17400 Dallas Parkway, Ste 216

Dallas, TX 75287
Tel: (972) 241-4698
Fax: (972) 241-4439
www.akulalaw.com

EMPLOYEE H-1B CHECKLIST

*Entire Checklist Must Be Completed to Process Your Case*

Current Nonimmigrant Status (IF APPLICABLE): ______________________

(E.g.: H1/F1/L1/H4/L2....)

Name of Employee:

______________________________ _______________________________________
LAST GIVEN NAME(S)

Date of Birth (mm/dd/yyyy): ________________________

Place of Birth (City, State, Country): _____________ ______________ ______________

Citizen of: ___________________

Current passport #________________________________

Valid from _______________________ To ___________________

Cellular Telephone Number: ____________________

E-mail address: _______________________________

1. U.S. Physical Address (Please include the address of your actual residence. Do
Not use your work address.) (IF APPLICABLE):
________________________________________________________________________

2. Permanent Address Abroad (include city, state, country, and postal code/DO NOT
SUBMIT US ADDRESS):

________________________________________________________________________

3. Social Security Number (IF APPLICABLE): ___________________________

4. Date of Latest Arrival to the U.S. (IF APPLICABLE): _______________________

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 17400 Dallas Parkway, Ste 216
Dallas, TX 75287
Tel: (972) 241-4698
Fax: (972) 241-4439
www.akulalaw.com

5. I-94 # (IF APPLICABLE): _________________________________________

6. Date Current Status Expires (IF APPLICABLE): ________________________

8. Date First Received H/L status: ___________________________

9. Have you ever held H/L status previously (circle one) Yes No

If you responded “Yes” to # 9, you must submit a complete list of all your
previous stays in the U.S. (include date entered, date departed, nonimmigrant
visa status, etc.)

10. Have you ever been denied H-1B/L-1 status (circle one) Yes No

If you responded “Yes” to #10, you must submit details regarding the denial
(include date of denial, whether the H-1B/L-1 was denied by USCIS or at the
Consulate, etc.)

11. Do you have an approved I-140 (circle one) Yes No

12. Nearest U.S. Consulate if visa stamping is needed ___________________

13. Will your dependents need change of status or extension (circle one) Yes No

If you responded “Yes” to #12, you must provide dependent name(s) and email
address in order for a Questionnaire to be sent for completion.

DEPENDENT (1) NAME: ___________________

DEPENDENT EMAIL: ________________________

DEPENDENT (2) NAME: ___________________

DEPENDENT EMAIL: ________________________

THE EMPLOYEE MUST PROVIDE THE FOLLOWING DOCUMENTS:

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 17400 Dallas Parkway, Ste 216
Dallas, TX 75287
Tel: (972) 241-4698
Fax: (972) 241-4439
www.akulalaw.com

1. Copy of all university level educational credentials (Please include copies of all
degrees, diplomas, transcripts, marks sheets, and consolidated marks sheets, etc.).
2. Copy of all pages of valid foreign passport (Please note that you must submit all
pages of your passport, even blank pages.).
3. Copy of all pages of previous passport, either cancelled or expired, if the previous
passport contains any visa stamps issued by the U.S. consulate.).
4. Copy of I-94 (IF APPLICABLE) .
5. Copies of all or any previous I-797 approval notices. Also include copies of any
PERM and/or I-140 approval notices (IF APPLICABLE).
6. Employment Verification Letters/Experience Letters (IF APPLICABLE).
7. Educational evaluation for foreign degrees (IF APPLICABLE).
8. Copy of Social Security Card (IF APPLICABLE).
9. Copies of most recent paystubs or Earnings Statements (Please include paystubs
for at least the last 3-4 months.) (IF APPLICABLE).
10. Updated Resume (Please note that your resume MUST list the name of your
previous and current employers and NOT the name of clients for whom you
worked or the names of projects you were assigned.).

IF CHANGING STATUS FROM H4 to H1 THE FOLLOWING

DOCUMENTATION IS ALSO REQUIRED.

11. Copy of marriage certificate with English translation.

12. Copies of spouse’s H-1B Approval Notices.
13. Copies of spouse’s current passport, visa stamp, and I-94.
14. Copies of spouse’s most recent W-2.
15. Copies of spouse’s most recent paystubs or Earnings Statements (Please include
paystubs for at least the last 2 months.).

**PLEASE NOTE: THE FOLLOWING SECTION MUST BE

COMPLETED IN ORDER TO PROCESS YOUR PETITION**

INFORMATION ABOUT THE BENEFICIARY’S PUBLIC BENEFITS

This information is only required for petitions that seek a change of status or an extension of
nonimmigrant stay in the United States. If you are filing this petition without a request for the
beneficiary’s change of status or extension of stay, you may skip.

Provide the requested information and submit documentation as outlined in the Instructions.

