Employer Questionnaire for H-1B Visa Petition

Joseph Kallabat & Associates, P.C.
7031 Orchard Lake Road, Suite 302
West Bloomfield, MI 48322
Tel (248) 865-3331 - Fax (248) 865-3323

1.	First Name of Employee
	Last Name
2.	Name of Employer (Full Name of Organization)
3.	Nature of Employer's Business Activities
4.	Address (Number, Street, City, and Town, State ZIP code)
5.	Telephone
6.	Fax
7.	IRS Tax ID #
8.	Name of the employer's representative who will sign the papers
	Title
9.	Employee's Job Title
	Yearly Salary
	Is this a unionized position?	yes no
	Will an American Worker be displaced by this foreign worker?	yes no
	Has your organization made efforts to recruit American workers for this position?	yes no
10.	Address where the employee will work (on-site or 3rd party/Client location).
11.	Date of establishment
12.	Number of employees
	Current number of Employees on H-1B status
13.	Gross Annual Income
14.	Net Annual Income
	Is your organization a Non-Profit organization as defined by the Internal Revenue Service?	yes no
	Has your organization ever been cited for violations by the Immigration and Naturalization Service or the Department of Labor?	yes no
15.	If applicable, provide the following technical environment information
	Hardware
	Software
	Languages
	Database
	Operating System
	Utilities
	Tools
16.	Please provide the following daily task activity information
	A. Activity
	% of Time
	B. Activity
	% of Time
	C. Activity
	% of Time
	D. Activity
	% of Time
	E. Activity
	% of Time
17.	Please provide a detailed description of the employee's proposed job duties and responsibilities
18.	If applicable, team composition and size
	A. Position Title
	Number of Employees Employed In That Position
	B. Position Title
	Number of Employees Employed In That Position
	C. Position Title
	Number of Employees Employed In That Position
	D. Position Title
	Number of Employees Employed In That Position
19.	Minimum educational requirements for this position