Form I-129 - Petition For A Nonimmigrant Worker - Department Of Homeland Security Page 7
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36Part 8. Declaration, Signature, and Contact Information of Person Preparing Form, If Other Than
Petitioner (continued)
3.
Preparer's Mailing Address
Street Number and Name
Apt.
Ste.
Flr. Number
City or Town
State
ZIP Code
Province
Postal Code
Country
4.
Preparer's Contact Information
Daytime Telephone Number
Fax Number
Email Address (if any)
Preparer's Declaration
By my signature, I certify, swear, or affirm, under penalty of perjury, that I prepared this petition on behalf of, at the request of, and
with the express consent of the petitioner or authorized signatory. The petitioner has reviewed this completed petition as prepared by
me and informed me that all of the information in the form and in the supporting documents, is complete, true, and correct.
5.
Signature and Date
Signature of Preparer
Date of Signature
(mm/dd/yyyy)
Form I-129 08/13/15 Y
Page 7 of 36
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