H-1B Temporary Specialty Worker Department Checklist for Extension Applications International Faculty & Scholars Office UC San Diego Phone (858) 246-1448 Fax (858) 246-1440 ifsoh1b@ucsd.edu http://ifso.ucsd.edu The list below is for items to be provided by the department. There is a separate checklist of documents for the H-1B applicant. Please submit the items from both checklists to IFSO at the same time. Do not staple the documents. 1. H-1B Department Request Form (do not include this General Information page and Checklist) 2. Statement of Actual Wage Determination with original signature (NOT required for unionized positions, UNLESS salary falls off-scale) 3. Office of Research Affairs Certification with original signature (a.k.a. Deemed Export Control Certification) 4. Letter from Employer. On letterhead & signed (submit original); include ONLY information as illustrated in sample. (Additional information may raise red flags.) 5. If Staff title, copy of Job Description 7. 6. Copy of Job Offer Letter signed and accepted by prospective employee. Clinical Appointments Appointments of internationals with foreign medical degrees that require clinical duties must submit the following: o o o ECFMG certification (unless graduate of a Canadian medical school); US Medical Licensing Examination (USMLE) - Steps 1-3 or National Board of Medical Board of Medical Examiners (NBME) examinations - Parts 1-3 or FLEX examination; and CA medical license fully compliant with Medical Board regulations. Filing Checks and Fees DHS Checks $ 460 I-129 Petition Processing Fee $1,225 Premium Processing Fee (Recommended) Online Recharge $2,200 IFSO Service Fee (Online Recharge Form) Request checks with UC San Diego IPPS/MyPayments. All checks should be made payable to US Department of Homeland Security. Please include all necessary checks at time of the application submission. UC San Diego checks now expire within 180 days of issuance. ALL H-1B fees MUST be paid by the sponsoring department. Fees are not rechargeable to the international scholar. IFSO recommends the Premium Processing Fee to minimize the risk of lapse in State of California driving privileges. The Premium Processing Fee may be paid by the scholar if used solely for gaining personal benefits such as driver s license/california ID renewals, personal travel outside of the country, etc. 2017/06 NG International Faculty & Scholar Office UC San Diego 9500 Gilman Drive Mail Code: 0123 La Jolla, CA 92093-0123 USA
H-1B Temporary Specialty Worker Department Request Form, Part I H-1B Request Type: Extension Amendment B Both Name of prospective H-1B: (Family/Last Name) (First/Given Name) (Middle Name) Highest academic degree earned by H-1B: Field of major: Proposed UC San Diego title: Proposed UC San Diego title code: If applicable, Career Tracks subclassification code for UC San Diego staff title: Minimum Requirements For This Title Academic degree: Acceptable disciplines for degree: Number and titles of staff H-1B holder will supervise: H-1B s supervisor's job title: Is employment experience required? Yes No If yes, state minimum number of months, indicate occupation required Will the H-1B employee teach classes? Yes No Is training for this job required, in addition to experience, e.g. medical residency training? (not including postdoctoral scholar work) YES NO If yes, state minimum number of months, field(s)/name(s) of training Is this a Medical/Clinical appointment? Yes, proceed to answer questions below No Is a medical license required? Yes No Is board eligibility required? Yes No Is board certification required? Yes No Is another license required? Yes No If yes, state type: Any other special requirement: Yes No If yes, state type: H-1B Ext/Amend start date: H-1B Ext/Amend end date*: *NOTE for Postdoctoral Scholar-Employee positions: The H-1B is job-specific, so do not request more time on this H-1B request than the institutional 5-year (or 6 th -year exception) limit would allow for the postdoctoral appointment. Any change in job title from Postdoctoral Scholar requires an amended petition, complete with new internal recharge and external filing fees. Annual salary: Percentage time: Work Site -physical location of scholar s activity, include all relevant on- or off-campus sites List ALL work sites for the scholar. If more than three work sites please add an additional page. 1) Building: 2) Building: 3) Building: Address: Address: Address: 2018/02 DR (Do not abbreviate building name) (Provide physical address. If none available, use the official address)
H-1B Temporary Specialty Worker Department Request Form, Part II UC San Diego must submit a Labor Condition Application ( LCA ) to the US Department of Labor and have it approved before submitting the H-1B petition to the US Department of Homeland Security (DHS). Carefully read the LCA and other statements below and certify that you will uphold them. WE CERTIFY THAT 1. The salary being paid to the above-named employee is at least the actual wage being paid to all other individuals with similar experience and qualifications for the specific employment in question or the prevailing wage level for the occupation in the 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 other US workers in the same classification. 3. Employing this person will not adversely affect the working conditions of US workers similarly employed. 4. There is no strike, lockout, or work stoppage due to labor dispute in this occupation. 5. We agree to comply fully with the terms of the LCA stated above for the duration of the employee s employment in H-1B status at UC San Diego, including paying the listed salary as of the H-1B petition approval date. Any prospective changes in appointment title, significant salary changes, employment locations, and reduction of hours must be cleared with the International Faculty & Scholars Office prior to changes happening. 6. We fully understand that any willful violation connected with providing inaccurate information in this LCA may incur a severe penalty that has a long-range impact on the entire UC San Diego campus. 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. I have read the above conditions and agree to each point. Name Signature Phone Number Department Chair: Sponsor/Supervisor: Department Contact: Mail Code: Department Name: Department Contact E-mail: Index # (for mail to USDHS) Are you requesting Premium Processing for this petition? Yes No Please submit this form to IFSO along with the other forms listed on the H-1B applicant s checklist and the Visa Recharge Services From. (see: http://ifso.ucsd.edu/dept-facilitators/online-recharge.html) 2017/09 NG
