International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

Academic H-1B Petition: Instructions and Forms

Eligibility H-1B program allows employers to temporarily employ international workers in the U.S. on a nonimmigrant basis in specialty occupations. A specialty occupation requires the theoretical and practical application of a body of highly specialized knowledge and require a minimum of a Bachelor’s degree in the specific specialty as a minimum for entry into the occupation (e.g. sciences, medicine, health care, education, biotechnology, and business specialties, etc.). The employee must have received the required degree before the petition is submitted. The employee must have a diploma or other certification from the institution to indicate that all degree requirements have been met.

The wage for the position must meet the requirements of U.S Department of Labor (USDOL) regulations. ISSS will facilitate the process of obtaining a prevailing wage but should not be view as setting the wage.

H-1B status is employer specific; the employee or beneficiary may only work for the employer who sponsors the status. The employee may have more than one H-1B approval at a time.

An initial period of stay up to 3 years in H-1B status may be granted by U.S. Citizenship and Immigration Services (USCIS); extensions up to 3 years thereafter. The cumulative duration in H-1B status is a maximum of 6 years.

H-1B status recognizes dual intent. This means an employee may apply for permanent residency while in H-1B status.

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

H-1B Process Overview

Step 1: Prevailing Wage and Actual Wage After the necessary paperwork is received from the department, the International Scholar Advisor in ISSS will submit a prevailing wage request to the National Prevailing Wage Center (NPWC) or by accessing other legitimate sources of information such as the DOL Online Wage Library. The prevailing wage rate is defined as the as the average wage paid to similarly employed workers in specific occupation in the area of intended employment. It is currently taking about 3 months to receive a prevailing wage determination from NPWC.

The actual wage is the wage rate paid by the employer to all other individuals with experience and qualifications similar to the H-1B nonimmigrant, for the specific position in question. When there are employees with similar experience, education, job responsibilities, the wage rate can be expressed as a range. When there are no other similarly situated employees, then the actual wage is the salary offered to the H-1B employee. Any large discrepancies in wages offered must be justified by legitimate business-related criteria.

The employer is required to pay the prevailing wage or the actual wage paid by the employer to workers with similar skills and qualifications, whichever is higher.

Step 2: Labor Condition Application After a prevailing wage has been received, a Labor Condition Application (LCA/ETA Form 9035E/9035) is submitted to Department of Labor attesting to the compliance with the requirements of the H-1B program. The LCA will be filed electronically by the International Scholar Advisor using DOL’s iCERT System. LCAs cannot be submitted more than 6 months before the start date of the period of employment.

Step 3: Submission to U.S. Citizenship and Immigration Services for Adjudication After all required documentation including a certified LCA are received, the International Scholar Advisor will complete Form I-129 Petition for a Nonimmigrant Worker, in addition to the H-1B supplements. The petition, certified LCA, employer support letter, additional documentation, filing fees will be submitted to USCIS California Service Center. Normal processing time is 2-3 months, possibly longer if USCIS requests additional information.

For an additional fee of $1,225, the employer may request expedited processing of the H-1B petition. USCIS guarantees 15 calendar day processing or will refund the Premium Processing Service fee.

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

Employer Obligations

In filing an H-1B petition the employer is attesting that the following conditions have been met:

• Salary being paid to the above-named employee is at least the actual wage being paid to all otherindividuals with similar experience and qualifications for the specific employment in question or theprevailing wage level for the occupation in the intended area of employment, whichever is higher.

• The vacation time, sick leave, and other benefits offered to the nonimmigrant worker are equivalent tothat offered to U.S. workers in the same classification.

• Employing this person will not adversely affect the working condition of U.S. workers similarly employed.• There is no strike, lockout, or work stoppage due to labor dispute in this occupation.• Notice of Intent to Hire an H-1B worker has been given to other employees at the worksite; notices

posted at two conspicuous locations.• To comply fully with the terms of the LCA for the duration of the employee’s employment in

H-1B status at UC Santa Cruz, including paying the listed salary.• As required by DHS agree to pay the reasonable cost of return transportation to the employee’s home

country if s/he is dismissed before the end of the authorized period of H-1B employment.

