H1B Sample.

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 14

CHITTINENI,

Name Provided:
SASIKANTH
Full Name in Native Alphabet: DOES NOT APPLY

Other Names Used: NO

Telecode Name Used: NO

Sex: MALE

Marital Status: MARRIED

Date of Birth: 30 JULY 1980


VISAKHAPATNAM,
Place of Birth: ANDHRA
PRADESH, INDIA
Nationality: INDIA

Other Nationalities: NO

National Identification Number: DOES NOT APPLY

U.S. Social Security Number: DOES NOT APPLY

U.S. Taxpayer ID Number: DOES NOT APPLY


Edit Address and Phone
Information
Home Address: No 21 RAMAN STREET
KILPAUK
City: CHENNAI
State/Province: TAMILNADU
Postal Zone/ZIP Code: 600010
Country: INDIA
Same Mailing Address? NO
HEXAWARE TECHNOLOGIES LTD, PLOT
Mailing Address:
NO H5
SIPCOT INFORMATION TECHNOLOGY
PARK
City: KANCHIPURAM
State/Province: TAMILNADU
Postal Zone/ZIP Code: 603103
Country: INDIA
Primary Phone Number: 919282201090
Secondary Phone Number: 918912515815
Work Phone Number: 914447451011
Email Address: [email protected]
Edit Passport/Travel Document Information
Passport/Travel Document Type: REGULAR
Passport/Travel Document Number: E7394138
Passport Book Number: DOES NOT APPLY
Country/Authority that Issued Passport/Travel
INDIA
Document:
City where issued: VISAKHAPATNAM
State/Province where issued: ANDHRA PRADESH
Country where issued: INDIA
Issuance Date: 30 JANUARY 2005
Expiration Date: 29 JANUARY 2015
Have you ever lost a passport or had one stolen? NO

Travel Information

Edit Travel Information


 The List of Purposes of Trip to the U.S.

Purpose of Trip to the U.S. (1): TEMPORARY WORKER (H)


SPECIALTY OCCUPATION
Specify:
(H1B)
Application Receipt/Petition
REFER PETITION
Number:

Have you made specific travel plans?


YES

Provide a complete itinerary for your travel to the U.S.

Date of Arrival in U.S.:


20 APRIL 2012
Arrival City:
JAMESBURG

Date of Departure from U.S.:


30 SEPTEMBER 2014

Departure City:
JAMESBURG

 The Location(s) you plan to visit in the U.S.

Location (1): JAMESBURG

Address where you will stay in the U.S.:


HEXAWARE TECHNOLOGIES INC, 1095

CRANBURY SOUTH RIVER ROAD SUITE 10

JAMESBURG, NEW JERSEY 08831

Person/Entity Paying for Your Trip:


COMPANY/ORGANIZATION

Name of Company/Organization Paying for Trip:


HEXAWARE TECHNOLOGIES LIMITED

Telephone Number:
914447451000

Relationship to You:
EMPLOYER

Address of Company/Organization Paying:


PLOT NO H5 SIPCOT INFORMATION TECHNOLOGY

PARK NAVALLUR POST SIRUSERI

City:
CHENNAI

State/Province:
TAMILNADU

Postal Zone/ZIP Code:


603103

Country:
INDIA

Edit Travel Companions Information

Other Persons Traveling with You: NO


Edit Previous U.S. Travel Information
Have you ever been in the U.S.? NO
Have you ever been issued a U.S. visa? NO
Have you ever been refused a U.S. Visa, been
refused admission to the United States, or
NO
withdrawn your application for admission at the
port of entry?
Has anyone ever filed an immigrant petition on
your behalf with the United States Citizenship NO
and Immigration Services?

U.S. Contact Information

Edit U.S. Point of Contact Information


Contact Person Name in the U.S.: SRINIVASAN, HARI
Organization Name in the U.S.: HEXAWARE TECHNOLOGIES INC
Relationship to You: EMPLOYER
1095, CRANBURY SOUTH RIVER ROAD
U.S. Contact Address:
SUITE 10
JAMESBURG, NEW JERSEY 08831
Phone Number: (609)409-6957
Email Address: [email protected]

Family Information

Edit Family Information: Relatives


Father's Surnames:
CHITTINENI

Father's Given Names:


CHELLIAH

Father's Date of Birth:


01 SEPTEMBER 1953

Is your father in the U.S.?


