Sample Form I-130 - Petition for Alien Relative

1 form I-130 02/13/19 Page 1 of 12 Petition for Alien Relative Department of Homeland Security Citizenship and Immigration Services For USCIS Use OnlyDid you gain lawful permanent resident status orcitizenship through adoption?USCISForm I-130 OMB No. 1615-0012 Expires 02/28/2021 Attorney State Bar Number (if applicable)Select this box if form G-28 is Number(if any)Attorney or Accredited Representative USCIS Online Account Number (if any)To be completed by an attorney or accredited representative (if any).START HERE - Type or print in black ink. A-NumberRemarksAction StampFee StampPetition was filed on (Priority Date mm/dd/yyyy):PDR request granted/denied - New priority date (mm/dd/yyyy): Previously ForwardedI-485 Filed SimultaneouslyBen. A-File Reviewed204(a)(2)(A) Resolved203(g) Resolved204(g) ResolvedField Investigation201(b) Spouse - IR-1/CR-1201(b) Child - IR-2/CR-2201(b) Parent - IR-5203(a)(1) Unm.

2 S/D - F1-1203(a)(2)(A) Spouse - F2-1203(a)(2)(A) Child - F2-2203(a)(2)(B) Unm. S/D - F2-4203(a)(3) Married S/D - F3-1203(a)(4) Brother/Sister - F4-1 Section of Law/Visa CategoryResubmittedInitial ReceiptCompletedSentReceivedApprovedRetu rnedRelocatedPart 1. Relationship (You are the Petitioner. Your Relative is the Beneficiary) am filing this Petition for my (Select only one box):Child was adopted (not an Orphan or Hague Convention adoptee) the beneficiary is your brother/sister, are you related by adoption? you are filing this Petition for your child or parent,select the box that describes your relationship (Select onlyone box):Child was born to parents who were married to each other at the time of the child's birth Child was born to parents who were not married to each other at the time of the child's birthA-Your Full Name(Last Name) Name(First Name) Social Security Number (if any)Personal InterviewPet.

3 A-File ReviewedSpouseBrother/SisterParentChildY esNoYesNo Part 2. Information About You (Petitioner) Registration Number (A-Number) (if any)USCIS Online Account Number (if any)2. A- If you need extra space to complete any section of this Petition , use the space provided in Part 9. Additional and submit as many copies of Part 9., as necessary, with your which USCIS office ( , NBC, VSC, LOS, CRO) was form I-130 adjudicated? SAMPLEForm I-130 02/13/19 Page 2 of 12 Part 2. Information About You (Petitioner)(continued) of Birth of Birth (mm/dd/yyyy) your current mailing address the same as your physical address? or TownProvinceCountryPostal Code ZIP Numberand Care Of Name Numberand or CodeProvinceCountryPostal CodePhysical Address 2If you answered "No" to Item Number 11.

4 , provide information on your physical address in Item Numbers - From (mm/dd/yyyy) To (mm/dd/yyyy) From (mm/dd/yyyy) To (mm/dd/yyyy) Numberand or CodeProvinceCountryPostal CodePhysical Address 1 Address HistoryProvide your physical addresses for the last five years, whether inside or outside the United States. Provide your current address first if it is different from your mailing address in ItemNumbers - of Birth Other Names Used (if any)Provide all other names you have ever used, including aliases,maiden name, and Name (Last Name) Name (First Name) many times have you been married? Marital StatusYour Marital Information WidowedAnnulledSeparatedSingle, Never MarriedMarriedDivorced12/22/1974 India123 Park Avenue45 Edison08837 NJUSAR ahul GuptaMuradabad SAMPLEForm I-130 02/13/19 Page 3 of Name (Last Name) Name (First Name) NameNames of All Your Spouses (if any)Spouse 1 Provide information on your current spouse (if currently married)first and then list all your prior spouses (if any).

5 Place of Your Current Marriage (if married)Part 2. Information About You (Petitioner)(continued)Date Marriage Ended (mm/dd/yyyy) Name (First Name) Name (Last Name) Marriage Ended (mm/dd/yyyy) of Current Marriage (if currently married)(mm/dd/yyyy)Parent 1's InformationInformation About Your ParentsGiven Name (First Name) Middle NameFamily Name(Last Name) of Birth (mm/dd/yyyy) of ResidenceCity/Town/Village of of Birth 2's InformationGiven Name (First Name) Middle NameFamily Name(Last Name) of Birth (mm/dd/yyyy) of ResidenceCity/Town/Village of of Birth Additional Information About You (Petitioner) am a (Select only one box) CitizenLawful Permanent ResidentIf you are a citizen, complete Item Number citizenship was acquired through (Select only onebox).

