How To Set Up An Flr Pdf
Form I-130A 02/27/17 Due north Folio ane of 6
USCIS
Form I-130A
OMB No. 1615-0012
Expires 07/31/2018
To be completed by an chaser or accredited representative (if any).
START Hither - Type or print in black ink. ►
Role 1. Information About You lot (Spouse
Beneficiary)
4.c.
4.f.
4.h.
4.chiliad.
4.d.
4.a.
iv.b.
Street Number
and Name
Apt. Ste. Flr.
Metropolis or Town
Country 4.east. ZIP Lawmaking
Province
Land
Postal Code
Physical Address 1
Address History
Provide your concrete addresses for the last five years, whether
inside or outside the United States. Provide your electric current
address commencement. If yous need extra space to complete this section,
use the space provided in Part 7. Additional Information.
6.c.
6.f.
six.h.
6.k.
half-dozen.d.
6.a.
half dozen.b.
Street Number
and Name
Apt. Ste. Flr.
Urban center or Boondocks
State half-dozen.east. ZIP Code
Province
Country
Postal Lawmaking
Physical Address 2
Select this box if
Form G-28 is
fastened.
Attorney State Bar Number
(if applicable)
Chaser or Accredited Representative
USCIS Online Account Number (if any)
Date From (mm/dd/yyyy) seven.a.
Dateast To (mm/dd/yyyy) 7.b.
Family unit Name
(Last Name)
Given Name
(Showtime Proper noun)
Middle Name
Your Full Name
iii.c.
3.b.
iii.a.
ane. Conflicting Registration Number (A-Number) (if any)
►
►
A-
USCIS Online Business relationship Number (if whatsoever) two.
Date From (mm/dd/yyyy) v.a.
Date To (mm/dd/yyyy) v.b.
Postal Lawmaking
Land
Province
Urban center or Boondocks
Apt. Ste. Flr.
Street Number
and Name
8.b.
8.a.
8.due east.
eight.f.
8.d.
8.c.
Provide your final address outside the United States of more than than
one year (even if listed above).
The purpose of this form is to collect additional information for a spouse beneficiary of Form I-130, Petition for Conflicting Relative. If
your spouse is a U.S. citizen, lawful permanent resident, or non-citizen U.S. national who is filing Class I-130 on your behalf, you
must complete and sign Course I-130A, Supplemental Data for Spouse Casher, and submit it with the Form I-130 filed past
your spouse. If y'all reside overseas, y'all nevertheless must complete Form I-130A, but you do not demand to sign the course.
Volag Number
(if any)
Last Physical Address Outside the United States
Supplemental Information for Spouse Casher
Section of Homeland Security
U.S. Citizenship and Immigration Services
Form I-130A 02/27/17 N Page two of 6
9.b. Date To (mm/dd/yyyy)
9.a. Date From (mm/dd/yyyy)
Function 1. Data About Yous (The Spouse
Beneficiary)
Full Name of Parent one
Information About Parent 1
Given Proper noun
(First Name)
Centre Name
thirteen. City/Town/Village
of Birth
14.
16. Country of Residence
City/Boondocks/Hamlet of Residence 15.
Country of Birth
11. Date of Birth (mm/dd/yyyy)
Family Name
(Maiden Due northame)
Role 2. Information About Your Employment
Provide your employment history for the last five years,
whether inside or outside the United States. Provide your
current employment beginning. If you lot are currently unemployed,
type or print "Unemployed" in Detail Number i. below. If you
need extra space to complete this section, use the space
provided in Part 7. Additional Information.
Employment History
Metropolis or Town ii.c.
2.f.
2.h.
Province
Country
2.g. Postal Lawmaking
Zero Lawmaking 2.e. State 2.d.
Street Number
and Name
2.a.
2.b. Apt. Ste. Flr.
Employer ane
i. Name of Employer/Visitor
Date of Nativity (mm/dd/yyyy) 18.
State of Birth
22. City/Town/Village of Residence
Country of Residence 23.
21.
City/Town/Village
of Birthursday
20.
Centre Name
Given Name
(Offset Name)
Information About Parent two
17.a.
