Form I-140 - Immigrant Petition For Alien Worker Page 5
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6Part 7. Information on Spouse and All Children of the Person for Whom You Are Filing (continued)
Person 3
Person 5
3.a. Family Name
5.a. Family Name
(Last Name)
(Last Name)
3.b. Given Name
5.b. Given Name
(First Name)
(First Name)
3.c. Middle Name
5.c. Middle Name
►
►
3.d.
Date of Birth
(mm/dd/yyyy)
5.d.
Date of Birth
(mm/dd/yyyy)
3.e.
Country of Birth
5.e.
Country of Birth
3.f.
Relationship
5.f.
Relationship
3.g.
Applying for Adjustment of Status?
Yes
No
5.g.
Applying for Adjustment of Status?
Yes
No
3.h. Applying for Visa Abroad?
Yes
No
5.h. Applying for Visa Abroad?
Yes
No
Person 4
Person 6
4.a.
Family Name
6.a.
Family Name
(Last Name)
(Last Name)
4.b.
Given Name
6.b.
Given Name
(First Name)
(First Name)
4.c.
Middle Name
6.c.
Middle Name
(mm/dd/yyyy) ►
(mm/dd/yyyy) ►
4.d. Date of Birth
6.d. Date of Birth
4.e. Country of Birth
6.e. Country of Birth
4.f.
Relationship
6.f.
Relationship
4.g. Applying for Adjustment of Status?
Yes
No
6.g. Applying for Adjustment of Status?
Yes
No
4.h.
Applying for Visa Abroad?
Yes
No
6.h.
Applying for Visa Abroad?
Yes
No
Part 8. Signature of Petitioner
I certify, under penalty of perjury under the laws of the United States
(
)
2.
Daytime Phone Number
-
of America, that this petition and the evidence submitted with it are all
true and correct. I authorize U.S. Citizenship and Immigration Services
(
)
3.
Mobile Phone Number
-
(USCIS) to release to other government agencies any information from
my USCIS records, if USCIS determines that such action is necessary
4.
E-mail Address (if any)
to determine eligibility for the benefit sought.
5.
Job Title of Position with Petitioning Employer, If the
1.a. Signature of Petitioner
Petition Is Being Filed by an Employer
1.b. Date of Signature (mm/dd/yyyy) ►
NOTE: If you do not fully complete this form or fail to submit
the required documents listed in the instructions, a final decision
on your petition may be delayed or the petition may be denied.
Form I-140 01/17/17 N
Page 5 of 6
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