It is the responsibility of the department to notify ISSS if any conditions of employment change at any time so that the International Scholar Advisor may notify the proper government agency if necessary. This includes adding or change of work location(s), dismissal, or early termination of employment.

Employers are required to maintain a public inspection file as well as other supporting documentation. Public inspection files are housed in International Student and Scholar Services. For more information regarding the contents of the public access records, please contact Linda Harris.

The Wage and Hour Division (WHD) of Department of Labor has the authority to enforce LCA requirements. Should there be a complaint by an aggrieved person WHD will initiate an investigation. There are three levels of penalties for LCA violations. Penalties may include (1) payment of back wages for failure to pay the required wage rate; (2) civil fines from $1000 per infraction to $35,000 civil monetary penalty; (3) a ban of 1-3 years or more on employers being able to file H-1B and permanent residence petitions.

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

H-1B Temporary Specialty Worker-Department Checklist

In order to begin the application process please submit the following items to ISSS, International Scholar Advisor, at mailstop: Global Engagement. There is a separate checklist for the H-1B applicant. Do not staple the documents.

H-1B Department Application

Statement of Actual Wage Determination with original signature (not required for unionized positions, unless salary falls off-scale)

Salary Scale

Deemed Export Control Certification with original signature

Letter from Employer. Original letterhead, signed with 30 days. Please see letter template.

Copy of job description, posting, or announcement (includes job duties, the required education, and any prior work experience)

Copy of Job Offer Letter (signed and accepted by prospective employee)

Employee Application. Two sets of paper copies of the immigration documents and supporting documentation.

USCIS filing fee(s), in form of separate checks, made payable to “U.S. Department of Homeland Security.” Please request check(s) at the time of the application submission. All H-1B filing fees must be paid by the sponsoring department. These fees cannot be paid or passed onto the employee.

o $460o $500o $1,225

Form I-129 Petition for a Nonimmigrant Worker filing fee Fraud Detection & Protection Fee (for new, transfer, or concurrent petitions) Optional Premium Processing Service fee

Departmental Request to Waive Safe Harbor Provision (Optional). See form for more information.

Prevailing Wage Survey (Optional). To request a prevailing wage determination for a position in advance of anofficial offer. Submit survey plus copy of the job description, posting, or announcement.

Important Notes Request H-1B employment for the period in which there is funding. Initial period of H-1B employment is three years; may be

renewed for another three years for an aggregate total of six years.

ISSS recommends premium processing service to reduce adjudication time to 15 days; to minimize the risk of a lapse in employmenteligibility; or to obtain certain benefits (i.e. CA driver’s license) in which H-1B status is required. The employer is required to pay forexpedited service if a business necessity otherwise the employee may pay for PPS if for personal gain or benefit.

Per 20 CFR § 655.734 the employer must provide notice of filing of a Labor Condition Application (LCA) to employees at theworksite. For positions covered by a collective bargaining agreement, notice shall be given to the collective bargainingrepresentative (electronic posting). For non-union position, a paper notice shall be posted for ten days in at least two conspicuous locations at the work site where the H1B employee will be working. After the posting period has ended please return the original notices to ISSS.

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

H-1B Petition: Department ApplicationH-1B Request Type: New Employment Change of Employer Concurrent Extension Amendment

Hiring Department/Unit: Division:

Name & Title of Hiring Authority: Mail Code:

Person Preparing Form: (if different from Above) Title or Position:

Phone Number: Email:

Position Description Prospective H-1B Employee’s Name: Email & Phone: (if available)

Proposed UCSC Job Title: Job Title of Supervisor for this position:

Intended H-1B start date: Intended H-1B end date:

Describe the job duties to be performed (begin with important one first). Attach a position description if needed. Include details regarding the research areas/fields, courses to taught, and/or software or equipment to be used.

Is this position covered by a Collective Bargaining Agreement (CBA)? Yes No

Is this a full-time position? Yes No If no, number of hours per week:

Basic Rate of Pay Offered: $ Is this rate of pay hourly or yearly?

