Instructions For Form I-817 - Application For Family Unity Benefits (Page 6 of 14) in pdf

Part 2. Basis for Application

Item Numbers 1.a. - 1.h. I am applying for Family Unity benefits because. Select the box that applies to your

particular circumstance.

Item Numbers 2.a. - 2.d. I am requesting. Select the box that relates to what you are requesting.

Part 3. Information About Your Relationship

Information About Your Spouse or Parent

Item Numbers 1.a. - 12. The information requested is about the legalized alien through whom you are claiming eligibility

or an applicant qualifying for legalization under the LIFE Act. You must provide all the requested information.

Complete Only if You Are Applying Based on a Marital Relationship or You Were Previously Married

Item Numbers 13. - 20. Complete this section if you are applying based on a qualifying marital relationship or you were

previously married. You must provide all of the requested information.

1. Select the box that reflects your marital status.

2. If you are married, divorced, or widowed, provide the requested information about your marriages.

3. In addition, if you were previously married, select Item Number 20. to indicate that you have completed this section.

Complete Only if You Are Applying Based on a Child/Parent Relationship

Item Numbers 21.a. - 24.e. Complete this section if you are applying based on a qualifying child/parent relationship.

You must provide all of the requested information.

1. Provide the requested information about your relationship to the legalized alien and complete Item Numbers 21.a. -

24.e. If you need extra space to complete this section, use the space provided in Part 9. Additional Information, and

submit supporting documentation required in accordance to the Foreign Affairs Manual.

2. Provide the requested information about your marital status.

Part 4. Other Information

Item Numbers 1. - 38. The information requested is about you. You must provide all the requested information in Item

Numbers 1. - 24.f. You must answer all the questions in Item Numbers 25.a. - 38.

Part 5. Applicant’s Statement, Certification, Acknowledgement of Appointment at USCIS Application Support

Center, Signature, and Contact Information.

Item Numbers 1.a. - 6.b. Select the appropriate box to indicate that you either read this application yourself or someone

interpreted this application for you from English to a language in which you are fluent. If applicable, select the box to

indicate if someone prepared this application for you. You must also affirm that you have read and understand or that an

interpreter or preparer read to you and you understand the Acknowledgement of Appointment at USCIS Application

Support Center in Part 5. Further, you must sign and date your application and provide your daytime telephone

number, mobile telephone number (if any), and email address (if any). Every application MUST contain the signature

of the applicant (or parent or legal guardian, if applicable). A stamped or typewritten name in place of a signature is not

acceptable.

Part 6. Interpreter’s Contact Information, Certification, and Signature.

Item Numbers 1.a. - 6.b. If you used anyone as an interpreter to read the Instructions and questions on this application to

you in a language in which you are fluent, the interpreter must fill out this section, provide his or her name, the name and

address of his or her business or organization (if any), his or her daytime telephone number, and his or her email address

(if any). The interpreter must also certify that he or she has read the Acknowledgement of Appointment at USCIS

Application Support Center in Part 5. to you in the same language in which you are fluent. The interpreter must sign

and date the application.

Form I-817 Instructions 12/23/16 N

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Instructions For Form I-817 - Application For Family Unity Benefits Page 6