Form I-130, Petition for Alien Relative Instructions

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This form contains 451 fields organized into 110 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Additional Information Entry 3 (Page/Part/Item and Explanation)
Entry 3 Page Number Text
Enter the page number of the form that the additional information in this entry refers to.
Max length: 2 characters
Entry 3 Part Number Text
Enter the part number of the form that the additional information in this entry refers to.
Max length: 6 characters
Entry 3 Item Number Text
Enter the item number (or item letter) on the form that the additional information in this entry refers to.
Max length: 6 characters
Entry 3 Explanation Text
Provide the full additional information or explanation that corresponds to the page, part, and item number listed above.
Additional Information Entry 4 (Page/Part/Item and Explanation)
Page Number (Reference) Text
Enter the page number of the form that the additional information in this entry refers to.
Max length: 2 characters
Part Number (Reference) Text
Enter the part number of the form that the additional information in this entry relates to.
Max length: 6 characters
Item Number (Reference) Text
Enter the item number of the form question that you are providing additional information for.
Max length: 6 characters
Explanation / Additional Information Text
Provide the full explanation or additional details that correspond to the referenced page, part, and item number.
Additional Information Entry 5 (Page/Part/Item and Explanation)
Entry 5 Page Number Text
Enter the page number of the form that this additional information refers to.
Max length: 2 characters
Entry 5 Part Number Text
Enter the part number of the form that this additional information refers to.
Max length: 6 characters
Entry 5 Item Number Text
Enter the item number of the form that this additional information refers to.
Max length: 6 characters
Entry 5 Explanation Text
Provide the additional information or explanation for the page, part, and item number listed above.
Additional Information Entry 6 (Page/Part/Item and Explanation)
Page Number (Reference) Text
Enter the page number of the form that this additional information refers to.
Max length: 2 characters
Part Number (Reference) Text
Enter the part number of the form that this additional information relates to.
Max length: 6 characters
Item Number (Reference) Text
Enter the item number (and letter, if applicable) that this additional information is answering or explaining.
Max length: 6 characters
Additional Information Explanation Text
Provide the full additional information or explanation corresponding to the referenced page, part, and item.
Additional Information Entry 7 (Page/Part/Item and Explanation)
Page Number (Additional Information Entry 7) Text
Enter the page number of the form that this additional information refers to.
Max length: 2 characters
Part Number (Additional Information Entry 7) Text
Enter the part number of the form that this additional information refers to.
Max length: 6 characters
Item Number (Additional Information Entry 7) Text
Enter the item number of the form question that this additional information refers to.
Max length: 6 characters
Explanation (Additional Information Entry 7) Text
Provide the additional information or explanation corresponding to the page, part, and item listed above.
Address Outside the United States (Item 13)
Foreign Postal Code Text
Enter the postal code for the beneficiary's address outside the United States.
Max length: 9 characters
Foreign Address Unit (Apt/Ste/Flr) Text
Enter the apartment, suite, or floor information for the beneficiary's address outside the United States, if applicable. Fill only if 'Apt.', 'Ste.', 'Flr.' is 'Yes' and depends on 'any' fields selection.
Max length: 6 characters
Depends on: Apt., Ste., Flr.
Apt. Checkbox
Check this box if the address outside the United States includes an apartment number.
Ste. Checkbox
Check this box if the address outside the United States includes a suite number.
Flr. Checkbox
Check this box if the address outside the United States includes a floor number.
Foreign Street Address Text
Enter the street number and street name of the beneficiary's address outside the United States.
Max length: 34 characters
Foreign City or Town Text
Enter the city or town of the beneficiary's address outside the United States.
Max length: 20 characters
Foreign Country Text
Enter the country where the beneficiary's address outside the United States is located.
Foreign Province Text
Enter the province of the beneficiary's address outside the United States.
Max length: 20 characters
Attorney/Accredited Representative Info (if any)
Form G-28 Attached Checkbox
Check this box if an attorney or accredited representative is representing the petitioner/beneficiary and a signed Form G-28 is included with this filing.
Volag Number Text
Enter the accredited representative’s Volag (voluntary agency) number, if any. Fill only if 'Form G-28 Attached' is 'Yes'.
Max length: 15 characters
Depends on: Form G-28 Attached
Attorney State Bar Number Text
Enter the attorney’s state bar number, if applicable. Fill only if 'Form G-28 Attached' is 'Yes'.
Max length: 10 characters
Depends on: Form G-28 Attached
USCIS Online Account Number (Attorney/Representative) Text
Enter the attorney’s or accredited representative’s USCIS Online Account Number, if any. Fill only if 'Form G-28 Attached' is 'Yes'.
Max length: 12 characters
Depends on: Form G-28 Attached
Beneficiary Contact Information
Mobile Telephone Number Text
Enter the beneficiary's mobile telephone number, if any.
Max length: 15 characters
Email Address Text
Enter the beneficiary's email address, if any.
Beneficiary Current Employer
Current Employer Name Text
Enter the beneficiary's current employer's name (or enter "Unemployed" if the beneficiary is not currently employed).
Max length: 38 characters
Beneficiary Employer Address
Employer Street Address Text
Enter the current employer’s street number and street name.
Max length: 34 characters
Apt. Checkbox
Check this box if the beneficiary’s current employer address is an apartment and you will enter an apartment number.
Ste. Checkbox
Check this box if the beneficiary’s current employer address is a suite and you will enter a suite number.
Flr. Checkbox
Check this box if the beneficiary’s current employer address includes a floor and you will enter a floor number.
Employer Address Unit (Apt/Ste/Flr) Text
Enter the apartment, suite, or floor number for the current employer’s address, if applicable. Fill only if 'Apt.', 'Ste.', 'Flr.' any is 'Yes'.
Max length: 6 characters
Depends on: Apt., Ste., Flr.
Employer City or Town Text
Enter the city or town for the current employer’s address.
Max length: 20 characters
Employer State Combobox
Enter the state for the current employer’s address.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK OR GA KY WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
Employer ZIP Code Text
Enter the ZIP code for the current employer’s address.
Max length: 5 characters
Employer Province Text
Enter the province for the current employer’s address, if applicable.
Max length: 20 characters
Employer Postal Code Text
Enter the postal code for the current employer’s address, if applicable.
Max length: 9 characters
Employer Country Text
Enter the country for the current employer’s address.
Beneficiary Entry Question (Ever in U.S.)
Yes Checkbox
Check this box if the beneficiary has ever been in the United States.
No Checkbox
Check this box if the beneficiary has never been in the United States.
Beneficiary Family Member (Person 1) Information
Person 1 Relationship to Beneficiary Text
Enter Person 1’s relationship to the beneficiary (for example, spouse or child).
Person 1 Family Name (Last Name) Text
Enter Person 1’s family name (last name).
Person 1 Given Name (First Name) Text
Enter Person 1’s given name (first name).
Person 1 Middle Name Text
Enter Person 1’s middle name.
Person 1 Date of Birth Date
Enter Person 1’s date of birth.
Person 1 Country of Birth Text
Enter the country where Person 1 was born.
Beneficiary Family Member (Person 2) Information
Person 2 Relationship to Beneficiary Text
Enter how Person 2 is related to the beneficiary (for example, spouse or child).
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 name (last name).
Person 2 Given Name (First Name) Text
Enter Person 2's given name (first name).
