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Basic Information

User Name *		Work Authorization*
First Name *		Middle Name
Last Name *		Email *
Date of Birth *		Citizenship *
Phone Number *		Gender * Male Female	Entered In USA

Current Address

Country *		State *
City *		Zip Code *
Street-1		Suite/apt
Home Phone		Mobile

Permanent Address Same As Current Address

Country		State
City		Zip Code
Street-1		Suite/apt
Home Phone		Mobile

Emergency Contact Details

Emergency Contact Name*		Emergency Contact Email*
Emergency Contact No*

Marital Status

Marital Status	Yes No	Dependents	Yes No
User Description