Minimum degree and field of study required for this position:

Does employer require a second degree or diploma? Yes No

Does this position supervise other employees? Yes No

If yes, indicate number of employee workers: Considered: Subordinate Peer

Is training for the job opportunity required? Yes No

If yes, specify number of months and field/name of training required.

Is previous employment experience required? Yes No

If yes, specify number of months of experience required and indicate the occupation:

Are there any special requirements? List specific skills, licenses/certification, or additional requirements of the job opportunity. Yes No

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

Will travel be required to perform the job duties? Yes No

If yes, provide details-area(s), frequency, nature of travel.

Worksite Address. Provide street address, city, state, and zip code.

If work is to be performed at multiple location(s) other than address listed above provide building name, additional address for the worksite(s).

LCA Attestation

UC Santa Cruz must submit a Labor Condition Application (LCA) to the US Department of Labor and have it approved before submitting the H-1B petition to U.S. Citizenship & Immigration Services. Please read the statements below. By signing below you attest you will uphold them.

1. Salary being paid to the above-named employee is at least the actual wage being paid to all other individuals withsimilar experience and qualifications for the specific employment in question or the prevailing wage level for theoccupation in the intended area of employment, whichever is higher.

2. The vacation time, sick leave, and other benefits offered to this employee are equivalent to that offered to U.S.workers in the same classification.

3. Employing this person will not adversely affect the working condition of U.S. workers similarly employed.4. There is no strike, lockout, or work stoppage due to labor dispute in this occupation.5. We will post a Notice of Intent to File a Labor Condition Application to Hire an H-1B Temporary Worker to other

employees at the worksite; in two conspicuous locations.6. We agree to comply fully with the terms of the LCA for the duration of the employee’s employment in

H-1B status at UC Santa Cruz, including paying the listed salary.7. As required by DHS we agree to pay the reasonable cost of return transportation to the employee’s home country if

s/he is dismissed before the end of the authorized period of H-1B employment.Name and Signature Date Department Chair:

Supervisor/P.I.:

Divisional Dean or Coordinator:

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

Statement of Actual Wage Determination As per Department of Labor regulations the following information must be available for public examination. The public inspection file is housed in office of International Student & Scholar Services. *Not required for Union positions unless salary falls off-scale*

Department, Center, or Hiring Unit:

Position Title:

Salary Offer:

There are (number) of other employees in the Department with the same job title and similar duties to this position.*

The salary ranges of these individuals, in the department or next larger academic unit, with the same job title and similar qualifications applicant: from $: to $ per year. Please attach salary scales.

*If the employee is the only one in the position, the actual wage is the wage offered to him/her. Notate as such in the ‘Salary Offer’field. Please do not compare someone with 10 years of experience with someone with 2 years of experience. They do not have similar qualifications.

Within this salary range, the individual salary is determined by taking into consideration various factors (check all that apply):

Level of Education/Type of Degree Degree or Level of Responsibility/Supervision Years of Experience in the field Number of Publications/Publication Record Skills/Specialized Knowledge Other objective business-related criteria Specific job responsibility Please specify:

I hereby certify that this salary information reflects the actual wage level paid to all other individuals with similar experience and qualifications working this department. If there is more than one wage paid, I am able to explain the reason(s) for this differential in wage rates. If required to do so I am able to provide documentation that will include the names and payroll records of similarly employed individuals to verify these statements to Department of Labor.

Signature of Chair or Supervisor: Date:

Name: Title:

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

I-129 Deemed Export Control Requirement

This certification must be completed by the supervisor of the nonimmigrant employee or someone who is otherwise knowledgeable about the beneficiary’s intended work. If you do not have the information to complete this certification relating to Deemed Export Control (EAR or ITAR) please contact the Office or Research. ISSS will complete the H-1B application once the office receives confirmation that the position does not fall under the scope of the Deemed Export Control. Alternately, if an Export Control license is necessary, clearance must be granted by the Office of Research. Any future changes or extensions of the sponsored H-1B worker’s employment must also be reviewed for compliance.

