Form I-290B 05/17/18 Page 1 of 6 Notice of Appeal or Motion Department of Homeland Security U.S. Citizenship and Immigration Services To be completed by an attorney or accredited representative (if any).USCIS Form I-290B OMB No. 1615-0095 Expires 05/31/2020 Part 1. Information About the Applicant or Petitioner 1.b. 1.c. 1.a.Family Name (Last Name) Given Name (First Name) Middle Name Mailing Address (or Military APO/FPO Address, if applicable) 5.d.City or Town5.e.State5.f.ZIP Code5.g.Postal CodeStreet Number and Name5.b. 5.c. Flr. Apt. Ste. 5.h.5.i.Country Province Attorney State Bar Number (if applicable) Attorney or Accredited Representative USCIS Online Account Number (if any) Select this box if Form G-28 is attached.5.a. In Care Of Name (if any) Please visit www.uscis.gov/i-290b/jurisdiction for information on the immigration benefit types that are eligible for an appeal or motion using this form.START HERE - Type or print in black ink.2. Business or Organization (if applicable)3.A-Alien Registration Number (A-Number, if any) 4. USCIS Online Account Number (if any) If you are an individual filing this appeal or motion, complete Item Number 1. If you are a business or organization, complete Item Number 2. For USCIS Use Only RemarksReceiptResubmittedReturnedReloc Rec'dReloc Sent Date / / / Date / / / Date / / / Date / / / Date / / / Date / / / Date / / / Date / / / Part 2. Information About the Appeal or MotionPlease indicate whether you are filing an appeal to the Administrative Appeals Office (AAO) or a motion. You are not allowed to file both an appeal and a motion on a single form. If you select more than one box, your filing may be rejected. NOTE: DO NOT use this form if you are filing an appeal relating to a Form I-130, Petition for Alien Relative, or a Form I-360, Self-Petition for a Widow(er) of a U.S. Citizen. You must file those appeals with the Board of Immigration Appeals using Form EOIR-29. (USPS ZIP Code Lookup) American LegalNet, Inc. www.FormsWorkFlow.com Form I-290B 05/17/18 Page 2 of 6 I am filing an appeal to the AAO. My brief and/or additional evidence is attached. I am filing an appeal to the AAO. I will submit my brief and/or additional evidence to the AAO within 30 calendar days of filing the appeal. 1.a.1.b.I am filing an appeal to the AAO. I will not be submitting a brief and/or additional evidence. 1.c.I am filing a motion to reopen. My brief and/or additional evidence is attached. 1.d.I am filing a motion to reconsider. My brief is attached. 1.e. USCIS Form for the Application or Petition That is the Subject of This Appeal or Motion (for example, Form I-140, I-360, I-129, I-485, I-601)2. Requested Nonimmigrant or Immigrant Classification (for example, H-1B, R-1, O-1, EB-1, EB-2, if applicable)4.Date of the Adverse Decision (mm/dd/yyyy)5.3. Receipt Number for the Application or PetitionI am filing a motion to reopen and a motion to reconsider. My brief and/or additional evidence is attached. 1.f. Part 2. Information About the Appeal or Motion (continued)Office That Issued the Adverse Decision6. Part 3. Basis for the Appeal or Motion In Part 7. Additional Information, or on a separate sheet of paper, you must provide a statement regarding the basis for the appeal or motion. If you attach a separate sheet of paper, type or print your name and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet.Appeal: Provide a statement that specifically identifies an erroneous conclusion of law or fact in the decision being appealed. You must provide this information with your Form I-290B even if you intend to submit a brief later.Motion to Reopen: A motion to reopen must state new facts and be supported by documentary evidence demonstrating eligibility for the requested immigration benefit at the time you filed the application or petition.Motion to Reconsider: A motion to reconsider must demonstrate that the decision was based on an incorrect application of law or policy, and that the decision was incorrect based on the evidence in the case record at the time of the decision. The motion must be supported by citations to appropriate statutes, regulations, precedent decisions, or statements of USCIS policy. Part 4. Applicant's or Petitioner's Statement, Contact Information, Certification, and SignatureNOTE: Read the Penalties section of the Form I-290B Instructions before completing this part.If you are filing an appeal or motion based on an APPLICATION OR PETITION FILED BY AN INDIVIDUAL (NOT A BUSINESS OR ORGANIZATION), complete this section:I can read and understand English, and I have read and understand every question and instruction on this form and my answer to every question. 1.a.NOTE: Select the box for either Item Number 1.a. or 1.b. If applicable, select the box for Item Number 2. Applicant's or Petitioner's Statement Section AThe interpreter named in Part 5. has read to me every question and instruction on this form, and my answer to every question, in 2.At my request, the preparer named in Part 6. prepared this form for me based only upon information I provided or authorized.a language in which I am fluent. I understood all of this information as interpreted. 1.b., Applicant's or Petitioner's Contact InformationApplicant's or Petitioner's Daytime Telephone Number3. Applicant's or Petitioner's Email Address (if any)5.Applicant's or Petitioner's Mobile Telephone Number (if any)4. American LegalNet, Inc. www.FormsWorkFlow.com Form I-290B 05/17/18 Page 3 of 6 Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS may require that I submit original documents to USCIS at a later date. Furthermore, I authorize the release of any information from any of my records that USCIS may need to determine my eligibility for the immigration benefit that I seek. Applicant's or Petitioner's CertificationI further authorize release of information contained in this form, in supporting documents, and in my USCIS records, to other entities and persons where necessary for the administration and enforcement of U.S. immigration law.I certify, under penalty of perjury, that all of the information in my form and any document submitted with it were provided or authorized by me, that I reviewed and understand all of the information contained in, and submitted with, my form, and that all of this information is complete, true, and correct. Date of Signature (mm/dd/yyyy)6.b. Applicant's or Petitioner's Signature6.a. Applicant's or Petitioner's SignatureIf you are filing an appeal or motion based on a PETITION FILED BY A BUSINESS OR ORGANIZATION (NOT AN INDIVIDUAL), complete this section: Section B Part 4. Applicant's or Petitioner's Statement, Contact Information, Certification, and Signature (continued) Petitioner's StatementI can read and understand English, and I have read and understand every question and instruction on this form and my answer to every question. 1.a.NOTE: Select the box for either Item Number 1.a. or 1.b. If applicable, select the box for Item Number 2.a language in which I am fluent. I understood all of this information as interpreted. The interpreter named in Part 5. has read to me every question and instruction on this form, and my answer to every question, in 1.b., 2.At my request, the preparer named in Part 6. prepared this form for me based only upon information I provided or authorized. Petitioner's Contact InformationDaytime Telephone Number5. Email Address (if any)7.Mobile Telephone Number (if any)6. Provide the following information about the petitioner's authorized signatory. 3.b. 3.c. 3.a.Family Name (Last Name) Given Name (First Name) Middle Name 4. TitleCopies of any documents submitted are exact photocopies of unaltered, original documents, and I understand that, as the petitioner, I may be required to submit original documents to USCIS at a later date. Petitioner's CertificationI authorize the release of any information from my records, or from the petitioning organization's records, to USCIS or other entities and persons where necessary to