Tata Consultancy Consultancy Services Limited
Emp.No.
172816
BA Co. Name
US VISA QUESTIONNAIRE
Onsite WON 1008208
(Please read instructions given in the last page before filling up this questionnaire) Type of Visa H1B Ind ivid ual L1B Blanket I n dL1B ivid ual L1A Blanket L1A Name (As per passport)
Given Name
M M x e S Male
Date of Birth
Surname (Family Name)
D YY D
10
10
19 77
M M Date of Joining
01
DD
02
YY
20 06
Female TCSL / BA Designation
Grade
ASST. CONSULTANT
C3A
Do you have an observatio n page in your passport? If yes, please include a copy of the observatio n page
GG V
Base Branch Documents Sent By (Br anc h)
Social Security Number (if any) More Info.
612-73-2998
Consulate
YES
NO Mumba
Delhi
Complete Residential Address (in Home Country) Address: Address: (Should be within the Jurisdiction of
Kolkata
Chennai
Others Please Specify
Hyderaba d
Client Name & Project Site Address (More Info.) Client Name :
Consulate)
Santosh Kumar Jha, D-1-12/4,DLF, Bhopura City/District : Sahibabad,GZB PIN: 201005
Uttar State: Pradesh Country : India
Present Contact No. +91-9810922019 Emp. E-mail ID:
[email protected]
Project Site Address (as per PRD): Corporate Headquarters One Boston Scientific Place Natick, City : State: MA United States Zip Code : 01760-1537 RM / AM : Raj
kishor
E-mail IDs of stake holders 1
[email protected] [Offshore/Onsite] to whom 2
[email protected] processing status to be informed (More Info.) Degree / Name of University Specialization Place of University PG As Appearing in the Certificate (only Diplomas/Bachelors/Masters) B.E Shivaji University Electronics Maharashtra
Rele Releva vant nt to Soft Softwa ware re (a) (a) US Visa questionnaire Ver 6.6 -19.02.10
Not Not releva relevant nt to Soft Softwa ware re (b)
Year of passing
2000
Tota Totall Expe Experie rienc nce e (a+b (a+b)) TCSL Internal
e c n e i r e p x E k r o W
Prior to joining TCSL
04_ Years 03___Months
___ Years ___ Months
In TCSL
06__ Years _01_ Months
In BA Organization
_10__ Years 04__ Months
All previous entry/exit dates to/from the United States. Include all kinds of travel (vacation, business etc.). Make sure that the project details and work location in CV are consistent with the below dates. If worked for more than one clients/locations during one visit, mention all the clients/locations. Visa Entry date Exit date from Client Name (s) City (ies) & State (s) Type into U.S. U.S. M D YY M D YY M D M D L1A 11 09 08 02 02 09 Electronic Arts Redwood City, CA L1A
11
15
09
12
05
09
Electronic Arts
Redwood City, CA (Contd.. 2)
:: 2 ::
US Salary ( TO BE FILLED IN BY FDFU) (USD per annum) Documents for all types of Petitions (also for Blanket Petitions)
1. Updated Resume 2. Project and Role Description (PRD) 3. Copy of Passport/previous US Visas 4. Copy of Degree/PG Certificate(s)
Additional documents for H1B
All semester Mark Sheets (with subject names and marks) 2. Experience Certificate(s) from previous employer(s), if any 3. Copy of earlier L1/H1 approvals ( If applicable) 1.
Additional documents for Individual L1A/L1B Petitions 1. All semester Mark
Sheets (with subject names and marks) 2. Latest Form 16 & payslip
Details of Previous Petition(s) / Visa(s) 1. Please provide the details of previous petition(s), if any [check the petition(s) ]. Petition Type (Blanket/Individual/Ex tension) BLANKET
Visa Type (L-1A, L-1B, H1B) L1-A
Valid till (Check I-129 or I129S form in your petition documents) 23JUNE2011
Approved / Denied / Withdrawn (If denied, specify denied by whomUSCIS or US Consulate in India) APPROVED
2. Please provide the details of previous visa(s), if any [check your visa(s) from passport]. Visa Type (L1, H1, B1, H4, L2) L1
Visa Expiry Date 23JUNE2011
Signature of the associate : Santosh Jha
PED (Petition Expiry Date)
P# (Petition Number)
23JUNE2011
Place: Delhi
Date:
17/05/2011
US Visa questionnaire Ver 6.6 -19.02.10
TCSL Internal
INSTRUCTIONS:
Ensure that the details filled in this questionnaire are matching with the details given in the CV,PRD and experience certificate
Ensure that all the documents listed above are attached before submitting this questionnaire to your local FDFU
US Visa questionnaire Ver 6.6 -19.02.10
TCSL Internal
BOOKMARKS – DO NOT PRINT THIS PAGE Social Security Number: Applicable only if you have traveled to USA before under L1 or H1 status. Type N.A. if not applicable Client Name and Project Site Address: Mention name of the client and location with the zip code where you will be working E-mail Ids of Stake Holders: E-mails will be sent to these addresses at each stage of processing your petition.
US Visa questionnaire Ver 6.6 -19.02.10
TCSL Internal