Please print, complete and submit by fax or airmail.
No petitioner's signature
required.
Name of Organization: _________________________________________
Address of Organization:
______________________________________
Authorized Officer:
________________________________ (Please print)
Title:________________________Tel. No. (
)_____________________
FAX No. ( ) ________ Federal ID #:
_________Current # of workers:___
Type of business:______________________ Business
established:19__
Est. Gross annual inc of organization: $__________________________
Time/Shift of work assigned to
RN:______________________________
Salary Offered to RN: ________________per hour/week/year.
Position
Offered:____________________________________________
Name of RN to be petitioned:
_________________________________
His/her
Address:_____________________________________________
*ACTUAL EMPLOYER*
If the Registered Nurse is working in a facility or hospital, it is acceptable
to be petitioned by a different
employer. The petitioner may offer you a job in the future as Registered Nurse
and show ability to pay your salary.
**IMPORTANT:**
All job offer petitions must include evidence of ability to pay salary proffered
to the alien. Please submit INS' requirement with this form. Acceptable
documents include, but not limited to: Financial statements; profit and loss
statement; W-2's of all employees, monthly payroll, income tax return, bank
statement or personnel records. If you have 100+ employees, a simple
statement stating that you have 100+ employees and have the ability to pay the
salary, is acceptable. This letter should be sent to us but addressed to INS on
your company letterhead and signed by your chief finance officer.
Kindly return this information by mail to
E-mail: workandstay@usa.com
Fax: 626-447-2191
US Address: P.O. Box 654, Temple City, CA 91780
2/F Manican Building Kamagong corner Baticulin Sts.,
San Antonio Village, Makati City, Philippines 1203
Copyright 2000 TPC
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