Ascend Technology Inc

1879 Lundy Avenue, Suite 289,

San Jose, California 95131
Tel: 1-888-782-2361 Ext: 101, Fax: 1-888-782-2361
Email: info@ascendtechnologies.net
Web: www.ascendglobaltech.com

Kindly fill up this form and send it to directly hr@ascendtechnologies.net with all
the attachments.

H-1B CAP REGISTRATION INFORMATION of Beneficiary

1. Full name (First, Middle, Last) ________Surid Anirban_____________________

2. All other names used, if any _______________________________________________________

3. Date of birth ___04-12-1991___________________________________

4. Social Security Number, if any _______________________________________________________

5. A#, if any _______________________________________________________

6. Province and Country of birth

___________________________Bangladesh__________________________

7. Country of citizenship
______________Bangladesh_________________________________________

8. Foreign Residence/Address ______Bashundhara R/A,Block E , Tenement-5 , flat D1,

Dhaka,Bangladesh_________________________________________________

_______________________________________________________

9. Has a Labor Certification and/or Immigrant Petition (I-140) ever been filed for you? If so, please list
name of petitioner, date, location, receipt #, and disposition of filing.

_________________________________________no_________________________________________
__

10. Have you ever been granted H-1B classification in the past? If so, please list name of petitioner, date,
location, receipt #, and disposition of filing.

_______________________________________no___________________________________________
_

11. Have you ever been denied H-1B classification? If so, please list name of petitioner, date, location,
receipt #, and disposition of filing

________________________________no__________________________________________________
__

1
 Ascend Technology Inc
1879 Lundy Avenue, Suite 289,
San Jose, California 95131
Tel: 1-888-782-2361 Ext: 101, Fax: 1-888-782-2361
Email: info@ascendtechnologies.net
Web: www.ascendglobaltech.com

12. Has the petitioning company ever previously filed an H-1B petition for you? If so, please list date,
location, receipt #, and disposition of filing

_____________________________________no_____________________________________________
_

13. Are you currently on or have you ever been granted nonimmigrant status in the USA (such as J status,
F status, B status, etc.? If yes, please explain below
________________________________________________________no__________________________
14. Job Title ________________________________________________________

15. Description of duties ___________________________________________________________

____________________________________________________________________________________

16. Address of work, if different

from petitioner’s address ________________________________________________________

17. Full time salary/wages offered ________________________________________________________

(per hour or per year)

18. Other wages ________________________________________________________

19. Dates of intended employment ________________________________________________________

20.Highest Level of Education ________B.Sc. In Computer

Science________________________________________________

21. Total time spent in the U.S. on H or L status (include dependent spouse/children)
Name: From: To:

If in the U.S., please complete this section below.

22. Date of last arrival __________________________________________________

23. I-94 Departure/Arrival Record # __________________________________________________

24. Current nonimmigrant status / Expires: ____________ / __________________

25. Passport #: A03142823

__________________________________________________
2
 Ascend Technology Inc
1879 Lundy Avenue, Suite 289,
San Jose, California 95131
Tel: 1-888-782-2361 Ext: 101, Fax: 1-888-782-2361
Email: info@ascendtechnologies.net
Web: www.ascendglobaltech.com

26. Date passport issued 13/02/2022

________________________________________________________

27. Date passport expires __12/02/2032______________________________________________________

28. Current U.S. Address (if any) ________________________________________________________

29. Marital Status

________________________________no_____________________________________

30. Children? (Y/N)

______________________________no______________________________________

Additionally, providing the following documentation for each H-1B CAP candidate is
recommended in order to avoid typographical errors, misinformation regarding degree
level, and lapse of nonimmigrant status:

● Copy of H-1B CAP applicant's passport attached: Y/N

● Copy of H-1B CAP applicant's educational credentials (degrees & marksheets) attached: Y/N
● If currently residing in USA, attached all that is applicable to you as mentioned in Questions 22-30 above: Attached
Y/N

Copy of H-1B CAP applicant's proof of nonimmigrant status, as applicable (I-94s for all nonimmigrant
classifications, I-20s for F1 students, EAD cards for F1 students and L2s, most recent H4/L2 approval
notices, etc.)