Uscic Form 1-130 - Petition For Alien Relative
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2OMB No. 1615-0012; Expires 12/31/2015
Department of Homeland Security
I-130, Petition for Alien Relative
U.S. Citizenship and Immigration Services
DO NOT WRITE IN THIS BLOCK - FOR USCIS OFFICE ONLY
A#
Action Stamp
Fee Stamp
Section of Law/Visa Category
201(b) Spouse - IR-1/CR-1
201(b) Child - IR-2/CR-2
201(b) Parent - IR-5
203(a)(1) Unm. S or D - F1-1
203(a)(2)(A)Spouse - F2-1
(priority date)
Petition was filed on:
203(a)(2)(A) Child - F2-2
Personal Interview
Previously Forwarded
203(a)(2)(B) Unm. S or D - F2-4
Pet.
Ben. " A" File Reviewed
I-485 Filed Simultaneously
Field Investigation
204(g) Resolved
203(a)(3) Married S or D - F3-1
203(a)(2)(A) Resolved
203(g) Resolved
203(a)(4) Brother/Sister - F4-1
Remarks:
A. Relationship
You are the petitioner. Your relative is the beneficiary.
1. I am filing this petition for my:
2. Are you related by adoption?
3. Did you gain permanent residence through adoption?
Spouse
Parent
Brother/Sister
Child
Yes
No
Yes
No
B. Information about you
C. Information about your relative
(Middle)
1. Name (Family name in CAPS)
(Middle)
1. Name (Family name in CAPS)
(First)
(First)
2. Address (Number and Street)
2. Address (Number and Street)
(Apt. No.)
(Apt. No.)
(Zip/Postal Code)
(Town or City)
(State/Country)
(Zip/Postal Code)
(Town or City)
(State/Country)
3. Place of Birth (Town or City)
(State/Country)
3. Place of Birth (Town or City)
(State/Country)
5. Gender
6. Marital Status
6. Marital Status
4. Date of Birth
4. Date of Birth
5. Gender
Male
Married
Single
Male
Married
Single
Female
Widowed
Divorced
Widowed
Divorced
Female
7. Other Names Used (including maiden name)
7. Other Names Used (including maiden name)
8. Date and Place of Present Marriage (if married)
8. Date and Place of Present Marriage (if married)
9. U.S. Social Security Number (If any)
10. Alien Registration Number
9. U.S. Social Security Number (If any)
10. Alien Registration Number
11. Name(s) of Prior Spouse(s)
12. Date(s) Marriage(s) Ended
11. Name(s) of Prior Spouse(s)
12. Date(s) Marriage(s) Ended
13. If you are a U.S. citizen, complete the following:
13. Has your relative ever been in the U.S.?
No
Yes
My citizenship was acquired through (check one):
14. If your relative is currently in the U.S., complete the following:
He or she arrived as a:
Birth in the U.S.
(visitor, student, stowaway, without inspection, etc.)
Naturalization. Give certificate number and date and place of issuance.
Date arrived
Arrival/Departure Record (I-94)
Parents. Have you obtained a certificate of citizenship in your own name?
Date authorized stay expired, or will expire, as
No
Yes. Give certificate number, date and place of issuance.
shown on Form I-94 or I-95
14. If you are a lawful permanent resident alien, complete the following:
15. Name and address of present employer (if any)
Date and place of admission for or adjustment to lawful permanent
residence and class of admission.
Date this employment began
16. Has your relative ever been under immigration proceedings?
14b. Did you gain permanent resident status through marriage to a
U.S. citizen or lawful permanent resident?
Yes Where
No
When
Yes
No
Rescission
Removal
Exclusion/Deportation
Judicial Proceedings
RESUBMITTED
Ret'd
INITIAL RECEIPT
RELOCATED: Rec'd
Sent
Denied
COMPLETED: Appv'd
Form I-130 (03/23/15) Y
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