Parent 2's Information
Part 2. Information About Your Beneficiary
(continued)
29.a. Family Name
(Last Name)
Beneficiary's Employer 2
29.b. Given Name
(First Name)
20.
Full Name of Employer
29.c. Middle Name
21.a.
Street Number
30.
Date of Birth (mm/dd/yyyy)
and Name
21.b.
Apt.
Ste.
Flr.
31.
Gender
Male
Female
32.
Country of Birth
21.c.
City or Town
21.d.
State
21.e.
ZIP Code
33.a. City/Town/Village of Residence
21.f.
Province
33.b. Country of Residence
21.g.
Postal Code
21.h.
Country
Other Information About Your Beneficiary
22.
Beneficiary's Occupation (specify)
34.
Has your beneficiary ever been previously married?
Yes
No
23.a.
Employment Start Date (mm/dd/yyyy)
If you answered "Yes" to Item Number 34., provide the names
of each prior spouse and the date each prior marriage ended in
23.b.
Employment End Date (mm/dd/yyyy)
Item Numbers 35.a. - 36. If you need to provide information
for more than one spouse, use the space provided in Part 8.
Additional Information.
Name of Previous Spouse
Information About Your Beneficiary's Parents
35.a. Family Name
Parent 1's Information
(Last Name)
24.a. Family Name
35.b. Given Name
(Last Name)
(First Name)
24.b. Given Name
35.c. Middle Name
(First Name)
36.
Date Marriage Ended
24.c. Middle Name
(mm/dd/yyyy)
25.
Date of Birth (mm/dd/yyyy)
37.
Has your beneficiary ever been in the United States?
26.
Gender
Male
Female
Yes
No
27.
Country of Birth
If your beneficiary is currently in the United States, complete
Item Numbers 38.a. - 38.h.
38.a.
He or she last entered as a (for example, visitor, student,
28.a. City/Town/Village of Residence
exchange alien, crewman, stowaway, temporary worker,
without inspection):
28.b. Country of Residence
38.b. I-94 Arrival-Departure Record Number
►
38.c.
Date of Arrival (mm/dd/yyyy)
Form I-129F 04/10/17 N
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