EXTRAORDINARY ABILITY ALIEN QUESTIONNAIRE

Please print this form and write or type your answers into the right column

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GENERAL INFORMATION
Full Name (with last name in caps):  
U.S. Address:

  		 
Address in your home country:

  		 
Email Address:  
Mobile Telephone:  
Home Telephone:  
Office Telephone:  
Fax number:  
Social security number:  
Date of Birth:  
Place of Birth (City, Country):  
Country of Nationality:  
Employer's Name:  
Employer's Main Address:


  		 
Your Worksite Address, if different:


  		 
Employer's Main Telephone Number:  


INFORMATION REGARDING YOUR EMPLOYMENT
Job title:  
Annual salary:  
Provide a detailed job description including specific responsibilities:


  		 
Requirements for this position (include educational requirements, specific skills, experience, and expertise required):  





 
Provide information about the importance of your work/research and how it will benefit and impact the U.S:  





 
Provide information regarding the number of people you supervise, if any, and what type of employees they are (e.g., scientists, post docs, and technicians):  




 


INFORMATION ABOUT EMPLOYEE'S FAMILY (if applicable)

Spouse
Name:  
Address:

  		 
Date & Place of Birth:
  		 

Child #1
Name:  
Address:

  		 
Date & Place of Birth:
  		 

Child #2
Name:  
Address:

  		 
Date & Place of Birth:
  		 

Child #3
Name:  
Address:

  		 
Date & Place of Birth:
  		 


Required evidence to prove your eligibility as an Extraordinary Ability Alien - unless you have received a major, internationally recognized award such as the Nobel Prize, you must provide as much of the below documentation as you can (you must have at least three of the following):
  • Evidence you have received lesser nationally or internationally recognized awards or prizes (must include a description of the selective process in which recipients are chosen);
  • Evidence of your membership in any professional and/or scientific societies where outstanding achievements are required (must include information regarding the requirements and/or selective process for membership);
  • Evidence that others have published materials in professional journals about you and/or your work, including evidence that your work has been cited by others;
  • Evidence you have judged or reviewed, or been invited to judge or review, the work of other scientists or engineers in your field;
  • Copies of documentation regarding any patents you hold, or other documentation showing you have made original scientific or scholarly research contributions;
  • Copy of the first pages of all published articles which you authored or co-authored. Be sure to include the page(s) where your name appears as the author;
  • Evidence you have performed in a leading or critical role for an organization with a distinguished reputation; and
  • Evidence you command a high salary compared to others in your field.

Additional Required Documents - please mail the following documents along with the completed questionnaire to us:
  • Updated and detailed resume, including a publications list if applicable;
  • Letters of reference from others in your field detailing your outstanding contributions (letter should detail how you have made original scientific contributions, if any, and the author of the letter's resume should be included);
  • Copies of diplomas and/or transcripts from all universities that you have attended;
  • Education evaluation, if available and you have a degree from a foreign institution;
  • Copy of Form I-94 (front and back) for you, your spouse and children (if applicable);
  • Copies of all passports (exclude blank pages);
  • Copies of all prior U.S. work authorization documents (e.g., H-1B or O-1 approval notices, EAD, I-20s, and etc.).
  • Copy of birth certificates for you, your spouse and children (if applicable); and
  • Copy of your marriage certificate (if applicable).

Although the list of documents above may appear onerous, it is important to be thorough because the more complete you are with the document gathering process, the better we can prepare your case.

After you submit the necessary information and documents to Immigration Law Group, we will write a detailed statement to support the permanent residency petition, and email a draft of this statement to you for review before all of the documents are finalized for filing with the USCIS.

Immigration Law Group LLP
3590 N. First St., Suite 310
San Jose, CA 95134
Tel (408) 432-9200
Fax (408) 432-9191


Please answer the following questions. (If your answer is "YES" on any one of these questions, explain on a separate piece of paper.

a. Have you ever, in or outside the U.S.:
  1. knowingly committed any crime of moral turpitude or a drug-related offense for which you have not been arrested?
  2. been arrested, cited, charged, indicted, fined, or imprisoned for breaking or violating any law or ordinance, excluding traffic violations?
  3. been the beneficiary of a pardon, amnesty, rehabilitation decree, other act of clemency or similar action?
  4. exercised diplomatic immunity to avoid prosecution for a criminal offense in the U.S.?

___ Yes   __ No

b. Have you received public assistance in the U.S. from any source, including the U.S. government or any state, county, city, or municipality (other than emergency medical treatment), or are you likely to receive public assistance in the future?

___ Yes   __ No

c. Have you ever:
  1. within the past 10 years been a prostitute or procured anyone for prostitution, or intend to engage in such activities in the future?
  2. engaged in any unlawful commercialized vice, including, but not limited to, illegal gambling?
  3. knowingly encouraged, induced, assisted, abetted or aided any alien to try to enter the U.S. illegally?
  4. illicitly trafficked in any controlled substance, or knowingly assisted, abetted or colluded in the illicit trafficking of any controlled substance?

___ Yes   __ No

d. Have you ever engaged in, conspired to engage in, or do you intend to engage in, or have you ever solicited membership or funds for, or have you through any means ever assisted or provided any type of material support to, any person or organization that has ever engaged or conspired to engage, in sabotage, kidnapping, political assassination, hijacking, or any other form of terrorist activity?

___ Yes   __ No

e. Do you intend to engage in the U.S. in:
  1. espionage?
  2. any activity a purpose of which is opposition to, or the control or overthrow of, the Government of the U.S., by force, violence or other unlawful means?
  3. any activity to violate or evade any law prohibiting the export from the Untied States of goods, technology or sensitive information?

___ Yes   __ No

f. Have you ever been a member of, or in any way affiliated with, the Communist Party or any other totalitarian party?

___ Yes   __ No

g. Did you, during the period March 23, 1933 to May 8, 1945, in association with either the Nazi Government of Germany or any organization or government associated or allied with the Nazi Government of Germany, ever order, incite, assist or otherwise participate in the persecution of any person because of race, religion, nationality, ethnic origin, or political opinion?

___ Yes   __ No

h. Have you ever engaged in genocide, or otherwise ordered, incited, assisted or otherwise participated in the killing of any person because of race, religion, nationality, ethnic origin, or political opinion?

___ Yes   __ No

i. Have you ever been deported from the U.S., or removed from the U.S. at government expense, excluded within the past year, or are you now in exclusion or deportation proceedings?

___ Yes   __ No

j. Are you under a final order of civil penalty of violating section 274C of the Immigration Act for use of fraudulent documents, or have you by fraud or willful misrepresentation of a material fact, ever sought to procure, or procured, a visa, other documentation, entry into the U.S., or any other immigration benefit?

___ Yes   __ No

k. Have you ever left the U.S. to avoid being drafted into the U.S. Armed Forces?

___ Yes   __ No

l. Have you ever been a J non-immigrant exchange visitor who was subject to the 2 year foreign residence requirement and not yet complied with that requirement or obtained a waiver?

___ Yes   __ No

m. Are you now withholding custody of a U.S. Citizen child outside the U.S. from a person granted custody of the child?

___ Yes   __ No

n. Do you plan to practice polygamy in the U.S.?

___ Yes   __ No