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Petition For Alien Relative: Department of Homeland Security Form I-130

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Petition for Alien Relative USCIS

Department of Homeland Security Form I-130


OMB No. 1615-0012
U.S. Citizenship and Immigration Services Expires 02/28/2021

For USCIS Use Only Fee Stamp Action Stamp


A-Number
A-
Initial Receipt
Resubmitted
Relocated Section of Law/Visa Category
Received g z oi(b) Spouse - IR-I/CR-I Q Q 201(b) Child - m-2/CR-2 Q
203(a)(1) Unm. S/D - Fl-1 Q 203(a)(2)(B) Unm. S/D - F2-4
sent 203(a)(2)(A) Spouse - F2-1 Q 203(a)(3) Married S/D - F3-1
203(a)(2)(A) Child - F2-2 Q 203(a)(4) Brother/Sister - F4-1
01(b) Parent - IR-5Q
Completed
Approved Petition
Fieldwas filed on (Priority
InvestigationQ Date mm/dd/yyyy):
Personal InterviewQ 204(a)(2)(A) Resolved Previously ForwardedQ Pet. A-File ReviewedQ I-485 Filed Simultaneously 203(g) Resolve

Returned PDR request granted/denied - New priority date (mm/dd/yyyy):

Remarks

which USCIS office (e.g., NBC, VSC, LOS, CRO) was Form 1-130 adjudicated?

To be completed by an attorney or accredited representative (if any).


Select this box if Volag Number Attorney State Bar Attorney or Accredited Representative
Form G-28 is (if any) Number USCIS Online Account Number (if any)
(if applicable)
attached.

• START HERE - Type or print in black ink.


If you need extra space to complete any section of this petition, use the space provided in Part 9. Additional Information.
Complete and submit as many copies of Part 9., as necessary, with your petition.

Part 1. Relationship (You are the Petitioner. Your Part 2. Information About You (Petitioner)
relative is the Beneficiary)
1. Alien Registration Number (A-Number) (if any)
1. I am filing this petition for my (Select only one box): y _
Spouse Parent Brother/Sister Child 2. USCIS Online Account Number (if any)
2. If you are filing this petition for your child or parent,
select the box that describes your relationship (Select only
one box): 3. U.S. Social Security Number (if any)
Child was born to parents who were married to
each other at the time of the child's birth
Stepchild/Stepparent
Child was born to parents who were not married Your Full Name
to each other at the time of the child's birth 4.a. Family Name
Child was adopted (not an Orphan or Hague (Last Name)
Convention adoptee) 4.b. Given Name
(First Name)
3. If the beneficiary is your brother/sister, are you related
by adoption? Yes No 4.c. Middle Name
4. Did you gain lawful permanent resident status or
citizenship through adoption? Yes
No

Form 1-130 02/13/19


Page 1 of 12
Part 2. Information About You (Petitioner) Address History
(continued)
Provide your physical addresses for the last five years,
whether inside or outside the United States. Provide your
Other Names Used (if any) current address first if it is different from your mailing
Provide all other names you have ever used, including address in Item Numbers 10.a. - 10.i.
aliases, maiden name, and nicknames. Physical Address 1
5.a. Family Name 12.a. Street Number
(Last Name) and Name
5.b. Given Name
(First Name) 12.b. Apt. Ste. Flr.

5.c. Middle Name 12.c. City or Town

Other Information 12.d. State 12.e. ZIP Code


6. City/Town/Village of Birth
12.f. Province

7. Country of Birth 12.g. Postal Code


12.h. Country

8. Date of Birth (mm/dd/yyyy)


13.a. Date From (mm/dd/yyyy)
9. Sex Male Female
13.b. Date To PRESENT

Mailing Address (USPS ZIP Code Lookup) (min/dd/yyyy) Physical


10.a. In Care Of Name
Address 2
14.a. Street Number
10.b. Street Number and Name
and Name
14.b. Apt. Ste. Flr.
10.c. Apt. Ste. Flr.
14.c. City or Town
14.d. State 14.e. ZIP Code
10.d. City or
Town 14.f. Province
10.f. ZIP Code
10.e. State 14.g. Postal Code

10.g. Province 14.h. Country

10.h. Postal Code


10.i. Country
15.a. Date From (mm/dd/yyyy)

11. Is your current mailing address the same as your 15.b. Date To (min/dd/yyyy)
physical address? Yes No

If you answered "No" to Item Number 11., provide Your Marital Information
information on your physical address in Item Numbers 12.a.
- 13.b. 16. How many times have you been married? n•
17. Current Marital Status

Single, Never Married Married Divorced


Widowed Separated Annulled
Form I-130 02/13/19 Page 2 of 12
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