How to reach
us?
Toll-free number:
1-866-360-4LAW
1-866-360-4529
Our location
Main Office:
16177 Brookhurst Ave
Fountain Valley, CA 92708.
Tel: (714) 636-6030
(714) 389-7880
>>Map
Orange County
14411 Brookhurst Ave,
Suite A
Garden Grove, CA 92843
Tel: (714) 775-7770
>>Map
Rosemead
8450 Garvey Ave. Suite 208
Rosemead, CA 91770.
Tel:
(626) 307-4000
>>Map
Other branches:
626-288-0854 (San Gabriel
Valley) |
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Questionnaire and Work Order
The information requested below is essential
for us to assist you with your work permits and visas. Due to the nature
of immigration requirements, some of the essential information is of a
personal nature. All details will remain strictly confidential and will
be utilized only to obtain the proper documents for you.
To download a MS Word version of this document, right click on
this link and select "Save Target As" (for mac users, CTRL + click).
Part I: Personal Particulars
1. Full (Legal) Name: _________________________________
2.
Date of Birth (DD/MM/YY): / /
(Male/Female - please delete or underline
appropriately)
3. Country of Citizenship: _________________ Country of Birth:
_________________
Former Nationality: _________________
4. Passport Expiration Date (DD/MM/YY): / /
(List even if expired)
5. Daytime Phone Number: _________________ Evening Phone Number:
_________________
Mobile Phone Number: _________________ Fax Number: _________________
E-mail Address: _________________
6. Company Name:
_________________________________________________________________
7. Company Address:
_______________________________________________________________
8. Home Address:
__________________________________________________________________
9. Date of Hire with Current Employer (DD/MM/YY): / /
10. Current Job Title:
__________________________________________________________
11. Do you possess post-secondary degrees? ___ Bachelors/4 year
equivalent ___ Masters/Doctorate
Part II: Spouse, children, and other dependents
Complete this section only if you have a spouse, children, or other
dependents that will be relocating with you. Do not complete this
section if you have children that will simply visit you periodically.
1. Accompanying Family Details:
|
Full (Legal) Name |
Date of Birth
(DD/MM/YY) |
Relationship |
Country of Citizenship |
Passport Expiration |
|
___________________ |
/ /
|
___________ |
___________ |
___________ |
|
(Male/Female-please delete or underline appropriately) |
|
___________________ |
/ /
|
___________ |
___________ |
___________ |
| (Male/Female) |
|
___________________ |
/ /
|
___________ |
___________ |
___________ |
| (Male/Female) |
|
___________________ |
/ /
|
___________ |
___________ |
___________ |
| (Male/Female) |
|
___________________ |
/ /
|
___________ |
___________ |
___________ |
| (Male/Female) |
2. If you do not intend for you and your family to relocate at
the same time, please explain below:
__________________________________________________________________________
__________________________________________________________________________
3. Will you be traveling with a pet? ___ Yes ___ No
Part III: Details of Relocation/Assignment Overseas
1. Information about the place where you will be working:
Country: _______________________________ City of Employment:
_________________
Planned Date of Departure (DD/MM/YY): / / Is this
date flexible: ___ Yes ___ No
Expected Duration in Country:
_________________________________________________________________
(If you are not relocating, please detail
the terms of your assignment, i.e., 3 wks in, 1 wk out for 6 months
total.)
Date(s) of planned Business/Home finding trip(s) (DD/MM/YY):
________________________
2. Information about the job that you will be performing:
Job Title:
__________________________________________________________________
Basic Duties:
_______________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Official Name of Employer in Country (destination country):
_____________________________
3. Relationship between Employer in Origin Country and Employer
in Destination Country:
___ Subsidiary, Parent, or Division of same company ___ None ___
Other
4. Which entity will pay you? ___ Employer in destination
country ___ Employer in origin country
5. Employer Contact Information (to secure company paperwork
required for immigration):
A. Human Resource or Management Contact in Origin Country:
Name: _______________________________ Position:
_______________________________
Phone Number: ________________________ Email:
_________________________________
Fax Number: _______________________
B. Human Resource or Management Contact in Destination Country:
Name: _______________________________ Position:
_______________________________
Phone Number: ________________________ Email:
_________________________________
Fax Number: _______________________
Part IV: Work Order
Signature: ____________________________________ Date (DD/MM/YY):
/ / |
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