H-1B: PROSPECTIVE EMPLOYEE CHECKLIST
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1 H-1B REQUEST (REV. 12/2016) Part I of II is to be completed by the sponsoring department. Part II of II is to be completed by the foreign national. PART II OF II (SCHOLAR/STAFF) H-1B: PROSPECTIVE EMPLOYEE CHECKLIST Surname (Family Name): First (Given) Name: 1) Signature page of the Web Form, signed in blue ink. 2) One (1) copy of the biographic and expiration pages in your passport (these two (2) pieces of information may be either on the same page or different pages). 3) Copies of previous U.S. immigration documents (including front and back of I-94) and all other relevant documents. Please include the same documents for any dependents. 4) Current H-1B employees transferring to Duke (H-1B portability applications): DHS regulations require that in order to transfer your H-1B status to Duke University, you must still be a current H-1B employee at the time Duke s H-1B petition is received by DHS. In order to verify that you are currently employed and eligible for H- 1B portability, please provide copies of the last 3 pay stubs you received from your current employer or a letter from the employer verifying your employment and confirming your last date of employment. 5) One (1) copy of your current curriculum vitae (CV), signed and dated. 6) One (1) copy of all required diplomas, transcripts, certificates, and licenses. If a document is not in English it must be accompanied by a verbatim translation (see Rules for Documents). NOTE: A copy of a medical license or an ECFMG certificate is not sufficient without a copy of the medical degree. If the position is a clinical faculty, house staff, or a position in allied health, see the additional documentation requirements on the Documentation & Requirements form. 7) One (1) copy of an equivalency evaluation if the required degree was not earned inside the U.S. This requirement is to prove that you hold the qualifications required for the job. Please see Documentation & Requirements and Rules for Documents for more information. 8) One (1) completed copy of Document Certification Form, signed in blue ink. 9) One (1) completed copy of the Statement of Prior H Classification Form, signed in blue ink. 10) H-1B Extensions: Current Duke H-1B employees must include copies of monthly pay statements that cover the period of current H-1B approval. Check Work for copies. 11) H-4 Supplement for Dependents. NOTE: If you have dependents who will need to either change to or extend H-4 status in the U.S., the eldest dependent must complete the H-4 Supplement for Dependents. The filing fee for the supplement is your responsibility. Make check payable to: U.S. Department of Homeland Security. All dependents must provide one copy of their biographic and expiration page of their passport, front and back of their Form I-94, all immigration documents such as I-20, DS-2019, I-797, etc. If you did not receive an I-94 card at the port of entry, print a copy from the following website: NG891zpmZL! Please assemble the foregoing documents in the order provided by this checklist and submit the materials together in one package to your Duke Department.
2 DOCUMENTATION & REQUIREMENTS FOR CLINICAL H-1B SPONSORSHIP ALLIED HEALTH CARE OCCUPATIONS Allied health care occupations include, but are not limited to, physical therapists, medical technologists, medical technicians, occupational therapists, and advanced nursing positions. Special documentation may be required depending upon the specific occupation. Contact Duke Visa Services immediately for details. CLINICAL FACULTY Visiting faculty are prohibited from providing patient care except when the care is incidental to the primary activities of teaching and research. Since H-1B status does not permit self-employment, membership in the Private Diagnostic Clinic is not possible. Faculty physicians who will have any patient care responsibilities must obtain either a full North Carolina license or a Faculty Limited license from the NCBME. In addition to the general documents listed above, the following documents are also required [Submit one (1) copy of each; follow the Rules for Documents]: 1. Diploma or similar proof of medical education from your medical school. 2. License or authorization to practice in the home country. 3. Either a letter from the NCBME confirming that all requirements for Faculty Limited license have been met or a copy of a full, unrestricted license to practice in North Carolina. NCBME applications for licensure are available on the web at Or contact the NCBME directly by telephone (919) or (919) or via info@ncmedboard.org. CLINICAL FACULTY ENGAGED IN NON-INCIDENTAL PATIENT CARE AND CLINICAL TRAINEES (a.k.a., HOUSE STAFF) As a result of the Immigration Act of 1990, some graduates of foreign medical schools may qualify for H-1B classification for the purpose of engaging in non-incidental patient care. All of the following documentation is required [Submit one (1) copy of each; follow the Rules for Documents]: 1. An ECFMG certificate valid through the anticipated start date of the training program. 2. Proof of passage of Steps 1, 2, 3 of the USMLE. Older exams may potentially be used, but please contact Duke Visa Services for more information. 3. Proof of NC medical licensure at the appropriate level. Contact Office of Graduate Medical Education (OGME) to obtain an application. NOTE: Graduates of U.S. medical schools or LCME-accredited Canadian schools do not need item 1.
