Systemonex Inc H1B Form

(Please fill Required details Accordingly)

1. Provide Name of Beneficiary

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

2. Other Information
Date of birth Gender U.S. Social Security Number
(mm/dd/yyyy) Male Female►

Alien Registration Number (A-Number)

(Please Check your EAD Put USCIS No) Country of Birth
► A-

Province of Birth Country of Citizenship or Nationality

If the beneficiary is in the United States, complete the following:

Date of Last Arrival (mm/dd/yyyy) I-94 Arrival-Departure Record Number Passport Number
►

Date Passport or Travel Date Passport or Travel Document Passport or Travel Document Country
Document Issued (mm/dd/yyyy) Expires (mm/dd/yyyy) of Issuance

Current Nonimmigrant Status Date Status Expires or D/S

(mm/dd/yyyy)

Student and Exchange Visitor Information System (SEVIS) Employment Authorization Document (EAD)
Number (Check your I20) Number

3. Current Residential U.S. Address

Street Number and Name Apt. Ste. Flr. Number

City or Town State ZIP Code

Passport Office Address (City) Country

Beneficiary's Foreign (India) Address as on Passport

Street Number and Name Apt.Ste. Flr. Number

City or Town State

 Province Postal Code Country

1. Beneficiary's Highest Level of Education (select only one box)

a. NO DIPLOMA f. Bachelor's degree (for example: BA, AB, BS)

b. HIGH SCHOOL GRADUATE DIPLOMA or g. Master's degree (for example: MA, MS, MEng,
the equivalent (for example: GED) MEd, MSW, MBA)
c. Some college credit, but less than 1 year h. Professional degree (for example: MD, DDS, DVM, LLB, JD)

d. One or more years of college, no degree i. Doctorate degree (for example: PhD, EdD)
e. Associate's degree (for example: AA, AS)

2. Major/Primary Field of Study

a. Name of the United States Institution of Higher Education

b. Date Degree Awardedc. Type of United States Degree

d. Address of the United States institution of higher education

Street Number and Name Apt. Ste. Flr. Number

City or Town State ZIP Code

USCIS H1B VISA FEE :-

H1B Registration fee: $10

Lawyer Fee : $500
Basic Visa filing fee ( I-129 filing Fee ) : $460
Fraud Prevention & Detection Fee: $500
ACWIA / USCIS Fee: $1500
Total Fee according to USCIS : $ 2970
Please Attached All documents which here mentioned:

1. Full Passport with All Pages 10. SSN (Signed)

2. High School and Intermediate Marksheet with Certificate 11. EAD
3. Bachelor Degree with all Semester Marksheet 12. VISA
4. Master degree with all Transcript or Marksheet 13. DL Copy / State ID (All)
5. I-94 14. Client Email ID (If on Project)
6. I-20 copy 15. Any Other Certification (if have)
7. Original Resume
8. Badge ID (If on Project)
9. College ID