NO

Mother's Surnames:
CHITTINENI

Mother's Given Names:


VIJAYAKUMARI

Mother's Date of Birth:


04 MAY 1959

Is your mother in the U.S.?


NO

 Do you have any immediate relatives, not including parents in the U.S.?
YES

Relative Name (1): CHITTINENI, RADHA


Relationship to you: SIBLING
U.S. LEGAL PERMANENT RESIDENT
Status:
(LPR)

Edit Family Information: Spouse

Spouse's Full Name: DEVARAPALLI, DIVYA


Spouse's Date of Birth: 11 JULY 1985
Spouse's Nationality: INDIA
Spouse's City of Birth: NELLORE
Spouse's Country of Birth: INDIA
SAME AS HOME
Spouse’s Address:
ADDRESS

Work / Education / Training Information

Edit Present Work Information


Primary Occupation:
COMPUTER SCIENCE

Present Employer or School Name:


HEXAWARE TECHNOLOGIES LTD

Present Employer or School Address:


PLOT NO H5 SIPCOT INFORMATION TECHNOLOGY
PARK NAVALLUR POST SIRUSERI

City:
CHENNAI

State/Province:
TAMILNADU

Postal Zone/Zip Code:


600017

Country:
INDIA

Work Phone Number:


914447451000

Monthly Salary in Local Currency (if employed):


50000

Briefly Describe your Duties:


• SUPPORTED ISSUES IN THE FORM OF TICKETS IN THE REMEDY TOOL. •
ATTENDED BUSINESS MEETING IN GERMANY FOR ROLL OUT PROJECT. •
INVOLVING IN ENHANCEMENT PROJECT. • HELPED THE CUSTOMER TO
AUTOMATE TEST SCRIPTS USING THE RWD TOOL • PREPARING USER MANUALS,
CONFIGURATION GUIDES AND CONDUCTED TRAINING SESSIONS FOR END
USERS. • ASSISTED USER ACCEPTANCE TESTING • PREPARED FUNCTIONAL SPEC
FOR NEW CUSTOMIZED REPORTS • INVOLVED IN ENHANCEMENTS • INVOLVING
IN INTEGRATION AND MANUAL TESTING. • CONFIGURED TRANSPORTATION
PLANNING POINTS FOR EDC PLANT. • DEFINED NEW SHIPMENT TYPES AND
SHIPMENT COST TYPES FOR EDC PLANT • CONFIGURED NEW ROUTES FOR
INCOTERMS PROJECT • CONFIGURED NEW CONDITION TABLE, ACCESS
SEQUENCE AND CONDITION TYPES FOR INCOTERMS PROJECT.

