Form I-526 04/15/19 Page 1 of 13 For USCIS Use Only Immigrant Petition by Alien Entrepreneur Department of Homeland Security U.S. Citizenship and Immigration ServicesUSCIS Form I-526 OMB No. 1615-0026 Expires 04/30/2021START HERE - Type or print in black ink. Part 1. Information About YouAlien Registration Number (A-Number) (if any) Your Full Name4.a.Family Name (Last Name) 4.b. Given Name (First Name) 4.c. Middle Name 1.Street Number and Name Mailing Address7.a. In Care Of Name (if any) 7.b. 7.c. 7.d. City or Town 7.h.Postal Code 7.i.Country 7.e. State7.f.ZIP Code USCIS Online Account Number (if any)2. 7.g.Province A- Apt. Ste. Flr.Provide the following information about yourself. U.S. Social Security Number (if any)3. Other Names UsedList all other names you have ever used, including aliases, maiden name, and nicknames. If you need extra space to complete this section, use the space provided in Part 11. Additional Information.5.a.Family Name (Last Name) 6.a.Family Name (Last Name) 6.b. Given Name (First Name) 6.c. Middle Name Fee Receipt Action BlockClassification Resubmitted Received Priority Date Relocated Sent Received 5.b. Given Name (First Name) 5.c. Middle Name Remarks Select this box if Form G-28 is attached to represent the applicant.Attorney or Accredited Representative USCIS Online Account Number (if any) To be completed by an attorney or BIA-accredited representative (if any).(USPS ZIP Code Lookup ) American LegalNet, Inc. www.FormsWorkFlow.com Form I-526 04/15/19 Page 2 of 13 Part 1. Information About You (continued) Physical Address 9.a. Street Number and Name 9.b. Provide your physical addresses for the last five years. Provide your present address first. If you need extra space to complete this section, use the space provided in Part 11. Additional Information. Apt. Ste. Flr.9.c. City or Town 9.d.State9.e.ZIP Code Country 9.h. Postal Code 9.g. Province9.f. 9.i.9.j. Present10.a. Street Number and Name 10.b. Apt. Ste. Flr.10.c. City or Town 10.d.State10.e.ZIP Code Country 10.h. Postal Code 10.g. Province10.f. 10.i.10.j. Country 11.h. Postal Code 11.g.11.i.From (mm/dd/yyyy) 11.j.To (mm/dd/yyyy) 12.a. Street Number and Name 12.b. Apt. Ste. Flr.12.c. City or Town 12.d.State12.e.ZIP Code Country 12.h. Postal Code 12.g. Province12.f. 12.i.12.j.13.a. Street Number and Name 13.b. Apt. Ste. Flr.13.c. City or Town 13.d.State13.e.ZIP Code Country 13.h. Postal Code 13.g. Province13.f. 13.i.13.j.11.a. Street Number and Name 11.b. Apt. Ste. Flr.11.c. City or Town 11.d.State11.e.ZIP Code Province11.f. If you answered "No" to Item Number 8., provide your physical address in Item Numbers 9.a. - 9.h.8.Is your current mailing address the same as your physical address? Yes No From (mm/dd/yyyy) To (mm/dd/yyyy) From (mm/dd/yyyy) To (mm/dd/yyyy) From (mm/dd/yyyy) To (mm/dd/yyyy) From (mm/dd/yyyy) To (mm/dd/yyyy) American LegalNet, Inc. www.FormsWorkFlow.com Form I-526 04/15/19 Page 3 of 13 Employment History Part 1. Information About You (continued)Provide your employment history for the last five years. (If none, so state.) List present employment first. If you need extra space to complete this section, use the space provided in Part 11. Additional Information. Employer Name14.a.14.b. Street Number and Name 14.c. Apt. Ste. Flr.14.d. City or Town 14.e.State14.f.ZIP Code Country 14.i. Postal Code 14.h. Province14.g. Job Title14.j.14.k.14.l. Employer Name15.a.15.b. Street Number and Name 15.c. Apt. Ste. Flr.15.d. City or Town 15.e.State15.f.ZIP Code Country 15.i. Postal Code 15.h. Province15.g. Job Title15.j. Employer Name16.a.16.b. Street Number and Name 16.c. Apt. Ste. Flr.16.d. City or Town 16.e.State16.f.ZIP Code Country 16.i. Postal Code 16.h. Province16.g. Job Title16.j.16.k.16.l. Employer Name17.a.17.b. Street Number and Name 17.c. Apt. Ste. Flr.17.d. City or Town 17.e.State17.f.ZIP Code Country 17.i. Postal Code 17.h. Province17.g. Job Title17.j.17.k.17.l. From (mm/dd/yyyy) To (mm/dd/yyyy) From (mm/dd/yyyy) To (mm/dd/yyyy) From (mm/dd/yyyy) To (mm/dd/yyyy) 15.k.15.l.From (mm/dd/yyyy) To (mm/dd/yyyy) American