Form I-130 02/13/19Page 1 of 12 Petition for Alien Relative Department of Homeland Security U.S. Citizenship and Immigration Services For USCIS Use OnlyDid you gain lawful permanent resident status or citizenship through adoption? USCIS Form I-130 OMB No. 1615-0012Expires 02/28/2021 Attorney State Bar Number (if applicable) Select this box if Form G-28 is attached.Volag 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 Simultaneously Ben. A-File Reviewed 204(a)(2)(A) Resolved203(g) Resolved 204(g) Resolved Field Investigation201(b) Spouse - IR-1/CR-1201(b) Child - IR-2/CR-2201(b) Parent - IR-5 203(a)(1) Unm. S/D - F1-1 203(a)(2)(A) Spouse - F2-1203(a)(2)(A) Child - F2-2 203(a)(2)(B) Unm. S/D - F2-4 203(a)(3) Married S/D - F3-1 203(a)(4) Brother/Sister - F4-1 Section of Law/Visa CategoryResubmittedInitial ReceiptCompletedSentReceivedApprovedReturnedRelocated Part 1. Relationship (You are the Petitioner. Your relative is the Beneficiary)1.I am filing this petition for my (Select only one box):Child was adopted (not an Orphan or Hague Convention adoptee)Stepchild/Stepparent3.4.If the beneficiary is your brother/sister, are you related by adoption?2.If you are filing this petition for your child or parent, select the box that describes your relationship (Select only one 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 Name4.a.Family Name (Last Name) 4.b. Given Name (First Name) 4.c. Middle Name3.U.S. Social Security Number (if any)Personal Interview Pet. A-File Reviewed Spouse Brother/Sister Parent Child Yes No Yes No Part 2. Information About You (Petitioner)1.Alien 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 Information. Complete and submit as many copies of Part 9., as necessary, with your petition. At which USCIS office (e.g., NBC, VSC, LOS, CRO) was Form I-130 adjudicated? American LegalNet, Inc. www.FormsWorkFlow.com Form I-130 02/13/19Page 2 of 12 Part 2. Information About You (Petitioner) (continued)7.Country of Birth 8.Date of Birth (mm/dd/yyyy) 9.Sex Male Female Mailing Address10.b. 10.c.10.d. 10.e.10.g.10.i.10.h.11.Is your current mailing address the same as your physical address? Yes No10.a.City or TownProvinceCountry Postal Code ZIP Code10.f.StateStreet Number and Name Apt. Ste. Flr. In Care Of Name 14.c.14.f.14.h.14.g.14.d.14.a.14.b.Street Number and Name Apt. Ste. Flr. City or Town State 14.e. ZIP Code Province Country Postal Code Physical Address 2If you answered "No" to Item Number 11., provide information on your physical address in Item Numbers 12.a. - 13.b. Date From (mm/dd/yyyy)13.a.Date To (mm/dd/yyyy)13.b. Date From (mm/dd/yyyy)15.a.Date To (mm/dd/yyyy)15.b. 12.c.12.f.12.h.12.g.12.d.12.a.12.b.Street Number and Name Apt. Ste. Flr. City or Town State 12.e. ZIP Code Province Country Postal Code Physical 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 Item Numbers 10.a. - 10.i. Other Information6.City/Town/Village of Birth Other Names Used (if any)Provide all other names you have ever used, including aliases, maiden name, and nicknames. 5.a.Family Name (Last Name) 5.b. Given Name (First Name) 5.c. Middle Name 17.How many times have you been married?16.Current Marital Status Your Marital Information Widowed Annulled Separated Single, Never Married Married Divorced (USPS ZIP Code Lookup) American LegalNet, Inc. www.FormsWorkFlow.com Form I-130 02/13/19Page 3 of 12 20.a.Family Name (Last Name) 20.b. Given Name (First Name) 20.c. Middle Name Names of All Your Spouses (if any)Spouse 1Provide information on your current spouse (if currently married) first and then list all your prior spouses (if any). Place of Your Current Marriage (if married) Part 2. Information About You (Petitioner) (continued) Date Marriage