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Fillable Printable Form I-929

Fillable Printable Form I-929

Form I-929

Form I-929

Form I-929 04/13/17 YPage 1 of 7
Form I-929, Petition for Qualifying Family
Member of a U-1 Nonimmigrant
Department of Homeland Security
U.S. Citizenship and Immigration Services
FOR USCIS USE ONLY
START HERE -- TYPE OR PRINT LEGIBLY USING BLACK INK
Bene. A-file
reviewed
Yes
No
U-1 A-file
reviewed
Yes
No
Bene. filed I-485
Yes
No
U-1 adjusted
No
Yes
U-1 I-485 pending
Yes
No
Action BlockBar Code (USCIS Use only)
Remarks
OMB No. 1615-0106; Expires 04/30/2019
I am filing for my: (Select one)
Parent:Child:
Part 1. Information About You
Last Name (Family Name)
First Name (Given Name)
Middle Name
Last Name (Family Name)
First Name (Given Name)
Middle Name
Part 2. Information About Your Alien Relative
Street Number and NameApt. Number
CityZip Code
Current AddressCurrent Address
State
Street Number and NameApt. Number
CityState/Province
CountryPostal/Zip Code
Safe Mailing Address If Other Than AboveMailing Address If Other Than Above
Apt. Number
CityZip Code
Date of Birth
Date of Birth
A-Number
A-Number
State
Spouse
Biological Child
Stepchild
Adopted Child
Biological Parent
Stepparent
Parent who adopted me
Street Number and Name
Form I-929 04/13/17 YPage 2 of 7
Country of BirthSocial Security Number
Country of Citizenship/Nationality
Gender: (Select one)
If you ever used other names, provide them below:
Last Name (Family Name)First Name (Given Name)
Middle Name
Last Name (Family Name)First Name (Given Name)
Middle Name
Last Name (Family Name)First Name (Given Name)
Middle Name
If alien relative ever used other names, provide them below:
Last Name (Family Name)First Name (Given Name)
Middle Name
Last Name (Family Name)First Name (Given Name)
Middle Name
Last Name (Family Name)First Name (Given Name)
Middle Name
Last Name (Family Name)First Name (Given Name)
Middle Name
Last Name (Family Name)First Name (Given Name)
Middle Name
Place of MarriagePlace of Marriage
Country of BirthSocial Security Number
Country of Citizenship/Nationality
Gender: (Select one)
Marital Status: (Select one)
Spouse's Name:
Marital Status: (Select one)
Spouse's Name:
MaleFemale
Single (Never Married)
Divorced
Married
Widowed
Single (Never Married)Married
DivorcedWidowed
Male
Female
Part 1. Information About You (Cont'd)
Part 2. Information About Your Alien Relative (Cont'd)
Form I-929 04/13/17 YPage 3 of 7
Number of marriages including current marriage:
List any previous marriages beginning with the most
recent. If you need more space, attach an additional sheet
of paper.
Last Name (Family Name)First Name (Given Name)
Middle Name
Place of Marriage
Place of Termination
Prior Spouse's Name:
Date of Marriage
Date of Termination
Reason for Termination:
Number of marriages including current marriage:
List any previous marriages beginning with the most
recent. If you need more space, attach an additional sheet
of paper.
Last Name (Family Name)First Name (Given Name)
Middle Name
Place of Marriage
Place of Termination
Prior Spouse's Name:
Date of Marriage
Date of Termination
Last Name (Family Name)First Name (Given Name)
Middle Name
Place of Marriage
Place of Termination
Prior Spouse's Name:
Date of Marriage
Date of Termination
Reason for Termination:
Last Name (Family Name)First Name (Given Name)
Middle Name
Place of Marriage
Place of Termination
Prior Spouse's Name:
Date of Marriage
Date of Termination
Reason for Termination:
DivorceDeathAnnulment
Other
Reason for Termination:
DivorceDeath
Other
Annulment
DivorceDeathAnnulment
Other
DivorceDeath
Other
Annulment
Part 1. Information About You (Cont'd)
Part 2. Information About Your Alien Relative (Cont'd)
Form I-929 04/13/17 YPage 4 of 7
Receipt Number
Check one:Complete if your relative is in the United States
Place of AdmissionDate of Admission
Class of AdmissionDate Authorized to Stay
Part 3. Information About Your Alien Relative's Children
Middle Name
First Name (Given Name) Last Name (Family Name)
Date of BirthPlace of Birth
State/ProvinceStreet Number and NameApt. NumberCity
Postal/Zip CodeCountry
Gender: (Select one)
A-NumberCountry of Birth
Biological ChildStepchildAdopted Child
MaleFemale
