Important: This questionnaire is used in the immigration application process. Failure to complete the questionnaire fully will delay processing. Any changes after filing will need to be evaluated in advance and may require an amended



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Department questionnaire



IMPORTANT: This questionnaire is used in the immigration application process. Failure to complete the questionnaire fully will delay processing. Any changes after filing will need to be evaluated in advance and may require an amended petition.

Please provide all the information requested below. Should you have any questions regarding the information requested feel free to contact Assistant General Counsel Jigisha Patel at (617) 373-7073.

The Department is responsible for completing all ‘Department’ forms and providing the required supporting documents. The Employee is responsible for completing all ‘Employee’ forms and providing the relevant supporting documents. Answer all questions, even if the answer is ‘N/A’ or ‘None’. Incomplete questionnaires will delay the Office of the General Counsel’s ability to complete the University’s petition in a timely manner.

DEPARTMENT DOCUMENTS CHECKLIST:


  • PLEASE DO NOT STAPLE ANY DOCUMENTS

  • The Office of the General Counsel can file an H-1B petition up to six months before the requested start date. Planning ahead may avoid having to pay premium processing fees to obtain a decision in time!

Please ensure that all of the following documents are included in the immigration packet (if time-sensitive please contact Jigisha Patel to review). If the immigration packet is not complete with all of the required documents attached, it will not be date-stamped and will be returned to the department for proper completion. To avoid delays, please ensure all requested documents are provided.

_____ Completed department questionnaire (must be fully completed)

_____ Completed beneficiary’s personal information questionnaire and documents

_____ Copy of job posting for position (or position description if waived)

_____ Copy of signed offer/appointment letter (if submitting a draft please remember to forward a copy of the final signed letter when ready, as well as any reappointment letters if employment is continued in the same visa status)

_____ Direct Pay form(s) for the petition filing fee(s) if applicable

*Submit as a package to Jigisha Patel in the Office of the General Counsel at 378 Columbus Place

Name of Person Completing Questionnaire: _ __________________________________________

Title: ____________________________________________________________________________

Signature: ____________________________________

Date: ________________________________________

Name of Beneficiary: _____________________________________________________________ (For whom this petition will be filed)

The employee is: _____ new to NU hire _____ continued NU employment

_____ transfer within NU _____ part-time at NU; employed elsewhere

_____ other: please specify______________________________________________

This person is: _____ in the United States _____ not in the U. S. Where? ___________________

Hiring Department: _____________________________________________________________

Department Administrative Contact: _______________________________ Extension: ___________

Supervisor’s name and title: ______________________________________ Extension: ___________

Title of position offered: _____________________________________Position Grade: ___________

Total hours per week: ___________ Number of workers foreign national will supervise: __________

Rate of pay offered: _______________________________________ per: ____________________
*Required information: How did you arrive at this amount? This is required and will be used for our audit file. _____________________________________________________________________

_________________________________________________________________________________

Occupation Category for the position i.e. Chemists, Materials Scientist, Medical Scientists, Electrical Engineers, Computer Systems Analysts, etc. (please focus on the job duties and the research conducted to make the determination not the employee’s credentials for the position): _________________________

__________________________________________________________________________________



Site where employee will be working (mark all that apply, employee can only work at site locations listed in petition):

_____Boston Campus _____Nahant _____Burlington Campus _____Dedham _____Fermi Labs

Other____________________________________________________________________________

Will the employee be working off site? Yes: ________ No: _________

IF YES, please answer the following:


  1. The beneficiary of this petition will be assigned to work at an off-site location for all or part of the period for which H-1B classification sought.

Yes: _____ No: _____

  1. Placement of the beneficiary off-site during the period of employment will comply with the statutory and regulatory requirements of the H-1B nonimmigrant classification.

