Form I-914 - Application For T Nonimmigrant Status Page 7
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10PART E. Information About Your Family Members (continued)
2.
Children
a.
Family Name (Last Name)
Given Name (First Name)
Middle Name (if any)
Date of Birth (mm/dd/yyyy)
Country of Birth
Relationship
Current Location
b.
Family Name (Last Name)
Given Name (First Name)
Middle Name (if any)
Date of Birth (mm/dd/yyyy)
Country of Birth
Relationship
Current Location
c.
Family Name (Last Name)
Given Name (First Name)
Middle Name (if any)
Date of Birth (mm/dd/yyyy)
Country of Birth
Relationship
Current Location
Complete Form I-914, Supplement A, Application for Family Member of T-1 Recipient, for each family member listed above for
whom you are now applying to have join you in the United States, and attach it to this application.
PART F. Applicant's Statement, Contact Information, Declaration, Certification, and Signature
NOTE: Read the Penalties section of the Form I-914 Instructions before completing this part.
Applicant's Statement
NOTE: Select the box for either Item A. or B. in Item Number 1. If applicable, select the box for Item Number 2.
1. Applicant's Statement Regarding the Interpreter
A.
I can read and understand English, and I have read and understand every question and instruction on this application
and my answer to every question.
B.
The interpreter named in Part G. read to me every question and instruction on this application and my answer to every
question in
,
a language in which I am fluent, and I understood everything.
2.
Applicant's Statement Regarding the Preparer
At my request, the preparer named in Part H.,
,
prepared this application for me based only upon information I provided or authorized.
Page 7
Form I-914 02/27/17 Y
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