This form contains 451 fields organized into 97 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name	Type	Description
57. Name in Native Language
57.c Middle Name (Native Language)	Text	Enter the beneficiary's middle name written in the beneficiary's native written language (use the original script if not Roman letters), or leave blank if none.
57.a Family Name (Native Language)	Text	Enter the beneficiary's family (last) name written in the beneficiary's native written language (use the original script if not Roman letters).
57.b Given Name (Native Language)	Text	Enter the beneficiary's given (first) name written in the beneficiary's native written language (use the original script if not Roman letters).
58. Address in Native Language (Street, Apt/Ste/Flr, City, Province, Postal Code, Country)
58.b. Apt.	Checkbox	Check this box when the beneficiary's address includes an apartment number and you are providing that apartment information in the native-language address fields.
58.b. Ste.	Checkbox	Check this box when the beneficiary's address includes a suite number and you are providing that suite information in the native-language address fields.
58.b. Flr.	Checkbox	Check this box when the beneficiary's address includes a floor number and you are providing that floor information in the native-language address fields.
58.b Apt/Ste/Flr	Text	Enter the apartment, suite, or floor identifier for the beneficiary's address in the beneficiary's native language, or leave blank if not applicable. Max length: 6 characters
58.c City or Town	Text	Enter the city or town of the beneficiary's foreign address written in the beneficiary's native language. Max length: 20 characters
58.d Province	Text	Enter the province, state, or region for the beneficiary's foreign address in the beneficiary's native language. Max length: 20 characters
58.f Country	Text	Enter the country name of the beneficiary's foreign address in the beneficiary's native language.
58.e Postal Code	Text	Enter the postal code or ZIP code for the beneficiary's address as it appears locally, written in the beneficiary's native language. Max length: 9 characters
58.a Street Number and Name	Text	Enter the beneficiary's street number and street name for their foreign address written in the beneficiary's native language (use native script if it does not use Roman letters). Max length: 34 characters
59. Spouse - Last address lived together
59.b. Apt.	Checkbox	Check this box if the spouse's last address where you lived together included an apartment (Apt.) number. Fill only if 'I am filing this petition for my' is 'Spouse'. Depends on: Part 1 - Spouse
59.b. Ste.	Checkbox	Check this box if the spouse's last address where you lived together included a suite (Ste.) designation. Fill only if 'I am filing this petition for my' is 'Spouse'. Depends on: Part 1 - Spouse
59.b Apartment, Suite, or Floor	Text	Enter the apartment, unit, suite, or floor number for the spouse's last address where you physically lived together, or leave blank if not applicable. Fill only if 'I am filing this petition for my' is 'Spouse'. Max length: 6 characters Depends on: Part 1 - Spouse
59.b. Flr.	Checkbox	Check this box if the spouse's last address where you lived together included a floor (Flr.) designation. Fill only if 'I am filing this petition for my' is 'Spouse'. Depends on: Part 1 - Spouse
59.a Street Number and Name	Text	Enter the street number and street name of the spouse's last address where you physically lived together (for example, "123 Main St"). Fill only if 'I am filing this petition for my' is 'Spouse'. Max length: 34 characters Depends on: Part 1 - Spouse
59.c City or Town	Text	Enter the city or town of the spouse's last address where you physically lived together. Fill only if 'I am filing this petition for my' is 'Spouse'. Max length: 20 characters Depends on: Part 1 - Spouse
59.e ZIP Code	Text	Enter the ZIP code for the spouse's last address where you physically lived together, including any leading zeros if applicable. Fill only if 'I am filing this petition for my' is 'Spouse'. Max length: 5 characters Depends on: Part 1 - Spouse
59.d State	Combobox	Enter the U.S. state or equivalent administrative division for the spouse's last address where you physically lived together. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC
59.f Province	Text	Enter the province, region, or other applicable administrative area for the spouse's last address where you physically lived together (used for non-U.S. addresses). Fill only if 'I am filing this petition for my' is 'Spouse'. Max length: 20 characters Depends on: Part 1 - Spouse
59.h Country	Text	Enter the country of the spouse's last address where you physically lived together. Fill only if 'I am filing this petition for my' is 'Spouse'. Depends on: Part 1 - Spouse
59.g Postal Code	Text	Enter the postal code for the spouse's last address where you physically lived together, if different from the U.S. ZIP code field. Fill only if 'I am filing this petition for my' is 'Spouse'. Max length: 9 characters Depends on: Part 1 - Spouse
60. Dates lived together (From/To)
60.a Date From (Lived Together)	Date	Enter the date when you and the spouse/partner began living together (the starting date of the shared residence). Fill only if 'I am filing this petition for my' is 'Spouse'. Depends on: Part 1 - Spouse
60.b Date To (Lived Together)	Date	Enter the date when you and the spouse/partner stopped living together, or the end date of the period you cohabited. Fill only if 'I am filing this petition for my' is 'Spouse'. Depends on: Part 1 - Spouse
61. USCIS office (City and State)
61.a USCIS office — City or Town	Text	Enter the name of the city or town of the USCIS office where the beneficiary will apply for adjustment of status. Max length: 20 characters
61.b USCIS office — State	Combobox	Enter the state of the USCIS office where the beneficiary will apply for adjustment of status. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC
62. U.S. Embassy/Consulate for immigrant visa (City, Province, Country)
62.a. City or Town	Text	Enter the city or town where the U.S. Embassy or U.S. Consulate that will process the immigrant visa is located. Max length: 20 characters
62.b. Province	Text	Enter the province, state, region, or administrative area where that U.S. Embassy or U.S. Consulate is located. Max length: 20 characters
62.c. Country	Text	Enter the country in which the U.S. Embassy or U.S. Consulate that will handle the immigrant visa application is located.
A-Number
A-Number (if any)	Text	Enter the applicant's USCIS A-Number digits that follow the printed 'A-' prefix; leave blank if you do not have an A-Number. Max length: 9 characters
Additional Information About Beneficiary - Immigration Proceedings
53. Ever in immigration proceedings — No	Checkbox	Check this box if the beneficiary was never in immigration proceedings.
53. Ever in immigration proceedings — Yes	Checkbox	Check this box if the beneficiary was ever in immigration proceedings.
54. Removal	Checkbox	If you answered "Yes" to Item 53, check this box to indicate the proceedings were removal proceedings. Fill only if '53. Ever in immigration proceedings — Yes' is 'Yes'. Depends on: 53. Ever in immigration proceedings — Yes
54. Exclusion/Deportation	Checkbox	If you answered "Yes" to Item 53, check this box to indicate the proceedings were exclusion or deportation proceedings. Fill only if '53. Ever in immigration proceedings — Yes' is 'Yes'. Depends on: 53. Ever in immigration proceedings — Yes
54. Rescission	Checkbox	If you answered "Yes" to Item 53, check this box to indicate the proceedings were rescission proceedings. Fill only if '53. Ever in immigration proceedings — Yes' is 'Yes'. Depends on: 53. Ever in immigration proceedings — Yes
54. Other Judicial Proceedings	Checkbox	If you answered "Yes" to Item 53, check this box to indicate the proceedings were other judicial proceedings (provide the type, location, and date). Fill only if '53. Ever in immigration proceedings — Yes' is 'Yes'. Depends on: 53. Ever in immigration proceedings — Yes
City or Town (Immigration Proceedings)	Text	Enter the name of the city or town where the immigration proceeding took place. Fill only if '53. Ever in immigration proceedings — Yes' is 'Yes'. Max length: 20 characters Depends on: 53. Ever in immigration proceedings — Yes
State (Immigration Proceedings)	Combobox	Enter the U.S. state or foreign provincial/region where the immigration proceeding took place (use the full name or standard abbreviation). Fill only if '53. Ever in immigration proceedings — Yes' is 'Yes'. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC Depends on: 53. Ever in immigration proceedings — Yes
Date of Proceedings	Date	Enter the date when the immigration proceeding occurred. Fill only if '53. Ever in immigration proceedings — Yes' is 'Yes'. Depends on: 53. Ever in immigration proceedings — Yes
Additional Information Row 1 (3.a-3.d)
Row 1 — Page Number (3.a)	Text	Enter the page number that this additional information refers to for Row 1. Max length: 2 characters
Row 1 — Part Number (3.b)	Text	Enter the part number of the form to which this additional information refers for Row 1. Max length: 6 characters
Row 1 — Item Number (3.c)	Text	Enter the item number on the form that this additional information refers to for Row 1. Max length: 6 characters
Row 1 — Additional Information (3.d)	Text	Provide the detailed additional information, explanation, or continuation of your answer that corresponds to the Page Number, Part Number, and Item Number entered above for Row 1. Fill only if 'Row 1 — Page Number (3.a)', 'Row 1 — Part Number (3.b)', 'Row 1 — Item Number (3.c)' are provided (all). Depends on: Row 1 — Page Number (3.a), Row 1 — Part Number (3.b), Row 1 — Item Number (3.c)
Additional Information Row 2 (4.a-4.d)
4.a Page Number	Text	Enter the page number of the petition that this additional information refers to (for example, "1"). Max length: 2 characters
4.b Part Number	Text	Enter the part number of the form to which this additional information applies (for example, "2"). Max length: 6 characters
4.c Item Number	Text	Enter the item (question) number on the form that this additional information is referring to (for example, "3"). Max length: 6 characters
4.d Additional Information	Text	Provide the full additional explanation or supplemental information for the referenced page/part/item; type or paste the complete text you want included on this supplemental page. Fill only if '4.a Page Number', '4.b Part Number', '4.c Item Number' are provided (all). Depends on: 4.a Page Number, 4.b Part Number, 4.c Item Number
Additional Information Row 3 (5.a-5.d)
5.a Page Number	Text	Enter the page number on the petition that this additional information refers to. Max length: 2 characters
5.b Part Number	Text	Enter the part number on the form to which this additional information applies. Max length: 6 characters
5.c Item Number	Text	Enter the item or question number on the form that this additional information references. Max length: 6 characters
5.d Additional Information	Text	Type or print the full additional information or explanation referenced by the Page Number, Part Number, and Item Number above; include your name and A-Number at the top of each sheet if applicable. Fill only if '5.a Page Number', '5.b Part Number', '5.c Item Number' are provided (all). Depends on: 5.a Page Number, 5.b Part Number, 5.c Item Number
Additional Information Row 4 (6.a-6.d)
Row 4 — Page Number (6.a)	Text	Enter the page number of the form to which this additional information in row 4 refers. Max length: 2 characters
Row 4 — Part Number (6.b)	Text	Enter the part number of the form to which this additional information in row 4 refers. Max length: 6 characters
Row 4 — Item Number (6.c)	Text	Enter the item number on the form that this additional information in row 4 addresses. Max length: 6 characters
Row 4 — Additional Information (6.d)	Text	Provide the full additional information, explanation, or details related to the referenced page, part, and item for row 4. Fill only if 'Row 4 — Page Number (6.a)', 'Row 4 — Part Number (6.b)', 'Row 4 — Item Number (6.c)' are provided (all). Depends on: Row 4 — Page Number (6.a), Row 4 — Part Number (6.b), Row 4 — Item Number (6.c)
Additional Information Row 5 (7.a-7.d)
Row 5 — 7.a Page Number	Text	Enter the page number on the petition or attached sheet that corresponds to this additional information entry. Max length: 2 characters
Row 5 — 7.b Part Number	Text	Enter the part number on the form to which this additional information refers. Max length: 6 characters
Row 5 — 7.c Item Number	Text	Enter the item number within the referenced part that this supplemental information addresses. Max length: 6 characters
Row 5 — 7.d Additional Information	Text	Provide the full additional information, explanation, or answer related to the referenced page, part, and item. Fill only if 'Row 5 — 7.a Page Number', 'Row 5 — 7.b Part Number', 'Row 5 — 7.c Item Number' are provided (all). Depends on: Row 5 — 7.a Page Number, Row 5 — 7.b Part Number, Row 5 — 7.c Item Number
Applicant Name (Family, Given, Middle)
Family Name (Last Name)	Text	Enter your family name (last name or surname) exactly as it should appear on official records.