Ended (mm/dd/yyyy)23.24.c. Middle Name22.c. Given Name (First Name) 22.b. Family Name (Last Name) 22.a.Spouse 221.Date Marriage Ended (mm/dd/yyyy) 18.Date of Current Marriage (if currently married) (mm/dd/yyyy) Parent 1's Information Information About Your ParentsGiven Name (First Name) Middle Name Family Name (Last Name) 25.Date of Birth (mm/dd/yyyy) 28. Country of Residence City/Town/Village of Residence29.Country of Birth 30.a.Parent 2's InformationGiven Name (First Name) Middle Name Family Name (Last Name) 31.Date of Birth (mm/dd/yyyy) 33.34. Country of Residence City/Town/Village of Residence35.Country of Birth Additional Information About You (Petitioner)36.I am a (Select only one box): U.S. Citizen Lawful Permanent ResidentIf you are a U.S. citizen, complete Item Number 37.My citizenship was acquired through (Select only one box): Birth in the United States Naturalization Parents If you answered "Yes" to Item Number 38., complete the following:Certificate Number 39.a.Have you obtained a Certificate of Naturalization or a Certificate of Citizenship?38. Yes No27.37.39.c.Date of Issuance (mm/dd/yyyy) Place of Issuance39.b. Full Name of Parent 1Full Name of Parent 224.a.24.b.30.b.30.c.26.Sex Male Female32.Sex Male Female19.a. City or Town 19.b.State19.c.Province19.d.Country American LegalNet, Inc. www.FormsWorkFlow.com Form I-130 02/13/19Page 4 of 12 If you are a lawful permanent resident, complete Item Numbers 40.a. - 41.40.a.Class of Admission 40.b.Date of Admission (mm/dd/yyyy) Place of Admission 40.c.City or TownDid you gain lawful permanent resident status through marriage to a U.S. citizen or lawful permanent resident?41. No Yes Part 2. Information About You (Petitioner) (continued) Employment HistoryProvide your employment history for the last five years, whether inside or outside the United States. Provide your current employment first. If you are currently unemployed, type or print "Unemployed" in Item Number 42. City or Town43.c.43.f.43.h.ProvinceCountry 43.g.Postal Code ZIP Code43.e.State43.d.Street Number and Name43.a. 43.b. Apt. Ste. Flr. Employer 142.Name of Employer/Company City or Town47.c.47.f.47.h.ProvinceCountry 47.g.Postal Code ZIP Code47.e.State47.d.Street Number and Name47.a. 47.b. Apt. Ste. Flr. 48.Your Occupation Date From (mm/dd/yyyy)49.a.Date To (mm/dd/yyyy)49.b. 1.Not Hispanic or Latino Hispanic or Latino Ethnicity (Select only one box)Race (Select all applicable boxes)Native Hawaiian or Other Pacific Islander Black or African American American Indian or Alaska Native 2.Asian White Height3.FeetInches Weight Pounds 4. Part 3. Biographic InformationNOTE: Provide the biographic information about you, the petitioner.Employer 246.Name of Employer/Company 44.Your Occupation Date From (mm/dd/yyyy)45.a.Date To (mm/dd/yyyy)45.b. Black Gray Green Maroon Pink Hazel Brown Blue Eye Color (Select only one box)5. Unknown/Other40.dState American LegalNet, Inc. www.FormsWorkFlow.com Form I-130 02/13/19Page 5 of 12 Part 4. Information About Beneficiary1.Alien Registration Number (A-Number) (if any) A- USCIS Online Account Number (if any)2. 3.U.S. Social Security Number (if any) Beneficiary's Full Name4.a.Family Name (Last Name) 4.b. Given Name (First Name) 4.c. Middle Name 5.a.Family Name (Last Name) 5.b. Given Name (First Name) 5.c. Middle Name Other Names Used (if any)Provide all other names the beneficiary has ever used, including aliases, maiden name, and nicknames. Other Information About Beneficiary6.City/Town/Village of Birth 7.Country of Birth 11.f.11.h.11.g.ProvinceCountry Postal Code Provide the address in the United States where the beneficiary intends to live, if different from Item Numbers 11.a. - 11.h. If the address i