3 4 5 9  Lawrenceville - Suwanee  Rd., Suite A,  Suwanee ,  Georgia

Tel: (770) 271-5244 ● Toll Free:  (888) 768-7252 ● Fax: (770) 271-5604 ● Cornel@PotraLawFirm.com ● www.potralawfirm.com

Avtorneys:  Cornel Potra – Admitted: Georgia & Washington  ●  Kristina F Potra – Admitted: Georgia

This questionnaire is for the exclusive use of Potra Law Firm.  Please answer all the questions.  Do not leave any questions unanswered.  If you do not have an answer to a question, please insert “N/A”.  It is your responsibility to provide true and accurate information, as well as the evidentiary documents requested.

 

This Document Is For The Attorney’s Office Use Only

 

  

QUESTIONNAIRE I-129 R 

FOR RELIGIOUS WORKER

TO BE COMPLETED BY THE CHURCH OR THE NONPROFIT ORGANIZATION

 

Information about the Church/Institution/Organization

 1. Full name of the Church/Institution/Organization

 

 

 2. Current address:

a. Street number

b. City

c. State/Province

d. Zip Code

  

 

 

 3. Telephone Number

 4. Fax Number

 5. Email Address

 

 6. Basic info about the church/institution:

a. The year it was established

 

b. The church/institution's leadership

  

Number of Deacons

Number of Presbyters

Number of Music ministers

Number of Teachers

Name of the Senior Pastor

Name of the Assistant Pastor

Number of Full time employees

Number of Adult and minor members

 

  7. The name of the person who will sign the  documents

 

 

 8. Please describe the need for a religious worker. 

 9. Please provide a detailed work schedule for each

day of  the week, but no more than forty hours a week.

10. How much will the church pay the Beneficiary? 

      Give salary per year. e.g.$24,000/year

 

11. Please specify the education and the experience

      required to perform the offered position

12. Please provide any other requirements for the

      performance of the offered position, such as: 

      the ability to speak and communicate in another

      language, driver’s license, ability to play a

      certain instrument, sing, preach, etc

   
 

 

 
 

pLEASE PROVIDE THE FOLLOWING DOCUMENTS AND INFORMATION:

  

*

IRS 501(c)(3) Letter attesting to the non-profit status of the church or religious organization
 
   
*

Documents evidencing the ability of the church/institution to pay the proffered wage (bank statements for the past three years or/and a certified CPA report attesting to the financial sufficiency of the church/institution;
 
 
 
   
*

An official letter from the church/institution offering the religious worker the religious position within the institution.  The letter should contain in a paragraph or two a brief history of the church/institution.  Please include information regarding the date the church/institution was founded, the membership – please give numbers – please specify how many children and how many adults.  Please specify how many full time paid employees in the church/institution.  Also, please specify how many unpaid/voluntary employees in the church/institution.  Please give a paragraph in which you will explain the need for a religious worker.  E.g. Due to the fact that our church has grown so rapidly, the needs have been increased as well.  We are now seeking a Youth Pastor or a Senior Pastor to meet the needs of the congregation.  In another paragraph, please state that you believe the Beneficiary is fully qualified to meet the requirements for the offered position.  Please give a little background of the Beneficiary’s experience and education;
 
 
 
 
 
 
 
 
 
 
 
 
 
   
*

Please provide a letter from the church/institution describing in detail the professional responsibilities to be fulfilled by the Beneficiary – Give a Job Description with a daily schedule and all the duties the Beneficiary will perform routinely;
 
 
 
   
*

Please provide a letter attesting to the religious affiliation between the two churches/institutions, the sponsoring church/institution and the church/institution where the Beneficiary worked for the past full two years prior to the offer of employment.  We must establish the religious doctrinal, organizational, governmental, the worship style connection between the two institutions
 
 
 
 
 
   
*

Please provide a contract between the church/institution and the Beneficiary.  Attorney Potra will help you draft the contract, if you decide you will need help with that one.

 
 
   

NOTE: THIS DOCUMENT IS THE PRODUCT OF POTRA LAW FIRM. THE USE OF THIS QUESTIONNAIRE BY OTHER INDIVIDUALS OR LAW FIRMS IN ASSISTING OTHERS WITH THE COMPLETION OF DOCUMENTS, OR FOR ANY OTHER PURPOSES, IS STRICTLY PROHIBITED.   POTRA LAW FIRM MAINTAINS ITS COPYRIGHTS OVER THE TRANSLATION OF THIS DOCUMENT.  PERMISSION TO USE THIS DOCUMENT MAY BE OBTAINED ONLY FROM POTRA LAW FIRM.  COPYRIGHT © January 17, 2007.