Given Name (First Name)	Text	Enter your given name or first name as you normally use it on official documents.
Middle Name	Text	Enter your middle name or middle initial if you have one; if none, leave this field blank or enter 'N/A' if instructed.
Attorney or Accredited Representative (G-28) and IDs
Form G-28 is attached	Checkbox	Check this box if an Attorney or Accredited Representative Form G-28 is attached to this petition. Fill only if 'Form G-28' is attached.
Volag Number (if any)	Text	Enter the VOLAG (voluntary agency) identification number associated with the attorney or accredited representative, if one exists; leave blank if not applicable. Fill only if 'Select this box if Form G-28 is attached.' is 'Yes'. Max length: 15 characters
Attorney State Bar Number (if applicable)	Text	Enter the attorney's state bar membership or registration number if applicable; leave blank if the representative is not an attorney or does not have a bar number. Fill only if 'Select this box if Form G-28 is attached.' is 'Yes'. Max length: 10 characters
Attorney or Accredited Representative USCIS Online Account Number (if any)	Text	Enter the USCIS online account number for the attorney or accredited representative if they have one; leave blank if none. Fill only if 'Select this box if Form G-28 is attached.' is 'Yes'. Max length: 12 characters
Beneficiary Contact (Mobile, Email)
Mobile Telephone Number	Text	Enter the beneficiary's mobile telephone number (include country and area code as needed). Max length: 15 characters
Email Address	Text	Enter the beneficiary's email address for contact (if any).
Beneficiary Full Name (4.a-4.c)
4.a Family Name (Last Name)	Text	Enter the beneficiary's family or last name exactly as it appears on legal documents.
4.b Given Name (First Name)	Text	Enter the beneficiary's given or first name as used on official records.
4.c Middle Name	Text	Enter the beneficiary's middle name, if any; if none, leave this field blank or enter 'N/A' if instructed.
Beneficiary's Employment Information
Name of Current Employer	Text	Enter the beneficiary's current employer name, or type 'Unemployed' if the beneficiary has no employer. Max length: 38 characters
Employer Street Number and Name	Text	Provide the employer's street number and street name for the employer's mailing or physical address. Max length: 34 characters
51.c. Apt.	Checkbox	Check this box when the beneficiary's address includes an apartment number and you will provide that apartment number in the adjacent field.
51.c. Ste.	Checkbox	Check this box when the beneficiary's address includes a suite number and you will provide that suite number in the adjacent field.
51.c. Flr.	Checkbox	Check this box when the beneficiary's address includes a floor number and you will provide that floor number in the adjacent field.
Apt./Suite/Floor	Text	Enter the apartment, suite, unit, or floor designation for the employer's address if applicable. Max length: 6 characters
City or Town	Text	Enter the city or town where the employer is located. Max length: 20 characters
State	Combobox	Enter the state or regional subdivision where the employer is located. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC
ZIP Code	Text	Provide the employer's ZIP code for U.S. addresses or leave blank if not applicable. Max length: 5 characters
Province	Text	Enter the province, territory, or region for the employer's address if applicable. Max length: 20 characters
Date Employment Began	Date	Enter the date when the beneficiary began employment with this employer.
Postal Code	Text	Provide the employer's postal code for international or non‑U.S. addresses. Max length: 9 characters
Country	Text	Enter the country in which the employer is located.
Beneficiary's Entry Information
45. Ever in the United States? — Yes	Checkbox	Check this box if the beneficiary has ever been physically present in the United States.
45. Ever in the United States? — No	Checkbox	Check this box if the beneficiary has never been physically present in the United States.
46.d Authorized Stay Expiration Date or D/S	Date	Enter the date the beneficiary's authorized stay expired or will expire as shown on Form I-94 or Form I-95, or type "D/S" to indicate Duration of Status.
46.a Class of Admission	Combobox	Enter the beneficiary's class of admission (visa category or admission code) used when they arrived in the United States. HSC H2A AS N6 U2 C4 ASD L1A O2 P2S S2 MIS E2C O3 PAL 1B2 UU I T4 LZ EWI D1 J1 A3 C3 R1 FSM R2 RE5 O1 1BS Q3 J1S P4 M2 T5 RE H3B L2 WT WD G5 H1B DA N2 AW B2 ML B1B D2 A2 T3 S1 DT H3 PAR G3 N3 V2 IN U3 H2 T1 SDF P3S CH P3 N1 V1 TC M1 L1 BE G1 H2B B1D TWO DX F2 E2 FUG N4 J2 N8 CP GT U5 WI CW1 WB TN1 N9 H3A C1 ST H1 K3 P1S EAO G4 K2 C2 CC U4 GB DE H1C IMM TB K1 CW2 F1 Q1 A1 1B4 X 1B5 H4 E3 N7 1B1 P2 O1B B1 P1A P1B S9 TD V3 L1B 1B3 TN2 G2 T2 B1C B1A E1 RW J2S OP N5 P1 PI Q2 H2R K4 H1A UN U1 O1A
46.b Form I-94 Arrival-Departure Record Number	Text	Enter the beneficiary's Form I-94 arrival-departure record number exactly as it appears on the I-94. Max length: 11 characters
46.c Date of Arrival	Date	Enter the date the beneficiary arrived in the United States as shown on arrival records.
47 Passport Number	Text	Enter the beneficiary's passport number exactly as it appears in their passport. Max length: 30 characters
Beneficiary's Marital Information
Number of times married	Text	Enter how many times the beneficiary has been married (provide a whole number). Max length: 5 characters
Widowed	Checkbox	Check this box if the beneficiary's spouse has died and the beneficiary is currently widowed.
Annulled	Checkbox	Check this box if the beneficiary's marriage was annulled and is considered legally void.
Separated	Checkbox	Check this box if the beneficiary is legally separated or living apart from their spouse but not divorced.
Single, Never Married	Checkbox	Check this box if the beneficiary has never been married and is currently single.
Married	Checkbox	Check this box if the beneficiary is currently married.
Divorced	Checkbox	Check this box if the beneficiary's prior marriage(s) ended in divorce and they are currently divorced.
Date of current marriage	Date	Enter the date the beneficiary's current marriage began. Fill only if 'Married' Married is 'Yes'. Depends on: Married
Beneficiary's Physical Address (11.a - 11.h)
11.f Province	Text	Enter the province, region, or equivalent subdivision for the beneficiary's address if the address is outside the United States; leave blank if the address is in the U.S. Max length: 20 characters
11.g Postal Code	Text	Enter the postal code for the beneficiary's address (used for international addresses) or leave blank if not applicable. Max length: 9 characters
11.h Country	Text	Enter the full name of the country where the beneficiary physically resides. Max length: 29 characters
11.a Street Number and Name	Text	Enter the beneficiary's street number and street name for their physical address; if the beneficiary lives outside the United States in a home without a street number or name, leave this blank. Max length: 34 characters
11.b. Apt.	Checkbox	Check this box if the beneficiary's physical address includes an apartment number and you are entering that apartment number in the adjacent field.
11.b. Ste.	Checkbox	Check this box if the beneficiary's physical address includes a suite number and you are entering that suite number in the adjacent field.
11.b. Flr.	Checkbox	Check this box if the beneficiary's physical address includes a floor number and you are entering that floor number in the adjacent field.
