Employee Visa Form

EMPLOYEE VISA FORM

Purpose: This form collects employee-provided information and declarations necessary for employer sponsorship of an employment-based visa. The employee must complete all sections truthfully and provide supporting documentation as indicated in the checklist.

Personal Information

Date of birth:    Place of birth:

Passport issuing country:    Passport expiration date:

Phone number:    Email address:

Position Information (Employer Sponsorship)

Reporting manager:    Work location:

Proposed start date:    Employment duration / term:

Full-time    Part-time    Temporary / Fixed-term

Visa Request & Immigration History

Requested visa type (select all that apply):
H-1B    L-1    O-1    TN    Other:

Current immigration status:    Date of most recent entry:

Have you ever been denied a visa, entry, or had a petition refused?    Yes    No

Have you ever been removed, deported, or otherwise ordered to depart a country?    Yes    No

Employment History (Most Recent)

Title:    From:    To:

Employment History (Prior)

Title:    From:    To:

Education

References (Professional)

Phone:    Email:    Relationship:

Phone:    Email:    Relationship:

Phone:    Email:    Relationship:

Supporting Documents Checklist

Please indicate included documents:
Copy of passport bio page    Resume / CV    Signed offer letter
Prior visa documentation    Degree transcripts / diplomas    Recent pay stubs
Police certificate (if required)    Medical exam results (if required)    Passport photos

Legal Disclosures & Authorizations

At-Will Employment: I understand that, unless otherwise provided in a separate written agreement signed by an authorized representative of the employer, employment is at-will and may be terminated by either party at any time with or without cause or notice.

Equal Opportunity: I acknowledge that the employer provides equal employment opportunities without regard to protected characteristics and will assess visa-related matters consistent with applicable employment and immigration laws.

Authorization to Verify: I authorize the employer, its representatives, and any third-party agents retained by the employer to verify any information provided in this form, to contact prior employers, educational institutions, and references, and to obtain records relevant to my immigration status, criminal history, and employment background.

I consent to a criminal background check and verification of my immigration history.    I do not consent

Employer Sponsorship Details (For HR use)

HR contact name:    HR phone:    HR email:

Employer will pay filing fees and associated sponsorship costs:    Yes    No

Criminal & Security Disclosures

Have you ever been convicted of, or pleaded guilty or no contest to, a felony or misdemeanor (other than minor traffic offenses)?    Yes    No

Applicant Certification and Signature

I certify under penalty of perjury that the information provided in this form is true, complete, and correct to the best of my knowledge. I understand that willful misrepresentation may result in denial of immigration benefits and disciplinary action, up to and including termination of employment. I authorize the release of information required to process visa petitions and to verify any information contained herein.

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