Form I-690 - Application For Waiver Of Grounds Of Inadmissibility Page 6

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Part 4. Interpreter's Contact Information, Certification, and Signature (continued)
Interpreter's Mailing Address
3.
Street Number and Name
Apt.
Ste.
Flr.
Number
City or Town
State
ZIP Code
Province
Postal Code
Country
Interpreter's Contact Information
4.
Interpreter's Daytime Telephone Number
5.
Interpreter's Email Address (if any)
Interpreter's Certification
I certify that:
I am fluent in English and
, which is the same language provided in Part 3.,
Item B., in Item Number 1.
I have read to this applicant every question and instruction on this application, as well as the answer to every question, in the language
provided in Part 3., Item B., in Item Number 1.; and
I have read the Acknowledgement of Appointment at USCIS Application Support Center to the applicant, in the same language
provided in Part 3., Item B., Item Number 1. The applicant has informed me that he or she understands every instruction and
question on the application, as well as the answer to every question, and the applicant verified the accuracy of every answer; and
The applicant has also informed me that he or she understands the ASC Acknowledgement and that by appearing for a USCIS ASC
biometric services appointment and providing his or her fingerprints, photograph, and/or signature, he or she is re-affirming that the
contents of this application and all supporting documentation are complete, true, and correct.
Interpreter's Signature
6.
Interpreter's Signature
Date of Signature
(mm/dd/yyyy)
Part 5. Contact Information, Statement, Certification, and Signature of the Person Preparing this
Application, If Other Than the Applicant
Provide the following information concerning the preparer.
Preparer's Full Name
1.
Preparer's Family Name (Last Name)
Preparer's Given Name (First Name)
2.
Preparer's Business or Organization Name (if any)
Form I-690 12/23/16 N
Page 6 of 8

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