11.b Apartment / Suite / Floor	Text	Enter the apartment, suite, or floor number or identifier for the beneficiary's address, or leave blank if not applicable. Max length: 6 characters
11.c City or Town	Text	Enter the city or town of the beneficiary's physical address. Max length: 20 characters
11.e ZIP Code	Text	Enter the ZIP Code for the beneficiary's U.S. address (leave blank if the address is outside the United States). Max length: 5 characters
11.d State	Combobox	If the address is in the United States, enter the U.S. state (typically the two-letter abbreviation); leave blank if the address is outside the United States. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC
Birth Information (City/Town of Birth, Country of Birth, Date of Birth)
City/Town/Village of Birth	Text	Enter the city, town, or village where the beneficiary was born. Max length: 38 characters
Country of Birth	Text	Enter the country where the beneficiary was born.
Date of Birth	Date	Enter the beneficiary's date of birth.
Certificate Details (Number, Place, Date)
Certificate Number	Text	Enter the identifying number printed on your Certificate of Naturalization or Certificate of Citizenship. Fill only if '38. Certificate of Naturalization or Citizenship - Yes' is 'Yes'. Depends on: 38. Certificate of Naturalization or Citizenship - Yes
Date of Issuance	Date	Enter the date when the certificate was issued. Fill only if '38. Certificate of Naturalization or Citizenship - Yes' is 'Yes'. Depends on: 38. Certificate of Naturalization or Citizenship - Yes
Place of Issuance	Text	Enter the city, state/province, and country where the certificate was issued. Fill only if '38. Certificate of Naturalization or Citizenship - Yes' is 'Yes'. Depends on: 38. Certificate of Naturalization or Citizenship - Yes
Certificate Obtained (Yes/No)
38. Certificate of Naturalization or Citizenship - Yes	Checkbox	Check this box if you have obtained a Certificate of Naturalization or a Certificate of Citizenship.
38. Certificate of Naturalization or Citizenship - No	Checkbox	Check this box if you have not obtained a Certificate of Naturalization or a Certificate of Citizenship.
Date Marriage Ended (Question 24)
Date Marriage Ended (Question 24)	Date	Enter the date when the marriage ended for the beneficiary.
Date of Current Marriage
Date of Current Marriage	Date	Enter the date of your current marriage (the date you were legally married). Fill only if 'Current Marital Status' is 'Married'. Depends on: 17. Married
Employer 1 - Name, Address, Occupation, Dates (Items 42-45.b)
Employer 1 - Street Number and Name	Text	Enter the street number and street name for the employer's address. Max length: 34 characters
Employer 1 - Apt.	Checkbox	Check this box if the employer's street address includes an apartment number (use the adjacent field to enter the apartment number).
Employer 1 - Ste.	Checkbox	Check this box if the employer's street address includes a suite number (use the adjacent field to enter the suite number).
Employer 1 - Flr.	Checkbox	Check this box if the employer's street address includes a floor number (use the adjacent field to enter the floor).
Employer 1 - Unit (Apt/Ste/Flr)	Text	Enter the apartment, suite, or floor number or other unit identifier for the employer's address. Max length: 6 characters
Employer 1 - City or Town	Text	Enter the city or town where the employer is located. Max length: 20 characters
Employer 1 - Province	Text	Enter the province or region for the employer's address if applicable. Max length: 20 characters
Employer 1 - Postal Code	Text	Enter the postal code for the employer's address (used for international addresses). Max length: 9 characters
Employer 1 - ZIP Code	Text	Enter the ZIP code or postal code for the employer's address. Max length: 5 characters
Employer 1 - State	Combobox	Enter the state or regional subdivision where the employer is located. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC
Employer 1 - Country	Text	Enter the country in which the employer is located. Max length: 29 characters
Employer 1 - Name of Employer/Company	Text	Enter the full name of the employer or company for this employment record. Max length: 34 characters
Employer 1 - Your Occupation	Text	Enter the job title or occupation you held at this employer.
Employer 1 - Date From	Date	Enter the date when you began employment with this employer.
Employer 1 - Date To	Date	Enter the date when your employment with this employer ended or write the current date if still employed.
Employer 2 - Name, Address, Occupation, Dates (Items 46-49.b)
Employer 2 - Street Number and Name	Text	Enter the street number and street name for the employer's address. Max length: 34 characters
Employer 2 - Apt. (Apartment)	Checkbox	Check this box if the employer's street address includes an apartment number and you will enter that apartment number in the adjacent field.
Employer 2 - Ste. (Suite)	Checkbox	Check this box if the employer's street address includes a suite number and you will enter that suite number in the adjacent field.
Employer 2 - Flr. (Floor)	Checkbox	Check this box if the employer's street address includes a floor number and you will enter that floor number in the adjacent field.
Employer 2 - Apt./Suite/Floor	Text	Enter the apartment, suite, unit, or floor identifier for the employer's address, if applicable. Max length: 6 characters
Employer 2 - City or Town	Text	Enter the city or town where the employer is located. Max length: 20 characters
Employer 2 - Province	Text	Enter the province, region, or state subdivision for the employer's non-U.S. address, if applicable. Max length: 20 characters
Employer 2 - Postal Code	Text	Enter the postal code for the employer's non-U.S. address; leave blank if not applicable. Max length: 9 characters
Employer 2 - ZIP Code	Text	Enter the ZIP code for the employer's U.S. address; leave blank if not applicable. Max length: 5 characters
Employer 2 - State	Combobox	Enter the U.S. state (or regional subdivision) in which the employer is located. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC
Employer 2 - Country	Text	Enter the country where the employer is located.
Employer 2 - Your Occupation	Text	Enter your job title or occupation at Employer 2.
Employer 2 - Date From	Date	Enter the date you began employment with this employer.
Employer 2 - Date To	Date	Enter the date you ended employment with this employer or indicate ongoing employment per the form instructions.
Employer 2 - Name of Employer/Company	Text	Enter the full legal name of the employer or company for Employer 2. Max length: 34 characters
Ethnicity (Part 3 - Item 1)
Item 1 - Not Hispanic or Latino	Checkbox	Check this box if you do not identify your ethnicity as Hispanic or Latino (select only one box for Item 1).
Item 1 - Hispanic or Latino	Checkbox	Check this box if you identify your ethnicity as Hispanic or Latino (select only one box for Item 1).
Eye Color (Part 3 - Item 5)
Part 3 - Item 5: Blue	Checkbox	Check this box if your eye color is Blue; select only one box.
Part 3 - Item 5: Brown	Checkbox	Check this box if your eye color is Brown; select only one box.
Part 3 - Item 5: Hazel	Checkbox	Check this box if your eye color is Hazel; select only one box.
Part 3 - Item 5: Pink	Checkbox	Check this box if your eye color is Pink; select only one box.
Part 3 - Item 5: Maroon	Checkbox	Check this box if your eye color is Maroon; select only one box.
Part 3 - Item 5: Green	Checkbox	Check this box if your eye color is Green; select only one box.
Part 3 - Item 5: Gray	Checkbox	Check this box if your eye color is Gray; select only one box.
Part 3 - Item 5: Black	Checkbox	Check this box if your eye color is Black; select only one box.
Part 3 - Item 5: Unknown/Other	Checkbox	Check this box if your eye color is Unknown or not listed (Other); select only one box.
Form Bottom Field (page footer)
Footer — Page/Identifier	Text	Enter the page number or other footer identifier exactly as it should appear in the form footer (e.g., page number).
Form Footer - Page Number
Page Number	Text	Enter the current page number of the form (the numeric page index shown at the bottom of the page).
Form footer - Page/Edition field
Page Number (form footer)	Text	Enter the page number for this PDF form as it should appear in the footer (for example, '8' or '8 of 12').
Form Footer / Page Field
Page Number	Text	Enter the page number for this form page as shown on the printed form (the sequential page index).
Form page number	Text	Enter the page number shown on this form (the numeric page identifier for this sheet).
Page Number (Footer)	Text	Enter the page number shown on this form's footer for this page.
Form Footer / Page Field (bottom field 1)
Footer Page Number 1	Number	Enter the page number displayed on the form footer for this page.
Form Footer Field
Form Footer Field 1	Text	Enter the text that belongs in the form footer at the bottom center of the page (for example a page number or document identifier).
Footer Page Number	Text	Enter the form's page number as it appears in the footer (e.g., 1, 2, 3) to identify this page within the document.
Form footer/identifier (bottom)
Form footer identifier	Text	Enter the form’s footer identifier or tracking code shown at the bottom center of the page (for example a form-specific code, control number, or other internal identifier).
Form Page Identifier (footer)
Form page identifier (footer)	Text	Enter the page identifier as it appears in the form footer (for example the page number or other footer label shown on this page).
Form Page Number
Form Page Number	Text	Enter the form's page number exactly as shown on the document (for example: 1).
General
Part 3. Biographic Information. 4. Weight. Enter Pounds. Enter First Digit of Three Digits	Text	Max length: 1 characters
Part 3. Biographic Information. 4. Weight. Enter Pounds. Enter Second Digit of Three Digits	Text	Max length: 1 characters
Part 3. Biographic Information. 4. Weight. Enter Pounds. Enter Third Digit of Three Digits	Text	Max length: 1 characters
Hair Color
Bald (No hair)	Checkbox	Check this box if the beneficiary has no hair (is bald).
Black	Checkbox	Check this box if the beneficiary's hair color is black.
Blond	Checkbox	Check this box if the beneficiary's hair color is blond.
Brown	Checkbox	Check this box if the beneficiary's hair color is brown.
Gray	Checkbox	Check this box if the beneficiary's hair color is gray.
Red	Checkbox	Check this box if the beneficiary's hair color is red.
Sandy	Checkbox	Check this box if the beneficiary's hair color is sandy (light brown/bronze).
White	Checkbox	Check this box if the beneficiary's hair color is white.
Unknown/Other	Checkbox	Check this box if the beneficiary's hair color is unknown or does not match the listed options.
