Instructions For Notice Of Appeal Of Decision Under Sections 245a Or 210 Of The Immigration And Nationality Act (Form I-694) (Page 5 of 5) in pdf

Instructions For Notice Of Appeal Of Decision Under Sections 245a Or 210 Of The Immigration And Nationality Act (Form I-694) Page 5

Penalties

If you knowingly and willfully falsify or conceal a material fact or submit a false document with your Form I-694, we will

deny your Form I-694 and may deny any other immigration benefit. In addition, you will face severe penalties provided

by law, and may be subject to criminal prosecution.

USCIS Privacy Act Statement

AUTHORITIES: The information requested on this form, and the associated evidence, is collected under the

Immigration and Nationality Act, section 101.

PURPOSE: The primary purpose for providing the requested information on this form is to determine if you have

established eligibility for the immigration benefit for which you are filing. DHS will use the information you provide to

grant or deny the immigration benefit you are seeking.

DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and

any requested evidence, may delay a final decision or result in denial of the requested benefit.

ROUTINE USES: DHS may share the information you provide on this form with other Federal, state, local, and foreign

government agencies and authorized organizations. DHS follows approved routine uses described in the associated

published system of records notices [DHS/USCIS-007 - Benefits Information System and DHS/USCIS-001 - Alien File,

Index, and National File Tracking System of Records] which you can find at DHS may also share

the information, as appropriate, for law enforcement purposes or in the interest of national security.

Paperwork Reduction Act

An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection

of information, unless it displays a currently valid OMB control number. The public reporting burden for this collection

of information is estimated at 1 hour and 30 minutes per response, including the time for reviewing instructions,

gathering the required documentation and information, completing the form, preparing statements, attaching necessary

documentation, and submitting the form. Send comments regarding this burden estimate or any other aspect of this

collection of information, including suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services,

Regulatory Coordination Division, Office of Policy and Strategy, 20 Massachusetts Ave NW, Washington, DC 20529-

2140; OMB No. 1615-0034. Do not mail your completed Form I-694 to this address.

Form I-694 Instructions 12/23/16 N

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Instructions For Notice Of Appeal Of Decision Under Sections 245a Or 210 Of The Immigration And Nationality Act (Form I-694) Page 5