Form I-817 - Application For Family Unity Benefits Page 9
Download a blank fillable Form I-817 - Application For Family Unity Benefits in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form I-817 - Application For Family Unity Benefits with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10
11
12Part 4. Other Information (continued)
Applicant's Contact Information
Have you EVER committed a serious nonpolitical crime
37.
3.
Applicant's Daytime Telephone Number
outside the United States before you arrived in the United
States?
Yes
No
4.
Applicant's Mobile Telephone Number (if any)
Have you EVER been convicted of a felony or three or
38.
more misdemeanors in the United States?
Applicant's Email Address (if any)
5.
Yes
No
Part 5. Applicant's Statement, Contact
Acknowledgement of Appointment at USCIS
Information, Acknowledgement of Appointment
Application Support Center
at USCIS Application Support Center,
Certification, and Signature
I,
,
understand that the purpose of a USCIS ASC appointment is
NOTE: Read the information on penalties in the Penalties
for me to provide my fingerprints, photograph, and/or
section of the Form I-817 Instructions before completing this
signature and to re-affirm that all of the information in my
part.
application is complete, true, and correct and was provided by
me. I understand that I will sign my name to the following
Applicant's Statement
declaration which USCIS will display to me at the time I
provide my fingerprints, photograph, and/or signature during
NOTE: Select the box for either Item Number 1.a. or 1.b.
my ASC appointment.
If applicable, select the box for Item Number 2.
By signing here, I declare under penalty of perjury that I
I can read and understand English, and have read and
1.a.
have reviewed and understand my application, petition, or
understand every question and instruction on this
request as identified by the receipt number displayed on the
application, as well as my answer to every question. I
screen above, and all supporting documents, applications,
have read and understand the Acknowledgement of
petitions, or requests filed with my application, petition, or
Appointment at USCIS Application Support
request that I (or my attorney or accredited representative)
Center.
filed with USCIS, and that all of the information in these
1.b.
The interpreter named in Part 6. has also read to me
materials is complete, true, and correct.
every question and instruction on this application, as
I also understand that when I sign my name, provide my
well as my answer to every question, in
fingerprints, and am photographed at the USCIS ASC, I will be
re-affirming that I willingly submit this application; I have
,
reviewed the contents of this application; all of the information
a language in which I am fluent. I understand every
in my application and all supporting documents submitted with
question and instruction on this application as
my application were provided by me and are complete, true, and
translated to me by my interpreter, and have provided
correct; and if I was assisted in completing this application, the
complete, true, and correct responses in the language
person assisting me also reviewed this Acknowledgement of
indicated above. The interpreter named in Part 6. has
Appointment at USCIS Application Support Center with me.
also read the Acknowledgement of Appointment at
USCIS Application Support Center to me, in the
language in which I am fluent, and I understand this
Application Support Center (ASC) Acknowledgement
as read to me by my interpreter.
2.
I have requested the services of and consented to
,
who
is
is not an attorney or accredited
representative, preparing this application for me. This
person who assisted me in preparing my application
has reviewed the Acknowledgement of Appointment
at USCIS Application Support Center with me, and
I understand the ASC Acknowledgement.
Form I-817 12/23/16 N
Page 9 of 12
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Tc-817 - Application For Personalized Plates And Replacement Of Existing Personalized Plates
Legal
Form Tc-817 - Application For Personalized Plates And Replacement Of Existing Personalized License Plates
Financial
Form Tc-817 - Application For Personalized Plates And Replacement Of Existing Personalized Plates
Financial
Related Categories
Parent category: Legal