Fillable Printable Form I-730

Form I-730

Street Number and Name:

Apt. Number

State or Province:

Country:

Lawful Permanent Resident based on previous Refugee status

Lawful Permanent Resident based on previous Asylee status

Form I-730 (05/30/17) N Page 1

Telephone Number including Country and City/Area Code:

Department of Homeland Security

U.S. Citizenship and Immigration Services

I-730, Refugee/Asylee Relative Petition

START HERE - Type or print legibly in black ink.

Part 1. Information About You, the Petitioner

Address of Residence (Where you physically reside)

City:

Refugee

Asylee

Zip/Postal Code:

OMB No. 1615-0037; Expires 05/31/2019

FOR USCIS OFFICE ONLY

Section of Law

207 (c)(2) Spouse

207 (c)(2) Child

208 (b)(3) Spouse

208 (b)(3) Child

Action Stamp

Part 2. Information About Your Alien Relative, the Beneficiary

Family Name (Last name), Given Name (First name), Middle Name:

Street Number and Name:

City:

State or Province:

Country:

Reserved

Receipt

Remarks

My Status:

The beneficiary is my:

Spouse

Unmarried child who is a (n):

(

)

Number of relatives for whom I am filing separate Form I-730s:

Family Name (Last name), Given Name (First name), Middle Name:

Mailing Address (If different from residence) - C/O:

Street Number and Name:

Apt. Number:

City:

State or Province:

Country:

Zip/Postal Code:

Your E-Mail Address, if available:

Gender:

Date of Birth (mm/dd/yyyy):

Country of Birth:

Country of Citizenship/Nationality:

U.S. Social Security Number

(If applicable):

Address of Residence (Where the beneficiary physically resides)

Zip/Postal Code:

Mailing Address (If different from residence) - C/O:

Street Number and Name:

City:

State or Province:

Country: Zip/Postal Code:

Telephone Number including Country and City/Area Code:

The Beneficiary's E-Mail Address, if available:

Gender:

Date of Birth (mm/dd/yyyy):

Country of Birth:

Country of Citizenship/Nationality:

U.S. Alien Registration Number:

U.S. Social Security Number

(If applicable):

Beneficiary Not Previously Claimed

Beneficiary Previously Claimed On:

CSPA Eligible:

(e.g., Form I-590, Form I-589, etc.)

N/A

Yes

Apt. Number

Male

Female

Male

Biological Child Stepchild Adopted Child

A-

U.S. Alien Registration Number:

Other Names Used (Including maiden name):

If previously married, names of prior spouses:

Dates (mm/dd/yyyy) and Places Previous Marriages Ended:

Please provide documentation indicating how marriages ended

(e.g., death certificate, divorce certificate, etc.):

Date (mm/dd/yyyy) and Place Asylee Status was granted in the

United States

If You Were Approved for Refugee Status, Date (mm/dd/yyyy)

and Place Admitted to the United States as a Refugee:

If married, Name of Spouse, Date (mm/dd/yyyy), and Place of

Present Marriage:

Part 1. Information About You, the Petitioner

(Continued)

If married, Name of Spouse, Date (mm/dd/yyyy), and Place of

Present Marriage:

If previously married, names of prior spouses:

Dates (mm/dd/yyyy) and Places Previous Marriages Ended: Please

provide documentation indicating how marriages ended (e.g.,

death certificate, divorce certificate, etc.):

Beneficiary is outside the United States and will apply for

travel authorization at a USCIS Office or a U.S. Embassy or

consulate in:

Beneficiary is currently in the United States.

To Be Completed By

Attorney or Representative, if any.

Fill in box if G-28 is attached to represent the petitioner.

Part 2. Information About Your Alien Relative, the

Beneficiary (Continued)

Other Names Used (Including maiden name):

City and Country

Part 2. Information About Your Alien Relative, the Beneficiary (Continued)

Name and mailing address of the beneficiary written in the language of the country where he or she now resides:

Family Name:

Given Name: Middle Name:

Address - C/O:

Street Number and Name:

City/State or Province:

Check the box, a. through d., that applies:

The beneficiary has never been in the United States

The beneficiary is now in immigration court proceedings in the

United States Where?

The beneficiary has never been in immigration court proceedings in the United States

Apt. Number:

Zip/Postal Code:

The beneficiary is not now in immigration court proceedings in the

United States, but has been in the past. Where?

What is the beneficiary's native language? Is the beneficiary fluent in English? What other languages does the beneficiary speak

fluently:

Country:

Date (mm/dd/yyyy) and Place you received your approval for

Refugee Status while living abroad

Attorney State License

Number:

Volag Number:

Yes

Form I-730 (05/30/17) N Page 2

Part 3. Two-Year Filing Deadline

Part 2. Information About Your Alien Relative, the Beneficiary (Continued)

List Each of the beneficiary's entries into the United States, if any, beginning with the most recent entry. Submit a copy of each I-94

and/or copy of the beneficiary's passport showing all the entry and exit stamps for each entry. Attach an additional sheet if the

beneficiary has more than two entries into the United States:

Are you filing this application more than two years after the date you were admitted to the United States as a refugee or granted asylee

status?

Yes

If you answered "Yes" to the previous question, explain the delay in filing and submit evidence to support your explanation (Attach

additional sheets of paper if necessary):

WARNING: Any beneficiary who is in the United States illegally is subject to removal if Form I-730 is not granted by USCIS. Any

information provided in completing this petition may be used as a basis for the institution of, or as evidence in, removal

proceedings, even if the petition is later withdrawn. Unexcused failure by the beneficiary to appear for an appointment to provide

biometrics (such as fingerprints and photographs) and biographical information within the time allowed may result in denial of

Form I-730. Information provided on this form and biometrics and biographical information provided by the beneficiary may also

be used in producing an Employment Authorization Document if the beneficiary is granted derivative refugee or asylee status.

Part 4. Warning

Place (City and State):

I-94 Number:

Date of Arrival (mm/dd/yyyy):

Date Status Expires (mm/dd/yyyy):

Status:

Passport Number:

Travel Document Number:

Country of Issuance for Passport or Travel Document:

Expiration Date for Passport

or Travel Document:

Expiration Date for Passport

or Travel Document:

Country of Issuance for Passport or Travel Document:

Travel Document Number:

Passport Number:

Status:

Date Status Expires (mm/dd/yyyy):

Date of Arrival (mm/dd/yyyy):

I-94 Number:

Place (City and State):

Form I-730 (05/30/17) N Page 3

Part 5. Petitioner's Statement, Contact Information, Declaration, Certification, and Signature

Form I-730 (05/30/17) N Page 4

NOTE: Read the Penalties section of the Form I-730 Instructions before completing this part.

2. At my request, the preparer named in Part 8.,

petition for me based only upon information I provided or authorized.

a language in which I am fluent, and I understood everything.

The interpreter named in Part 7. read to me every question and instruction on this petition and my answer to every question

1.b.

I can read and understand English, and I have read and I understand every question and instruction on this petition and my

answer to every question.

1.a.

Petitioner's Statement

NOTE: Select the box for either Item Number 1.a. or 1.b. If applicable, select the box for Item Number 2.

prepared this

Petitioner's Contact Information

3. Petitioner's Daytime Telephone Number

Petitioner's Email Address (if any) 5.

4. Petitioner's Mobile Telephone Number (if any)

Petitioner's Declaration and Certification

Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS may

require that I submit original documents to USCIS at a later date. Furthermore, I authorize the release of any information from any of

my records that USCIS may need to determine my eligibility for the immigration benefit I seek.

I further authorize release of information contained in this petition, in supporting documents, and in my USCIS records to other

entities and persons where necessary for the administration and enforcement of U.S. immigration laws.

I understand that USCIS may require me to appear for an appointment to take my biometrics (fingerprints, photograph, and/or

signature) and, at that time, if I am required to provide biometrics, I will be required to sign an oath reaffirming that:

1) I provided or authorized all of the information contained in, and submitted with, my petition;

2) I reviewed and understood all of the information in, and submitted with, my petition; and

3) All of this information was complete, true, and correct at the time of filing.

I certify, under penalty of perjury, that all of the information in my petition and any document submitted with it were provided or

authorized by me, that I reviewed and understand all of the information contained in, and submitted with, my petition, and that all of

this information is complete, true, and correct.

Petitioner's Signature

Petitioner's Signature6.a.

Date of Signature (mm/dd/yyyy)6.b.

NOTE TO ALL PETITIONERS: If you do not completely fill out this petition or fail to submit required evidence listed in the

Instructions, USCIS may deny your petition.

Form I-730 (05/30/17) N Page 5

NOTE: Read the information on penalties in the Penalties section of the Form I-730 Instructions before completing this part.

Part 6. Beneficiary's Statement, Contact Information, Declaration, Certification, and Signature if in the

United States

NOTE: If the beneficiary is not currently in the United States, or is not 14 years of age or older, this section should be left

blank.

2. At my request, the preparer named in Part 8.,

petition for me based only upon information I and the petitioner provided or authorized.

a language in which I am fluent, and I understood everything.

The interpreter named in Part 7. read to me every question and instruction on this petition and my answer to every question

1.b.

I can read and understand English, and I have read and I understand every question and instruction on this petition and my

answer to every question.

1.a.

Beneficiary's Statement

NOTE: Select the box for either Item Number 1.a. or 1.b. If applicable, select the box for Item Number 2.

prepared this

Beneficiary's Contact Information

3. Beneficiary's Daytime Telephone Number

Beneficiary's Email Address (if any) 5.

4. Beneficiary's Mobile Telephone Number (if any)

Beneficiary's Declaration and Certification