Yes: _____ No: _____

  1. The beneficiary will be paid the higher of the prevailing or actual wage at any and all off-site locations.

Yes: _____ No: _____

  1. How many hours per week? __________________

  2. List Name and Address of off-site location(s): _______________________________________

___________________________________________________________________________

Will the beneficiary employee be working on a Federally Funded Project? Yes: _____ No: ______

If Yes, please cite the grant(s): ___________________________________________________



With respect to the technology or technical data the petitioner will release or otherwise provide access to the employee, the supervisor certifies that s/he has reviewed the Export Administration Regulations (EAR) and the International Traffic in Arms Regulations (ITAR) and has determined that (check one):

a. A license is not required from either U.S. Department of Commerce or the U.S. Department of State to release such technology or technical data to the foreign person. ______

b. A license is required from the U.S. Department of Commerce and/or the U.S. Department of State to release such technology or technical data to the employee and the petitioner will prevent access to the controlled technology technical data by the employee until and unless the petitioner has received the required license or other authorization to release it to the employee. ______

Will the employee be working on a cooperative research and development project or a co-production project under a reciprocal government-to-government agreement administered by the U.S. Department of Defense? Yes: _______ No: _______

If Yes, please provide additional information: ______________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Employment/ Immigration Petition effective dates requested:

Start date for petition: __________________ End date for petition: _________________

NOTE: Research appointments are typically made for no longer than the current grant period. Please indicate how long you anticipate this person will reasonably be working with the principal investigator, for a period not to exceed three years. H-1B status may be sought for up to three years and extended for an additional three (or less) thereafter. If the University terminates an employee in H-1B status before the end date of the petition, the University must offer return transportation to the individual’s home country. For many employment-based visa statuses an employee’s valid immigration status in the US may be tied to their employment. Please contact the Office of the General Counsel for assistance.

Detail Minimum requirements for the position, including educational and experience requirements:



NOTE: PLEASE DESCRIBE WHAT THE POSITION REQUIRES AT A MINIMUM INCLUDING DEGREE FIELD(S) OF STUDY, NOT WHAT CREDENTIALS AND EXPERIENCE THE APPLICANT HAS.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________



PLEASE ALSO ENCLOSE A COPY OF THE JOB POSTING (OR POSITION DESCRIPTION IF POSTING WAIVED). *Please still complete the above, providing degree field(s) of study acceptable as this information is needed to file the petition.

Describe fully the job duties to be performed: ___________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

List any special requirements: ________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________
FEES: Direct Pay Request (DPAY) forms must accompany this form when the package is submitted to the Office of the General Counsel. Accounts Payable will not process immigration filing fees without the Office of the General Counsel’s sign-off. The General Counsel’s office will deliver the DPAY forms to the Accounts Payable office.

REMINDER: It is the legal obligation of the University/Employer to pay the filing fees associated with an H-1B petition. The employee cannot pay the fees and must not be asked to reimburse the department for the petition or anti-fraud filing fees.

Please ensure that the DPAY indicates that the check will be made payable to:



U.S. Department of Homeland Security

Please use the following vendor name and address on the DPAY form for H-1B petition filing fees:



U.S. Department of Homeland Security

California Service Center

ATTN: CAP EXEMPT H-1B Processing Unit

24000 Avila Road, Room 2312

Laguna Niguel, CA 92677
If filing a petition that is not an H-1B, please contact the Office of the General Counsel to confirm vendor name and address as well as filing fee amounts.

A SEPARATE DPAY FORM IS REQUIRED FOR EACH FILING FEE CHECK

If this is a new to NU hire: $325 for the basic petition filing fee

$500 for the required anti-fraud fee (for H-1B petitions only)

If this is an extension for a current employee: $325 for the basic petition filing fee



NOTE: If time is of the essence and there is a need/desire to receive a response within 15 days of filing, premium processing is available for $1,225 in addition to the fees noted above. Normal processing time varies but can range anywhere between two to four months. While Northeastern must pay the required basic petition filing fee and anti-fraud fee, the employee beneficiary may opt to pay the optional premium processing fee if for personal reasons.

Beneficiaries who are in the U.S. may not travel outside the U.S. while the petition is pending or it may be deemed abandoned. Please contact the Office of the General Counsel for assistance prior to traveling outside of the U.S.

Revised February 2014





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