Person 2 Middle Name Text
Enter Person 2's middle name, if any.
Beneficiary Family Member (Person 3) Information
Person 3 First Name Text
Enter Person 3's given name (first name).
Person 3 Middle Name Text
Enter Person 3's middle name, if any.
Person 3 Last Name Text
Enter Person 3's family name (last name).
Person 3 Country of Birth Text
Enter the country where Person 3 was born.
Person 3 Date of Birth Date
Provide Person 3's date of birth.
Person 3 Relationship to Beneficiary Text
Describe how Person 3 is related to the beneficiary (for example, spouse, son, or daughter).
Max length: 29 characters
Beneficiary Foreign Address (Native Written Language)
Apt. Checkbox
Check this box if the beneficiary’s foreign address (in their native written language) includes an apartment number.
Ste. Checkbox
Check this box if the beneficiary’s foreign address (in their native written language) includes a suite number.
Flr. Checkbox
Check this box if the beneficiary’s foreign address (in their native written language) includes a floor number.
Apartment/Suite/Floor (Native Language) Text
Enter the beneficiary’s apartment, suite, or floor identifier (if any) in their native written language. Fill only if 'Apt.', 'Ste.', 'Flr.' is 'Yes' for any fields selection.
Max length: 6 characters
Depends on: Apt., Ste., Flr.
City or Town (Native Language) Text
Enter the beneficiary’s city or town in their native written language.
Max length: 20 characters
Province (Native Language) Text
Enter the beneficiary’s province, state, or region in their native written language.
Max length: 20 characters
Country (Native Language) Text
Enter the beneficiary’s country in their native written language.
Postal Code (Native Language) Text
Enter the beneficiary’s postal code in their native written language.
Max length: 9 characters
Street Number and Name (Native Language) Text
Enter the beneficiary’s street number and street name in their native written language.
Max length: 34 characters
Beneficiary Full Legal Name
Family Name (Last Name) Text
Enter the beneficiary’s family name (last name) as it appears on their legal documents.
Given Name (First Name) Text
Enter the beneficiary’s given name (first name) as it appears on their legal documents.
Middle Name Text
Enter the beneficiary’s middle name as it appears on their legal documents.
Beneficiary Identifiers (A-Number / USCIS Online Account / SSN)
Alien Registration Number (A-Number) Text
Enter the beneficiary’s Alien Registration Number (A-Number), if they have one.
Max length: 9 characters
USCIS Online Account Number Text
Enter the beneficiary’s USCIS Online Account Number, if they have one.
Max length: 12 characters
U.S. Social Security Number (SSN) Text
Enter the beneficiary’s U.S. Social Security Number, if they have one.
Max length: 9 characters
Beneficiary Marital Information
Number of Marriages Text
Enter the total number of times the beneficiary has been married.
Max length: 5 characters
Widowed Checkbox
Check this box if the beneficiary's spouse has died and the beneficiary has not remarried.
Annulled Checkbox
Check this box if the beneficiary's most recent marriage was annulled.
Separated Checkbox
Check this box if the beneficiary is legally or permanently separated from their spouse but not divorced.
Single, Never Married Checkbox
Check this box if the beneficiary has never been married.
Married Checkbox
Check this box if the beneficiary is currently married.
Divorced Checkbox
Check this box if the beneficiary is currently divorced.
Date of Current Marriage Date
Enter the date the beneficiary's current marriage began (if currently married). Fill only if 'Married' is 'Yes'.
Depends on: Married
Beneficiary Name (Native Written Language)
Beneficiary Middle Name (Native Script) Text
Enter the beneficiary’s middle name written in their native written language.
Beneficiary Family Name (Native Script) Text
Enter the beneficiary’s family name (last name) written in their native written language.
Beneficiary Given Name (Native Script) Text
Enter the beneficiary’s given name (first name) written in their native written language.
Beneficiary Physical Address (Item 11)
Province Text
Enter the province for the beneficiary’s physical address, if applicable.
Max length: 20 characters
Postal Code Text
Enter the postal code for the beneficiary’s physical address, if applicable.
Max length: 9 characters
Country Text
Enter the country of the beneficiary’s physical address.
Max length: 29 characters
Street Number and Name Text
Enter the beneficiary’s street number and street name for their physical address.
Max length: 34 characters
Apt. Checkbox
Check this box if the beneficiary’s address in Item 11 includes an apartment number.
Ste. Checkbox
Check this box if the beneficiary’s address in Item 11 includes a suite number.
Flr. Checkbox
Check this box if the beneficiary’s address in Item 11 includes a floor number.
Apartment/Suite/Floor Text
Enter the apartment, suite, or floor identifier for the beneficiary’s physical address, if applicable. Fill only if 'Apt.', 'Ste.', 'Flr.' is 'Yes' and depends on 'any' fields selection.
Max length: 6 characters
Depends on: Apt., Ste., Flr.
City or Town Text
Enter the city or town of the beneficiary’s physical address.
Max length: 20 characters
ZIP Code Text
Enter the ZIP code for the beneficiary’s physical address.
Max length: 5 characters
State Combobox
Enter the state of the beneficiary’s physical address.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK OR GA KY WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
Beneficiary U.S. Entry Details (If Currently in U.S.)
Authorized Stay Expiration (or D/S) Text
Enter the date the beneficiary’s authorized stay expired or will expire as shown on Form I-94 or Form I-95, or enter “D/S” if the beneficiary has duration of status.
Class of Admission Combobox
Enter the beneficiary’s class of admission when he or she arrived in the United States.
U5 FSM C3 C1 H1A TWO GT WB O1 C4 OP CW1 DX H3A TD U4 BE G5 F2 H2 RE5 F1 DE ML H3B IN ST S2 H1B DT WI 1B4 J2 T2 N3 G2 E2 EAO UU O1A CC L1B X N7 E2C S9 EWI PAR SDF P1A WT LZ Q3 E3 TN1 N5 D2 I CW2 T5 U1 IMM E1 M1 V2 K1 N9 R1 D1 J2S K3 L1A 1B1 WD L1 1B5 G3 A3 O1B 1B3 A1 H2B MIS PI ASD 1BS R2 P3S Q1 B2 N8 A2 J1 RE U3 B1D K4 H2A H3 U2 UN G4 H4 V3 M2 P1 B1B P2S P4 AW DA K2 PAL TB H1 O3 Q2 TC H2R P2 TN2 N1 HSC GB T3 AS CH O2 B1 L2 CP N6 T4 1B2 B1C FUG G1 J1S N2 RW S1 P1B V1 H1C N4 C2 B1A P1S T1 P3
I-94 Record Number Text
Enter the beneficiary’s Form I-94 Arrival-Departure Record Number.
Max length: 11 characters
Date of Arrival Date
Enter the date the beneficiary arrived in the United States.
Biographic Information
Weight – Pounds (Hundreds Digit) Text
Enter the hundreds digit of your weight in whole pounds.
Max length: 1 characters
Weight – Pounds (Tens Digit) Text
Enter the tens digit of your weight in whole pounds.
Max length: 1 characters
Weight – Pounds (Ones Digit) Text
Enter the ones digit of your weight in whole pounds.
Max length: 1 characters
Birth Information
Date of Birth Date
Enter your date of birth.
Male Checkbox
Check this box if your sex is male.
Female Checkbox
Check this box if your sex is female.