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 17400 Dallas Parkway, Ste 216
Dallas, TX 75287
Tel: (972) 241-4698
Fax: (972) 241-4439
www.akulalaw.com

16. Are you currently certified to receive, since obtaining the nonimmigrant status that you
seek to extend or that you seek to change, the following public benefits?
(select all that apply).

___ Yes, I have received or am currently certified to receive the following public
benefits : ( select all that apply)

___ Any Federal, State, local or tribal cash assistance for income maintenance
___ Supplemental Security Income (SSI)
___ Temporary Assistance for Needy Families (TANF)
___General Assistance (GA)
___ Supplemental Nutrition Assistance Program (SNAP, formerly called
“Food Stamps”)
___ Section 8 Housing Assistance under the Housing Choice Voucher
Program
___ Section 8 Project-Based Rental Assistance (including Moderate
Rehabilitation)
___ Public Housing under the Housing Act of 1937, 42 U.S.C 1437 et seq.
___ Federally-Funded Medicaid

___ No, I have not received any of the above listed public
benefits.
___ No, I am not certified to receive any of the above listed public benefits.

If you answered yes above, please provide the following details:

I.
A. Agency that Granted the Benefit
____________________________________

B. Date You Started Receiving the Benefit or if Certified,

Date You will start Receiving the Benefit (mm/dd/yyyy)
________________________________

C. Date Benefit Ended or Expires (mm/dd/yyyy)

_________________________________________

II.

A. Agency that Granted the Benefit

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 17400 Dallas Parkway, Ste 216
Dallas, TX 75287
Tel: (972) 241-4698
Fax: (972) 241-4439
www.akulalaw.com

______________________________

B. Date You Started Receiving the Benefit or if Certified,

Date You will start Receiving the Benefit (mm/dd/yyyy)
________________________________

C. Date Benefit Ended or Expires (mm/dd/yyyy)

_________________________________________

III.

A. Agency that Granted the Benefit

______________________________

B. Date You Started Receiving the Benefit or if Certified,

Date You will start Receiving the Benefit (mm/dd/yyyy)
__________________________________

C. Date Benefit Ended or Expires (mm/dd/yyyy)

_________________________________________

IV.

A. Agency that Granted the Benefit

__________________________________

B. Date You Started Receiving the Benefit or if Certified,

Date You will start Receiving the Benefit (mm/dd/yyyy)
________________________________________

C. Date Benefit Ended or Expires (mm/dd/yyyy)

_________________________________________

17. If you answered “Yes” to Item Number 1., do any of the following apply? Provide the
evidence listed in the Form I-129 Instructions.

___ You enlisted in the Armed Forces, or are serving in active duty or in
the Ready Reserve Component of the U.S. Armed Forces.
___ You are the spouse or the child of an individual who is enlisted in
the Armed Forces, or who is serving in active duty or in the
Ready Reserve Component of the U.S. Armed Forces.

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 17400 Dallas Parkway, Ste 216
Dallas, TX 75287
Tel: (972) 241-4698
Fax: (972) 241-4439
www.akulalaw.com

___ At the time you received the public benefits, you (or your spouse or
parent) was enlisted in the Armed Forces, or was serving in active duty
or in the Ready Reserve Component of the U.S. Armed Forces.
___ At the time you received the public benefits, you were present in the
United States in a status exempt from the public charge ground of
inadmissibility.
___ At the time you received the public benefits, you were present in the
United States after being granted a waiver of the public charge ground of
inadmissibility.
___ You are a child currently residing abroad who entered the United
States with a nonimmigrant visa to attend an N-600K, Application for
Citizenship and Issuance of Certificate Under INA Section 322 interview.
___ None of the above statements apply

18. Have you received, applied for, or been certified to receive federally-funded Medicaid in
connection with any of the following (select all that apply). Submit evidence as outlined in
the instructions.
___ An emergency medical condition
___ For a service under the Individuals with Disabilities Education Act(IDEA)
___ Other school-based benefits or services available up to the oldest age eligible for
secondary education under State law
___ While under the of age 21
___ While pregnant or during the 60-day period following the last day of
pregnancy

19. Provide the applicable dates From(mm/dd/yyyy)_________________

To: (mm/dd/yyyy)________________

IN ADDITION, THE EMPLOYEE SHOULD PROVIDE THE FOLLOWING

INFORMATION REGARDING HIS/HER EDUCATION AND EXPERIENCE

Employment Details

Name of the Company Duration {From (mm/yyyy) To (mm/yyyy)} Position

1.
2.

3.

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 17400 Dallas Parkway, Ste 216
Dallas, TX 75287
Tel: (972) 241-4698
Fax: (972) 241-4439
www.akulalaw.com

4.
5.
6.

Education Details

Name of College/University Attendance Dates Graduation Date Degree Earned

{From (mm/yyyy) To (mm/yyyy)}

1.
2.
3.
4.
5.
6.

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