Full Name of Parent 2
Family Name
(Last Name)
iii. Your Occupation
Date From (mm/dd/yyyy) 4.a.
Date To (mm/dd/yyyy) 4.b.
City or Boondocks 6.c.
6.f.
6.h.
Province
Country
6.yard. Postal Code
ZIP Code 6.due east. State six.d.
Street Number
and Name
6.a.
6.b. Apt. Ste. Flr.
Employer 2
5. Name of Employer/Company
ten.a.
10.b.
10.c.
17.b.
17.c.
12. Sexual practice
Male Female
19. Sexual practice
Male Female
Form I-130A 02/27/17 N Page 3 of 6
Function two. Data Nigh Your Employment
(continued)
7. Your Occupation
3.
Provide your final occupation outside the United states if not
shown in a higher place. If you never worked exterior the United States,
provide this information in the space provided in Part 7.
Additional Information.
Your Occupation
ane. Name of Employer/Visitor
Date From (mm/dd/yyyy) eight.a.
Date To (mm/dd/yyyy) 8.b.
Dateastward From (mm/dd/yyyy) 4.a.
Date To (mm/dd/yyyy) iv.b.
Role 3. Information About Your Employment
Outside the U.s.
The interpreter named in Part 5. read to me every
question and instruction on this form and my reply
to every question in
1.b.
a language in which I am fluent, and I understood
everything.
,
2. At my request, the preparer name in Part 6.,
prepared this form for me based simply upon
information I provided or authorized.
,
Spouse Casher'southward Daytime Telephone Number 3.
Spouse Casher'due south Contact Information
Spouse Casher's Email Address (if any) 5.
Spouse Casher'due south Mobile Telephone Number (if any) 4.
Spouse Casher'due south 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 originafifty documents to USCIS at a later
date. Furthermore, I authorize the releaseastward of any information
from any of my recordsouthward tchapeau United states of americaCIS may need to determindue east my
eligibility for the immigration benefit I come acrossk.
I further authorize release of information contained in this form,
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.
Metropolis or Town 2.c.
2.f.
2.h.
Province
Country
2.g. Postal Code
ZIP Code 2.e. State two.d.
Street Number
and Name
2.a.
2.b. Apt. Ste. Flr.
I can read and empathise English, and I have read
and understand every question and instruction on this
course and my reply to every question.
i.a.
Annotation: Select the box for either Item Number 1.a. or 1.b. If
applicable, select the box for Particular Number 2.
Role 4. Spouse Beneficiary's Statement, Contact
Data, Certification, and Signature
Spouse Beneficiary's Statement
NotE: Read the Penalties due southection of the Form I-130 and
Form I-130A Instructions before comppermiting this part.
I certify, under penalisation of perjury, that I provided or authorized
all of the information in this form, I understand all of the
data contained in, and submitted with, my grade, and that
all of this information is complete, truthful, and right.
Spouse Beneficiary'south Signature
Appointment of Signature (mm/dd/yyyy) vi.b.
Spouse Casher's Signature (sign in ink) 6.a.
NOTE TO ALL SPOUtilize ExistNEFICIARIES: If you practice not
completely fill out this form or fai50 to submit required documents
listed in thdue east Instructions, USCIS may deny the Form I-130 filed
on y'allr behalf.
Don't forget to sign in ink!
Class I-130A 02/27/17 N Folio 4 of vi
Interpreter'south Business or System Name (if any) 2.
Interpreter's Given Proper noun (First Name) ane.b.
Interpreter's Family unit Name (Final Name) 1.a.
Interpreter's Full Name
Part v. Interpreter'south Contact Data,
Certification, and Signature
Provide the following information about the interpreter yous used
to complete Form I-thirteen0A if he or southhe isouth different from the
interpreter used to complete the Form I-130 filed on your behalf.
Interpreter'southward Mailing Address
3.c. City or Boondocks
three.d. State 3.due east. ZIP Code
iii.f.
Postal Code
Street Number
and Proper name
3.a.
3.b. Apt. Ste. Flr.