STATEMENT OF ACTUAL WAGE DETERMINATION NOT REQUIRED FOR UNIONIZED POSITIONS UNLESS SALARY FALLS OFF-SCALE THE FOLLOWING INFORMATION, PER DEPARTMENT OF LABOR (DOL) REGULATIONS, MUST BE AVAILABLE FOR PUBLIC EXAMINATION. [REF: 20 C.F.R. S 655.731 (b)(2), 655.760 (a)(3)] Job Title: If applicable, Career Tracks subclassification code: Annual Salary: Please identify the number of employees in the same title and step as this position within the ;. (department or division name) Indicate the salary range of these individuals (do not include this position). Use department or division as appropriate to ensure that there is a range of salaries: from $ to $ per year. Within this salary range, an individual salary is determined by taking various factors into consideration, specifically (check all that apply): Level of education/type of Degree Years of experience in the field Specific job responsibility Degree of independent responsibility Nature of duties involved Number of Publications/Publication Record Other (please specify): (# of employees) Salaries of employees may be adjusted on an annual basis, based upon budget reviews and costs of living assessments, etc. CERTIFICATION: I hereby certify that this salary information reflects the actual wage level paid to all other individuals with similar experience and qualifications working in 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 for the Department of Labor. Print Supervisor Name Title Supervisor Signature 2017/05 NG
Office of Research Affairs Certification This certification must be completed by the supervisor of the nonimmigrant employee (i.e., the nonimmigrant faculty, researcher or staff on whose behalf the University is filing a U.S. Citizenship and Immigration Services Form I-129 for H-1B or O-1 status). If you do not have the information necessary to complete this certification, please contact the Office of Research Affairs at the numbers listed below to complete the processing of this certification. Will this nonimmigrant employee have any IT administrator responsibilities or access? Yes No If yes, contact the export control office at export@ucsd.edu. I, the supervisor, hereby certify that the research agreement (e.g. contract or grant) on which the nonimmigrant employee will be working: does not restrict or prohibit the participation of foreign persons in the project; does not restrict or prohibit the research team s right to publish any of the data or research results; And in performing the work under the visa, the beneficiary will not: be working on any research project that is or should be subject to a Technology Control Plan (such a plan may be required if there is access to export controlled technical information, materials, software, or encryption code, which could be received in the form of confidential or proprietary information transmitted by a sponsor or third party); be working on any service agreements; or be given access to equipment specifically designed or developed for military (ITAR) or space applications. I am familiar with the job duties and other particulars of employment of the nonimmigrant employee listed below and hereby affirm that the contents of the foregoing certification are true, to the best of my knowledge, information, and belief. Supervisor Signature Print Supervisor Name Department Nonimmigrant Employee Last Name First Name Middle Name(s) If you are unable to complete this certification or require additional information, please contact: Brittany Whiting Export Control Officer 858-534-4175 export@ucsd.edu Garrett Eaton Senior Export Analyst 858-822-4136 export@ucsd.edu For more information on Export controls please go to: http://blink.ucsd.edu/sponsor/exportcontrol/index.html 2017/10 DR
Sample Letter for Extension of H-1B Employment By DHS requirements, the following letters should be on official UC San Diego stationery & signed in blue ink ONLY To: Re: US Citizenship & Immigration Services Dr. XXX [First Name, Middle Initial, & Last Name] We would like to request continuation of the previously approved H-1B employment for Dr. XXX. The terms and conditions of the previously authorized H-1B employment have not changed. Dr. XXX is continuing in full-time [research focusing on studies on antibody structure. He is determining the structural/functional relationship of immunoglobulins and using the information gained to construct antibody-derived molecules with novel biological functions.] Dr. XXX s annual salary will be [$ ]. We wish to employ him until [December 31, 2013 maximum three years from current expiration; maximum six years total of all H-1B]. Sincerely, [Department Chair]] Sample Letter for Amendment and/or Extension of H-1B Employment By DHS requirements, the following letters should be on official UC San Diego stationery & signed in blue ink ONLY. To: Re: US Citizenship & Immigration Services Dr. XXX [First Name, Middle Initial, & Last Name] We would like to temporarily employ Dr. XXX in H-1B status from [June 1, 2012] until [May 31, 2015 three years maximum] to [conduct research on the deformation mechanisms in tungsten-based and intermetallic-based materials using analytical electron microscopy]. Her annual salary will be [$ ]. Dr. XXX is well qualified for our position. [In 1988 she received a Master of Science degree in Metallurgical Engineering from the University of Tennessee, Knoxville, and in 1993 received a PhD in Materials Science from the University of Tennessee, Knoxville]. She has recently been working as a [Postgraduate Research Fellow at Ohio State University conducting research on the deformation mechanisms and microstructural characterization of intermetallic materials]. She has published numerous research articles [in the area of intermetallic materials]. Sincerely, [Department Chair] 2016/06 CS2