Fillable Form I-130 - Petition For Alien Relative (Page 9 of 12) in pdf

Part 5. Other Information (continued)

Petitioner's Contact Information

Petitioner's Daytime Telephone Number

Relative 2

8.a.

Family Name

(Last Name)

Petitioner's Mobile Telephone Number (if any)

8.b.

Given Name

(First Name)

8.c.

Middle Name

Petitioner's Email Address (if any)

Relationship

Petitioner's Declaration and Certification

WARNING: USCIS investigates the claimed relationships and

verifies the validity of documents you submit. If you falsify a

Copies of any documents I have submitted are exact

family relationship to obtain a visa, USCIS may seek to have

photocopies of unaltered, original documents, and I understand

you criminally prosecuted.

that USCIS may require that I submit original documents to

USCIS at a later date. Furthermore, I authorize the release of

PENALTIES: By law, you may be imprisoned for up to 5

any information from any of my records that USCIS may need

years or fined $250,000, or both, for entering into a marriage

to determine my eligibility for the immigration benefit I seek.

contract in order to evade any U.S. immigration law. In

addition, you may be fined up to $10,000 and imprisoned for

I further authorize release of information contained in this

up to 5 years, or both, for knowingly and willfully falsifying

petition, in supporting documents, and in my USCIS records to

or concealing a material fact or using any false document in

other entities and persons where necessary for the administration

submitting this petition.

and enforcement of U.S. immigration laws.

I understand that USCIS may require me to appear for an

Part 6. Petitioner's Statement, Contact

appointment to take my biometrics (fingerprints, photograph,

Information, Declaration, and Signature

and/or signature) and, at that time, if I am required to provide

biometrics, I will be required to sign an oath reaffirming that:

NOTE: Read the Penalties section of the Form I-130

Instructions before completing this part.

1) I provided or authorized all of the information

contained in, and submitted with, my petition;

Petitioner's Statement

2) I reviewed and understood all of the information in,

and submitted with, my petition; and

NOTE: Select the box for either Item Number 1.a. or 1.b. If

applicable, select the box for Item Number 2.

3) All of this information was complete, true, and correct

at the time of filing.

I can read and understand English, and I have read

1.a.

and understand every question and instruction on this

I certify, under penalty of perjury, that all of the information in

petition and my answer to every question.

my petition and any document submitted with it were provided

or authorized by me, that I reviewed and understand all of the

The interpreter named in Part 7. read to me every

1.b.

information contained in, and submitted with, my petition, and

question and instruction on this petition and my

that all of this information is complete, true, and correct.

answer to every question in

Petitioner's Signature

a language in which I am fluent. I understood all of

6.a.

Petitioner's Signature (sign in ink)

this information as interpreted.

At my request, the preparer named in Part 8.,

6.b.

Date of Signature (mm/dd/yyyy)

prepared this petition for me based only upon

information I provided or authorized.

NOTE TO ALL PETITIONERS: If you do not completely

fill out this petition or fail to submit required documents listed

in the Instructions, USCIS may deny your petition.

Form I-130 02/27/17 N

Page 9 of 12

Form I-130 - Petition For Alien Relative Page 9

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