Country of Birth Text
Enter the country where you were born.
City/Town/Village of Birth Text
Enter the name of the city, town, or village where you were born.
Birth Information (City/Country/Date)
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.
Current Mailing Address Same as Physical Address
Yes Checkbox
Check this box if your current mailing address is the same as your physical address.
No Checkbox
Check this box if your current mailing address is different from your physical address.
Current Marriage Date
Date of Current Marriage Date
Enter the date you were married in your current marriage. Fill only if 'Current Marital Status' is 'Married'.
Depends on: Married
Dates Physically Lived Together
Date Lived Together From Date
Enter the date you and your spouse began physically living together at the address listed above. Fill only if 'I am filing this petition for my' is 'Spouse'.
Depends on: Spouse
Date Lived Together To Date
Enter the date you and your spouse stopped physically living together at the address listed above. Fill only if 'I am filing this petition for my' is 'Spouse'.
Depends on: Spouse
Daytime Telephone Number
Daytime Telephone Number Text
Enter the beneficiary's daytime telephone number (if any).
Max length: 15 characters
Employer 1 Employment Details
Employer 1 Street Address Text
Enter Employer 1’s street number and street name.
Max length: 34 characters
Apt. Checkbox
Check this box if the Employer 1 address includes an apartment number.
Ste. Checkbox
Check this box if the Employer 1 address includes a suite number.
Flr. Checkbox
Check this box if the Employer 1 address includes a floor number.
Employer 1 Address Unit Text
Enter the apartment, suite, or floor identifier for Employer 1’s address (if any).
Max length: 6 characters
Employer 1 City or Town Text
Enter the city or town for Employer 1’s address.
Max length: 20 characters
Employer 1 Province Text
Enter the province for Employer 1’s address, if applicable.
Max length: 20 characters
Employer 1 Postal Code Text
Enter the postal code for Employer 1’s address, if applicable.
Max length: 9 characters
Employer 1 ZIP Code Text
Enter the ZIP code for Employer 1’s address.
Max length: 5 characters
Employer 1 State Combobox
Enter the state for Employer 1’s address.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK OR GA KY WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
Employer 1 Country Text
Enter the country for Employer 1’s address.
Max length: 29 characters
Employer 1 Name Text
Enter the name of your Employer 1 (employer or company).
Max length: 34 characters
Your Occupation (Employer 1) Text
Enter your occupation or job title while working for Employer 1.
Employment Date From (Employer 1) Date
Enter the date you started working for Employer 1.
Employment Date To (Employer 1) Date
Enter the date you stopped working for Employer 1 (or the end date of this employment).
Employer 2 Employment Details
Street Number and Name Text
Enter the street address (number and street name) for your second employer.
Max length: 34 characters
Apt. Checkbox
Check this box if Employer 2’s address includes an apartment number.
Ste. Checkbox
Check this box if Employer 2’s address includes a suite number.
Flr. Checkbox
Check this box if Employer 2’s address includes a floor number.
Address Unit (Apt/Ste/Flr) Text
Enter the apartment, suite, or floor number for your second employer’s address, if applicable.
Max length: 6 characters
City or Town Text
Enter the city or town where your second employer is located.
Max length: 20 characters
Province Text
Enter the province for your second employer’s address, if applicable.
Max length: 20 characters
Postal Code Text
Enter the postal code for your second employer’s address, if applicable.
Max length: 9 characters
ZIP Code Text
Enter the ZIP code for your second employer’s address.
Max length: 5 characters
State Combobox
Enter the state where your second employer is located.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK OR GA KY WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
Country Text
Enter the country where your second employer is located.
Your Occupation Text
Enter your job title or occupation while working for your second employer.
Employment Start Date Date
Enter the date you started working for your second employer.
Employment End Date Date
Enter the date you stopped working for your second employer.
Employer/Company Name Text
Enter the name of your second employer or company.
Max length: 34 characters
Employment Start Date
Employment Start Date Date
Enter the date the beneficiary's current employment began.
Ethnicity (Select One)
Not Hispanic or Latino Checkbox
Check this box if your ethnicity is not Hispanic or Latino.
Hispanic or Latino Checkbox
Check this box if your ethnicity is Hispanic or Latino.
Eye Color (Select One)
Blue Checkbox
Check this box if your eye color is blue (select only one eye color).
Brown Checkbox
Check this box if your eye color is brown (select only one eye color).
Hazel Checkbox
Check this box if your eye color is hazel (select only one eye color).
Pink Checkbox
Check this box if your eye color is pink (select only one eye color).
Maroon Checkbox
Check this box if your eye color is maroon (select only one eye color).
Green Checkbox
Check this box if your eye color is green (select only one eye color).
Gray Checkbox
Check this box if your eye color is gray (select only one eye color).
Black Checkbox
Check this box if your eye color is black (select only one eye color).
Unknown/Other Checkbox
Check this box if your eye color is unknown or not listed (select only one eye color).
Form Identification
Form Identification Code Text
Enter the form’s identification or tracking code to uniquely identify this form submission.
Form Identification Footer Text Text
Enter the form identification information shown in the page footer (such as the form number and edition date).
Form/Page Identifier Text
Enter the form or page identification/tracking text associated with this page as shown in the form footer.
Form Identification Code Text
Enter the form identification or tracking code associated with this page of the form.
Form Metadata
Form Metadata Notes Text
Enter any internal or system metadata associated with this form page if instructed, otherwise leave this field blank.
Form Footer Metadata Text
Enter the internal form footer metadata value exactly as provided (typically used for form tracking or system-generated information).
Form Barcode / Internal Metadata Text
Enter the internal form metadata or barcode string for this page, if provided (otherwise leave this field blank).
Form Processing
Form Processing Notes Text
Enter any notes or internal comments needed to process this form.
Form Processing Notes Text
Enter any internal notes or processing information needed for handling this form.
General Information
Form Internal Tracking Code Text
Enter the internal tracking or barcode value associated with this Form I-130 page, if provided.
Hair Color (select one)
Bald (No hair) Checkbox
Check this box if the person has no hair (is bald).
Black Checkbox
Check this box if the person’s hair color is black.
Blond Checkbox
Check this box if the person’s hair color is blond.
Brown Checkbox
Check this box if the person’s hair color is brown.
Gray Checkbox
Check this box if the person’s hair color is gray.
Red Checkbox
Check this box if the person’s hair color is red.
Sandy Checkbox
Check this box if the person’s hair color is sandy.
White Checkbox
Check this box if the person’s hair color is white.
Unknown/Other Checkbox
Check this box if the person’s hair color is unknown or not listed.
Height
Height (Feet) Combobox
Enter your height in whole feet.
2 5 4 3 8 7 6
Height (Inches) Combobox
Enter the remaining inches of your height in whole inches.
1 2 5 4 3 8 11 0 7 10 6 9
How Petitioner Acquired U.S. Citizenship
Birth in the United States Checkbox
Check this box if you acquired U.S. citizenship 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 you acquired U.S. citizenship by becoming naturalized. Fill only if 'U.S. Citizen' is 'Yes'.
Depends on: U.S. Citizen
Parents Checkbox
Check this box if you acquired U.S. citizenship through your parent(s) (for example, derived or acquired citizenship through parents). Fill only if 'U.S. Citizen' is 'Yes'.
