Form I-90 - Application To Replace Permanent Resident Card Page 5
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7Part 6. Interpreter's Contact Information,
Interpreter's Signature
Certification, and Signature
7.a.
Interpreter's Signature (sign in ink)
Provide the following information about the interpreter.
Interpreter's Full Name
7.b.
Date of Signature
(mm/dd/yyyy)
1.a.
Interpreter's Family Name (Last Name)
Part 7. Contact Information, Declaration, and
Signature of the Person Preparing this
1.b.
Interpreter's Given Name (First Name)
Application, if Other Than the Applicant
Provide the following information about the preparer.
2.
Interpreter's Business or Organization Name (if any)
Preparer's Full Name
Interpreter's Mailing Address
1.a. Preparer's Family Name (Last Name)
3.a.
Street Number
and Name
1.b.
Preparer's Given Name (First Name)
3.b.
Apt.
Ste.
Flr.
2.
Preparer's Business or Organization Name (if any)
3.c. City or Town
3.d. State
3.e. ZIP Code
Preparer's Mailing Address
3.f.
Province
3.a.
Street Number
and Name
3.g. Postal Code
3.b.
Apt.
Ste.
Flr.
3.h.
Country
3.c. City or Town
Interpreter's Contact Information
3.d. State
3.e. ZIP Code
4.
Interpreter's Daytime Telephone Number
3.f.
Province
3.g. Postal Code
5.
Interpreter's Mobile Telephone Number (if any)
3.h.
Country
6.
Interpreter's Email Address (if any)
Preparer's Contact Information
Interpreter's Certification
4.
Preparer's Daytime Telephone Number
I certify, under penalty of perjury, that:
5.
Preparer's Mobile Telephone Number (if any)
I am fluent in English and
,
which is the same language provided in Part 5., Item Number
1.b., and I have read to this applicant in the identified language
6.
Preparer's Email Address (if any)
every question and instruction on this application and his or her
answer to every question. The applicant informed me that he or
she understands every instruction, question, and answer on the
application, including the Applicant's Certification, and has
verified the accuracy of every answer.
Form I-90 02/27/17 N
Page 5 of 7
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Parent category: Legal