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Form I-129 Edition 03/10/21
For
USCIS
Use
Only
Petition for a Nonimmigrant Worker
Department of Homeland Security
U.S. Citizenship and Immigration Services
USCIS
Form I-129
OMB No. 1615-0009
Expires 09/30/2021
Classification Approved
Consulate/POE/PFI Notified
Extension Granted
COS/Extension Granted
Partial Approval (explain)
Action BlockReceipt
Class:
No. of Workers:
Job Code:
Validity Dates:
From:
To:
At:
Legal Name of Individual Petitioner
If you are an individual filing this petition, complete Item Number 1. If you are a company or an organization filing this petition,
complete Item Number 2.
Family Name (Last Name) Given Name (First Name) Middle Name
1.
Contact Information4.
Part 1. Petitioner Information
START HERE - Type or print in black ink.►
2. Company or Organization Name
3. Mailing Address of Individual, Company or Organization
City or Town State ZIP Code
In Care Of Name
Street Number and Name
Apt. Flr. NumberSte.
Daytime Telephone Number
U.S. Social Security Number (if any)
Email Address (if any)
Individual IRS Tax Number
Mobile Telephone Number
Federal Employer Identification Number (FEIN)
5. Other Information
►►
Postal Code CountryProvince
►
(USPS ZIP Code Lookup)
N/A
N/A - filled by Petitioner
N/A - filled by Petitioner - MJ
OPEN SOURCE ECOLOGY
MAYSVILLE
64469
MO
OPEN SOURCE ECOLOGY
909 SW WILLOW ROAD
N/A
45-4997514
N/A
N/A
UNITED STATES OF AMERICA
8164491224
8168663217