1. Is the nature of the employee’s work controlled, confidential, or proprietary (e.g. the results of thework/research projects are not intended for teaching, publication, or to be otherwise shared broadlywith the interested public and within the scientific community)? Yes No

2. The research agreement the employee is working on limits access to foreign persons. Yes No

3. Will the employee have access to any third party-owned technical data or technology that isconsidered controlled, proprietary, or confidential to the third party owner? This includes U.S.government furnished technical data with dissemination controls or other restrictive markings, as wellas ITAR-controlled software. Yes No

4. Will the employee have access to equipment, technology, or data specifically designed or developedfor military or space applications? (see U.S. Munitions List under 22 CFR § 121)

Yes No

Beneficary’s Name: Beneficiary’s Country of Citizenship:

Name of Chair/Supervisor/P.I.: Department:

Signature: Date:

If all answers are “No,” submit this form with other H-1B application materials.

If any are “Yes,” please send this form to Tani Prestage (taniprestage@ucsc.edu) for secondary approval before submitting to ISSS. After secondary review it has been determined that a license for Export Control is not required.

Signature of Special Agreements Officer: Date:

Signature of Compliance Officer: For UARC positions. Date:

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

NOTICE OF INTENT TO FILE A LABOR CONDITION APPLICATION (LCA) TO EMPLOY AN H-1B TEMPORARY WORKER

PER 20 CFR 655.734(S)(1)(ii)(A)-(B), employers are required to inform their employees of the intent to hire an H-1B worker. This is to provide notice that UC Santa Cruz is seeking to employ an H-1B nonimmigrant worker.

EMPLOYER (Division & Department):

NUMBER of H-1B WORKERS SOUGHT:

POSITION TITLE:

WAGES BEING OFFERED (Hourly/Salary):

LOCATION of EMPLOYMENT (Bldg & Room):

DATES of H-1B EMPLOYMENT:

The Labor Condition Application is available for public inspection at the International Student & Scholar Services (ISSS) office. Complaints alleging misrepresentation of material facts in the labor condition application and/or failure to comply with the terms of the labor condition application may be filed with any office of the Wage and Hour Division of the U.S. Department of Labor.

Posting of Notices Information A notice must be posted in two conspicuous locations, at the workplace for at least ten (10) consecutive working days. If there are multiple worksites please post a notice at each site. Return all original postings to ISSS.

DATES of POSTING: From (mm/dd/year) To (mm/dd/year)

LOCATION of POSTING: (Bldg, Floor, Room. City and Zip Code if non UCSC campus location)

LOCATION of POSTING: (Bldg, Floor, Room. City and Zip Code if non-UCSC campus location)

NAME of PERSON POSTING NOTICES: SIGNATURE: DATE:

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

Sample Letter of Support from Department-New H-1B Employment Print on letterhead or stationary, sign in blue ink.

Date

Department of Homeland Security U.S. Citizenship & Immigration Services California Service Center

RE: Form I-129 Petition for Nonimmigrant Worker, New Employment Beneficiary: [Name of Employee: First, Middle, Last Name]

To Whom It May Concern:

The University of California Santa Cruz would like to temporarily employ [employee] in H-1B status in the specialty occupation of [position title] at [place of employment if not at UCSC] for [length of time-3 years maximum]. The minimum requirement for this professional position is a [Ph.D., Master’s, etc.] degree in [discipline, field of study]. As a beneficiary, Dr./Mr./Ms. [employee] will be involved in [brief description of research/teaching, activities, and/or duties].

[Employee] is well qualified for the position. He/she obtained [degree, area of study] from [institution] in [location]. [Describe knowledge, skills, relevant experience, or other special qualifications needed by the employee to carry out the position].

Based on the [employee]’s experience we wish to employ him/her for a temporary period from [beginning date] to [ending date] with an annual salary of [$ per year].

The temporary nature of the H-1B status is understood. Should our H-1B petition be approved we fully intend to comply with the regulations regarding employment of H-1B individuals. I confirm that in the event that [employee] is dismissed before the end of his/her period of authorized employment, we will be responsible for the reasonable cost of return transportation to his/her home country.

Sincerely,

Name Department Chair, Director, Hiring Authority

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

Sample Letter of Support from Department-H-1B Extension Print on letterhead or stationary, sign in blue ink.