Height and Weight (Part 3 - Items 3-4)
Part 3 - Item 3: Height (Feet)	Combobox	Enter your height in whole feet (for example, 5 for five feet). 8 6 5 4 7 2 3
Part 3 - Item 3: Height (Inches)	Combobox	Enter the additional inches of your height beyond the feet you provided (for example, 7 for seven inches). 8 0 6 5 4 7 2 9 10 11 3 1
Part 3 - Item 4: Weight (Pounds)	Text	Enter your weight in pounds as a whole number (for example, 150). Max length: 3 characters
Identifiers (A-Number, USCIS Online Account Number, SSN)
Alien Registration Number (A-Number)	Text	Enter the beneficiary's A-Number (Alien Registration Number) exactly as it appears on their immigration documents, including the leading letter if present. Max length: 9 characters
USCIS Online Account Number	Text	Enter the beneficiary's USCIS Online Account Number (if any) as shown on their USCIS online profile or correspondence. Max length: 12 characters
U.S. Social Security Number (SSN)	Text	Enter the beneficiary's Social Security Number, if any, using all digits exactly as issued (do not include spaces or dashes unless shown on your card). Max length: 9 characters
Interpreter's Certification and Signature (Part 7, Items 'I certify' & 7.a-7.b)
Part 7 — Language Interpreted	Text	Enter the language (other than English) in which you interpreted for the petitioner, i.e., the language you are certifying fluency in. Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Part 7, Item 7.b — Date of Signature	Date	Enter the date when the interpreter signed this form. Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Part 7, Item 7.a — Interpreter's Signature	Text	Enter the interpreter's signature (their name as signed) to attest that the certification statement is true. Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Max length: 1 characters Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Interpreter's Contact Information (Part 7, Items 4-6)
Item 4 — Interpreter's Daytime Telephone Number	Text	Enter the interpreter's primary daytime telephone number, including area code and country code if applicable. Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Max length: 10 characters Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Item 6 — Interpreter's Email Address (if any)	Text	Enter the interpreter's email address used for contact, or leave blank if none. Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Max length: 38 characters Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Item 5 — Interpreter's Mobile Telephone Number (if any)	Text	Enter the interpreter's mobile or cell phone number, including area code and country code if applicable, or leave blank if none. Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Max length: 10 characters Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Interpreter's Full Name (Part 7, Items 1.a-2)
Part 7, Item 1.b — Interpreter's Given Name (First Name)	Text	Enter the interpreter's given name (first name) exactly as it should appear on the form. Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Part 7, Item 1.a — Interpreter's Family Name (Last Name)	Text	Enter the interpreter's family name (last name) exactly as it should appear on the form. Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Part 7, Item 2 — Interpreter's Business or Organization Name (if any)	Text	Enter the name of the interpreter's business or organization, or leave blank if the interpreter has none. Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Max length: 38 characters Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Interpreter's Mailing Address (Part 7, Items 3.a-3.h)
Part 7, Item 3.c - City or Town	Text	Enter the city or town for the interpreter's mailing address. Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Max length: 20 characters Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Part 7, Item 3.a - Street Number and Name	Text	Enter the interpreter's street number and street name for their mailing address (for example, "123 Main St"). Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Max length: 34 characters Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Part 7 (3.b) Apt.	Checkbox	Check this box when the interpreter's mailing address includes an apartment (Apt.) number and you are providing that apartment number in the adjacent field. Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Part 7 (3.b) Ste.	Checkbox	Check this box when the interpreter's mailing address includes a suite (Ste.) number and you are providing that suite number in the adjacent field. Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Part 7 (3.b) Flr.	Checkbox	Check this box when the interpreter's mailing address includes a floor (Flr.) designation and you are providing that floor number in the adjacent field. Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Part 7, Item 3.b - Apartment, Suite, or Floor	Text	Enter the interpreter's apartment, suite, unit, or floor identifier for the mailing address, if applicable; otherwise leave blank. Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Max length: 6 characters Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Part 7, Item 3.g - Postal Code	Text	Enter the postal code for the interpreter's mailing address (used for non-U.S. addresses). Fill only if 'Part 7, Item 3.h - Country' is not 'United States'. Max length: 9 characters Depends on: Part 7, Item 3.h - Country
Part 7, Item 3.e - ZIP Code	Text	Enter the ZIP code for the interpreter's mailing address (include ZIP+4 if available). Fill only if 'Part 7, Item 3.h - Country' is 'United States'. Max length: 5 characters Depends on: Part 7, Item 3.h - Country
Part 7, Item 3.d - State	Combobox	Enter the U.S. state or equivalent region for the interpreter's mailing address (use the standard abbreviation if required). Fill only if 'Part 7, Item 3.h - Country' is 'United States'. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC Depends on: Part 7, Item 3.h - Country
Part 7, Item 3.h - Country	Text	Enter the country for the interpreter's mailing address. Fill only if 'Part 6, Item 1.b — Petitioner's Statement (The interpreter named in Part 7...)' is 'Yes'. Max length: 29 characters Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Part 7, Item 3.f - Province	Text	Enter the province, territory, or region for the interpreter's mailing address if applicable for non-U.S. addresses. Fill only if 'Part 7, Item 3.h - Country' is not 'United States'. Max length: 20 characters Depends on: Part 7, Item 3.h - Country
Lawful Permanent Resident - Admission Details (Items 40.a-41)
40.a Class of Admission	Text	Enter the admission class or USCIS category under which you were granted lawful permanent resident status (for example a family‑based or employment‑based classification or specific visa code). Fill only if 'I am a' is 'Lawful Permanent Resident'. Depends on: Lawful Permanent Resident
40.b Date of Admission	Date	Enter the date you were admitted as a lawful permanent resident. Fill only if 'I am a' is 'Lawful Permanent Resident'. Depends on: Lawful Permanent Resident
40.c City or Town of Admission	Text	Enter the city or town where you were admitted as a lawful permanent resident. Fill only if 'I am a' is 'Lawful Permanent Resident'. Depends on: Lawful Permanent Resident
41. Gained lawful permanent resident status through marriage — No	Checkbox	Check this box if you did not gain lawful permanent resident (LPR) status through marriage to a U.S. citizen or a lawful permanent resident. Fill only if 'I am a' is 'Lawful Permanent Resident'. Depends on: Lawful Permanent Resident
41. Gained lawful permanent resident status through marriage — Yes	Checkbox	Check this box if you gained lawful permanent resident (LPR) status through marriage to a U.S. citizen or a lawful permanent resident. Fill only if 'I am a' is 'Lawful Permanent Resident'. Depends on: Lawful Permanent Resident
40.d State of Admission	Combobox	Enter the U.S. state (or applicable region/province) where you were admitted as a lawful permanent resident. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC
Mailing Address (Items 10.a-10.i and Item 11)
11 Yes	Checkbox	Check this box if your current mailing address is the same as your physical address.
11 No	Checkbox	Check this box if your current mailing address is different from your physical address (if checked, provide your physical address in Items 12.a–13.b).
10.b Street Number and Name	Text	Enter the street number and full street name for your mailing address (include house/building number and street). Max length: 34 characters
10.c Apt.	Checkbox	Check this box if your mailing address includes an apartment number (enter the apartment number in the adjacent field).
10.c Ste.	Checkbox	Check this box if your mailing address includes a suite number (enter the suite number in the adjacent field).
10.c Flr.	Checkbox	Check this box if your mailing address includes a floor designation (enter the floor in the adjacent field).
10.c Apt/Ste/Flr (unit)	Text	Enter the apartment, suite, or floor number associated with the street address (unit or secondary address info). Max length: 6 characters
10.d City or Town	Text	Enter the city or town name for your mailing address. Max length: 20 characters
10.g Province	Text	If applicable, enter the province, region, or administrative area for your mailing address (used for non‑U.S. addresses). Max length: 20 characters
10.h Postal Code	Text	Enter the postal code for your mailing address (used for international addresses where different from U.S. ZIP). Max length: 9 characters
10.f ZIP Code	Text	Enter the ZIP code or postal code used for your mailing address. Max length: 5 characters
10.e State	Combobox	Enter the state or U.S. territory for your mailing address (use the standard name or abbreviation). MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC
10.i Country	Text	Enter the country name for your mailing address.
10.a In Care Of Name	Text	Enter the name of the person or organization who should receive mail at this address (the 'in care of' recipient). Max length: 34 characters
Marital Information (Items 16-17)
16. Number of times you have been married	Text	Enter the total number of times you have been legally married (including current and prior marriages). Max length: 5 characters
17. Widowed	Checkbox	Check this box if your spouse is deceased and you have not remarried.
17. Annulled	Checkbox	Check this box if your marriage was annulled (declared null and void).
17. Separated	Checkbox	Check this box if you are currently separated from your spouse (living apart or legally separated).
17. Single, Never Married	Checkbox	Check this box if your current marital status is single and you have never been married.
