Uscis Form I-407 - Instructions For Record Of Abandonment Of Lawful Permanent Residential Status Page 2

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Item Number 9. E-mail Address (if any). Provide an E-mail address where the alien can be reached.
Item Number 10. Reasons for Abandonment. Enter the reasons for abandoning lawful permanent resident status.
Item Numbers 11.a. - 12.c. Documents Surrendered and Location of Submission. Select the corresponding box(es) of
documents surrendered, list other documents surrendered, and select the corresponding boxes for location of submission.
If Item Number 11.b. is selected, provide a detailed written statement explaining why the document cannot be
surrendered. This statement should be signed under oath before a DHS or consular officer. If you cannot appear before a
DHS or consular officer, then you must include in the statement, “I certify under penalty of perjury under United States
law that this statement is true and correct.”
Item Numbers 13.a. - 13.c. Certification. The permanent resident alien, or if 17 years of age or younger, his or her
parents, custodial parents, or legal guardians, must sign Form I-407 before it is accepted by DHS. If the lawful permanent
resident is a minor 17 years of age or younger, then each legal parent, custodial parents, or duly appointed legal guardian
must sign Form I-407 and consent to the submission of Form I-407. If the minor has only one legal parent, the sole legal
parent can sign Form I-407, but must submit proof showing that any other parent has died, has had his or her parental
rights terminated according to the law, or that the parent who is signing Form I-407 has sole legal custody of the minor. A
guardian should submit letters of guardianship or other proof of the authority to sign for the minor lawful permanent
resident alien.
Item Numbers 14.a. - 14.d. Parents, Custodial Parents, or Legal Guardian Name, Signature, and Date, if
applicable. The parents, custodial parents, or legal guardian must sign and print their name and date in this section if they
are consenting to Form I-407 being submitted for the minor (17 years of age or younger) for whom they are responsible.
They must also submit evidence to establish sole parental or custodial responsibility, if applicable.
Lawful permanent residents submitting Form I-407 by mail should carefully read the following section of the instructions
regarding the rights of lawful permanent residents. If Form I-407 is completed in person, then before asking the
individual to sign Form I-407, the DHS officer or the DOS consular officer must explain that:
By signing Form I-407, the alien waives the right to a hearing before an immigration judge who would decide
whether the alien lost his/her legal permanent resident status due to abandonment. If the alien chooses a hearing
before an immigration judge instead, the alien would have the right:
(1) To be represented at no expense to the U.S. Government by an attorney or accredited representative;
(2) To challenge any evidence that DHS may present against the alien;
(3) To present evidence in the alien's favor;
(4) To require that DHS prove, by clear, unequivocal, and convincing evidence, that the alien has lost his or her
lawful permanent resident status through abandonment; and
(5) To appeal a decision against the alien.
Part 2. Certification and Signature of the Interpreter
If an interpreter is used to complete the form or at an interview, provide the interpreter's signature and information.
Part 3. For Government Use Only
If the alien is interviewed, the interviewing DHS or consular officer must select Item Number 1. and complete Item
Numbers 3. - 4.d. on the form.
If the alien is not interviewed, the DHS or consular officer must select Item Number 2., provide an explanation, and
complete Item Numbers 3. - 4.d. on the form.
What Is the Filing Fee?
There is no filing fee for processing Form I-407.
Form I-407 Instructions 02/26/15 N
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