When I went to Nepal for H1 visa stamping my I-40 was already approved. It should not be a problem. You have a choice of immigrating into the US. All they asked me that which company am I working for, what do you do there and what technology are you using. Three simple questions and all one sentence answers and visa was approved. Max101's post should be the complete guide for anyone who is going to Nepal for H1 stamping. Wow.. he has covered everything! Thanks Max101. Shram Karyalaya's process also went ok (not bad) for me. There is a one storey old house right across the street from Shram Karyalaya. There you can find people who will prepare the documents for you. I spent NRs 1000 for the whole "Foreign Employment Authorization" sticker. 250 for insurance, 250 for health certificate and 500 government fee. They prepare those document s right infront of you in 10 minutes and you just have to go to Shram Karyalaya and submit it. It took me about 4 hours to get the actual sticker.