I 929

OMB No.
1615-0106; Expires 04/30/2019
Form I-929, Petition for Qualifying Family

Department of Homeland Security
U.S. Citizenship and Immigration Services Member of a U-1 Nonimmigrant
FOR USCIS USE ONLY

Bene. A-file Yes Action Block Bar Code (USCIS Use only)
reviewed
No
U-1 A-file Yes
reviewed
No
Bene. filed I-485
Yes No Remarks
U-1 adjusted
Yes No
U-1 I-485 pending
Yes No
START HERE -- TYPE OR PRINT LEGIBLY USING BLACK INK

I am filing for my: (Select one)
Spouse Child: Biological Child Parent: Biological Parent
Stepchild Stepparent
Adopted Child Parent who adopted me
Part 1. Information About You Part 2. Information About Your Alien Relative
Last Name (Family Name) Last Name (Family Name)
First Name (Given Name) First Name (Given Name)
Middle Name Middle Name
Current Address Current Address

Street Number and Name Apt. Number Street Number and Name Apt. Number
City State Zip Code City State/Province
Country Postal/Zip Code
Safe Mailing Address If Other Than Above Mailing Address If Other Than Above
Street Number and Name Apt. Number
City State Zip Code
Date of Birth A-Number Date of Birth A-Number
Form I-929 04/13/17 Y Page 1 of 7

Part 1. Information About You (Cont'd) Part 2. Information About Your Alien Relative (Cont'd)
Country of Birth Social Security Number Country of Birth Social Security Number
Country of Citizenship/Nationality Country of Citizenship/Nationality
Gender: (Select one) Male Female Gender: (Select one) Male Female
If you ever used other names, provide them below: If alien relative ever used other names, provide them below:
Last Name (Family Name) First Name (Given Name) Last Name (Family Name) First Name (Given Name)
Marital Status: (Select one) Marital Status: (Select one)

Single (Never Married) Married Single (Never Married) Married
Divorced Widowed Divorced Widowed
Spouse's Name: Spouse's Name:
Place of Marriage Place of Marriage
Form I-929 04/13/17 Y Page 2 of 7

Number of marriages including current marriage: Number of marriages including current marriage:
List any previous marriages beginning with the most List any previous marriages beginning with the most
recent. If you need more space, attach an additional sheet recent. If you need more space, attach an additional sheet
of paper. of paper.
Prior Spouse's Name: Prior Spouse's Name:
Middle Name Date of Marriage Middle Name Date of Marriage
Date of Termination Place of Termination Date of Termination Place of Termination
Reason for Termination: Reason for Termination:

Divorce Death Annulment Divorce Death Annulment
Other Other

Other Other
Form I-929 04/13/17 Y Page 3 of 7


Other Other
Check one: Complete if your relative is in the United States

I am a Lawful Permanent Resident Date of Admission Place of Admission
I obtained my Lawful
Permanent Residence on:
My Form I-485 is currently pending Class of Admission Date Authorized to Stay
Receipt Number
Part 3. Information About Your Alien Relative's Children
Last Name (Family Name) First Name (Given Name) Middle Name
Date of Birth Place of Birth Biological Child Stepchild Adopted Child

Gender: (Select one) Male Female
Street Number and Name Apt. Number City State/Province
Country Postal/Zip Code A-Number Country of Birth
Name of Mother
Name of Father
Form I-929 04/13/17 Y Page 4 of 7

Part 3. Information About Your Alien Relative's Children (Cont'd)

Name of Mother
Name of Father

Name of Mother
Name of Father

Form I-929 04/13/17 Y Page 5 of 7

Part 3. Information About Your Alien Relative's Children (Cont'd)
Name of Mother
Name of Father

Name of Mother
Name of Father
Name and address of your alien relative in the language written in the country where he/she currently resides.
C/O: (In Care Of) Street Number and Name Apt. Number
City/State or Province Country Postal/Zip Code
Form I-929 04/13/17 Y Page 6 of 7

Part 4. Processing Information
1. Select one:
a. 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
b.
your relative will apply for a visa.)
U.S. Embassy or consulate at:

City and Country
2. Is the person named in Part 2 or has this person ever been in deportation or removal proceedings in the United States?
a. No
b. Yes (Indicate when and where):
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.
Signature (sign in ink) Print Your Full Name Date
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.
Signature (sign in ink) Print Your Full Name Date
Firm Name Street Number and Name Suite Number
City/State or Province Postal/Zip Code Telephone Number
Form I-929 04/13/17 Y Page 7 of 7

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OMB No.

1615-0106; Expires 04/30/2019

Form I-929, Petition for Qualifying Family

FOR USCIS USE ONLY

START HERE -- TYPE OR PRINT LEGIBLY USING BLACK INK

Last Name (Family Name) Last Name (Family Name)

First Name (Given Name) First Name (Given Name)

Middle Name Middle Name

Current Address Current Address

City State Zip Code City State/Province

Country Postal/Zip Code

City State Zip Code

Date of Birth A-Number Date of Birth A-Number

Form I-929 04/13/17 Y Page 1 of 7

Country of Citizenship/Nationality Country of Citizenship/Nationality

Middle Name Middle Name

Middle Name Middle Name

Middle Name Middle Name

Marital Status: (Select one) Marital Status: (Select one)

Spouse's Name: Spouse's Name:

Middle Name Middle Name

Place of Marriage Place of Marriage

Form I-929 04/13/17 Y Page 2 of 7

Middle Name Date of Marriage Middle Name Date of Marriage

Place of Marriage Place of Marriage

Date of Termination Place of Termination Date of Termination Place of Termination

Reason for Termination: Reason for Termination:

Prior Spouse's Name: Prior Spouse's Name:

Middle Name Date of Marriage Middle Name Date of Marriage

Place of Marriage Place of Marriage

Date of Termination Place of Termination Date of Termination Place of Termination

Reason for Termination: Reason for Termination:

Form I-929 04/13/17 Y Page 3 of 7

Middle Name Date of Marriage Middle Name Date of Marriage

Place of Marriage Place of Marriage

Date of Termination Place of Termination Date of Termination Place of Termination

Reason for Termination: Reason for Termination:

Check one: Complete if your relative is in the United States

Part 3. Information About Your Alien Relative's Children

Date of Birth Place of Birth Biological Child Stepchild Adopted Child

Street Number and Name Apt. Number City State/Province

Country Postal/Zip Code A-Number Country of Birth

Form I-929 04/13/17 Y Page 4 of 7

Date of Birth Place of Birth Biological Child Stepchild Adopted Child

Street Number and Name Apt. Number City State/Province

Country Postal/Zip Code A-Number Country of Birth

Date of Birth Place of Birth Biological Child Stepchild Adopted Child

Street Number and Name Apt. Number City State/Province

Country Postal/Zip Code A-Number Country of Birth

Date of Birth Place of Birth Biological Child Stepchild Adopted Child

Form I-929 04/13/17 Y Page 5 of 7

Street Number and Name Apt. Number City State/Province

Country Postal/Zip Code A-Number Country of Birth

Date of Birth Place of Birth Biological Child Stepchild Adopted Child

Street Number and Name Apt. Number City State/Province

Country Postal/Zip Code A-Number Country of Birth

City/State or Province Country Postal/Zip Code

Form I-929 04/13/17 Y Page 6 of 7

U.S. Embassy or consulate at:

b. Yes (Indicate when and where):

Signature (sign in ink) Print Your Full Name Date

Part 6. Preparer's Information, If Other Than Person Signing Above

Signature (sign in ink) Print Your Full Name Date