Edit Previous Work Information

 Were you previously employed? YES


Employer Name (1): RENAULT NISSANTECHNOLOGY &
BUSINESS CENTRE INDIA PRIVATE
LIMITED
ASCENDAS IT PARK, MAHINDRA
Employer Address:
WORLD CITY SE
PLOT NO TP2 -1, NATHAM SUB POST
OFFICE,
City: CHENGALPET
State/Province: TAMILNADU
Postal Zone/Zip Code: 603002
Country: INDIA
Telephone Number: 914467482172
Job Title: SENIOR SOFTWARE ENGINEER
Supervisor's Surname: THANGAVELU
Supervisor's Given Name: RAVI
Employment Date From: 26 NOVEMBER 2010
Employment Date To: 15 MARCH 2011
• ANALYZING THE BUSINESS
REQUIREMENTS AND FINDING GAPS
FOR THE EXISTING PROCESS AND
MAPPING THE REQUIREMENTS. •
WORKING ON ENHANCEMENT OBJECTS
FOR NISSAN AFTER SALES PROJECT. •
Briefly describe your duties: WORKING ON QUERIES AND REPORTS. •
WORKING ON ICS AND MRP PRICE
CALCULATION PROCESS. • WORKING
ON INVOICE PRINT LAYOUTS. •
KNOWLEDGE INTERCHANGEABILITY
MASTER IN SCM APO SYSTEM. •
WORKING ON ETA/ETD PROCESS.
Employer Name (2): IBM INDIA PRIVATE LIMITED
Employer Address: MANYATA EMBASSY BUSINESS PARK
BLOCK -D1, 4HT FLOOR, OUTER RING
ROAD
City: BANGALORE
State/Province: KARNATAKA
Postal Zone/Zip Code: 560045
Country: INDIA
Telephone Number: 918040257777
Job Title: PACKAE SOLUTION CONSULTANT
Supervisor's Surname: HARIHARAN
Supervisor's Given Name: SRIDHAR
Employment Date From: 29 SEPTEMBER 2008
Employment Date To: 25 NOVEMBER 2010
• HANDLING THE DAY-TO-DAY ISSUES
OF THE USERS AND HELP RESOLVE THE
PROBLEMS THEY FACE IN DOING THE
TRANSACTIONS. • WORKING ON
REVAMPING OF EXISTING PRICING
PROCEDURES. • CONFIGURED CREDIT
MEMO PROCESS. • IMPLEMENTED
GURGAON AND NOIDA
MANUFACTURING PROCESSES BY
TEMPLATE ROLL OUT METHODOLOGY
FOR SGGI – SEKURIT DIVISION. •
SUGGESTED BEST SOLUTIONS FOR
EXISTING BUSINESS PROCESSES. •
PREPARED USER MANUALS,
CONFIGURATION GUIDES AND
CONDUCTED TRAINING SESSIONS FOR
END USERS. • CONFIGURED STOCKED
CONSUMABLE PROCESS TO HANDLE
MISCELLANEOUS SALES. • IDENTIFIED
THE EXISTING SYSTEM ISSUES AND
FIXING THEM. • CONFIGURED HIGH SEA
SALES PROCESS. • WORKED ON
Briefly describe your duties:
TRADING SALES PROCESS. •
IMPLEMENTED NET BILLING AND
EXPORT SALES PROCESS FOR FLOAT
DIVISION. • CONFIGURED STO SALES
PROCESS FOR BOTH FLOAT & SEKURIT
DIVISION. • CONFIGURED THIRD PARTY
SALES ORDER PROCESS FOR FLOAT
LINE. • WORKED ON SHIPMENT
PROCESS FOR BOTH FLOAT AND
SEKURIT DIVISION. • CONFIGURED NEW
BUSINESS PROCESS FOR SERVICE
RELATED SALES TO ELIMINATE
MANUAL POSTING. • DEVELOPMENT OF
NEW ROLES AND REVAMPING THE
EXISTING ROLES FOR FLOAT DIVISION.
• CONFIGURED SD CIN AREA AND
EXPERTISE IN HANDLING COUNTRY
VERSION OF INDIA (CIN) SETTINGS &
RELATED TRANSACTIONS. •
CONFIGURED SHIPMENT PROCESS FOR
BOTH FLOAT AND SEKURIT DIVISION. •
MASTER DATA UPLOAD USING BDC.
 Have you attended any educational
YES
institutions at a secondary level or above?
ARULMIGU MEENAKSHI AMMAN
Name of Institution (1):
COLLEGE OF ENGINEERING
Address of Institution: VADAMAVANDAL
City: KANCHIPURAM
State/Province: TAMILNADU
Postal Zone/ZIP Code: 604410
Country: INDIA
MASTER OF BUSINESS
Course of Study:
ADMINISTRATION
Date of Attendance From: 28 AUGUST 2001
Date of Attendance To: 08 MAY 2003
T SUBBARAMI REDDY & T
Name of Institution (2):
BALARAMRISHNA DEGREE COLLEGE
Address of Institution: MANGO GROVE, SRINAGAR
GAJUWAKA
City: VISAKHAPATNAM
State/Province: ANDHRA PRADESH
Postal Zone/ZIP Code: 530026
Country: INDIA
Course of Study: BACHELOR OF COMMERCE
Date of Attendance From: 16 JULY 1998
Date of Attendance To: 31 MARCH 2001
Edit Additional Information
Do you belong to a clan or tribe? NO
 Provide a List of Languages You Speak:
Language Name: (1): ENGLISH
Language Name: (2): TELUGU
Language Name: (3): TAMIL
 Have you traveled to any countries within the
YES
last five years?
Country Visited (1): GERMANY
Have you belonged to, contributed to, or
worked for any professional, social, or NO
charitable organization?
Do you have any specialized skills or training,
including firearms, explosives, nuclear, NO
biological, or chemical experience?
Have you ever served in the military? NO
Have you ever served in, been a member of, or
been involved with a paramilitary unit, vigilante
NO
unit, rebel group, guerrilla group, or insurgent
organization?
Security and Background Information

