Company Information
Your Company Name:
*
Doing Business As:
Date Company Founded
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Federal Employer ID Number (FEIN)
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What County Are you located in?
*
For example, Hudson County, New Jersey, USA
Corporate Phone Number
*
-
Area Code
Phone Number
Corporate Fax Number
-
Area Code
Phone Number
Fedex Account #
If you prefer us to bill you, please let us know.
Description of Business
NAICS #
*
Please confirm with your accountant
Your E-mail Address:
*
example@example.com
Company Data
{petitioner} Total Employees
*
This includes H1B, L, TN, Green Card, Citizens, etc
Total H Employees
*
Total L Employees
*
Gross Annual Income
*
Net Annual Income
*
Is the company H-1B Dependant or a Willful Violator?
*
Yes
No
Employer Contact Person (Signor)
Signor's First Name
*
Signor's Middle Name
Signor's Last Name
*
Signor's E-mail Address
*
Phone Number
*
-
Area Code
Phone Number
Cell Number
*
-
Area Code
Phone Number
Fax Number
-
Area Code
Phone Number
Please upload you form SS4 and any other relevant documents
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