I am a Lawful Permanent Resident
My Form I-485 is currently pending
I obtained my Lawful
Permanent Residence on:
First Name (Given Name)
Name of Mother
Middle Name Last Name (Family Name)
Middle Name
Name of Father
First Name (Given Name) Last Name (Family Name)
Part 1. Information About You (Cont'd)
Part 2. Information About Your Alien Relative (Cont'd)
Last Name (Family Name)First Name (Given Name)
Middle Name
Place of Marriage
Place of Termination
Prior Spouse's Name:
Date of Marriage
Date of Termination
Reason for Termination:
Last Name (Family Name)First Name (Given Name)
Middle Name
Place of Marriage
Place of Termination
Prior Spouse's Name:
Date of Marriage
Date of Termination
Reason for Termination:
DivorceDeathAnnulment
Other
DivorceDeath
Other
Annulment
Form I-929 04/13/17 YPage 5 of 7
Part 3. Information About Your Alien Relative's Children (Cont'd)
Middle Name
First Name (Given Name) Last Name (Family Name)
Date of BirthPlace of Birth
State/ProvinceStreet Number and NameApt. NumberCity
Postal/Zip CodeCountry
Gender: (Select one)
A-NumberCountry of Birth
Biological ChildStepchildAdopted Child
MaleFemale
First Name (Given Name)
Name of Mother
Middle Name Last Name (Family Name)
Middle Name
Name of Father
First Name (Given Name) Last Name (Family Name)
Middle Name
First Name (Given Name)
Last Name (Family Name)
Date of BirthPlace of Birth
State/ProvinceStreet Number and NameApt. NumberCity
Postal/Zip CodeCountry
Gender: (Select one)
Last Name (Family Name)
A-NumberCountry of Birth
Biological ChildStepchildAdopted Child
MaleFemale
First Name (Given Name)
Name of Mother
Middle Name
Middle Name
Name of Father
First Name (Given Name) Last Name (Family Name)
First Name (Given Name)
Middle Name
Last Name (Family Name)
Date of BirthPlace of Birth
Gender: (Select one)
Biological ChildStepchildAdopted Child
MaleFemale
Form I-929 04/13/17 YPage 6 of 7
Middle Name First Name (Given Name) Last Name (Family Name)
Apt. NumberStreet Number and NameC/O: (In Care Of)
Postal/Zip CodeCountryCity/State or Province
Name and address of your alien relative in the language written in the country where he/she currently resides.
Part 3. Information About Your Alien Relative's Children (Cont'd)
State/ProvinceStreet Number and NameApt. NumberCity
Postal/Zip CodeCountry A-NumberCountry of Birth
First Name (Given Name)
Name of Mother
Middle Name Last Name (Family Name)
Middle Name
Name of Father
First Name (Given Name)
Last Name (Family Name)
Middle Name
First Name (Given Name)
Last Name (Family Name)
Date of BirthPlace of Birth
State/ProvinceStreet Number and NameApt. NumberCity
Postal/Zip CodeCountry
Gender: (Select one)
A-NumberCountry of Birth
Biological ChildStepchildAdopted Child
MaleFemale
First Name (Given Name)
Name of Mother
Middle Name Last Name (Family Name)
Middle Name
Name of Father
First Name (Given Name) Last Name (Family Name)
Form I-929 04/13/17 YPage 7 of 7
Part 4. Processing Information
1. Select one:
a.
City and Country
U.S. Embassy or consulate at:
b.
2. Is the person named in Part 2 or has this person ever been in deportation or removal proceedings in the United States?
Part 5. Signature
I certify, or if outside the United States, I swear or affirm, under penalty of perjury under the laws of the United States of America,
that this petition and the evidence submitted with it, is all true and correct. I authorize the release of any information from my record
that U.S. Citizenship and Immigration Services needs to determine eligibility for the benefit I am seeking.
Print Your Full NameDate
Signature (sign in ink)
Part 6. Preparer's Information, If Other Than Person Signing Above
I declare that I prepared this petition at the request of the above person, and it is based on all the information that I have knowledge.
Print Your Full NameDate
Suite NumberStreet Number and NameFirm Name
Telephone NumberPostal/Zip Code
City/State or Province
The person named in Part 2 is now in the United States.
The person named in Part 2 is now outside the United States. (Indicate below at which U.S. Embassy or consulate
your relative will apply for a visa.)
a.
b.
No
Yes (Indicate when and where):
Signature (sign in ink)
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