Email Address  (required)


Relationship: The alien is my ___, i.e. spouse, parent, brother, sister, child



	

		
		
Are you related by adoption 

		
Did you gain permanent residence through adoption 

	


	
Information about the person filing the petition:


	

		
Name 

		
Address 
 
		
Place Of Birth (city and country) 

		
Date of birth 
 
		
Sex 

		
Marital status 

		
Other names used (including maiden) 

		
Date and place of present marriage 

		
Social security

		
Alien registration number (if any)

		
Name of prior husbands/ wives and the date(s) marriage(s) ended

		
If you are a U.S. citizen how was your citizenship acquired:
			
    -Birth in the U.S. 
			
    -Naturalization (give number of certificate, date and place it was issued) 
			
    -Parents, have you obtained certificate of citizenship in your own name; 
			
     If yes, give number of certificate, date and place it was issued
		

		
If you are a lawful permanent resident alien give date and place of admission for, or adjustment to, lawful permanent residence and class of admission 

		
Did you gain permanent residence through marriage to a Unites States citizen or lawful permanent resident?

		


		
Information about the person the petition is being filed for:


	

		
Name

		
Address

		
City

		
State

		
Postal Code

		
Country

		
Place of birth (city and country)

		
Date of birth

		
Sex 

		
Marital status

		
Other names used (including maiden) 

		
Date and place of present marriage 

		
Social security 

		
Alien registration number (if any) 

		
Name of prior husbands/ wives and the date(s) marriage(s) ended

		
Has your alien relative ever been in the U.S.? 

		
If currently in the U.S., he/she arrived as a ___, i.e. visitor, student

		
Arrival/ departure record number (I-94) 

		
Date arrived in the U.S. 

		
Date authorized stay expires

		
Name and address of present employer

		
Date the employment began 

		
Has your relative ever been under immigration proceeding?
    		
    -If yes, what type, when and where?

	


	
Further information about the person the petition is being filed for:


	

	
		
List husband/wife and all children, including relationship, date of birth and country of birth 

		
Address in the U.S. where your relative intends to live 

		
Your relative's address abroad 

		
If filling for husdand/wife, give last address at which you both lived

		
		


		
If seperate petitions are being submitted for other relatives, give names of each and relationhship
 
	
	
Have you ever filed a petition for this or any other alien before?
-If yes, give name, place and date of filing, and result