Date

U.S. Citizenship & Immigration Services California Service Center

RE: Form I-129 Petition for Nonimmigrant Worker, H-1B Extension Beneficiary: [Name of Employee: First, Middle, Last Name]

To Whom It May Concern:

We have determined that [employee’s] continued employment would be beneficial to [department, laboratory, Center, Institute, etc.] for [briefly list reasons and ongoing job duties].

We therefore offer [employee] additional employment for a period of [months or years], from [date] to [date], at an annual salary of [amount per year].

Please note that [employee’s] employment at UC Santa Cruz falls within the six-year limitation of stay provided to H-1B temporary workers. We agree to comply fully with the terms of the Labor Condition Application and to pay the reasonable cost of return transportation to his/her home country if [employee] is dismissed before the end of authorized H-1B employment.

Sincerely,

Name Department Chair, Director, Hiring Authority

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

Sample Letter of Support from Department- H-1B Employment Off-Site Print on letterhead or stationary, signed in blue ink.

Date

Department of Homeland Security U.S. Citizenship & Immigration Services California Service Center

RE: Form I-129 Petition for Nonimmigrant Worker [New Employment, Amendment, or Extension] Beneficiary: [Name of Employee: Given and Family Names]

To Whom It May Concern:

This letter is in support of an application for H-1B status for [employee]. The University of California Santa Cruz intends to continue employing [employee] as [job title] in [Institute, Center, Department name] for the period of [list H1B employment period].

We confirm our relationship with [employee] to be one of employer-employee. UCSC has the right to control the manner and means the [employee’s] work. [He/she] is expected to work on a day-to-day basis off-site at [location name and address]. We will provide [employee] tools and equipment to perform the duties of the position. [Employee] will report to [name and title of supervisor] at UCSC who will determine any assigned projects. UCSC will retain the right to determine exactly how, when, and in what manner [employee] will perform all tasks related to his/her position.

[Briefly list duties.] [Employee] will be on UCSC payroll, compensated at an annual salary of [amount] which is at or above the prevailing wage for [location of worksite]. Like all employees, [he/she] will be subject to performance and progress reviews; we reserve the right to terminate employment. UCSC will claim [employee] as an employee for tax purposes and provide [him/her] with standard employee benefits.

We agree to comply fully with the terms of the labor condition application for the duration of [employee’s] employment in H-1B status at UCSC. I confirm that in the event that [employee] is dismissed before the end of [his/her] period of authorized employment, we will be responsible for the reasonable cost of return transportation to [his/her] home country.

Sincerely,

Name Department Chair, Director, Hiring Authority

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

H-1B Petition: Employee Checklist

Submit two (2) legible copies of the following items to the hiring department or directly to the International Scholar Advisor. Do not staple documents.

H-1B Employee Application

Degree/diploma, highest degree earned • U.S. degree. If degree/diploma does not state the field of study, submit additional documentation

certifying your field of study. Of if the diploma has not yet been received provide official transcript orschool letter verifying degree in “XYZ field” has been completed.

• Foreign degree. If your degree was earned outside the U.S., you must obtain a credential evaluationto verify your degree is equivalent to a U.S. degree. The evaluation should include field of study, adetailed description of the material evaluated, and brief qualification and experience of theevaluator. Include original diploma or transcripts with English translation. Submit all pages of thecredential evaluation report.

CV or Resume. Do not need to include personal, immigration, volunteer information or grants received.

Passport Biographical page(s). Include your picture, name, date of birth, passport number, expiration date.

If currently or previously in the U.S: • I-94 Arrival/Departure Record. For paper version copy of front & back of I-94 card. For electronic

record, retrieve from www.cbp.gov/i94.• Visa: Most recent visa used for latest entry to U.S.• If F status (F-1/F-2): All I-20s issued and EAD card(s) for OPT, if applicable• If J status (J-1/J-2): All DS-2019s, J visa stamp, letters authorizing Academic Training

o If applicable, copy of USCIS Form I-612 Waiver Approval Notice if subject to 212(e) two-yearhome residency requirement.

