Petition by Entrepreneur to Remove Conditions on Permanent Resident Status Department of Homeland Security U.S. Citizenship and Immigration Services USCIS Form I-829 OMB No. 1615-0045 Expires: 04/30/2019 Received (mm/dd/yyyy) Resubmitted (mm/dd/yyyy) Relocated (mm/dd/yyyy) Fee Receipt Action Block For Received (mm/dd/yyyy) USCIS Sent (mm/dd/yyyy) Use Petitioner Interviewed Only (mm/dd/yyyy) Immigrant Classification DOE/A Remarks To be completed by an Attorney or Accredited Representative (if any). Select this box if Form G-28 is attached. Attorney State Bar Number (if applicable) Attorney or Accredited Representative USCIS Online Account Number (if any) START HERE - Type or print in black ink. Part 1. Basis for Petition 1. Is the investment associated with a Regional Center? Yes If you answered "Yes" to Item Number 1., complete Item Numbers 2.a. and 2.b. 2.a. What is the name of the Regional Center? No Part 2. Information About You 1.a. Family Name (Last Name) 1.b. Given Name (First Name) 1.c. Middle Name 2. Alien Registration Number (A-Number) (if any) A2.b. Regional Center Identification Number 3. USCIS Online Account Number (if any) 3.a. What is the name of the New Commercial Enterprise (NCE)? 4. U.S. Social Security Number (if any) 3.b. NCE Identification Number 5. 6. Date of Birth (mm/dd/yyyy) Gender Male Female Select only one box 4. 5. I am a conditional permanent resident based on my investment in a commercial enterprise. I am a conditional permanent resident who is the spouse, former spouse, or child of an entrepreneur, and I am filing separately from the entrepreneur's Form I-829. I am a conditional permanent resident spouse or child of an entrepreneur who has died. 7. Country of Birth 8. Country of Citizenship or Nationality 9. Date of Admission as a Conditional Permanent Resident (mm/dd/yyyy) 6. 10. Form I-526 Receipt Number on Which This Petition is Based Form I-829 04/21/17 N American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 11 Part 2. Information About You (continued) 11. Any Additional Form I-526 or Form I-829 Receipt Numbers for Other Petitions Filed by Entrepreneur Physical Address 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 12. Additional Information. 16.a. Street Number and Name 16.b. Apt. Ste. Flr. Other Names You Have Used List 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 12. Additional Information. 12.a. Family Name (Last Name) 12.b. Given Name (First Name) 12.c. Middle Name 13.a. Family Name (Last Name) 13.b. Given Name (First Name) 13.c. Middle Name Your U.S. Mailing Address 14.a. In Care Of Name (if any) 16.c. City or Town 16.d. State 16.f. Province 16.g. Postal Code 16.h. Country 16.e. ZIP Code Criminal History 17. Since becoming a conditional permanent resident, have you EVER been arrested, cited, charged, indicted, convicted, fined, or imprisoned for violating any law or ordinance (excluding minor traffic violations)? Yes 18. No 14.b. Street Number and Name 14.c. Apt. Ste. Flr. Since becoming a conditional permanent resident, have you EVER committed any crime for which you were not arrested? Yes No 14.d. City or Town 14.e. State 15. 14.f. ZIP Code Is your mailing address the same as your physical address? Yes No If you answered "Yes" to Item Number 17., you must provide certified court dispositions, arrest reports, statements of charges, indictment information, or any other charging documents that were issued. If you answered "Yes" to Item Number 18., provide the date and location (town or city/state or province/ country) of the events and provide an explanation in the space provided in Part 12. Additional Information. If you answered "No" to Item Number 15., you MUST provide your current physical address in the Item Numbers 16.a. - 16.h. If you need extra space to complete this section, use the space provided in Part 12. Additional Information. Part 3. Information About Your Current or Former Conditional Permanent Resident Spouse NOTE: If you have both a current spouse and a former conditional permanent resident spouse, use the space provided in Part 12. Additional Information to provide this same information about your current spouse or former conditional permanent resident spouse who you did not already include in Part 3. below. 1.a. Family Name (Last Name) 1.b. Given Name (First Name) 1.c. Middle Name Form I-829 04/21/17 N American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 11 Part 3. Information About Your Current or Former Conditional Permanent Resident Spouse (continued) 2. 3. Gender Male Female Other Information 9. Current Spouse Former Conditional Permanent Resident Spouse 10. 11. Date of Marriage (mm/dd/yyyy) Date Marriage Terminated (if applicable) (mm/dd/yyyy) 12. Is this spouse currently living with you? Is this spouse applying with you? Yes Yes No No Alien Registration Number (A-Number) (if any) A4. USCIS Online Account Number (if any) 5. Date of Birth (mm/dd/yyyy) 13. 14. Other Names Used List all other names your current spouse or former conditional permanent resident spouse has ever used, including aliases, maiden name, and nicknames. If you need extra space to complete this section, use the space provided in Part 12. Additional Information. 6.a. Family Name (Last Name) 6.b. Given Name (First Name) 6.c. Middle Name 7.a. Family Name (Last Name) 7.b. Given Name (First Name) 7.c. Middle Name Physical Address Provide your current spouse or former conditional permanent resident spouse's physical addresses for the last five years. Provide the present address first. If you need extra space to complete this section, use the space provided in Part 12. Additional Information. 8.a. Street Number and Name 8.b. Apt. Ste. Flr. Current Immigration Status (for example, conditional permanent resident, tourist/visitor, entered without inspection) 15. Is the current immigration status of your spouse or former spouse based on your current immigration status? Yes No Part 4. Information About Your Children Provide the following information about your children. Child 1 1.a. Family Name (Last Name) 1.b. Given Name (First Name) 1.c. Middle Name 2. 3. Gender Male Female Alien Registration Number (A-Number) (if any) A4. USCIS Online Account Number (if any) 5. Date of Birth (mm/dd/yyyy) Other Names Your