LegalNet, Inc. www.FormsWorkFlow.com Form I-526 04/15/19 Page 4 of 13 Part 1. Information About You (continued) Employer Name18.a.18.b. Street Number and Name 18.c. Apt. Ste. Flr.18.d. City or Town 18.e.State18.f.ZIP Code Country 18.i. Postal Code 18.h. Province18.g. Job Title18.j.18.k.18.l. Other Information About You21.20.City or Town of Birth State or Province of Birth 22.Sex Male FemalePlace of BirthCountry of Birth 23.NOTE: If you are a citizen of more than one country or your nationality differs from your citizenship, provide the information in Part 11. Additional Information. Country of Citizenship or Nationality24.Place of Arrival or Port-of-Entry27.a.City or Town 27.b.State Date Period of Authorized Stay Expires/Expired (mm/dd/yyyy) 28.b.Passport Number28.c. Travel Document Number28.d. I-94 Arrival-Departure Record Number28.a. Date Passport or Travel Document Expires (mm/dd/yyyy) 28.f. Country That Issued Passport or Travel Document 28.e. Current Nonimmigrant Status (if applicable)28.g.Date Current Nonimmigrant Status Expires (mm/dd/yyyy) 28.h. Part 2. Information About Your Investment Regional Center (if any)1.Is your investment associated with an approved Regional Center? No Yes2.Regional Center Name 3. Regional Center Identification Number 4. What is the receipt number for the approved Regional Center application upon which your petition is based? 5. If applicable, provide the New Commercial Enterprise (NCE) Identification Number.Date of Birth (mm/dd/yyyy) 19.Date of Arrival (mm/dd/yyyy) 26. Your Entry Into the United StatesFrom (mm/dd/yyyy) To (mm/dd/yyyy) Country of Last Foreign Residence25. American LegalNet, Inc. www.FormsWorkFlow.com Form I-526 04/15/19 Page 5 of 13Is the job-creating-entity (JCE) principally doing business in a targeted employment area?Is the new commercial enterprise (NCE) principally doing business in a targeted employment area? Part 2. Information About Your Investment (continued)Select the appropriate box to indicate the type of petition you are filing. If you select Item Number 6., provide the requested information.Targeted Employment Area (TEA)6. Petition Type and Required Capital InvestmentThis petition is based on an investment in a targeted employment area for which the required investment amount of capital has been adjusted downward.a.Is the area a rural area?b. No YesIs the area a high unemployment area?c. No YesAddress Where the NCE is Principally Doing Businessd.e.Is the area a rural area?f. No YesIs the area a high unemployment area?g. No YesAddress where the JCE is principally doing businessh. Composition of Your Investment and Your IncomeComposition of InvestmentTotal Amount Deposited or Committed to Deposit into U.S. Business Accounts for NCE9.Total Value of Assets Purchased for Use in NCE10.Total Value of All Property Transferred From Abroad for Use in NCE11.12.Total of All Debt Financing 13.Total Stock or Other Equity Purchases14.Other Capital Your Income15.Your Gross Income at Time of Investment16.Your Net Income at Time of Investment17.Your Current Gross Income18.Your Current Net IncomeYour Net Worth19.Your Net Worth at Time of Investment20. Your Current Net WorthUpward Adjustment Area 7. This petition is based on an investment in an area for which the required investment amount of capital has been adjusted upward.Non-TEA/Non-Upward Adjustment Area8. This petition is based on an investment in an area that is neither a targeted employment area nor an upward adjustment area.Street Number and Name City or Town StateZIP Code CountyStreet Number and Name Apt. Ste. Flr.City or Town StateZIP Code County$$$$$$$$$$$$ No Yes No Yes Flr. Ste. Apt. American LegalNet, Inc. www.FormsWorkFlow.com Form I-526 04/15/19 Page 6 of 13 Part 2. Information About Your Investment (continued)Your Sources of Investment CapitalPlease identify the sources of the capital you have invested or are actively in the process of investing into the NCE. (Select all that apply.)IncomeOtherIn the space below, describe the documentation included with this petition to demonstrate that the capital you have invested or ar