17. Married	Checkbox	Check this box if you are currently married.
17. Divorced	Checkbox	Check this box if you are currently divorced (your previous marriage has been legally dissolved).
Other Address (Outside U.S.) (13.a - 13.f)
13.e Postal Code	Text	Enter the postal code or ZIP code for the beneficiary's address outside the United States, using the format used in that country. Fill only if '13.a Street Number and Name' is not 'SAME'. Max length: 9 characters Depends on: 13.a Street Number and Name
13.b Apartment, Suite, or Floor	Text	Enter the apartment, suite, floor, unit number, or other secondary address information for the beneficiary's foreign address if applicable. Fill only if '13.a Street Number and Name' is not 'SAME'. Max length: 6 characters Depends on: 13.a Street Number and Name
13.b Apt. (Apartment)	Checkbox	Check this box if the beneficiary's other (outside U.S.) address includes an apartment number. Fill only if '13.a Street Number and Name' is not 'SAME'. Depends on: 13.a Street Number and Name
13.b Ste. (Suite)	Checkbox	Check this box if the beneficiary's other (outside U.S.) address includes a suite number. Fill only if '13.a Street Number and Name' is not 'SAME'. Depends on: 13.a Street Number and Name
13.b Flr. (Floor)	Checkbox	Check this box if the beneficiary's other (outside U.S.) address specifies a floor number. Fill only if '13.a Street Number and Name' is not 'SAME'. Depends on: 13.a Street Number and Name
13.a Street Number and Name	Text	Enter the street number and street name for the beneficiary's address outside the United States (leave blank if there is no street number). Max length: 34 characters
13.c City or Town	Text	Enter the city, town, or locality of the beneficiary's address outside the United States. Fill only if '13.a Street Number and Name' is not 'SAME'. Max length: 20 characters Depends on: 13.a Street Number and Name
13.f Country	Text	Enter the full name of the country where the beneficiary resides (do not use abbreviations). Fill only if '13.a Street Number and Name' is not 'SAME'. Depends on: 13.a Street Number and Name
13.d Province	Text	Enter the province, region, state, or other administrative division for the beneficiary's foreign address. Fill only if '13.a Street Number and Name' is not 'SAME'. Max length: 20 characters Depends on: 13.a Street Number and Name
Other Address and Contact Information (U.S. address 12.a - 12.e + Daytime Phone)
12.a Street Number and Name	Text	Enter the U.S. street number and full street name where the beneficiary intends to live (or type SAME if the address is the same as the beneficiary's physical address). Max length: 34 characters
12.b. Apt.	Checkbox	Check this box when the U.S. address includes an apartment (Apt.) number and you will enter that apartment number in the adjacent field. Fill only if '12.a Street Number and Name' is not 'SAME'. Depends on: 12.a Street Number and Name
12.b. Ste.	Checkbox	Check this box when the U.S. address includes a suite (Ste.) number and you will enter that suite number in the adjacent field. Fill only if '12.a Street Number and Name' is not 'SAME'. Depends on: 12.a Street Number and Name
12.b. Flr.	Checkbox	Check this box when the U.S. address includes a floor (Flr.) designation and you will enter that floor number in the adjacent field. Fill only if '12.a Street Number and Name' is not 'SAME'. Depends on: 12.a Street Number and Name
12.b Apartment, Suite, or Floor	Text	Enter the apartment, suite, unit, or floor designator and number for the U.S. mailing address, if applicable. Fill only if '12.a Street Number and Name' is not 'SAME'. Max length: 6 characters Depends on: 12.a Street Number and Name
12.c City or Town	Text	Enter the city or town name for the U.S. address where the beneficiary intends to live. Fill only if '12.a Street Number and Name' is not 'SAME'. Max length: 20 characters Depends on: 12.a Street Number and Name
12.e ZIP Code	Text	Enter the U.S. ZIP Code for the street address (use the 5-digit ZIP or ZIP+4 if available). Fill only if '12.a Street Number and Name' is not 'SAME'. Max length: 5 characters Depends on: 12.a Street Number and Name
12.d State	Combobox	Enter the U.S. state for the address, preferably using the two-letter state abbreviation (for example, CA for California). Fill only if '12.a Street Number and Name' is not 'SAME'. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC Depends on: 12.a Street Number and Name
14 Daytime Telephone Number	Text	Provide the beneficiary's daytime telephone number, including area code and country code if the number is not a U.S. number. Max length: 15 characters
Other Information (Item 6-9: City/Town, Country, DOB, Sex)
Item 8 - Date of Birth	Date	Enter your date of birth.
9. Sex — Male	Checkbox	Check this box if your sex is male (select only one sex option).
9. Sex — Female	Checkbox	Check this box if your sex is female (select only one sex option).
Item 7 - Country of Birth	Text	Enter the name of the country where you were born.
Item 6 - City/Town/Village of Birth	Text	Enter the name of the city, town, or village where you were born.
Other Names Used (5.a-5.c)
5.a Family Name (Last Name) — Other Name	Text	Enter an other family/last name the beneficiary has used, including aliases, maiden name, or nicknames.
5.b Given Name (First Name) — Other Name	Text	Enter an other given/first name the beneficiary has used, including aliases, maiden name, or nicknames.
5.c Middle Name — Other Name	Text	Enter an other middle name the beneficiary has used, including aliases, maiden name, or nicknames.
Other Names Used (Item 5.a-5.c)
5.a Family Name (Last Name)	Text	Enter the family/last name you have used or been known by (including maiden name or any alias) for the other name being reported. Fill only if 'Other Names Used' is 'Yes'.
5.b Given Name (First Name)	Text	Enter the given/first name you have used or been known by for the other name being reported. Fill only if 'Other Names Used' is 'Yes'.
5.c Middle Name	Text	Enter the middle name or initial you have used or been known by for the other name being reported, or leave blank if none. Fill only if 'Other Names Used' is 'Yes'.
Parent 1 — Name, Date of Birth, Sex
Parent 1 — Family Name (Last Name)	Text	Enter Parent 1's family/last name exactly as it appears on their legal or identity documents.
Parent 1 — Given Name (First Name)	Text	Enter Parent 1's given/first name exactly as it appears on their legal or identity documents.
Parent 1 — Middle Name	Text	Enter Parent 1's middle name as shown on their documents, or leave blank if they have no middle name.
Parent 1 — Date of Birth	Date	Enter Parent 1's date of birth.
Parent 1 — Sex: Male	Checkbox	Check this box if Parent 1's sex is male.
Parent 1 — Sex: Female	Checkbox	Check this box if Parent 1's sex is female.
Parent 2 — Name, Date of Birth, Sex, Birth and Residence
Parent 2 — Given Name (First Name)	Text	Enter Parent 2's given or first name exactly as it appears on legal documents.
Parent 2 — Middle Name	Text	Enter Parent 2's middle name(s) if any, or leave blank if none.
Parent 2 — Family Name (Last Name)	Text	Enter Parent 2's family name or surname exactly as it appears on legal documents.
Parent 2 — Date of Birth	Date	Enter Parent 2's date of birth.
Parent 2 — City/Town/Village of Residence	Text	Enter the city, town, or village where Parent 2 currently resides.
Parent 2 — Country of Residence	Text	Enter the country where Parent 2 currently resides.
Parent 2 — Country of Birth	Text	Enter the country in which Parent 2 was born.
Parent 2 — Sex: Male	Checkbox	Check this box if Parent 2's sex is male.
Parent 2 — Sex: Female	Checkbox	Check this box if Parent 2's sex is female.
Part 1 - Relationship (Select one - Relationship Type)
Part 1 - Spouse	Checkbox	Check this box if you are filing this petition for your spouse (select only one relationship box).
Part 1 - Brother/Sister	Checkbox	Check this box if you are filing this petition for your brother or sister (select only one relationship box).
Part 1 - Parent	Checkbox	Check this box if you are filing this petition for your parent (select only one relationship box).
Part 1 - Child	Checkbox	Check this box if you are filing this petition for your child (select only one relationship box).
Part 1 - Relationship Details for Child/Parent
Part 1 - Child was born to parents who were married to each other at the time of the child's birth	Checkbox	Check this box if you are filing for a child who was born to parents who were married to each other at the time of the child's birth. Fill only if 'I am filing this petition for my' is 'Child' or 'Parent'.
Part 1 - Child was adopted (not an Orphan or Hague Convention adoptee)	Checkbox	Check this box if you are filing for a child who was adopted (and is not an orphan or a Hague Convention adoptee). Fill only if 'I am filing this petition for my' is 'Child' or 'Parent'.
Part 1 - Stepchild/Stepparent	Checkbox	Check this box if you are filing for a child who is your stepchild or if you are the child's stepparent. Fill only if 'I am filing this petition for my' is 'Child' or 'Parent'.
Part 1 - Child was born to parents who were not married to each other at the time of the child's birth	Checkbox	Check this box if you are filing for a child who was born to parents who were not married to each other at the time of the child's birth. Fill only if 'I am filing this petition for my' is 'Child' or 'Parent'.
Part 1 Q3 - Beneficiary Brother/Sister: Related by Adoption (Yes/No)
Part 1 Q3 - Yes (Related by adoption)	Checkbox	Check this box if the beneficiary is your brother or sister and you are related to them by adoption. Fill only if 'I am filing this petition for my (Select only one box)' is 'Brother/Sister'.
Part 1 Q3 - No (Not related by adoption)	Checkbox	Check this box if the beneficiary is your brother or sister and you are not related to them by adoption. Fill only if 'I am filing this petition for my (Select only one box)' is 'Brother/Sister'.
Part 1 Q4 - Gained LPR/Citizenship Through Adoption (Yes/No)
Part 1 Q4 - No: Did not gain lawful permanent resident status or citizenship through adoption	Checkbox	Check this box if the beneficiary did not gain lawful permanent resident status or U.S. citizenship through adoption.
Part 1 Q4 - Yes: Gained lawful permanent resident status or citizenship through adoption	Checkbox	Check this box if the beneficiary gained lawful permanent resident (LPR) status or U.S. citizenship as a result of being adopted.
Part 2 - Petitioner Full Name (Family, Given, Middle)
Family Name (Last Name) — Petitioner	Text	Enter the petitioner's family or last name exactly as it appears on legal documents.
Given Name (First Name) — Petitioner	Text	Enter the petitioner's given or first name exactly as it appears on legal documents.
Middle Name — Petitioner	Text	Enter the petitioner's middle name(s); if none, leave this field blank or enter 'N/A' per form instructions.
