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Application Forms for Employer
INFORMATION ABOUT SPONSOR/PETITIONER/EMPLOYER
Please print, complete and submit by fax or airmail. No petitioner's signature
required. Information required by INS)
Name of Organization: _________________________________________
Address of Organization: _______________________________________
Authorized Officer: __________________________________ (Please print)
Title:_______________________________ (Please print)
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 to:
Ruben Ealdama,
Managing Director
Mailing Address: PO. Box 654, Temple City, CA 91780 / or to
Fax 626-447-2191
E-mail: workandstay@usa.com;
***End***
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