Depends on: U.S. Citizen
Immigration Proceedings Location and Date
Immigration Proceedings City or Town Text
Enter the city or town where the immigration proceedings took place. Fill only if 'Yes' is 'Yes'.
Max length: 20 characters
Depends on: Yes
Immigration Proceedings State Combobox
Enter the state where the immigration proceedings took place. Fill only if 'Yes' is 'Yes'.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK OR GA KY WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
Depends on: Yes
Immigration Proceedings Date Date
Enter the date when the immigration proceedings occurred. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Immigration Proceedings Question
No Checkbox
Check this box if the beneficiary has never been in immigration proceedings.
Yes Checkbox
Check this box if the beneficiary has ever been in immigration proceedings.
Immigration Proceedings Type
Removal Checkbox
Check this box if the beneficiary’s immigration proceedings were removal proceedings. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Exclusion/Deportation Checkbox
Check this box if the beneficiary’s immigration proceedings were exclusion or deportation proceedings. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Rescission Checkbox
Check this box if the beneficiary’s immigration proceedings were rescission proceedings. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Other Judicial Proceedings Checkbox
Check this box if the beneficiary’s immigration proceedings were another type of judicial proceeding not listed above. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Internal Use
Internal Use Notes Text
Enter any internal-use information or notes associated with this form submission.
Interpreter Certification Language
Fluent Language (Non-English) Text
Enter the non-English language in which the interpreter is fluent and that was used to interpret this petition. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Depends on: Interpreter read the petition to me (Part 7)
Interpreter Contact Information
Daytime Telephone Number Text
Enter the interpreter's daytime telephone number where they can be reached. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Max length: 10 characters
Depends on: Interpreter read the petition to me (Part 7)
Email Address Text
Enter the interpreter's email address, if they have one. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Max length: 38 characters
Depends on: Interpreter read the petition to me (Part 7)
Mobile Telephone Number Text
Enter the interpreter's mobile telephone number, if they have one. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Max length: 10 characters
Depends on: Interpreter read the petition to me (Part 7)
Interpreter Full Name
Interpreter Given Name (First Name) Text
Enter the interpreter's given name (first name). Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Depends on: Interpreter read the petition to me (Part 7)
Interpreter Family Name (Last Name) Text
Enter the interpreter's family name (last name). Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Depends on: Interpreter read the petition to me (Part 7)
Interpreter Business or Organization Name Text
Enter the name of the interpreter's business or organization, if any. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Max length: 38 characters
Depends on: Interpreter read the petition to me (Part 7)
Interpreter Mailing Address
City or Town Text
Enter the city or town of the interpreter’s mailing address. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Max length: 20 characters
Depends on: Interpreter read the petition to me (Part 7)
Street Number and Name Text
Enter the interpreter’s street address, including the house/building number and street name. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Max length: 34 characters
Depends on: Interpreter read the petition to me (Part 7)
Apt. Checkbox
Check this box if the interpreter’s mailing address street number and name is for an apartment, and enter the apartment number. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Depends on: Interpreter read the petition to me (Part 7)
Ste. Checkbox
Check this box if the interpreter’s mailing address street number and name is for a suite, and enter the suite number. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Depends on: Interpreter read the petition to me (Part 7)
Flr. Checkbox
Check this box if the interpreter’s mailing address street number and name is for a floor, and enter the floor number. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Depends on: Interpreter read the petition to me (Part 7)
Apartment/Suite/Floor Text
Enter the interpreter’s apartment, suite, or floor number, if applicable. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Max length: 6 characters
Depends on: Interpreter read the petition to me (Part 7)
Postal Code Text
Enter the postal code for the interpreter’s mailing address, if applicable. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Max length: 9 characters
Depends on: Interpreter read the petition to me (Part 7)
ZIP Code Text
Enter the ZIP code for the interpreter’s mailing address. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Max length: 5 characters
Depends on: Interpreter read the petition to me (Part 7)
State Combobox
Enter the state for the interpreter’s mailing address.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK OR GA KY WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
Country Text
Enter the country of the interpreter’s mailing address. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Max length: 29 characters
Depends on: Interpreter read the petition to me (Part 7)
Province Text
Enter the province for the interpreter’s mailing address, if applicable. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Max length: 20 characters
Depends on: Interpreter read the petition to me (Part 7)
Interpreter Signature and Date
Date of Signature Date
Enter the date the interpreter signed the form. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Depends on: Interpreter read the petition to me (Part 7)
Interpreter Signature Text
Enter the interpreter’s signature. Fill only if 'The interpreter named in Part 7. read to me every question and instruction on this petition' is 'Yes'.
Max length: 1 characters
Depends on: Interpreter read the petition to me (Part 7)
Last Address Lived Together (If Filing for Spouse)
Apt. Checkbox
Check this box if the last address where you and your spouse physically lived together included an apartment number. Fill only if 'I am filing this petition for my' is 'Spouse'.
Depends on: Spouse
Ste. Checkbox
Check this box if the last address where you and your spouse physically lived together included a suite number. Fill only if 'I am filing this petition for my' is 'Spouse'.
Depends on: Spouse
Apartment/Suite/Floor Text
Enter the apartment, suite, or floor number for the last address where you and your spouse physically lived together (if applicable). Fill only if 'Apt.', 'Ste.', 'Flr.' is 'Yes' for any fields selection.
Max length: 6 characters
Depends on: Apt., Ste., Flr.
Flr. Checkbox
Check this box if the last address where you and your spouse physically lived together included a floor number. Fill only if 'I am filing this petition for my' is 'Spouse'.
Depends on: Spouse
Street Number and Name Text
Enter the street number and street name of the last address where you and your spouse physically lived together. Fill only if 'I am filing this petition for my' is 'Spouse'.
Max length: 34 characters
Depends on: Spouse
City or Town Text
Enter the city or town for the last address where you and your spouse physically lived together. Fill only if 'I am filing this petition for my' is 'Spouse'.
Max length: 20 characters
Depends on: Spouse
ZIP Code Text
Enter the ZIP code for the last address where you and your spouse physically lived together (if applicable). Fill only if 'I am filing this petition for my' is 'Spouse'.
Max length: 5 characters
Depends on: Spouse
State Combobox
Enter the U.S. state for the last address where you and your spouse physically lived together (if applicable).
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK OR GA KY WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
Province Text
Enter the province for the last address where you and your spouse physically lived together (if applicable). Fill only if 'I am filing this petition for my' is 'Spouse'.
Max length: 20 characters
Depends on: Spouse
Country Text
Enter the country for the last address where you and your spouse physically lived together. Fill only if 'I am filing this petition for my' is 'Spouse'.
Depends on: Spouse
Postal Code Text
Enter the postal code for the last address where you and your spouse physically lived together (if applicable). Fill only if 'I am filing this petition for my' is 'Spouse'.
Max length: 9 characters
Depends on: Spouse
Lawful Permanent Resident Admission Details
Class of Admission Text
Enter the class of admission shown on your permanent resident documentation. Fill only if 'I am a' is 'Lawful Permanent Resident'.
Depends on: Lawful Permanent Resident
Date of Admission Date
Provide 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
Place of Admission – City or Town 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
Place of Admission – State Combobox
Enter the state where you were admitted as a lawful permanent resident.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK GA KY OR WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
LPR Status Obtained Through Marriage (Yes/No)
No Checkbox
Check this box if you did not gain lawful permanent resident (LPR) status through marriage to a U.S. citizen or lawful permanent resident. Fill only if 'I am a' is 'Lawful Permanent Resident'.
