H1B Sample.
H1B Sample.
H1B Sample.
Name Provided:
SASIKANTH
Full Name in Native Alphabet: DOES NOT APPLY
Sex: MALE
Other Nationalities: NO
Travel Information
Departure City:
JAMESBURG
Telephone Number:
914447451000
Relationship to You:
EMPLOYER
City:
CHENNAI
State/Province:
TAMILNADU
Country:
INDIA
Family Information
Mother's Surnames:
CHITTINENI
Do you have any immediate relatives, not including parents in the U.S.?
YES
City:
CHENNAI
State/Province:
TAMILNADU
Country:
INDIA
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
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
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?
Location Information