CANDIDATE SUMMARY SHEET (CSS)

PLEASE TYPE THE DETAILS ON THIS ALL ENTRIES MUST BE FILLED IN THIS FORM INDICATE BLANK ENTRIES WITH NOT APPLICABLE

(N/A)

PERSONAL INFORMATION
First Name (as it appears in passport) Ashish Middle Name Last Name (as it appears in passport) Phogat Date of Birth (MM/DD/YY) 03/26/86 Social Security #: 804 - 93 - 2660 State & Country of Birth

For COMPANY use ONLY HR Manager :_________________________________ Employee ID#:________________________________ Complete Client Name__________________________ Street Address_________________________________ City/St/Zip____________________________________ Salary $______________________________per year Has Labor been filed?____________________________ Has I-140 been filed?_____________________________ Has I-140 been approved?________________________ Has I-485 been filed? ____________________________ Priority Date: __________________________________

Haryana, India
Country of Citizenship India Marital Status: Single

US consulate where first visa was stamped :

Mumbai

For LEGAL DEPT. use ONLY Received on:____________________________________

Passport No.

Date Issued (MM/DD/YY) 12/14/07

Date Expires on (MM/DD/YY) 12/13/17

LCA City/State:_________________________________ LCA PW :_________________valid till______________ LCA#: _________________________________________ Signed I-539 included, if H4 is to be filed

G6088696 U.S Residential Address 2, Grotto Court, Germantown, MD - 20874 Complete Foreign Address (in home country including zip code) 101, Vikas Nagar, Rohtak - 124001

Email address and Phone number: Ashish.phogat@igate.com, 301-515-2073

CURRENT VISA STATUS INFORMATION

Date first entered the U.S (MM/DD/YY) 09/23/12 Visa status when first entered the U.S Valid - H1B I-94 # (from card issued at the Port-ofentry) 38656742827 Date of most recent arrival in US (MM/DD/YY) (from I-94 card issued at the port of entry) 09/23/12 I-94 expires on (MM/DD/YY) 12/31/12 Current immigration status (H-1B, H4, L1, L2, F1, TN) H1B Current H-1B approval notice # (10 digit number starting with EAC/WAC/SRC or LIN) EAC-12-031-52004

Revised: April 24, 2007 Page 1

CANDIDATE SUMMARY SHEET (CSS)

PLEASE TYPE THE DETAILS ON THIS FORM ALL ENTRIES MUST BE FILLED IN

CALCULATION OF DATES OF STAY IN THE U.S IN H OR L STATUS (to determine 6 H-1B year limit please list exact dates spent IN the U.S and visa category)
From (MM/DD/YY) To (MM/DD/YY) Visa Category (H or L) Total no. of months

09/23/12

12/19/12

3 months

Have you ever received a visa stamp from a U.S. consulate? YES If Yes, please complete the following and submit legible copies of the visa stamps.
Date of Issue 04/17/12 Location of Consulate (City & Country) MUMBAI, INDIA Visa Type H1B Expiration Date 12/31/12

INFORMATION OF YOUR SPOUSE AND/OR CHILDREN, if applicable:

Name of Dependent Relationshi p In the US or outside the US? If in the US, what is the visa status? Country of Birth I-94 expiration date

If your spouse and/or children are in the U.S , please follow these instructions
1. 2. Please go to the following link - -

http://www.uscis.gov/files/form/i-539.pdf.

Please complete the form online and print. Please have your spouse sign Part 5 in blue ink on page 2 of the Form I539 (The CIS only accepts original signature)

Please send the following documents and the signed I-539 alongwith your extension documentation:
Good photocopy of your spouse/childrens I-94 card. Photocopy of the marriage certificate (if your spouse is still using her maiden name). Photocopies of relevant pages of spouse's passport (introductory, validity of passport and the visa stamp pages). Photocopy of the birth certificate (if you have any children).

Revised April 24, 2007 Page 2