Depends on: Lawful Permanent Resident
Yes Checkbox
Check this box if you gained lawful permanent resident (LPR) status through marriage to a U.S. citizen or lawful permanent resident. Fill only if 'I am a' is 'Lawful Permanent Resident'.
Depends on: Lawful Permanent Resident
Mailing Address
Street Number and Name Text
Enter the street number and street name for your mailing address.
Max length: 34 characters
Apt. Checkbox
Check this box if the mailing address uses an apartment number in the address line.
Ste. Checkbox
Check this box if the mailing address uses a suite number in the address line.
Flr. Checkbox
Check this box if the mailing address uses a floor number in the address line.
Apartment/Suite/Floor Text
Enter your apartment, suite, or floor number for this mailing address, if applicable. Fill only if 'Apt.', 'Ste.', 'Flr.' is selected (any).
Max length: 6 characters
Depends on: Apt., Ste., Flr.
City or Town Text
Enter the city or town for your mailing address.
Max length: 20 characters
Province Text
Enter the province for your mailing address, if applicable.
Max length: 20 characters
Postal Code Text
Enter the postal code for your mailing address, if applicable.
Max length: 9 characters
ZIP Code Text
Enter the ZIP code for your mailing address.
Max length: 5 characters
State Combobox
Enter the state for your mailing address.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK OR GA KY WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
Country Text
Enter the country for your mailing address.
In Care Of Name Text
Enter the name of the person or organization that should receive mail at this address, if applicable.
Max length: 34 characters
Marital Information
Number of Marriages Text
Enter the total number of times you have been married.
Max length: 5 characters
Widowed Checkbox
Check this box if your spouse has died and you have not remarried.
Annulled Checkbox
Check this box if your most recent marriage ended by annulment and you are not currently married.
Separated Checkbox
Check this box if you are still legally married but currently separated from your spouse.
Single, Never Married Checkbox
Check this box if you are currently single and have never been married.
Married Checkbox
Check this box if you are currently married.
Divorced Checkbox
Check this box if your most recent marriage ended in divorce and you are not currently married.
Naturalization/Citizenship Certificate Details
Certificate Number Text
Enter the number shown on your Certificate of Naturalization or Certificate of Citizenship. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Date of Issuance Date
Enter the date your Certificate of Naturalization or Certificate of Citizenship was issued. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Place of Issuance Text
Enter the location where your Certificate of Naturalization or Certificate of Citizenship was issued. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Naturalization/Citizenship Certificate Obtained (Yes/No)
Yes Checkbox
Check this box if you have obtained a Certificate of Naturalization or a Certificate of Citizenship.
No Checkbox
Check this box if you have not obtained a Certificate of Naturalization or a Certificate of Citizenship.
Other Names Used
Other Last Name Text
Enter an additional family name (last name) you have ever used, such as a maiden name, alias, or nickname.
Other First Name Text
Enter an additional given name (first name) you have ever used, such as an alias or nickname.
Other Middle Name Text
Enter an additional middle name you have ever used, if any.
Other Names Used (if any)
Other Name Family Name (Last Name) Text
Enter the beneficiary’s family name (last name) as used in another name they have ever used.
Other Name Given Name (First Name) Text
Enter the beneficiary’s given name (first name) as used in another name they have ever used.
Other Name Middle Name Text
Enter the beneficiary’s middle name as used in another name they have ever used.
Parent 1 Date of Birth
Parent 1 Date of Birth Date
Enter Parent 1's date of birth.
Parent 1 Full Name
Parent 1 Last Name Text
Enter Parent 1’s family name (last name).
Parent 1 First Name Text
Enter Parent 1’s given name (first name).
Parent 1 Middle Name Text
Enter Parent 1’s middle name.
Parent 1 Sex
Male Checkbox
Check this box if Parent 1's sex is male.
Female Checkbox
Check this box if Parent 1's sex is female.
Parent 2 Birth and Residence
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 name of the country where Parent 2 currently resides.
Parent 2 Country of Birth Text
Enter the name of the country where Parent 2 was born.
Parent 2 Date of Birth
Parent 2 Date of Birth Date
Enter Parent 2’s date of birth.
Parent 2 Full Name
Parent 2 First Name Text
Enter Parent 2's given name (first name).
Parent 2 Middle Name Text
Enter Parent 2's middle name.
Parent 2 Last Name Text
Enter Parent 2's family name (last name).
Parent 2 Sex
Male Checkbox
Check this box if Parent 2's sex is male.
Female Checkbox
Check this box if Parent 2's sex is female.
Part 1 - Brother/Sister Related by Adoption (Yes/No)
Yes Checkbox
Check this box if the beneficiary is your brother or sister and you are related by adoption. Fill only if 'Brother/Sister' is selected.
Depends on: Brother/Sister
No Checkbox
Check this box if the beneficiary is your brother or sister and you are not related by adoption. Fill only if 'Brother/Sister' is selected.
Depends on: Brother/Sister
Part 1 - Child/Parent Relationship Description (select one)
Child born to married parents Checkbox
Check this box if the child was born to parents who were married to each other at the time of the child’s birth. Fill only if 'Parent', 'Child' is selected (any).
Depends on: Parent, Child
Child adopted (not an Orphan or Hague Convention adoptee) Checkbox
Check this box if the child was adopted and the adoption is not classified as an Orphan adoption or a Hague Convention adoption. Fill only if 'Parent', 'Child' is selected (any).
Depends on: Parent, Child
Stepchild/Stepparent Checkbox
Check this box if the petitioner and beneficiary have a stepchild/stepparent relationship. Fill only if 'Parent', 'Child' is selected (any).
Depends on: Parent, Child
Child born to unmarried parents Checkbox
Check this box if the child was born to parents who were not married to each other at the time of the child’s birth. Fill only if 'Parent', 'Child' is selected (any).
Depends on: Parent, Child
Part 1 - Filing Relationship (select one)
Spouse Checkbox
Check this box if you are filing this petition for your spouse.
Brother/Sister Checkbox
Check this box if you are filing this petition for your brother or sister.
Parent Checkbox
Check this box if you are filing this petition for your parent.
Child Checkbox
Check this box if you are filing this petition for your child.
Part 1 - Gained Lawful Permanent Resident Status or Citizenship Through Adoption (Yes/No)
No Checkbox
Check this box if you did not gain lawful permanent resident status or U.S. citizenship through adoption.
Yes Checkbox
Check this box if you gained lawful permanent resident status or U.S. citizenship through adoption.
Part 2 - Petitioner Full Name
Petitioner Family Name (Last Name) Text
Enter the petitioner's family name (last name).
Petitioner Given Name (First Name) Text
Enter the petitioner's given name (first name).
Petitioner Middle Name Text
Enter the petitioner's middle name, if any.
Part 2 - Petitioner Numbers (A-Number/Online Account/SSN)
Petitioner Social Security Number Text
Enter the petitioner's U.S. Social Security Number, if any.
Max length: 9 characters
Petitioner A-Number Text
Enter the petitioner's Alien Registration Number (A-Number), if any.
Max length: 9 characters
Petitioner USCIS Online Account Number Text
Enter the petitioner's USCIS Online Account Number, if any.