• If TN status: Proof of employment such as W-2 and 2-3 months of pay stubs• If H status (H-1B or H-4): all I-797A Approval Notice; 2-3 months of pay stubs and W-2• If ever issued an Employment Authorization Document (EAD)- front and back of all card(s).• Any Form I-140 receipt or approval notice, if applicable

Dependents. If your dependents are currently in the U.S. and plan to apply to change or extend his/her H-4 status, submit:

• Original Form I-539, available at https://www.uscis.gov/forms. Use the paper form, do not e-file.• $370 check, payable to “US Department of Homeland Security.”• 2 copies of passport identification page(s), with expiration date, for each dependent.• 2 copies of I-94 departure record for each dependent. Electronic record or paper I-94 card (front and back).• 2 copies of marriage certificate/license/birth certificates, with certified English translation, if needed.• 2 copies of current visa stamp, relevant immigration documents-I-20s, DS-2019s, or any I-797A Approval Notice.

If dependent(s) are outside the U.S., there is no need to file Form I-539. Upon approval of the H-1B petition, dependent spouse/children will need to apply for H-4 visa(s) to enter the U.S.

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

H-1B Employee Application

Employee Data Family/Last Name: Given/First Name(s): Middle Name: (if any)

Other Names Used: (if applicable)

Date of Birth: (mm/dd/yyyy) Gender: Male or Female Social Security Number: (if any)

Province of Birth: Country of Birth: Country of Citizenship:

Passport Number: Passport Issuance Date: (mm/dd/yyyy)

Passport Expiration Date: (mm/dd/yyyy)

Foreign Address: (Street number and Name, City or Town, State, Province, Postal Code, Country)

Home Phone Number: Office Number: Email:

List U.S. Embassy or Consulate to be notified if H-1B petition is approved. Required even if you have no travel plans.

Office Address (City): Country: Consulate Port of Entry Pre-flight inspection

Current Status. Complete if in the U.S. U.S. Residential Address: (Street Number and Name, City, State, Zip Code)

Home Phone Number: Office Number:

Current status: (J-1, F-1, H-1B) Date Status Expires: (mm/dd/yyyy)

I-94 Admission RecordNumber:

Date of Last Arrival in U.S.: (mm/dd/yyyy)

Any travel plans outside the U.S. in the next 6 months? Yes No If yes, provide departure and re-entry dates.

Are application(s) by dependent(s) being filed with the H-1B petition? Yes No If yes, how many?

Educational Background Information Highest Degree Earned: (Bachelor’s,Master’s, Doctorate)

Major Field of Study: Date Degree Awarded: (mm/dd/yyyy)

If degree was obtained in the U.S., provide Institution’s name and mailing address

Enter name as it appears in passport

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

Other Relevant Information If currently in F-1 status on Optional Practical Training, when does the EAD expire?

EAD #:

If currently in J-1 status on Academic Training, when does work permission expire? SEVIS ID #: N

Have you or your spouse had H-1B status in the past 7 year? Yes No If yes, provide period(s) of stay (mm/dd/yyyy) and status (H-1B or H-4) held. Use a separate sheet of paper if needed. If currently working in H1B, please also provide name of employer.

Have you ever been denied H-1B status? Yes No If yes, attached separate page with details

Have you, spouse, or anyone on your behalf ever filed an immigrant petition? Yes No If yes, attach copy of I-130 or I-140 receipt (pending) or approval notice

Have you ever filed an application for adjustment of status? Yes No If yes, attach copy of I-485 notice(s)

Have you ever been a J-1 Exchange Visitor or J-2 dependent? Yes No If yes, attach all DS-2019s SEVIS ID #: N

Have you ever been subject to the Two Year Home Residency requirement? Yes No If yes, when did you apply for waiver with Department of State? If approved, provide copy of USCIS Form I-612 approval notice.

Or, have you fulfilled the requirement by residing in your home country/place of permanent residence? Yes No If yes, include evidence you have resided outside the U.S. for two years.

Are you in exclusion or deportation proceedings? Yes No

For H-1B extension. Work Site information-provide the location, all on or off-campus site(s): Building Name: Physical Address:

Signature

I certify the information provided on this form is true and accurate to the best of my ability.