6 Birth in the United StatesNaturalizationParentsIf you answered "Yes" to Item Number 38., complete the following:Certificate you obtained a Certificate of Naturalization or a Certificate of Citizenship? of Issuance (mm/dd/yyyy)Place of Name of Parent 1 Full Name of Parent or UPIndiaIndiaSitaGupta08/01/1950 Muradabad UPIndiaIndia456789012309/01/2005 Parsipanny, SAMPLEForm I-130 02/13/19 Page 4 of 12If you are a lawful permanent resident, complete Item Numbers - of of Admission (mm/dd/yyyy)Place of or TownDid you gain lawful permanent resident status through marriage to a citizen or lawful permanent resident? 2. Information About You (Petitioner)(continued)Employment HistoryProvide your employment history for the last five years, whetherinside or outside the United States.

7 Provide your currentemployment first. If you are currently unemployed, type or print"Unemployed" inItem Number or Code ZIP Numberand of Employer/CompanyCity or Code ZIP Numberand OccupationDate From (mm/dd/yyyy) To (mm/dd/yyyy) Hispanic or LatinoHispanic or LatinoEthnicity (Select only one box)Race (Select all applicable boxes)Native Hawaiian or Other Pacific IslanderBlack or African AmericanAmerican Indian or Alaska 3. Biographic InformationNOTE:Provide the biographic information about you, the of OccupationDate From (mm/dd/yyyy) To (mm/dd/yyyy) Color (Select only one box) Wood Ave S500 Iselin08830 NJUSAStar Techonlogies Inc68 Whippany RdWhippany08812 NJUSAS oftware Engineer07/05/200208/31/201057175 Moon Technologies IncSoftware Engineer09/01 SAMPLEForm I-130 02/13/19 Page 5 of 12 Part 4.

8 Information About Registration Number (A-Number) (if any) A-USCIS Online Account Number (if any)2. Social Security Number (if any) Beneficiary's Full Name (Last Name) Name (First Name) Name (Last Name) Name (First Name) NameOther Names Used (if any)Provide all other names the beneficiary has ever used, including aliases, maiden name, and nicknames. Other Information About of Birth Code Provide the address in the United States where the beneficiary intends to live, if different from Item Numbers - If the address is the same, type or print "SAME" in Item Number or CodeStreet Number and Address and Contact or the beneficiary's address outside the United States, if different from Item Numbers - If the address is the same, type or print "SAME" in Item Number Number and 's Physical the beneficiary lives outside the United States in a home without a street number or name, leave Item Numbers and Numberand or TownZIP of Birth (mm/dd/yyyy) Color (Select only one box)BlackBrownRedWhiteUnknown/OtherSandy GrayBlondBald (No hair) 3.

9 Biographic Information (continued)Has anyone else ever filed a Petition for the beneficiary? Telephone Number (if any)NOTE:Select "Unknown" only if you do not know, and the beneficiary also does not know, if anyone else has ever filed a Petition for the UPIndiaMaharashtra400 001 India123 Park Avenue45 Edison08837 NJSAME4456 Laurel St78 Mumbai11/20 SAMPLEForm I-130 02/13/19 Page 6 of Marital Status WidowedAnnulledSeparatedSingle, Never MarriedMarriedDivorcedHow many times has the beneficiary been married?Part 4. Information About Beneficiary(continued) Address (if any)Mobile Telephone Number (if any) 's Marital Information of Beneficiary's Current Marriage(if married) of Current Marriage (if currently married)(mm/dd/yyyy)Names of Beneficiary's Spouses (if any)Provide information on the beneficiary's current spouse (if currently married) first and then list all the beneficiary's prior spouses (if any).

10 Name (Last Name) Name (First Name) NameSpouse Name (Last Name) Name (First Name) Marriage Ended (mm/dd/yyyy)Spouse 1 Date Marriage Ended (mm/dd/yyyy) information about the beneficiary's spouse and Name (Last Name) Name (First Name) NameInformation About Beneficiary's FamilyDate of Birth (mm/dd/yyyy) of of Birth (mm/dd/yyyy)Country of Name (Last Name) Name (First Name) NameCountry of BirthMiddle Name (First Name) Name (Last Name) of Birth (mm/dd/yyyy)RelationshipCity or SAMPLEForm I-130 02/13/19 Page 7 of 12 Middle Name (First Name) Name (Last Name) of BirthDate of Birth (mm/dd/yyyy)RelationshipPerson Name (Last Name) Name (First Name) 4. Information About Beneficiary(continued)Country of of Birth (mm/dd/yyyy) 's Entry InformationWas the beneficiary EVER in the United States?