Max length: 12 characters
Passport and Travel Document Details
Passport Number Text
Enter the beneficiary’s passport number as it appears on the passport.
Max length: 30 characters
Travel Document Number Text
Enter the beneficiary’s travel document number as it appears on the travel document.
Country of Issuance Text
Enter the country that issued the beneficiary’s passport or travel document.
Passport/Travel Document Expiration Date Date
Provide the expiration date of the beneficiary’s passport or travel document.
Person 4 Name
Person 4 Middle Name Text
Enter Person 4's middle name.
Person 4 Given Name (First Name) Text
Enter Person 4's given name (first name).
Person 4 Family Name (Last Name) Text
Enter Person 4's family name (last name).
Person 4 Relationship and Birth Details
Person 4 Country of Birth Text
Enter the country where Person 4 was born.
Person 4 Date of Birth Date
Enter Person 4's date of birth.
Person 4 Relationship Text
Enter Person 4's relationship to the petitioner or primary applicant (e.g., spouse, child, parent).
Max length: 29 characters
Person 5 Name
Person 5 Family Name (Last Name) Text
Enter Person 5's family name (last name/surname).
Person 5 Given Name (First Name) Text
Enter Person 5's given name (first name).
Person 5 Middle Name Text
Enter Person 5's middle name, if any.
Person 5 Relationship and Birth Details
Person 5 Relationship Text
Enter Person 5’s relationship to the beneficiary or petitioner as requested on the form.
Max length: 29 characters
Person 5 Country of Birth Text
Enter the country where Person 5 was born.
Person 5 Date of Birth Date
Enter Person 5’s date of birth.
Petitioner A-Number
Petitioner A-Number Text
Enter the petitioner's Alien Registration Number (A-Number), if any.
Max length: 9 characters
Petitioner Birth and Residence
City/Town/Village of Residence Text
Enter the city, town, or village where the petitioner currently resides.
Country of Residence Text
Enter the country where the petitioner currently resides.
Country of Birth Text
Enter the country where the petitioner was born.
Petitioner Citizenship Status (Citizen vs LPR)
U.S. Citizen Checkbox
Check this box if you (the petitioner) are a U.S. citizen.
Lawful Permanent Resident Checkbox
Check this box if you (the petitioner) are a lawful permanent resident (LPR/green card holder) and not a U.S. citizen.
Petitioner Name
Petitioner Family Name (Last Name) Text
Enter the petitioner's family name (last name).
Petitioner Given Name (First Name) Text
Enter the petitioner's given name (first name).
Petitioner Middle Name Text
Enter the petitioner's middle name, if any.
Petitioner's Contact Information
Daytime Telephone Number Text
Enter the petitioner's daytime telephone number.
Max length: 10 characters
Email Address Text
Enter the petitioner's email address, if any.
Max length: 38 characters
Mobile Telephone Number Text
Enter the petitioner's mobile telephone number, if any.
Max length: 10 characters
Petitioner's Signature and Date
Date of Signature Date
Enter the date on which the petitioner signed the petition.
Petitioner's Signature Text
Enter the petitioner's full legal signature as it will appear on the form.
Petitioner's Statement - English/Interpreter Selection
I can read and understand English Checkbox
Check this box if you can read and understand English and you read and understood every question and instruction on this petition.
Interpreter read the petition to me (Part 7) Checkbox
Check this box if the interpreter named in Part 7 read every question and instruction on this petition to you and you understood everything through that interpreter.
Language Interpreted Text
Enter the language in which the interpreter read the questions and instructions to you for this petition. Fill only if 'Interpreter read the petition to me (Part 7)' is 'Yes'.
Depends on: Interpreter read the petition to me (Part 7)
Petitioner's Statement - Preparer Request
Preparer prepared this petition at my request (Part 8) Checkbox
Check this box if you asked the preparer listed in Part 8 to prepare this petition using only information you provided or authorized.
Preparer Name (Part 8) Text
Enter the full name of the preparer listed in Part 8 who prepared this petition at your request. Fill only if 'Preparer prepared this petition at my request (Part 8)' is 'Yes'.
Depends on: Preparer prepared this petition at my request (Part 8)
Physical Address 1 (Address History)
Date From Date
Enter the date you began living at Physical Address 1. Fill only if 'No' is 'Yes'.
Depends on: No
Street Number and Name Text
Enter the street number and street name for Physical Address 1. Fill only if 'No' is 'Yes'.
Max length: 34 characters
Depends on: No
Apt. Checkbox
Check this box if your Physical Address 1 includes an apartment number. Fill only if 'No' is 'Yes'.
Depends on: No
Ste. Checkbox
Check this box if your Physical Address 1 includes a suite number. Fill only if 'No' is 'Yes'.
Depends on: No
Flr. Checkbox
Check this box if your Physical Address 1 includes a floor number. Fill only if 'No' is 'Yes'.
Depends on: No
Apartment/Suite/Floor Text
Enter the apartment, suite, or floor identifier for this address (if any). Fill only if 'No' is 'Yes'.
Max length: 6 characters
Depends on: No
City or Town Text
Enter the city or town for Physical Address 1. Fill only if 'No' is 'Yes'.
Max length: 20 characters
Depends on: No
State Combobox
Enter the state for Physical Address 1. Fill only if 'No' is 'Yes'.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK OR GA KY WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
Depends on: No
ZIP Code Text
Enter the ZIP code for Physical Address 1. Fill only if 'No' is 'Yes'.
Max length: 5 characters
Depends on: No
Province Text
Enter the province for Physical Address 1 (if applicable). Fill only if 'No' is 'Yes'.
Max length: 20 characters
Depends on: No
Country Text
Enter the country where Physical Address 1 is located. Fill only if 'No' is 'Yes'.
Depends on: No
Postal Code Text
Enter the postal code for Physical Address 1 (if applicable). Fill only if 'No' is 'Yes'.
Max length: 9 characters
Depends on: No
Date To Date
Enter the date you stopped living at Physical Address 1. Fill only if 'No' is 'Yes'.
Depends on: No
Physical Address 2 (Address History)
Street Number and Name (Physical Address 2) Text
Enter the street number and street name for your second physical address.
Max length: 34 characters
Apt. Checkbox
Check this box if the Physical Address 2 includes an apartment number.
Ste. Checkbox
Check this box if the Physical Address 2 includes a suite number.
Flr. Checkbox
Check this box if the Physical Address 2 includes a floor number.
Apartment/Suite/Floor (Physical Address 2) Text
Enter the apartment, suite, or floor identifier for this address, if applicable. Fill only if 'Apt.', 'Ste.', 'Flr.' is selected (any).
Max length: 6 characters
Depends on: Apt., Ste., Flr.
City or Town (Physical Address 2) Text
Enter the city or town for your second physical address.
Max length: 20 characters
State (Physical Address 2) Combobox
Enter the state for your second physical address.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK OR GA KY WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
ZIP Code (Physical Address 2) Text
Enter the ZIP code for your second physical address.
Max length: 5 characters
Province (Physical Address 2) Text
Enter the province for your second physical address, if applicable.
Max length: 20 characters
Country (Physical Address 2) Text
Enter the country for your second physical address.
Postal Code (Physical Address 2) Text
Enter the postal code for your second physical address, if applicable.