Edit Part 1
Do you have a communicable disease of public health significance? (Communicable diseases of
public significance include chancroid, gonorrhea, granuloma inguinale, infectious leprosy,
lymphogranuloma venereum, infectious stage syphilis, active tuberculosis, and others diseases as
determined by the Department of Health and Human Services.)
NO

Do you have a mental or physical disorder that poses or is likely to pose a threat to the safety or
welfare of yourself or others?
NO

Are you or have you ever been a drug abuser or addict?


NO

Edit Part 2

Have you ever been arrested or convicted for any offense or crime, even though subject of
NO
a pardon, amnesty, or other similar action?
Have you ever violated, or engaged in a conspiracy to violate, any law relating to
NO
controlled substances?
Are you coming to the United States to engage in prostitution or unlawful commercialized
vice or have you been engaged in prostitution or procuring prostitutes within the past 10 NO
years?
Have you ever been involved in, or do you seek to engage in, money laundering? NO
Have you ever committed or conspired to commit a human trafficking offense in the
NO
United States or outside the United States?
Are you the spouse, son, or daughter of an individual who has committed or conspired to
commit a human trafficking offense in the United States or outside the United States and NO
have you within the last five years, knowingly benefited from the trafficking activities?
Have you knowingly aided, abetted, assisted or colluded with an individual who has
committed or conspired to commit a severe human trafficking offense in the United States NO
or outside the United States?
Edit Part 3

Do you seek to engage in espionage, sabotage, export control violations, or any other illegal
activity while in the United States?
NO

Do you seek to engage in terrorist activities while in the United States or have you ever engaged
in terrorist activities?
NO

Have you ever or do you intend to provide financial assistance or other support to terrorists or
terrorist organizations?
NO

Are you a member or representative of a terrorist organization?


NO

Have you ever ordered, incited, committed, assisted, or otherwise participated in genocide?
NO

Have you ever committed, ordered, incited, assisted, or otherwise participated in torture?
NO

Have you committed, ordered, incited, assisted, or otherwise participated in extrajudicial killings,
political killings, or other acts of violence?
NO

Have you ever engaged in the recruitment or the use of the child soldiers?
NO

Have you, while serving as a government official, been responsible for or directly carried out, at
any time, particularly severe violations of religious freedom?
NO
Have you ever been directly involved in the establishment or enforcement of the population
controls forcing a woman to undergo an abortion against her free choice or a man or a woman to
undergo sterilization against his or her free will?
NO

Have you ever been directly involved in the coercive transplantation of human organs or bodily
tissue?
NO

Edit Part 4

Have you ever sought to obtain or assist others to obtain a visa, entry into the United
States, or any other United States immigration benefit by fraud or willful NO
misrepresentation or other unlawful means?
Edit Part 5

Have you ever withheld custody of a U.S. citizen child outside the United States from a
NO
person granted legal custody by a U.S. court?
Have you voted in the United States in violation of any law or regulation? NO
Have you ever renounced United States citizenship for the purpose of avoiding taxation? NO
Are you a former exchange visitor (J) who has not yet fulfilled the two-year foreign
NO
residence requirement?

Temporary Work Visa Information

Edit Temporary Work Visa Information


Application Receipt/Petition Number: REFER PETITION
Name of Person/Company who Filed Petition: HEXAWARE TECHNOLOGIES INC
Where Do You Intend to Work?
Name of Employer: HEXAWARE TECHNOLOGIES INC
Street Address: 1095 CRANBURY SOUTH RIVER ROAD
SUITE 10
JAMESBURG, NEW JERSEY 08831
Phone Number: (609)409-6957
Monthly Income (in USD): REFER LCA – A PART OF PETITION .

Location Information

Edit Location Information


Location where you will be submitting your application
Current Location: CHENNAI, INDIA

You might also like