm/dd/yyyy)
Printed Name of Preparer
Day time Phone Number (include Area/
Country Code, no spaces or dashes):
Form I-129CW 12/23/16 N Page 6
Part 8. Explanation (Provide on the space below the Question Number with your answers.)
Form I-129CW 12/23/16 N Page 7
IF
IN
THE
CNMI
Attachment - 1
Attach to Form I-129CW when more than one person is included in the petition. (List each person separately. Do not include
the person you named on Form I-129CW.)
Family Name (Last Name) Given Name (First Name) Full Middle Name
Foreign Address (Complete Address)
Address in the CNMI (Complete Address)
Country of Birth Country of Citizenship
A-Number (if any)Date of Birth (mm/dd/yyyy)
U.S. Social Security Number (if any)
Family Name (Last Name) Given Name (First Name) Full Middle Name
Foreign Address (Complete Address)
Address in the CNMI (Complete Address)
Country of Birth Country of Citizenship
Date of Birth (mm/dd/yyyy) U.S. Social Security Number (if any)
Date of Arrival
(mm/dd/yyyy)
I-94 # (Arrival-Departure Document) Current Nonimmigrant Status Date Status Expires
(mm/dd/yyyy)
Country Where Passport Issued Date Passport Expires
(mm/dd/yyyy)
Date Started With Group
(mm/dd/yyyy)
A-Number (if any)
IF
IN
THE
CNMI
Date of Arrival
(mm/dd/yyyy)
I-94 # (Arrival-Departure Document) Current Nonimmigrant Status Date Status Expires
(mm/dd/yyyy)
Country Where Passport Issued Date Passport Expires
(mm/dd/yyyy)
Date Started With Group
(mm/dd/yyyy)
Form I-129CW 12/23/16 N Page 8
IF
IN
THE
CNMI
Attachment - 1
Attach to Form I-129CW when more than one person is included in the petition. (List each person separately. Do not include
the person you named on Form I-129CW.)
Family Name (Last Name) Given Name (First Name) Full Middle Name
Foreign Address (Complete Address)
Address in the CNMI (Complete Address)
Country of Birth Country of Citizenship
A-Number (if any)Date of Birth (mm/dd/yyyy)
U.S. Social Security Number (if any)
Family Name (Last Name) Given Name (First Name) Full Middle Name
Foreign Address (Complete Address)
Address in the CNMI (Complete Address)
Country of Birth Country of Citizenship
Date of Birth (mm/dd/yyyy) U.S. Social Security Number (if any)
Date of Arrival
(mm/dd/yyyy)
I-94 # (Arrival-Departure Document) Current Nonimmigrant Status Date Status Expires
(mm/dd/yyyy)
Country Where Passport Issued Date Passport Expires
(mm/dd/yyyy)
Date Started With Group
(mm/dd/yyyy)
A-Number (if any)
IF
IN
THE
CNMI
Date of Arrival
(mm/dd/yyyy)
I-94 # (Arrival-Departure Document) Current Nonimmigrant Status Date Status Expires
(mm/dd/yyyy)
Country Where Passport Issued Date Passport Expires
(mm/dd/yyyy)
Date Started With Group
(mm/dd/yyyy)
Form I-129CW 12/23/16 N Page 9
IF
IN
THE
CNMI
Attachment - 1
Attach to Form I-129CW when more than one person is included in the petition. (List each person separately. Do not include
the person you named on Form I-129CW.)
Family Name (Last Name) Given Name (First Name) Full Middle Name
Foreign Address (Complete Address)
Address in the CNMI (Complete Address)
Country of Birth Country of Citizenship
A-Number (if any)Date of Birth (mm/dd/yyyy)
U.S. Social Security Number (if any)
Family Name (Last Name) Given Name (First Name) Full Middle Name
Foreign Address (Complete Address)
Address in the CNMI (Complete Address)
Country of Birth Country of Citizenship
Date of Birth (mm/dd/yyyy) U.S. Social Security Number (if any)
Date of Arrival
(mm/dd/yyyy)
I-94 # (Arrival-Departure Document) Current Nonimmigrant Status Date Status Expires
(mm/dd/yyyy)
Country Where Passport Issued Date Passport Expires
(mm/dd/yyyy)
Date Started With Group
(mm/dd/yyyy)
A-Number (if any)
IF
IN
THE
CNMI
Date of Arrival
(mm/dd/yyyy)
I-94 # (Arrival-Departure Document) Current Nonimmigrant Status Date Status Expires
(mm/dd/yyyy)
Country Where Passport Issued Date Passport Expires
(mm/dd/yyyy)
Date Started With Group
(mm/dd/yyyy)
Form I-129CW 12/23/16 N Page 10
7. The position is not temporary or seasonal employment, and the above named petitioning employer does not reasonably believe
the position to qualify for any other nonimmigrant worker classification.
8. The position falls within the list of occupational categories designated by the Secretary at 8 CFR 214.2(w)(1)(ix).
2. Name of person for whom you are filing:1. Name of employer or organization filing petition:
Employer Attestation
1. There are no qualified U.S. workers available to fill the position offered by the above named petitioning employer.
2. The above named petitioning employer is doing business as defined in the regulations at 8 CFR 214.2(w)(1)(ii).
3. The above named petitioning employer is a legitimate business as defined in the regulations at 8 CFR 214.2(w)(1)(vi).
5. The beneficiary meets the qualifications for the position.
6. The beneficiary, if present in the CNMI, is lawfully present in the CNMI.
Department of Homeland Security
U.S. Citizenship and Immigration Services
OMB No. 1615-0111; Expires 04/30/2018
CW Classification
Supplement to Form I-129CW
Check one:
3. Is the petitioning employer requesting an accommodation to the benefit process on behalf of the
beneficiary because of a disability or impairment? (See instructions for examples of accommodations.)
If you answered "Yes," check the box below that applies:
.
.
.
Yes
No
a. The beneficiary is deaf or hard of hearing and request the following accommodation (if requesting a sign-language
interpreter, indicate for what language (e.g. American Sign Language):
b. The beneficiary is blind or sight impaired and request the following accommodation:
c. The beneficiary has another type of disability (describe the nature of the disability and accommodation you are requesting):
a. Professional, technical, or management occupations
b. Clerical and sales occupations
c. Service occupations
d. Agricultural, fisheries, forestry, and related occupations
e. Processing occupations
f. Machine trade occupations
g. Benchwork occupations
h. Structural occupations
i. Miscellaneous occupations
4. The above named petitioning employer is an eligible employer as described in 8 CFR 214.2(w)(4) and will continue to comply
with the requirements for an eligible employer until such time as the employer no longer employs any CW-1 nonimmigrant
worker;
Form I-129CW 12/23/16 N Page 11
Employer Attestation
I certify under penalty of perjury, under the laws of the United States of America, that the contents of this attestation and the evidence
submitted with it are true and correct to the best of my knowledge. If filing on behalf of an organization, I certify that I am empowered
to do so by the organization. If this petition is to extend a prior petition, I certify that the proposed employment is under the same
terms and conditions as stated in the prior approved petition. I authorize the release of any information from my records, or from the
petitioning organization's record that U.S. Citizenship and Immigration Services needs to determine eligibility for the benefit sought.
Printed Name
Title
Employer/Organization Street Address
(do not use a post office)
City
Zip Code
Fax Number (if any)
E-mail Address (if any)
Daytime Phone Number (with area code)
State
Suite Number
Employer/Organization Name
Date (mm/dd/yyyy)
Signature
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