Application for Action on an Approved Application or Petition
USCIS
Form I-824
Department of Homeland Security
OMB No. 1615-0044
U.S. Citizenship and Immigration Services
Expires 10/31/2017
Returned
Fee Stamp
Action Block
Date
Date
Resubmitted
Date
Date
For
USCIS
Relocated
Use
Received
Sent
Only
Remarks
Date the Previously Approved Visa Petition Was
Priority Date:
Filed (Form I-130, I-140 or I-360):
Country of Chargeability:
Date the Previous Visa Petition Was Approved
Classification Code:
(Form I-130, I-140 or I-360):
To be completed
Select this box if
Attorney State Bar Number
Attorney or Accredited Representative
by an attorney or
Form G-28 is
(if applicable)
USCIS Online Account Number (if any)
attached.
BIA-accredited
representative (if any).
►
START HERE - Type or print in black ink.
9.
Country of Citizenship or Nationality
Part 1. Information About You (Person filing this
Application)
1.
I am the (select only one):
Applicant
Petitioner
10.
IRS Tax Number (if any)
on the previously approved application or petition.
11.
U.S. Social Security Number (if any)
2.a. Family Name
►
(Last Name)
2.b. Given Name
12.
USCIS Online Account Number (if any)
(First Name)
►
2.c. Middle Name
Mailing Address
3.
Company or Organization Name (if any)
13.a. In Care Of Name
4.
Current/Recent Immigration Status
13.b.
Street Number
and Name
NOTE: If you are a U.S. citizen, type or print “N/A”
for Item Number 4.
13.c.
Apt.
Ste.
Flr.
5.
Certificate of Naturalization or Citizenship Number
13.d.
City or Town
(if any)
13.e.
State
13.f.
ZIP Code
6.
Alien Registration Number (A-Number) (if any)
13.g.
Province
►
A-
13.h.
Postal Code
7.
Date of Birth (mm/dd/yyyy)
13.i.
Country
8.
Country of Birth
Form I-824 12/23/16 N
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