Max length: 9 characters
Date From (Physical Address 2) Date
Enter the date you started living at this address.
Date To (Physical Address 2) Date
Enter the date you stopped living at this address.
Place of Beneficiary's Current Marriage
Province Text
Enter the province where the beneficiary's current marriage took place. Fill only if 'Married' is 'Yes'.
Max length: 20 characters
Depends on: Married
City or Town Text
Enter the city or town where the beneficiary's current marriage took place. Fill only if 'Married' is 'Yes'.
Max length: 20 characters
Depends on: Married
State Combobox
Enter the state where the beneficiary's current marriage took place. Fill only if 'Married' is 'Yes'.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK OR GA KY WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
Depends on: Married
Country Text
Enter the country where the beneficiary's current marriage took place. Fill only if 'Married' is 'Yes'.
Depends on: Married
Place of Current Marriage
Marriage Place City/Town Text
Enter the city or town where your current marriage took place. Fill only if 'Current Marital Status' is 'Married'.
Max length: 20 characters
Depends on: Married
Marriage Place State Combobox
Enter the state where your current marriage took place.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK OR GA KY WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
Marriage Place Province Text
Enter the province where your current marriage took place. Fill only if 'Current Marital Status' is 'Married'.
Max length: 20 characters
Depends on: Married
Marriage Place Country Text
Enter the country where your current marriage took place. Fill only if 'Current Marital Status' is 'Married'.
Depends on: Married
Preparer Full Name
Preparer Given Name (First Name) Text
Enter the preparer’s given name (first name). Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Depends on: Preparer prepared this petition at my request (Part 8)
Preparer Business or Organization Name Text
Enter the name of the preparer’s business or organization, if any. Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Max length: 34 characters
Depends on: Preparer prepared this petition at my request (Part 8)
Preparer Family Name (Last Name) Text
Enter the preparer’s family name (last name). Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Depends on: Preparer prepared this petition at my request (Part 8)
Preparer Mailing Address
Preparer City or Town Text
Enter the city or town of the preparer’s mailing address. Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Max length: 20 characters
Depends on: Preparer prepared this petition at my request (Part 8)
Preparer Street Number and Name Text
Enter the street number and street name of the preparer’s mailing address. Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Max length: 34 characters
Depends on: Preparer prepared this petition at my request (Part 8)
Apt. Checkbox
Check this box if the preparer’s mailing address is an apartment number. Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Depends on: Preparer prepared this petition at my request (Part 8)
Ste. Checkbox
Check this box if the preparer’s mailing address includes a suite number. Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Depends on: Preparer prepared this petition at my request (Part 8)
Flr. Checkbox
Check this box if the preparer’s mailing address includes a floor number. Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Depends on: Preparer prepared this petition at my request (Part 8)
Preparer Address Unit (Apt/Ste/Flr) Text
Enter the apartment, suite, or floor number for the preparer’s mailing address, if applicable. Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Max length: 5 characters
Depends on: Preparer prepared this petition at my request (Part 8)
Preparer Postal Code Text
Enter the postal code for the preparer’s mailing address, if applicable. Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Max length: 9 characters
Depends on: Preparer prepared this petition at my request (Part 8)
Preparer ZIP Code Text
Enter the ZIP code for the preparer’s mailing address. Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Max length: 5 characters
Depends on: Preparer prepared this petition at my request (Part 8)
Preparer State Combobox
Enter the state of the preparer’s mailing address.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK OR GA KY WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
Preparer Country Text
Enter the country of the preparer’s mailing address. Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Depends on: Preparer prepared this petition at my request (Part 8)
Preparer Province Text
Enter the province for the preparer’s mailing address, if applicable. Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Max length: 20 characters
Depends on: Preparer prepared this petition at my request (Part 8)
Preparer's Contact Information
Preparer Mobile Telephone Number Text
Enter the preparer's mobile telephone number, if any. Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Max length: 10 characters
Depends on: Preparer prepared this petition at my request (Part 8)
Preparer Daytime Telephone Number Text
Enter the preparer's daytime telephone number. Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Max length: 10 characters
Depends on: Preparer prepared this petition at my request (Part 8)
Preparer Email Address Text
Enter the preparer's email address, if any. Fill only if 'At my request, the preparer named in Part 8. prepared this petition for me' is 'Yes'.
Max length: 38 characters
Depends on: Preparer prepared this petition at my request (Part 8)
Preparer's Signature
Preparer Printed Name Text
Enter the preparer’s full name as it should appear in print. Fill only if 'At my request, the preparer named in Part 8 prepared this petition for me' is 'Yes'.
Depends on: Preparer prepared this petition at my request (Part 8)
Preparer Signature Text
Enter the signature of the person who prepared this petition (the preparer signing in ink on the printed form). Fill only if 'At my request, the preparer named in Part 8 prepared this petition for me' is 'Yes'.
Max length: 1 characters
Depends on: Preparer prepared this petition at my request (Part 8)
Date of Signature Date
Enter the date the preparer signed this petition. Fill only if 'At my request, the preparer named in Part 8 prepared this petition for me' is 'Yes'.
Depends on: Preparer prepared this petition at my request (Part 8)
Preparer's Statement
Not an attorney/accredited representative Checkbox
Check this box if you are not an attorney or accredited representative and you prepared this petition for the petitioner with the petitioner’s consent. Fill only if 'At my request, the preparer named in Part 8… prepared this petition for me…' is 'Yes'.
Depends on: Preparer prepared this petition at my request (Part 8)
Attorney or accredited representative Checkbox
Check this box if you are an attorney or accredited representative for the petitioner in this case. Fill only if 'At my request, the preparer named in Part 8… prepared this petition for me…' is 'Yes'.
Depends on: Preparer prepared this petition at my request (Part 8)
Representation extends beyond preparation Checkbox
Check this box if your representation of the petitioner in this case extends beyond preparing this petition. Fill only if 'Attorney or accredited representative' is 'Yes'.
Depends on: Attorney or accredited representative
Representation does not extend beyond preparation Checkbox
Check this box if your representation of the petitioner in this case does not extend beyond preparing this petition. Fill only if 'Attorney or accredited representative' is 'Yes'.
Depends on: Attorney or accredited representative
Previously Filed a Petition for This Beneficiary or Any Other Alien (Yes/No)
Yes Checkbox
Check this box if you have ever previously filed a petition for this beneficiary or for any other alien.
No Checkbox
Check this box if you have never previously filed a petition for this beneficiary or for any other alien.
Prior Petition Details (If Yes)
Prior Petition Beneficiary Last Name Text
Enter the family name (last name) of the person for whom you previously filed a petition. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Prior Petition Beneficiary First Name Text
Enter the given name (first name) of the person for whom you previously filed a petition. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Prior Petition Beneficiary Middle Name Text
Enter the middle name of the person for whom you previously filed a petition, if any. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Prior Petition Result Text
Enter the outcome of the prior petition (for example, approved, denied, or withdrawn). Fill only if 'Yes' is 'Yes'.
Max length: 33 characters
Depends on: Yes
Prior Petition Date Filed Date
Enter the date the prior petition was filed. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Prior Petition Filing City or Town Text
Enter the city or town where the prior petition was filed. Fill only if 'Yes' is 'Yes'.
