Form I-924a - Annual Certification Of Regional Center
Download a blank fillable Form I-924a - Annual Certification Of Regional Center 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-924a - Annual Certification Of Regional Center 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
9USCIS
Annual Certification of Regional Center
Form I-924A
Department of Homeland Security
OMB No. 1615-0061
U.S. Citizenship and Immigration Services
Expires 12/31/2018
If you need extra space to complete any section of this request or if you would like to provide additional information about your
circumstances, use the space provided in Part 11. Additional Information. Complete and submit as many copies of Part 11., as
necessary, with your request.
►
START HERE - Type or print in black ink.
Part 1. Information About the Regional Center
Part 2. Information About the Managing
Company or Agency (if different from regional
1.
Name of Regional Center Entity
center entity)
1.
Name of Managing Company or Agency
2.
Name of Regional Center (if different from regional
center entity)
Managing Company or Agency Mailing Address
3.
Regional Center Identification Number
2.a. In Care Of Name (if any)
4.
Regional Center Receipt Number
2.b.
Street Number and
Name or PO Box
2.c.
Apt.
Ste.
Flr.
Regional Center Mailing Address
2.d.
City or Town
5.a. In Care Of Name (if any)
2.e.
State
2.f.
ZIP Code
5.b.
Street Number and
Name or PO Box
Contact Information for Managing Company or
5.c.
Apt.
Ste.
Flr.
Agency
3.
Daytime Telephone Number
5.d.
City or Town
5.e.
State
5.f.
ZIP Code
4.
Fax Number
Regional Center Contact Information
Email Address (if any)
5.
6.
Daytime Telephone Number
Website Address (if any)
6.
7.
Fax Number
NOTE for Multiple Managing Companies or Agencies: If
Email Address (if any)
8.
more than one managing company or agency is associated with
the regional center, provide the above information for all other
managing companies or agencies in the space provided in Part
Website Address (if any)
9.
11. Additional Information.
NOTE for Regional Center Mailing Address: If the regional
center mailing address is different from the physical address,
please provide the physical address of the regional center in the
space provided in Part 11. Additional Information.
Form I-924A 12/23/16 N
Page 1 of 9
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal