Form I-751 12/23/16 N Page 6 of 11
Part 7. Petitioner's Statement, Contact
Information, Acknowledgement of Appointment
at USCIS Application Support Center,
Certification, and Signature
NOTE: Select the box for either Item Number 1.a. or 1.b. If
applicable, select the box for Item Number 2.
1.a.
I can read and understand English, and have read and
understand every question and instruction on this
petition, as well as my answer to every question. I
have read and understand the Acknowledgement of
Appointment at USCIS Application Support
Center.
NOTE: If you selected Box 1.a. in Part 3., your spouse must
also read and sign the petition in Part 8. Signature of a
conditional resident child under 14 years of age is not required;
a parent may sign for a child.
Petitioner's Statement
NOTE: Read the information on penalties in the Penalties
section of the Form I-751 Instructions before completing this
part.
1.b.
The interpreter named in Part 9. has also read to me
every question and instruction on this petition, as well
as my answer to every question, in
a language in which I am fluent. I understand every
question and instruction on this petition as translated
to me by my interpreter, and have provided complete,
true, and correct responses in the language indicated
above. The interpreter named in Part 9. has also
read the Acknowledgement of Appointment at
USCIS Application Support Center to me, in the
language in which I am fluent, and I understand this
Application Support Center (ASC)
Acknowledgement as read to me by my interpreter.
,
2. I have requested the services of and consented to
is is not an attorney or accredited
representative, preparing this petition for me. This
person who assisted me in preparing my petition has
reviewed the Acknowledgement of Appointment at
USCIS Application Support Center with me, and I
understand the ASC Acknowledgement.
,
who
Petitioner's Contact Information
Petitioner's Daytime Telephone Number3.
Petitioner's Email Address (if any)5.
Petitioner's Mobile Telephone Number (if any)4.
Acknowledgement of Appointment at USCIS
Application Support Center
I, ,
understand that the purpose of a USCIS ASC appointment is for
me to provide fingerprints, photograph, and/or signature and to
re-affirm that all of the information in my petition is complete,
true, and correct and was provided by me. I understand that I
will sign my name to the following declaration which USCIS
will display to me at the time I provide my fingerprints,
photograph, and/or signature during my ASC appointment.
I also understand that when I sign my name, provide my
fingerprints, and am photographed at the USCIS ASC, I will be
re-affirming that I willingly submit this petition; I have reviewed
the contents of this petition; all of the information in my petition
and all supporting documents submitted with my petition were
provided by me and are complete, true, and correct; and if I was
assisted in completing this petition, the person assisting me also
reviewed this Acknowledgement of Appointment at USCIS
Application Support Center with me.
By signing here, I declare under penalty of perjury
that I have reviewed and understand my application,
petition, or request as identified by the receipt
number displayed on the screen above, and all
supporting documents, applications, petitions, or
requests filed with my application, petition, or request
that I (or my attorney or accredited representative)
filed with USCIS, and that all of the information in
these materials is complete, true, and correct.
If conditional residence was based on a marriage, I further
certify that the marriage was entered into in accordance with the
laws of the place where the marriage took place and was not for
the purpose of procuring an immigration benefit.