Part 2 - Petitioner Identifiers (A-Number, USCIS Account, SSN)
Part 2 - U.S. Social Security Number (SSN)	Text	Enter your U.S. Social Security Number if you have one, or leave this field blank if you do not have an SSN. Max length: 9 characters
Part 2 - Alien Registration Number (A-Number)	Text	Enter your Alien Registration Number (A-Number) as issued by USCIS, including the A- prefix if applicable, or leave blank if you do not have one. Max length: 9 characters
Part 2 - USCIS Online Account Number	Text	Enter your USCIS Online Account Number if you have one, or leave this field blank if you do not have an account. Max length: 12 characters
Part 5 - Item 1: Previously filed petition (Yes/No)
Part 5 - Item 1: Previously filed petition — Yes	Checkbox	Check this box if you have EVER previously filed a petition for this beneficiary or any other alien.
Part 5 - Item 1: Previously filed petition — No	Checkbox	Check this box if you have NEVER previously filed a petition for this beneficiary or any other alien.
Part 5 - Items 2-5: Previous petition details (Family, Given, Middle, City, State, Date Filed, Result)
Part 5 — Item 2.a: Previous Petition Family Name (Last Name)	Text	Enter the family/last name shown on the previously filed petition for this beneficiary. Fill only if 'Part 5 - Item 1: Previously filed petition — Yes' is 'Yes'. Depends on: Part 5 - Item 1: Previously filed petition — Yes
Part 5 — Item 2.b: Previous Petition Given Name (First Name)	Text	Enter the given/first name shown on the previously filed petition for this beneficiary. Fill only if 'Part 5 - Item 1: Previously filed petition — Yes' is 'Yes'. Depends on: Part 5 - Item 1: Previously filed petition — Yes
Part 5 — Item 2.c: Previous Petition Middle Name	Text	Enter the middle name shown on the previously filed petition for this beneficiary, if any. Fill only if 'Part 5 - Item 1: Previously filed petition — Yes' is 'Yes'. Depends on: Part 5 - Item 1: Previously filed petition — Yes
Part 5 — Item 5: Result of Previous Petition	Text	Enter the outcome of the previous petition, for example approved, denied, or withdrawn. Fill only if 'Part 5 - Item 1: Previously filed petition — Yes' is 'Yes'. Max length: 33 characters Depends on: Part 5 - Item 1: Previously filed petition — Yes
Part 5 — Item 4: Date Filed	Date	Enter the date the previous petition was filed. Fill only if 'Part 5 - Item 1: Previously filed petition — Yes' is 'Yes'. Depends on: Part 5 - Item 1: Previously filed petition — Yes
Part 5 — Item 3.a: City or Town Where Petition Was Filed	Text	Enter the city or town where the previous petition was filed. Fill only if 'Part 5 - Item 1: Previously filed petition — Yes' is 'Yes'. Max length: 20 characters Depends on: Part 5 - Item 1: Previously filed petition — Yes
Part 5 — Item 3.b: State Where Petition Was Filed	Combobox	Enter the U.S. state or foreign province where the previous petition was filed. Fill only if 'Part 5 - Item 1: Previously filed petition — Yes' is 'Yes'. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC Depends on: Part 5 - Item 1: Previously filed petition — Yes
Passport/Travel Document Information
Travel Document Number	Text	Enter the passport or travel document number exactly as it appears on the document, including any letters or punctuation.
Country of Issuance	Text	Enter the name of the country that issued the passport or travel document shown on the document.
Expiration Date for Passport or Travel Document	Date	Enter the expiration date of the passport or travel document.
Person 1 (Beneficiary's Family)
Person 1 - Relationship to Beneficiary	Text	Enter how Person 1 is related to the beneficiary (for example: spouse, son, daughter).
Person 1 - Family Name (Last Name)	Text	Enter Person 1's family or last name exactly as it appears on official documents.
Person 1 - Given Name (First Name)	Text	Enter Person 1's given or first name.
Person 1 - Middle Name	Text	Enter Person 1's middle name(s) or initial(s), if any; otherwise leave blank.
Person 1 - Date of Birth	Date	Enter Person 1's date of birth.
Person 1 - Country of Birth	Text	Enter the name of the country where Person 1 was born.
Person 2 (Beneficiary's Family)
Person 2 - Relationship to Beneficiary	Text	Enter how Person 2 is related to the beneficiary (for example, spouse, son, daughter).
Person 2 - Date of Birth	Date	Enter Person 2's date of birth.
Person 2 - Country of Birth	Text	Enter the country where Person 2 was born.
Person 2 - Family Name (Last Name)	Text	Enter Person 2's family/last name as it appears on legal documents.
Person 2 - Given Name (First Name)	Text	Enter Person 2's given or first name.
Person 2 - Middle Name	Text	Enter Person 2's middle name, or leave blank if none.
Person 3 (Beneficiary's Family)
Person 3 - Given Name (First Name)	Text	Enter Person 3's given (first) name as used on official records.
Person 3 - Middle Name	Text	Enter Person 3's middle name or initial, if any; otherwise leave this field blank.
Person 3 - Family Name (Last Name)	Text	Enter Person 3's family (last) name exactly as it appears on their legal or official documents.
Person 3 - Country of Birth	Text	Enter the country where Person 3 was born.
Person 3 - Date of Birth	Date	Enter Person 3's date of birth.
Person 3 - Relationship to Beneficiary	Text	Enter the relationship of Person 3 to the beneficiary (for example, spouse, son, daughter). Max length: 29 characters
Person 4 Information
Person 4 Middle Name	Text	Enter Person 4's middle name as shown on their documents, or leave blank or enter 'N/A' if they do not have one.
Person 4 Given Name (First Name)	Text	Enter Person 4's given (first) name exactly as it appears on their legal documents.
Person 4 Family Name (Last Name)	Text	Enter Person 4's family (last) name exactly as it appears on their legal documents.
Person 4 Country of Birth	Text	Enter the country where Person 4 was born using the full country name.
Person 4 Date of Birth	Date	Enter Person 4's date of birth.
Person 4 Relationship to Applicant	Text	Enter how Person 4 is related to the applicant/petitioner (for example, spouse, child, parent). Max length: 29 characters
Person 5 Information
Person 5 Family Name (Last Name)	Text	Enter Person 5's family (last) name exactly as it appears on their legal documents.
Person 5 Given Name (First Name)	Text	Enter Person 5's given (first) name exactly as it appears on their legal documents.
Person 5 Middle Name	Text	Enter Person 5's middle name(s); if they have no middle name, leave this field blank.
Person 5 Relationship	Text	Enter the beneficiary's relationship to the principal applicant (for example, spouse, child, parent). Max length: 29 characters
Person 5 Country of Birth	Text	Enter the name of the country where Person 5 was born.
Person 5 Date of Birth	Date	Enter Person 5's date of birth.
Petitioner — Citizenship Acquisition (Select one)
Birth in the United States	Checkbox	Check this box if your U.S. citizenship was acquired by being born in the United States. Fill only if 'U.S. Citizen' is 'Yes'. Depends on: U.S. Citizen
Naturalization	Checkbox	Check this box if your U.S. citizenship was acquired through the naturalization process. Fill only if 'U.S. Citizen' is 'Yes'. Depends on: U.S. Citizen
Parents	Checkbox	Check this box if your U.S. citizenship was acquired automatically or derivatively through one or both parents. Fill only if 'U.S. Citizen' is 'Yes'. Depends on: U.S. Citizen
Petitioner — Citizenship Status (I am a)
U.S. Citizen	Checkbox	Check this box if you are a U.S. citizen (select only this box if it applies).
Lawful Permanent Resident	Checkbox	Check this box if you are a lawful permanent resident (select only this box if it applies).
Petitioner — Country of Birth and Residence
City/Town/Village of Residence	Text	Enter the name of the city, town, or village where you currently reside.
Country of Residence	Text	Enter the full name of the country where you currently live or normally reside.
Country of Birth	Text	Enter the full name of the country in which you were born.
Petitioner's Contact Information
Petitioner's Daytime Telephone Number	Text	Enter the petitioner's daytime telephone number where they can be reached during business hours, including country and area code if applicable. Max length: 10 characters
Petitioner's Email Address (if any)	Text	Enter the petitioner's email address for contact, if they have one. Max length: 38 characters
Petitioner's Mobile Telephone Number (if any)	Text	Enter the petitioner's mobile/cell telephone number, including country and area code if applicable, if they have one. Max length: 10 characters
Petitioner's Signature and Date
Date of Signature	Date	Enter the date when the petitioner signed this form.
Petitioner's Signature	Text	Enter the petitioner's full handwritten signature exactly as signed to certify the petition.
Petitioner's Statement - Language/Interpreter
1.a I can read and understand English	Checkbox	Check this box if you personally can read and understand English and have read and understood every question and instruction on the petition and your answers to every question.
1.b The interpreter named in Part 7 read to me every question and instruction	Checkbox	Check this box if an interpreter (identified in Part 7) read every question and instruction on the petition to you in a language you understand, and you understood the interpreter's translation and your answers.
Interpreter language	Text	Enter the language the interpreter used to interpret the form for you (for example, "Spanish"), i.e., the language in which you were read the questions and answers. Fill only if '1.b The interpreter named in Part 7 read to me every question and instruction' Fill only if 1.b. is 'Yes'. Depends on: 1.b The interpreter named in Part 7 read to me every question and instruction
Physical Address 1 (Items 12.a-13.b)
Physical Address 1 - Date From (13.a)	Date	Enter the date you began living at this Physical Address 1.
Physical Address 1 - Street Number and Name (12.a)	Text	Enter the street number and full street name for Physical Address 1. Max length: 34 characters
Physical Address 1 - 12.b Apt.	Checkbox	Check this box when the physical address includes an apartment (Apt.) number.
Physical Address 1 - 12.b Ste.	Checkbox	Check this box when the physical address includes a suite (Ste.) number.
Physical Address 1 - 12.b Flr.	Checkbox	Check this box when the physical address includes a floor (Flr.) designation.
