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Bauerle
Senior Associate Attorney
+1 (415) 617-4574
dbauerle@balglobal.com
Please complete all fields in the following questionnaire and send it via email to
Berry Appleman & Leiden LLP [rraybuck@balglobal.com]
DATA AND FILE RETENTION NOTICE: After our services conclude, Berry
Appleman & Leiden LLP will, as a courtesy to you, make its best efforts to retain the
personal data you have provided and a copy of your file for a period of six (6) years. At
the end of said period, we may, at our discretion, destroy such personal data and file
without notice to you. At any point during the retention period, you may request delivery
of a copy of your file. However, please note that there may be a fee charged to retrieve
the file and deliver it to you.
PRIVACY POLICY: Berry Appleman and Leiden LLP (BAL) collects certain personal
information through various means, including questionnaires and its website. BAL is
committed to ensuring that your privacy is protected. The following describes what
information is collected and explains how that information may be used and shared with
third parties. BAL collects information that you submit via online forms on its website,
email and hard copy questionnaires. If BAL is handling your visa or immigration matter,
the information you provide may include your personal and family information,
educational background, and employment history. The information you submit will be
retained by BAL in a database maintained by BAL or its service provider, and will be
used by BAL to complete your request or to provide immigration services. BAL will not
share the information with any third party, except as otherwise set forth in this Privacy
Statement or in these notices. BAL may share the information to complete your request
or as necessary to provide immigration services to you and your family, including
disclosure to government agencies in the form of applications and petitions for
immigration benefits. BAL may also share the information with a successor in interest, an
affiliate or its consultants, who are obligated to maintain the confidentiality of the
information. For example, if BAL merges with another law firm, BAL may share the
information with that firm. BAL may also share the information as permitted or required
by law. For example, BAL may provide the information in response to a subpoena, a law
enforcement or governmental agency request, or a court order. BAL may also use the
information you provide to communicate with you directly via e-mail or direct mail, such
as to inform you about newsworthy topics and upcoming events that may be of interest to
you, or to confer with your regarding your immigration case. For example, BAL may use
your e-mail address to send you the firm's newsletter, to send you an announcements or
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alerts, or to send you questions or drafts relating to your immigration case. To guard your
nonpublic personal information, we maintain physical, electronic and procedural
safeguards. Please see below for BALs data and file retention policy. BAL may
implement security features to prevent the unauthorized release of personal information.
Please note, however, that BAL cannot guarantee the confidentiality of any
communication or material transmitted to/from BAL via the site or email. Accordingly,
BAL is not responsible for the security of information transmitted via the Internet. If you
have any concerns, questions, or complaints regarding BALs privacy policy or practices,
please contact BAL at privacy@balglobal.com.
NOTICE IN CASE OF CONVICTION, ARREST, CHARGE OR INDICTMENT: If
you have ever been convicted, arrested, cited, charged, indicted, fined, or imprisoned for
violating any law or ordinance in the U.S. or abroad, or received any expungements or
pardons, notify your BAL attorney to discuss how this may affect your eligibility for
visas or immigration benefits. Your attorney will require this information to evaluate how
it impacts your immigration processing. As this information may affect the ability to
obtain visas and immigration benefits, as well as affect the cost and speed of immigration
processing, we will provide this information to your employer.
By checking the box, you acknowledge that you: (1) have read and understand
this disclosure and consent to BAL's Joint Representation of you and the Company;
(2) have read and understand the Third Party Service Providers notice and consent
to the sharing of personal and family information with such third parties for
processing your immigration case or matter; (3) have read and understand the
Notices regarding Changes in Employment, Privacy Policy, and Data and File
Retention; and (4) have read and understand the Notice in Case of Conviction,
Arrest, Charge or Indictment and authorize BAL to make such disclosure to your
employer.
If you are not sure or wish to seek advice of independent counsel, you may return this
questionnaire after you have done so. If you do not accept the terms outlined above
please contact the attorney assigned to your case to discuss.
1-14-10
I. EMPLOYEE INFORMATION
1) Full Name (LAST, First Middle): 2) Maiden/Other Names:
LIU Weini
3) Gender: Female 4) Email Address(es):
weini.liu@jpmorgan.com
winnieliuzzz@gmail.com
5) Work Telephone Number: 6) Fax Number:
2126237294
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29) Special Notations on Card: 30) Date of First Entry in H-1 or L-1
Status: 08/15/2011 H1
31) Place of First Entry in H-1 or L-1 32) I-94 Number of First Entry:
Status (City, State): New York, NY 37892164025
33) I-94 Expiration of First Entry: 34) Status on I-94 Card of First Entry:
5
Name of Reference:
Relationship to you:
References Current Employer:
References Current Title:
References Contact Information:
P L/S Q L
EXACT Dates of Employment F inancial A pplications
(Month/Day/Year to Month/Day/Year): M anufacturing Applicat ions
A DA BA S
N atural
Base Salary: O bject O riented Technologi es
Cobol
Hours per week (if part-time): Vis ual Bas ic
P ERL
Detailed Job Description: CRM
M atlab, Labview, CodeV,
and/or Zemax
Techn ical pres entation s kills
TCP /IP
U N IX
A lgorithm developmen t &
implem enta tion
H ardw are/s oftw are integration
Lis t others here:
Name of Reference:
Relationship to you:
References Current Employer:
References Current Title:
References Contact Information:
Q A /Tes ting
Affiliate of JPMorgan Chase & Co.? N etw ork adminis tra tion
Yes No P roject managemen t
Computer s upport
Department: D ata analys is
J ava
Title/Occupation: C/C+ + /C#
P L/S Q L
EXACT Dates of Employment F inancial A pplications
(Month/Day/Year to Month/Day/Year): M anufacturing Applicat ions
A DA BA S
N atural
Base Salary: O bject O riented Technologi es
Cobol
Hours per week (if part-time): Vis ual Bas ic
P ERL
Detailed Job Description: CRM
M atlab, Labview, CodeV,
and/or Zemax
Techn ical pres entation s kills
TCP /IP
U N IX
A lgorithm developmen t &
implem enta tion
H ardw are/s oftw are integration
Lis t others here:
Name of Reference:
Relationship to you:
References Current Employer:
References Current Title:
References Contact Information:
Name of Reference:
Relationship to you:
References Current Employer:
References Current Title:
References Contact Information:
12
Yes No
Name of Reference:
Relationship to you:
References Current Employer:
References Current Title:
References Contact Information:
Name of Reference:
Relationship to you:
References Current Employer:
References Current Title:
References Contact Information:
11) The position entails/entailed 12) Have you been in the U.S. while
functional management duties in the employed by the foreign affiliate?
administration of budget or portion Yes No
thereof? Enter the approximate total number of
Yes No days you were in the U.S. during the
Administration of budget or portion dates indicated at the top of the page
thereof: (include all visits).
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and/or Zemax
Techn ical pres entation s kills
TCP /IP
U N IX
A lgorithm developmen t &
implem enta tion
H ardw are/s oftw are integration
Lis t others here:
V. SPECIAL QUALIFICATIONS
Please carefully review and answer as accurately as possible the following questions. If
your answer is Yes to any one of these questions, provide a detailed explanation.
1) Have you received any national/international awards and/or honors?
Yes No If yes, list here:
2) Have you written scholarly articles that have been published in journals?
Yes No If yes, list here:
5) Have you made any significant and/or original contributions in your field of
endeavor such as patents?
Yes No If yes, list here: