H-1B ELECTRONIC REGISTRATION

Information Collection

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Getech Case Number

Employee Information

First Name

Last Name

Gender

Female

Male

Birthday

Country of Citizenship

Phone Number

Country of Birth

Passport Number

Passport Issuance Date

Passport Expiration Date

School Full Name (Highest Education. If a foreign school, please note here):

Employer (Company) Name

EIN

DBA Name of Employer (Company) (If applicable)

Full Legal Name of Employer Contact Person

Email Address Used or to be Used to Register Employer (Company) MYUSCIS Account

Contact Person Title

Contact Phone

Employer (Company) Full Address

Work Address

Type a message here for us (optional)

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