Form I-600 - Petition To Classify Orphan As An Immediate Relative Page 9
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14Part 4. Accommodations for Individuals With Disabilities and/or Impairments
1.
Are you requesting an accommodation because of disabilities and/or impairments?
Yes
No
2.
If you answered "Yes" to Item Number 1., select all applicable boxes below to indicate who has the disabilities and/or impairments.
Petitioner
Spouse
Other Household Member
3.
If you answered "Yes" to Item Number 1., select all applicable boxes below. Provide information for each person with the
disabilities and/or impairments.
A.
Deaf or hard of hearing and request the following accommodations (If requesting a sign-language interpreter, indicate for
which language (e.g., American Sign Language)):
B.
Blind or have low vision and request the following accommodations:
C.
Another type of disability and/or impairment (Describe the nature of the disability and/or impairment and accommodation
you are requesting):
Part 5. Petitioner's Statement, ASC Acknowledgement (if applicable), Certification, Signature, and
Contact Information
Petitioner's Statement
Select the box for either Item 1.A. or 1.B. If applicable, select the box for Item Number 2.
1.A.
I can read and understand English, and have read and understand each and every question and instruction on this petition, as
well as my answer to each question. I have read and understand the Acknowledgement of Appointment at USCIS
Application Support Center (if applicable).
1.B.
The interpreter named in Part 9. has read to me each and every question and instruction on this petition, as well as my
answer to each question, in
, a language in which I am fluent.
I understand each and every question and instruction on this petition as translated to me by my interpreter, and have provided
complete, true, and correct responses. The interpreter named in Part 9. also has read the Acknowledgement of Appointment
at USCIS Application Support Center (if applicable) to me, in the language in which I am fluent, and I understand this ASC
Acknowledgement as read to me by my interpreter.
2.
I have requested the services of and consented to
,
who is
is not
an attorney or accredited representative, preparing this petition for me. This person who assisted me
in preparing my petition has reviewed the Acknowledgement of Appointment at USCIS Application Support Center (if
applicable) with me and I understand the ASC Acknowledgement.
Form I-600 12/23/16 N
Page 9 of 14
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