Form I-129 - Petition For A Nonimmigrant Worker - Department Of Homeland Security Page 24
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26Section 2.
Complete this section if you are filing for an R-1 religious worker (Continued)
Religious Denomination Certification
I certify under penalty of perjury under the laws of the United States of America that:
Name of Employing Organization
is affiliated with:
Name of Religious Denomination
and that the attesting organization within the religious denomination is tax-exempt as described in section under 501(c)(3)
of the Internal Revenue Code of 1986, subsequent amendment, or equivalent sections of prior enactments of the Internal
Revenue Code. The contents of this certification are true and correct to the best of my knowledge.
Signature
Date (mm/dd/yyyy)
Title
Printed Name
Attesting Organization Name
Suite Number
Attesting Organization Street Address (do not use a post office or private mail box)
Zip Code
City
State
Fax Number (if any)
E-mail Adddress (if any)
Daytime Phone Number (with area code)
Form I-129 Supplement Q/R (Rev. 06/12/09)Y Page 24
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