Form I-600 - Petition To Classify Orphan As An Immediate Relative Page 14
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14Part 10. Name, Contact Information, Statement, Certification, and Signature of the Person Preparing
this Petition, If Other Than the Petitioner and/or Spouse (continued)
Preparer's Contact Information
4.
Preparer's Daytime Telephone Number
5.
Preparer's Fax Number (if any)
6.
Preparer's Email Address (if any)
Preparer's Statement
I am not an attorney or accredited representative but have prepared this petition on behalf of the petitioner and/or the
7.A.
petitioner's spouse (if married) and with the petitioner's and/or petitioner's spouse's consent.
7.B.
I am an attorney or accredited representative and my representation of the petitioner and/or the petitioner's spouse (if married)
in this case (choose one) extends
does not extend
beyond the preparation of this petition.
Preparer's Certification
By my signature, I certify, swear, or affirm, under penalty of perjury, that I prepared this petition on behalf of, at the request of, and
with the express consent of the petitioner and/or the petitioner's spouse (if married). I completed this petition based only on responses
the petitioner and/or the petitioner's spouse provided to me. After completing the petition, I reviewed it and all of the petitioner's and/
or the petitioner's spouse's responses with the petitioner and/or the petitioner's spouse, who agreed with each and every answer on the
petition. If the petitioner and/or the petitioner's spouse supplied additional information concerning a question on the petition, I
recorded it on the petition. I also have read the Acknowledgement of Appointment at USCIS Application Support Center (if
applicable) to the petitioner and/or the petitioner's spouse and the petitioner and/or the petitioner's spouse has informed me that he and/
or she understands the ASC Acknowledgement.
Preparer's Signature
8.
Preparer's Signature
Date of Signature
(mm/dd/yyyy) ►
Form I-600 12/23/16 N
Page 14 of 14
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