Max length: 20 characters
Depends on: Yes
Prior Petition Filing State Combobox
Enter the state where the prior petition was filed. Fill only if 'Yes' is 'Yes'.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK GA KY OR WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
Depends on: Yes
Prior Petition Filed for Beneficiary (Yes/No/Unknown)
Yes Checkbox
Check this box if someone else has ever filed a petition for the beneficiary.
No Checkbox
Check this box if no one else has ever filed a petition for the beneficiary.
Unknown Checkbox
Check this box only if you do not know (and the beneficiary also does not know) whether anyone else has ever filed a petition for the beneficiary.
Race (Select All That Apply)
Black or African American Checkbox
Check this box if you identify your race as Black or African American.
American Indian or Alaska Native Checkbox
Check this box if you identify your race as American Indian or Alaska Native.
White Checkbox
Check this box if you identify your race as White.
Asian Checkbox
Check this box if you identify your race as Asian.
Native Hawaiian or Other Pacific Islander Checkbox
Check this box if you identify your race as Native Hawaiian or Other Pacific Islander.
Relative 1 Information
Relationship to Relative 1 Text
Enter your relationship to Relative 1 (for example, sibling, parent, or child).
Max length: 29 characters
Relative 1 Last Name Text
Enter the family name (last name) of Relative 1.
Relative 1 First Name Text
Enter the given name (first name) of Relative 1.
Relative 1 Middle Name Text
Enter the middle name of Relative 1, if any.
Relative 2 Name and Relationship
Relative 2 Middle Name Text
Enter Relative 2's middle name.
Relative 2 Given Name (First Name) Text
Enter Relative 2's given name (first name).
Relative 2 Family Name (Last Name) Text
Enter Relative 2's family name (last name).
Relative 2 Relationship Text
Enter the relationship of Relative 2 to the petitioner (for example, spouse, parent, sibling, child).
Max length: 29 characters
Sex (select one)
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 Information
Spouse 1 Last Name Text
Enter Spouse 1 family name (last name). Fill only if 'Number of Marriages' is greater than 0.
Depends on: Number of Marriages
Spouse 1 First Name Text
Enter Spouse 1 given name (first name). Fill only if 'Number of Marriages' is greater than 0.
Depends on: Number of Marriages
Spouse 1 Middle Name Text
Enter Spouse 1 middle name, if any. Fill only if 'Number of Marriages' is greater than 0.
Depends on: Number of Marriages
Date Marriage to Spouse 1 Ended Date
Enter the date the marriage to Spouse 1 ended. Fill only if 'Number of Marriages', 'Married' is 'No' and is greater than 0, all.
Depends on: Married, Number of Marriages
Spouse 1 Marriage End Date
Spouse 1 Marriage End Date Date
Enter the date your marriage to Spouse 1 ended. Fill only if 'How many times have you been married?' is '1 or more'.
Depends on: Number of Marriages
Spouse 1 Name
Spouse 1 Last Name Text
Enter the family name (last name) of your current spouse (or first listed spouse). Fill only if 'How many times have you been married?' is '1 or more'.
Depends on: Number of Marriages
Spouse 1 First Name Text
Enter the given name (first name) of your current spouse (or first listed spouse). Fill only if 'How many times have you been married?' is '1 or more'.
Depends on: Number of Marriages
Spouse 1 Middle Name Text
Enter the middle name of your current spouse (or first listed spouse), if any. Fill only if 'How many times have you been married?' is '1 or more'.
Depends on: Number of Marriages
Spouse 2 Information
Spouse 2 Family Name (Last Name) Text
Enter the last name (family name) of the beneficiary's spouse 2. Fill only if 'Number of Marriages' is greater than 1.
Depends on: Number of Marriages
Spouse 2 Given Name (First Name) Text
Enter the first name (given name) of the beneficiary's spouse 2. Fill only if 'Number of Marriages' is greater than 1.
Depends on: Number of Marriages
Spouse 2 Middle Name Text
Enter the middle name of the beneficiary's spouse 2, if any. Fill only if 'Number of Marriages' is greater than 1.
Depends on: Number of Marriages
Spouse 2 Date Marriage Ended Date
Enter the date the beneficiary's marriage to spouse 2 ended. Fill only if 'Number of Marriages' is greater than 1.
Depends on: Number of Marriages
Spouse 2 Marriage End Date
Spouse 2 Marriage End Date Date
Enter the date your marriage to Spouse 2 ended. Fill only if 'How many times have you been married?' is '2 or more'.
Depends on: Number of Marriages
Spouse 2 Name
Spouse 2 Middle Name Text
Enter the middle name of your second spouse. Fill only if 'How many times have you been married?' is '2 or more'.
Depends on: Number of Marriages
Spouse 2 Given Name (First Name) Text
Enter the given name (first name) of your second spouse. Fill only if 'How many times have you been married?' is '2 or more'.
Depends on: Number of Marriages
Spouse 2 Family Name (Last Name) Text
Enter the family name (last name) of your second spouse. Fill only if 'How many times have you been married?' is '2 or more'.
Depends on: Number of Marriages
U.S. Embassy/Consulate Location for Immigrant Visa Abroad
Embassy/Consulate City or Town Text
Enter the city or town where the U.S. Embassy or U.S. Consulate is located for the immigrant visa application abroad.
Max length: 20 characters
Embassy/Consulate Province Text
Enter the province, state, or region where the selected U.S. Embassy or U.S. Consulate is located.
Max length: 20 characters
Embassy/Consulate Country Text
Enter the country where the selected U.S. Embassy or U.S. Consulate is located.
U.S. Intended Address (Item 12)
U.S. Intended Street Address Text
Enter the street number and street name of the U.S. address where the beneficiary intends to live.
Max length: 34 characters
Apt. Checkbox
Check this box if the U.S. intended address (Item 12) is an apartment and you will provide an apartment number.
Ste. Checkbox
Check this box if the U.S. intended address (Item 12) is a suite and you will provide a suite number.
Flr. Checkbox
Check this box if the U.S. intended address (Item 12) includes a floor and you will provide a floor number.
U.S. Intended Address Unit Number Text
Enter the apartment, suite, or floor number for the U.S. intended address (as applicable). Fill only if 'Apt.', 'Ste.', 'Flr.' is 'Yes' and depends on 'any' fields selection.
Max length: 6 characters
Depends on: Apt., Ste., Flr.
U.S. Intended City or Town Text
Enter the city or town for the U.S. address where the beneficiary intends to live.
Max length: 20 characters
U.S. Intended ZIP Code Text
Enter the ZIP Code for the U.S. address where the beneficiary intends to live.
Max length: 5 characters
U.S. Intended State Combobox
Enter the U.S. state for the address where the beneficiary intends to live.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK GA KY OR WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
USCIS Office Location for Adjustment of Status
USCIS Office City or Town Text
Enter the city or town where the USCIS office is located for the beneficiary’s adjustment of status application.
Max length: 20 characters
USCIS Office State Combobox
Enter the U.S. state where the USCIS office is located for the beneficiary’s adjustment of status application.
NY NE AR SC UT MO VA NC OH ND PW MI MS RI TX PA VI AK GA KY OR WA AS PR HI AA NH MD MN MH GU NV SD KS LA DE CO IN IL CT MP NJ MA MT IA AP ID WY TN DC VT WV AZ CA WI ME FM AL NM OK AE FL
Weight
Weight (Pounds) Text
Enter your current body weight in pounds.
Max length: 3 characters