I-824, 2004, Application For Action On An Approved Application Or Petition
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2OMB No. 1615-0044: Expires 06/30/07
I-824, Application for Action on an
U.S. Department of Homeland Security
Approved Application or Petition
Bureau of Citizenship and Immigration Services
START HERE - Please type or print in black ink.
FOR CIS USE ONLY
Returned
Receipt
Part 1.
Information about you.
(Person filing this application)
Family Name (Last name)
Given Name (First Name)
Middle Name
Date
Date
Company or Organization Name
Resubmitted
Date
Home or Business Address - Street Number and Name
Apt./Suite #
Date
City
State or Province
Reloc Sent
Date
Zip/Postal Code
Country
Date
Reloc Rec'd
Mailing Address - Street Number and Name
Apt./Suite #
Date
C/O (in care of):
Date
Remarks
City
State or Province
Zip/Postal Code
Country
Daytime Phone # (Area/Country Code)
Country of Birth
Country of Citizenship
Date of Birth (mm/dd/yyyy)
IRS Tax # (if any)
Action Block
U.S. Social Security # (if any)
A # (if any)
Part 2. Reason for request (check one):
I am requesting:
(Check one box.)
A.
A duplicate approval notice.
B.
The CIS to notify a different U.S. Consulate or Port-of-Entry about the approval
of an application or petition. Please notify the U.S. Consulate or Port-of-Entry at:
To Be Completed by
The CIS to notify a U.S. Consulate that my status has been adjusted to
C.
Attorney or Representative, if any.
permanent resident. Please notify the U.S. Consulate at:
Fill in box if G-28 is attached to
represent the applicant.
D.
The CIS to send my approved immigrant visa to the National Visa Center (NVC).
ATTY State License #
E.
The CIS to notify the U.S. Department of State of my U.S. citizenship status.
Form I-824 (Rev. 07/09/04) N (Prior versions may be used until 09/30/04)
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