MULTINATIONAL MANAGER / EXECUTIVE 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 IN THE U.S.
Job title:  
Annual salary:  
Address(es) where you will work, if different from the principal place of business:


  		 


 
Provide a detailed description of your job in the U.S. (whether over people or functions) with emphasis on your managerial or executive duties:


  		 





 
Do you have the authority to hire and fire or make other personnel decisions?  

 
Do you manage other professionals or do you manage a function within the company?  

 
In your position in the U.S., if you manage other professionals (i.e., those who have college degrees), provide their names, titles, and the degrees they hold:

Name Title Degrees Held
 

 		  

 		  

 
 

 		  

 		  

 
 

 		  

 		  

 
 

 		  

 		  

 
 

 		  

 		  

 


INFORMATION REGARDING YOUR EMPLOYMENT OVERSEAS
Job title:  
Name of company organization abroad:  
Relation of U.S. company to overseas company (parent, branch, subsidiary, affiliate, joint venture):


  		 


 
Address(es) where you worked abroad:


  		 



 
Provide a detailed description of your job overseas with emphasis on your managerial (whether over people or functions) or executive duties:  







 
Did you have the authority to hire and fire or make other personnel decisions?  

 
Do you manage other professionals or do you manage a function within the company?  

 
If you managed professional staff members overseas, how many people did you manage? ______
Provide their names, titles, and the degrees they hold:

Name Title Degrees Held
 

 		  

 		  

 
 

 		  

 		  

 
 

 		  

 		  

 
 

 		  

 		  

 
 

 		  

 		  

 


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 Documents - please mail the following documents along with the completed questionnaire to us:
  • Documents evidencing the relationship between the U.S. and foreign entity;
  • Organizational chart for your last position overseas;
  • Organizational chart for your current position in the U.S;
  • Copy of your academic diplomas and transcripts;
  • Updated resume, including details about all of your positions with the company, both abroad and in the U.S.;
  • Copy of current I-94 card, front and back, including those for all accompanying family members (if any);
  • Copy of relevant passport pages (ID page and U.S. visas, if any), including those for accompanying family members;
  • Copy of all previously issued USCIS Approval Notices (I-797 Notice of Action), if any; and
  • Copy of all I-20s, front and back (if previously in F-1 status), and EAD (Employment Authorization Document), if any.


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