Physical Address 1 - Apartment/Suite/Floor (12.b)	Text	Enter the apartment, unit, suite, or floor number for Physical Address 1, if applicable. Fill only if '12.b Apt' is 'Yes'. Max length: 6 characters
Physical Address 1 - City or Town (12.c)	Text	Enter the city or town for Physical Address 1. Max length: 20 characters
Physical Address 1 - State (12.d)	Combobox	Enter the state, province, or region for Physical Address 1. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC
Physical Address 1 - ZIP Code (12.e)	Text	Enter the ZIP or postal code used for Physical Address 1. Max length: 5 characters
Physical Address 1 - Province (12.f)	Text	Enter the province, region, or administrative area for Physical Address 1, if applicable. Max length: 20 characters
Physical Address 1 - Country (12.h)	Text	Enter the country name for Physical Address 1.
Physical Address 1 - Postal Code (12.g)	Text	Enter the international postal code for Physical Address 1, if applicable. Max length: 9 characters
Physical Address 1 - Date To (13.b)	Date	Enter the date you stopped living at this Physical Address 1 (or leave blank if currently living there).
Physical Address 2 (Items 14.a-15.b)
Physical Address 2 - 14.a Street Number and Name	Text	Enter the street number and full street name for your second physical address. Fill only if 'Is your current mailing address the same as your physical address?' is 'No'. Max length: 34 characters
Physical Address 2 - 14.b Apt.	Checkbox	Check this box if the Physical Address 2 location is an apartment (enter the apartment number in the adjacent field).
Physical Address 2 - 14.b Ste.	Checkbox	Check this box if the Physical Address 2 location is a suite (enter the suite number in the adjacent field).
Physical Address 2 - 14.b Flr.	Checkbox	Check this box if the Physical Address 2 location is a floor (enter the floor number in the adjacent field).
Physical Address 2 - 14.b Apartment, Suite, or Floor	Text	Enter an apartment, suite, or floor identifier for this address, if applicable; leave blank if none. Fill only if 'Is your current mailing address the same as your physical address?' is 'No'. Max length: 6 characters
Physical Address 2 - 14.c City or Town	Text	Enter the city or town of the second physical address. Fill only if 'Is your current mailing address the same as your physical address?' is 'No'. Max length: 20 characters
Physical Address 2 - 14.d State	Combobox	Enter the state or primary administrative region for this address. Fill only if 'Is your current mailing address the same as your physical address?' is 'No'. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC
Physical Address 2 - 14.e ZIP Code	Text	Enter the ZIP code for this address, if applicable. Fill only if 'Is your current mailing address the same as your physical address?' is 'No'. Max length: 5 characters
Physical Address 2 - 14.f Province	Text	Enter the province, territory, or regional subdivision for this address, if applicable. Fill only if 'Is your current mailing address the same as your physical address?' is 'No'. Max length: 20 characters
Physical Address 2 - 14.h Country	Text	Enter the country name for this address. Fill only if 'Is your current mailing address the same as your physical address?' is 'No'.
Physical Address 2 - 14.g Postal Code	Text	Enter the international postal code for this address, if applicable. Fill only if 'Is your current mailing address the same as your physical address?' is 'No'. Max length: 9 characters
Physical Address 2 - 15.a Date From	Date	Enter the date you began living at this physical address. Fill only if 'Is your current mailing address the same as your physical address?' is 'No'.
Physical Address 2 - 15.b Date To	Date	Enter the date you stopped living at this physical address or leave blank if you currently reside there. Fill only if 'Is your current mailing address the same as your physical address?' is 'No'.
Place of Beneficiary's Current Marriage (City, State, Province, Country)
Province of Current Marriage	Text	Enter the province (if applicable) where the beneficiary's current marriage took place; if not applicable, leave blank or enter N/A as directed. Fill only if 'Married' Married is 'Yes'. Max length: 20 characters Depends on: Married
City or Town of Current Marriage	Text	Enter the name of the city or town where the beneficiary's current marriage took place. Fill only if 'Married' Married is 'Yes'. Max length: 20 characters Depends on: Married
State of Current Marriage	Combobox	Enter the state (or equivalent first-level administrative region) where the beneficiary's current marriage took place. Fill only if 'Married' Married is 'Yes'. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC Depends on: Married
Country of Current Marriage	Text	Enter the country where the beneficiary's current marriage took place. Fill only if 'Married' Married is 'Yes'. Depends on: Married
Place of Current Marriage (City, State, Province, Country)
City or Town of Current Marriage	Text	Enter the city, town, or village where your current marriage took place. Fill only if 'Current Marital Status' is 'Married'. Max length: 20 characters Depends on: 17. Married
State/Region of Current Marriage	Combobox	Enter the state, region, or territory (if applicable) where your current marriage took place. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC
Province of Current Marriage	Text	Enter the province or similar administrative division where your current marriage took place. Fill only if 'Current Marital Status' is 'Married'. Max length: 20 characters Depends on: 17. Married
Country of Current Marriage	Text	Enter the country where your current marriage took place. Fill only if 'Current Marital Status' is 'Married'. Depends on: 17. Married
Preparer Information (At Petitioner's Request)
At my request, the preparer named in Part 8	Checkbox	Check this box when the petitioner is confirming that, at the petitioner's request, the preparer named in Part 8 prepared this petition based only on information the petitioner provided or authorized.
Preparer Named in Part 8 — Name	Text	Enter the full name of the preparer (the person referenced in Part 8) who prepared this petition at the petitioner’s request. Fill only if 'At my request, the preparer named in Part 8' Fill only if 2. is 'Yes'. Depends on: At my request, the preparer named in Part 8
Preparer's Contact Information
Preparer's Mobile Telephone Number (if any)	Text	Enter the preparer's mobile/cell phone number, if available, including area code and any necessary country or extension codes. Fill only if 'At my request, the preparer named in Part 8., ______________________, prepared this petition for me based only upon information I provided or authorized.' is 'Yes'. Max length: 10 characters Depends on: At my request, the preparer named in Part 8
Preparer's Daytime Telephone Number	Text	Enter the preparer's primary daytime telephone number where they can be reached, including area code and any necessary country or extension codes. Fill only if 'At my request, the preparer named in Part 8., ______________________, prepared this petition for me based only upon information I provided or authorized.' is 'Yes'. Max length: 10 characters Depends on: At my request, the preparer named in Part 8
Preparer's Email Address (if any)	Text	Enter the preparer's email address for contact, if they have one. Fill only if 'At my request, the preparer named in Part 8., ______________________, prepared this petition for me based only upon information I provided or authorized.' is 'Yes'. Max length: 38 characters Depends on: At my request, the preparer named in Part 8
Preparer's Full Name and Business (Part 8, Items 1.a-2)
Part 8, Item 1.b - Preparer's Given Name (First Name)	Text	Enter the preparer's given (first) name as it should appear on the form. Fill only if 'Part 6, Item 2 — Petitioner's Statement (At my request, the preparer named in Part 8...)' is 'Yes'. Depends on: At my request, the preparer named in Part 8
Part 8, Item 2 - Preparer's Business or Organization Name (if any)	Text	Enter the name of the preparer's business or organization, or leave blank if none. Fill only if 'Part 6, Item 2 — Petitioner's Statement (At my request, the preparer named in Part 8...)' is 'Yes'. Max length: 34 characters Depends on: At my request, the preparer named in Part 8
Part 8, Item 1.a - Preparer's Family Name (Last Name)	Text	Enter the preparer's family (last) name as it should appear on the form. Fill only if 'Part 6, Item 2 — Petitioner's Statement (At my request, the preparer named in Part 8...)' is 'Yes'. Depends on: At my request, the preparer named in Part 8
Preparer's Mailing Address (Part 8, Items 3.a-3.h)
Preparer's City or Town (3.c)	Text	Enter the city or town for the preparer's mailing address. Fill only if 'Part 6, Item 2 — Petitioner's Statement (At my request, the preparer named in Part 8...)' is 'Yes'. Max length: 20 characters Depends on: At my request, the preparer named in Part 8
Preparer's Street Number and Name (3.a)	Text	Enter the street number and street name for the preparer's mailing address. Fill only if 'Part 6, Item 2 — Petitioner's Statement (At my request, the preparer named in Part 8...)' is 'Yes'. Max length: 34 characters Depends on: At my request, the preparer named in Part 8
3.b. Apartment (Apt.)	Checkbox	Check this box if the preparer's mailing address includes an apartment number (Apt.), and then enter the apartment number in the adjacent field. Fill only if 'Part 6, Item 2 — Petitioner's Statement (At my request, the preparer named in Part 8...)' is 'Yes'. Depends on: At my request, the preparer named in Part 8
3.b. Suite (Ste.)	Checkbox	Check this box if the preparer's mailing address includes a suite number (Ste.), and then enter the suite number in the adjacent field. Fill only if 'Part 6, Item 2 — Petitioner's Statement (At my request, the preparer named in Part 8...)' is 'Yes'. Depends on: At my request, the preparer named in Part 8
3.b. Floor (Flr.)	Checkbox	Check this box if the preparer's mailing address includes a floor number (Flr.), and then enter the floor number in the adjacent field. Fill only if 'Part 6, Item 2 — Petitioner's Statement (At my request, the preparer named in Part 8...)' is 'Yes'. Depends on: At my request, the preparer named in Part 8
Preparer's Apt./Ste./Flr. (3.b)	Text	Enter the apartment, suite, or floor number for the preparer's mailing address, if applicable. Fill only if 'Part 6, Item 2 — Petitioner's Statement (At my request, the preparer named in Part 8...)' is 'Yes'. Max length: 5 characters Depends on: At my request, the preparer named in Part 8