3.yard.
iii.h. Land
Province
Interpreter's Certification
I am fluent in English and
which is the same language provided in Part 4., Detail Number
1.b., and I take read to this spouse beneficiary in the identified
language every question and instruction on this form and his or
her respond to every question. The spouse beneficiary informed
me that he or she understands every instruction, question, and
reply on the course, including the Spouse Beneficiary'due south
Certification, and has verified the accuracy of every answer.
I certify, under penalty of perjury, that:
,
Interpreter'south Signature
Appointment of Signature (mm/dd/yyyy) 7.b.
Interpreter's Signature (sign in ink) 7.a.
Part six. Contact Informationorth, Decemberlaration, and
Signature of theast Person Preparing this Forthou, if
Other Than the Spoemploy Beneficiary
Provide the following data nigh the preparer yous used
to complete Form I-130A if he or she is different from the
preparer used to complete the Form I-130 filed on your behalf.
Preparer'due south Given Proper noun (First Name) ane.b.
2. Preparer's Business or Organization Name (if any)
Preparer's Full Name
1.a. Preparer's Family Proper name (Last Proper noun)
Interpreter's Contact Information
Interpreter'southward Daytime Telephone Number 4.
Interpreter's E-mail Accost (if any) 6.
Interpreter's Mobile Telephone Number (if any) 5.
Preparer'due south Mailing Address
3.c. Urban center or Town
3.d. Land 3.e. Zippo Code
3.f.
Postal Code
Street Number
and Name
3.a.
3.b. Apt. Ste. Flr.
3.g.
3.h. State
Province
Class I-130A 02/27/17 North Page 5 of 6
Part 6. Contact Informationorthward, Declaration, and
Signature of the Person Preparing thursdayis Foryard, if
Other Than the Spoutilise Beneficiary (continued)
Preparer'due south Contact Information
Preparer's Mobile Phone Number (if any) 5.
Preparer'due south Daytime Telephone Number 4.
Preparer's Email Address (if any) 6.
Preparer's Statement
I am not an attorney or accredited representative simply
have prepared this grade on behalf of the spouse
beneficiary and with the spouse casher'southward consent.
seven.a.
NotE: If you are an attorney or accredited
representative whose representation extendsouth beyond
preparation of this form, you may be obliged to submit
a comppermited Form G-28, Notice of Entry of
Appearance adue south Attorney or Accredited Representative,
with this form.
I am an attorney or accredited representative and my
representation of the spouse casher in this case
extends doesouthward not extend existyond the preparation
7.b.
of this form.
Preparer's Certification
By my signature, I certify, under penalisation of perjury, that I
prepared this course at the request of the spouse casher. The
spouse casher and then reviewed this completed course and
informed me that he or she understands all of the information
contained in, and submitted with, his or her course, including the
Spouse Beneficiary's Certification, and that all of this
data is complete, true, and right. I completed this
form based only on data that the spouse beneficiary
provided to me or authorized me to obtain or use.
Preparer's Signature
8.a. Preparer's Signature (sign in ink)
eight.b. Date of Signature (mm/dd/yyyy)
Form I-130A 02/27/17 N Folio 6 of 6
Role 7. Additional Information
If you lot need extra space to provide any additional data
within this form, use the space beneath. If you demand more infinite
than what is provided, you may brand copies of this folio to
complete and file with this form or attach a dissever canvass of
paper. Type or print your name and A-Number (if any) at the
top of each canvas; indicate the Page Number, Role Number,
and Item Number to which your answer refers; and sign and
appointment each sheet.
A-Number (if any) ►
A-
3.a.
2.
Page Number 3.b. Part Number iii.c. Item Number
3.d.
Folio Number
Part Number Particular Number
Folio Number Part Number Item Number 5.a.
Page Number
5.b.
Part Number
5.c.
Item Number
5.d.
ane.b.
1.c.
1.a. Family unit Name
(Last Name)
Given Proper noun
(First Name)
Middle Name
4.c.4.b.
4.d.
4.a.
6.d.
6.c.six.b.6.a.
Page Number Part Number Item Number
7.d.
vii.c.7.b.7.a.
How To Set Up An Flr Pdf,
Source: https://fill.io/Form-I-130a-Form-I-130A
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