Signature: Date:

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

H-1B Petition: Prevailing Wage Survey

H-1B Request Type: New Employment Change of Employer Concurrent Extension Amendment

Hiring Department/Unit: Division:

Person Preparing Form:

Title or Position:

Phone Number: Email:

Position Description Proposed UCSC Job Title: Job Title of Supervisor for this position:

Describe the job duties to be performed (begin with primary/greatest effort first). Attach a position description if needed. Include details regarding the research areas/fields, courses to be taught, and/or software or equipment to be used. Is this position covered by a Collective Bargaining Agreement (CBA)? Yes No

Is this a full-time position? Yes No If no, number of hours per week:

Basic Rate of Pay Offered: $ Is this rate of pay hourly or yearly?

Minimum degree and field of study required for this position:

Does employer require a second degree or diploma? Yes No

Does this position supervise other employees? Yes No

If yes, indicate number of employee workers: Considered: Subordinate Peer

Is training for the job opportunity required? Yes No

If yes, specify number of months and field/name of training required.

Is previous employment experience required? Yes No

If yes, specify number of months of experience required and indicate the occupation:

Are there any special requirements? List specific skills, licenses/certification, or additional requirements of the job opportunity. Yes No Will travel be required to perform the job duties?

Yes No If yes, provide details-area(s), frequency, nature of travel.

Worksite Address. Provide street address, city, state, and zip code. If work is to be performed at multiple location(s) other than address listed above provide building name, additional address for the worksite(s).

International Student & Scholar Services (ISSS) Classroom Unit 101, 1156 High Street, Santa Cruz, CA, 95064

Phone: (831) 459-2858 | Fax: (831) 459-2382

Departmental Request to Waive the Safe Harbor Protection

UCSC recognizes the Safe Harbor Provision set forth by 20 C.F.R. § 655.731(a)(2)(ii)(A)(3) and 655.731(d)(1) when filing H-1B petitions on behalf of its employees.

Explanation of Safe Harbor An H-1B employer may choose to rely on a prevailing wage determination (PWD) provided by the Department of Labor (DOL) National Prevailing Wage Center (NPWC). Using a NPWC PWD provides wage protection in case of a DOL wage investigation. DOL will accept the wage determination if the employer properly described the job and has the proper documentation.

If an employer relies on a non-safe harbor source, then, in the course of a wage investigation, DOL can challenge that source, conduct a new prevailing wage determination based on OES data. If DOL determines the wage paid is less than found in the DOL determination, hold the employer responsible for paying back wages for the difference between the DOL determination and what the employer was actually paying.

By signing below, the Department/Division is requesting that ISSS to make an in-house prevailing wage determination. The Department/Division understands that in the event of a DOL audit foregoing safe harbor protection may subject the Department/Division to an unfavorable decision to pay back wages for the difference between the DOL determination and the actual wage.

Name Signature Date Divisional Dean or Coordinator

Divisional Coordinator

Supervisor/P.I.

Note: To calculate a prevailing wage determination ISSS must receive a thorough, written explanation of job description and duties.

Return completed memo to Linda Harris, ISSS, mailstop: Global Engagement

MEMORANDUM OF UNDERSTANDING

TO: International Student and Scholar Services

FROM: [Name, Title, Department/Center/Institute]

DATE:

RE: Beneficiary-Employee’s Request to Pay I-907 Premium Processing Application Fee

We understand, per 20 CFR 655.731, that as the employer seeking to hire an H-1B nonimmigrant in a specialty occupation we are required to pay the H-1B nonimmigrant the required wage rate. The wage requirement includes our obligation to offer benefits and eligibility for benefits provided as compensation for services, including payment of all USCIS filing fees as the “cost of doing business.”

At this time, we are requesting a waiver of the responsibility to pay the premium processing fee (Form I-907) since the benefit of the premium processing service is to accrue solely to the beneficiary employee and is being provided as a courtesy to assist him or her in meeting personal need(s).

Signature of Department Chair, Date Dean, or Division Coordinator

As the beneficiary of an H-1B petition, I take responsibility of paying the premium processing fee (Form I-907), a service I am requesting for my sole benefit.*

Signature of Employee Date

*Note to Employee: Please provide an explanation below or attach a separate sheet that describes thebasis for this request. This may be submitted directly and confidentially to ISSS.