Form I-918 - Supplement B, U Nonimmigrant Status Certification Page 3

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4.
Other. Include any additional information you would like
Part 4. Helpfulness Of The Victim
to provide.
For the following questions, if the victim is under 16 years of
age, incompetent or incapacitated, then a parent, guardian, or
next friend may act on behalf of the victim.
1.
Does the victim possess information concerning the
criminal activity listed in Part 3.?
Yes
No
2.
Has the victim been helpful, is the victim being helpful, or
is the victim likely to be helpful in the investigation or
prosecution of the criminal activity detailed above?
Yes
No
3.
Since the initiation of cooperation, has the victim refused
or failed to provide assistance reasonably requested in the
investigation or prosecution of the criminal activity
detailed above?
Yes
No
If you answer "Yes" to Item Numbers 1. - 3., provide an
explanation in the space below. If you need extra space to
complete this section, use the space provided in Part 7.
Additional Information.
Form I-918 Supplement B 02/07/17 N
Page 3 of 5

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