Preparer's Postal Code (3.g)	Text	Enter the postal code for the preparer's mailing address (typically used for non-U.S. addresses). Fill only if 'Preparer's Country (3.h)' is not 'United States'. Max length: 9 characters Depends on: Preparer's Country (3.h)
Preparer's ZIP Code (3.e)	Text	Enter the U.S. ZIP code for the preparer's mailing address. Fill only if 'Preparer's Country (3.h)' is 'United States'. Max length: 5 characters Depends on: Preparer's Country (3.h)
Preparer's State (3.d)	Combobox	Enter the U.S. state or territory for the preparer's mailing address (postal abbreviation or full name). Fill only if 'Preparer's Country (3.h)' is 'United States'. MT PR OK NY AS MI NJ VA MP TX RI NH WY AL LA ME AE SD KY IL CA MA NE AZ VI WI NM NV ND AR PW AK PA IN MD CO FM NC HI CT OH SC IA GA MO MN ID OR TN VT AP AA MS MH GU WV FL WA DE KS UT DC Depends on: Preparer's Country (3.h)
Preparer's Country (3.h)	Text	Enter the country name for the preparer's mailing address. Fill only if 'Part 6, Item 2 — Petitioner's Statement (At my request, the preparer named in Part 8...)' is 'Yes'. Depends on: At my request, the preparer named in Part 8
Preparer's Province (3.f)	Text	Enter the province, region, or administrative division for the preparer's mailing address, if applicable. Fill only if 'Preparer's Country (3.h)' is not 'United States'. Max length: 20 characters Depends on: Preparer's Country (3.h)
Preparer's Signature (signature and date)
Preparer's Signature (8.a)	Text	Enter the preparer's handwritten signature (the person who prepared the petition) exactly as signed in ink. Fill only if '7.a Preparer is not an attorney or accredited representative', '7.b I am an attorney or accredited representative' is 'Yes' (any). Max length: 1 characters Depends on: 7.a Preparer is not an attorney or accredited representative, 7.b I am an attorney or accredited representative
Date of Signature (8.b)	Date	Enter the date when the preparer signed the petition. Fill only if '7.a Preparer is not an attorney or accredited representative', '7.b I am an attorney or accredited representative' is 'Yes' (any). Depends on: 7.a Preparer is not an attorney or accredited representative, 7.b I am an attorney or accredited representative
Preparer's Statement 7.a
7.a Preparer is not an attorney or accredited representative	Checkbox	Check this box if you prepared the petition on behalf of the petitioner, you are not an attorney or accredited representative, and you did so with the petitioner's consent. Fill only if 'At my request, the preparer named in Part 8., ______________________, prepared this petition for me based only upon information I provided or authorized.' is 'Yes'. Depends on: At my request, the preparer named in Part 8
Preparer's Statement 7.b (representation extent)
7.b I am an attorney or accredited representative	Checkbox	Check this box if you are an attorney or accredited representative and you are stating that you represent the petitioner in this case. Fill only if 'At my request, the preparer named in Part 8., ______________________, prepared this petition for me based only upon information I provided or authorized.' is 'Yes'. Depends on: At my request, the preparer named in Part 8
7.b Representation extends beyond preparation	Checkbox	Check this box if your representation of the petitioner extends beyond merely preparing this petition. Fill only if '7.b I am an attorney or accredited representative' is 'Yes'. Depends on: 7.b I am an attorney or accredited representative
7.b Representation does not extend beyond preparation	Checkbox	Check this box if your representation of the petitioner is limited to preparing this petition and does not extend beyond that role. Fill only if '7.b I am an attorney or accredited representative' is 'Yes'. Depends on: 7.b I am an attorney or accredited representative
Prior Petition Filed (Yes / No / Unknown)
Prior Petition Filed — Yes (Item 10)	Checkbox	Check this box if someone other than the petitioner has previously filed a petition for the beneficiary.
Prior Petition Filed — No (Item 10)	Checkbox	Check this box if no one has ever filed a petition for the beneficiary.
Prior Petition Filed — Unknown (Item 10)	Checkbox	Check this box only if you and the beneficiary do not know whether anyone has ever filed a petition for the beneficiary.
Race (Part 3 - Item 2)
Part 3 - Item 2: Black or African American	Checkbox	Check this box if you identify your race as Black or African American (select all applicable boxes).
Part 3 - Item 2: American Indian or Alaska Native	Checkbox	Check this box if you identify your race as American Indian or Alaska Native (select all applicable boxes).
Part 3 - Item 2: White	Checkbox	Check this box if you identify your race as White (select all applicable boxes).
Part 3 - Item 2: Asian	Checkbox	Check this box if you identify your race as Asian (select all applicable boxes).
Part 3 - Item 2: Native Hawaiian or Other Pacific Islander	Checkbox	Check this box if you identify your race as Native Hawaiian or Other Pacific Islander (select all applicable boxes).
Relative 1 - Name and Relationship
Relative 1 - Relationship	Text	Enter the relationship of Relative 1 to the petitioner (for example, spouse, child, parent, sibling). Max length: 29 characters
Relative 1 - Family Name (Last Name)	Text	Enter Relative 1's family name (last name) exactly as it appears on their legal documents.
Relative 1 - Given Name (First Name)	Text	Enter Relative 1's given name (first name) exactly as it appears on their legal documents.
Relative 1 - Middle Name	Text	Enter Relative 1's middle name or initial as it appears on their legal documents, or leave blank if none.
Relative 2 Name and Relationship
Relative 2 Middle Name	Text	Enter the middle name(s) of Relative 2; if they have no middle name, leave this field blank. Fill only if 'You are also submitting separate petitions for other relatives' is 'Yes'.
Relative 2 Given Name (First Name)	Text	Enter the given or first name of Relative 2 as it appears on their legal documents. Fill only if 'You are also submitting separate petitions for other relatives' is 'Yes'.
Relative 2 Family Name (Last Name)	Text	Enter the family (last) name or surname of Relative 2 exactly as shown on their legal documents. Fill only if 'You are also submitting separate petitions for other relatives' is 'Yes'.
Relative 2 Relationship to Petitioner	Text	Enter the relationship of Relative 2 to the petitioner (for example, 'mother', 'brother', 'spouse'). Fill only if 'You are also submitting separate petitions for other relatives' is 'Yes'. Max length: 29 characters
Sex (Male / Female)
Male	Checkbox	Check this box if the beneficiary's sex is male.
Female	Checkbox	Check this box if the beneficiary's sex is female.
Spouse 1 — Name and Date Marriage Ended
Spouse 1 — Family Name (Last Name)	Text	Enter the spouse's family/last name as it appears on legal records. Fill only if 'How many times have you been married?' is greater than 0. Depends on: 16. Number of times you have been married
Spouse 1 — Given Name (First Name)	Text	Enter the spouse's given or first name. Fill only if 'How many times have you been married?' is greater than 0. Depends on: 16. Number of times you have been married
Spouse 1 — Middle Name	Text	Enter the spouse's middle name(s), if any; otherwise leave this field blank. Fill only if 'How many times have you been married?' is greater than 0. Depends on: 16. Number of times you have been married
Spouse 1 — Date Marriage Ended	Date	Enter the date on which the marriage to this spouse ended. Fill only if 'How many times have you been married?' is greater than 0. Depends on: 16. Number of times you have been married
Spouse 1 (Name and Date Marriage Ended)
Spouse 1 - Family Name (Last Name)	Text	Enter the spouse's family/last name as it appears on legal or official documents. Fill only if 'Number of times married' How many times has the beneficiary been married? is greater than or equal to 1. Depends on: Number of times married
Spouse 1 - Given Name (First Name)	Text	Enter the spouse's given/first name. Fill only if 'Number of times married' How many times has the beneficiary been married? is greater than or equal to 1. Depends on: Number of times married
Spouse 1 - Middle Name	Text	Enter the spouse's middle name(s), or leave blank if none. Fill only if 'Number of times married' How many times has the beneficiary been married? is greater than or equal to 1. Depends on: Number of times married
Spouse 1 - Date Marriage Ended	Date	Enter the date when this marriage ended for the spouse. Fill only if 'Number of times married' How many times has the beneficiary been married? is greater than or equal to 1. Depends on: Number of times married
Spouse 2 — Name and Date Marriage Ended
Spouse 2 — Date Marriage Ended	Date	Enter the date on which Spouse 2's marriage ended. Fill only if 'How many times have you been married?' is greater than 1. Depends on: 16. Number of times you have been married
Spouse 2 — Middle Name	Text	Enter Spouse 2's middle name or initial, if any; leave blank if none. Fill only if 'How many times have you been married?' is greater than 1. Depends on: 16. Number of times you have been married
Spouse 2 — Given Name (First Name)	Text	Enter Spouse 2's given or first name as it appears on legal documents. Fill only if 'How many times have you been married?' is greater than 1. Depends on: 16. Number of times you have been married
Spouse 2 — Family Name (Last Name)	Text	Enter Spouse 2's family or last name as it appears on legal documents. Fill only if 'How many times have you been married?' is greater than 1. Depends on: 16. Number of times you have been married
Spouse 2 (Name)
Spouse 2 — Family Name (Last Name)	Text	Enter the spouse's family (last) name for Spouse 2 exactly as it appears on legal documents. Fill only if 'Number of times married' How many times has the beneficiary been married? is greater than or equal to 2. Depends on: Number of times married
Spouse 2 — Given Name (First Name)	Text	Enter the spouse's given (first) name for Spouse 2 as shown on their legal documents. Fill only if 'Number of times married' How many times has the beneficiary been married? is greater than or equal to 2. Depends on: Number of times married
Spouse 2 — Middle Name	Text	Enter the spouse's middle name for Spouse 2, or leave blank if they have none. Fill only if 'Number of times married' How many times has the beneficiary been married? is greater than or equal to 2. Depends on: Number of times married

Form I-130, Petition for Alien Relative Instructions