Form I-600a - Application For Advance Processing Of An Orphan Petition Page 9
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12Part 6. Applicant's Duty of Disclosure
Certification: I understand the ongoing duty to disclose information concerning my suitability and eligibility as an adoptive parent,
as described in the Form I-600A and/or Form I-600 instructions, and I agree to notify the home study preparer and USCIS of any new
information that I am required to disclose.
Applicant's Signature
Date of Signature
►
(mm/dd/yyyy)
Part 7. Spouse's Statement, ASC Acknowledgement (if applicable), Certification, Signature, and
Contact Information
Spouse's Statement
Select the box for either Item Number 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 application, 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 application, 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 application 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 application for me. This person who assisted me
in preparing this application has reviewed the Acknowledgement of Appointment at USCIS Application Support
Center (if applicable) with me and I understand the ASC Acknowledgement.
Acknowledgement of Appointment at USCIS Application Support Center (if applicable)
I,
,
understand that the purpose of a USCIS Application Support Center (ASC) appointment is for me to provide my fingerprints, photograph,
and/or signature and to reverify that all of the information in this application is complete, true, and correct and was provided by me or my
spouse. I understand that I will sign my name to the following declaration which USCIS will display to me at the time I provide my
fingerprints, photograph, and/or signature during my ASC appointment:
By signing here, I declare under penalty of perjury that I have reviewed and understand this application as identified by the
receipt number displayed on the screen above, and all supporting documents, applications, petitions, or requests filed with this
application that I (or my attorney or accredited representative) filed with USCIS, and that all of the information in these
materials is complete, true, and correct.
I also understand that when I sign my name, provide my fingerprints, and am photographed at the USCIS ASC, I will be reverifying
that I willingly submit this application; I have reviewed the contents of this application; all of the information in this application and
all supporting documents submitted with my application are complete, true, and correct; and if I was assisted in completing this
application, the person assisting me also reviewed this Acknowledgement of Appointment at USCIS Application Support Center
(if applicable) with me.
Spouse's Certification
I certify, under penalty of perjury under the laws of the United States of America, that the information in this application and any
document submitted with this application is complete, true, and correct.
Form I-600A 12/23/16 N
Page 9 of 12
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