3 RULES FOR DOCUMENTS VISA PURPOSES ONLY These instructions are for visa purposes only. Licensing or certifying authorities usually have different, more stringent requirements for their purposes. If a license or certificate is required for a visa then the applicant must prepare a separate set of documents for licensing/certification purposes. This is also true for securing academic appointments and clinical privileges for different institutions. Only documents appropriate to the position need to be submitted. For example, if the job requires a Ph.D. in a specific field, then only the Ph.D. diploma is required. Equivalency evaluations must accompany foreign diplomas to show that the foreign degree is sufficient to qualify the individual for the position being offered. It will be necessary to have a professional credentials evaluation service do this work. Please see information below identifying some agencies that are nationally recognized for performing such evaluations. NOTE: For medical degrees (those recognizing the profession or qualification of physician or surgeon), the equivalency determinations have already been made by the Educational Commission for Foreign Medical Graduates (ECFMG). Duke Visa Services retains this documentation so you do not need to obtain equivalency determinations for such medical degrees. Transcripts are required for diplomas which do not list the field of study. For example, a Duke Ph.D. diploma carries only the degree of "Doctor of Philosophy." It does not list the field in which the Ph.D. was obtained. In this case an official transcript is necessary to show that the degree was received in the field in which the job is offered. Verbatim Translations must accompany all documents not in English, including diplomas written in Latin. Translations must be certified by a U.S. Consular Officer or by a recognized translation service. Translations done by faculty members have been accepted by U.S. Department of Homeland Security if the faculty member attaches a cover letter on department letterhead attesting to the accuracy of the translation and explaining his or her professional competence to translate. The cover letter and each page of the translation should bear the faculty member's signature and the date. Photocopies of diplomas, transcripts, certificates, etc. are acceptable if a certification statement is attached to the copies and is signed and dated by the foreign national. (See Certification of Documents instructions below.) Credential Evaluations For H-1B and O-1 Petitions For initial H-1B and O-1 applications, please obtain an original evaluation determination. It is imperative to obtain the credential evaluation as noted in Documentation for H-1B" to avoid needless delays. Please note that this is not required for any degrees that are required for the practice of medicine as Duke Visa Services can provide documentation for use by Duke in the filing of our H and O petitions. For reference, the following credentials evaluators are the most widely recognized in the U.S. and are accepted by DHS: World Education Services (WES), NY, NY Tel: Educational Credentials Evaluators (ECE), Milwaukee, WI Tel: International Education Research Foundation, Culver City, CA Tel: Josef Silny & Associates, Inc., International Education Consultants P.O. Box , Coral Gables, FL Tel: (305) Fax: (305)
4 DOCUMENT CERTIFICATION FORM 1. Collect original documents. DHS has the right to require you to produce the original. 2. Make 1 photocopy of each original document to be submitted to DHS. 3. Please sign in blue ink as sometimes one cannot distinguish black ink from a photocopy. This certification is prepared in compliance with Department of Homeland Security regulations relating to the verification of documents. Foreign National Name: Date of Birth: (month/day/year) Country of Birth: COPIES OF DOCUMENTS SUBMITTED ARE EXACT PHOTOCOPIES OF UNALTERED ORIGINAL DOCUMENTS AND I UNDERSTAND THAT I MAY BE REQUIRED TO SUBMIT ORIGINAL DOCUMENTS TO AN IMMIGRATION OR CONSULAR OFFICIAL AT A LATER DATE. Signature of person certifying Full name typed or printed Date
5 STATEMENT OF PRIOR H CLASSIFICATION FORM (Submit one (1) with original signature in blue ink) PLEASE TYPE Family Name: Given Name: Date of birth (month/day/year): Country of birth: 1. During the last 6 years have you been in the U.S. in any H visa classification? Yes No If you answered and marked No please move to item #2 of this form. If you answered and marked Yes please list all dates and H categories below. List only dates you were present in the United States. 2. During the last 6 years has either your spouse or any of your children been in the U.S. in any H visa classification? Yes No If you answered and marked No please sign and date at the bottom of this form. If you answered and marked Yes please list all dates and H categories below. List only dates they were present in the United States. Spouse Family Name: Given Name: Date of birth (month/day/year): Country of birth: Child Family Name: Given Name: Date of birth (month/day/year): Country of birth: Signature: Date:
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