Fillable Form I-914 - Application For T Nonimmigrant Status (Page 8 of 10) in pdf

Form I-914 - Application For T Nonimmigrant Status Page 8

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PART F. Applicant's Statement, Contact Information, Declaration, Certification, and Signature

(continued)

Applicant's Contact Information

Applicant's Daytime Telephone Number

Applicant's Mobile Telephone Number (if any)

Applicant's Email Address (if any)

Applicant's Declaration and Certification

Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS may

require that I submit original documents to USCIS at a later date. Furthermore, I authorize the release of any information from any

and all of my records that USCIS may need to determine my eligibility for the immigration benefit that I seek.

I authorize the release of any information from my record that USCIS needs to determine eligibility for the benefit I am seeking to

investigate my claim, and to investigate fraudulent claims. I further authorize USCIS to release information to law enforcement

agencies and prosecutors investigating crimes of trafficking or related crimes. I further authorize USCIS to release information to

Federal, State, and local public and private agencies providing benefits, to be used solely in making determinations of eligibility for

benefits pursuant to 8 USC 1641(c).

I furthermore authorize release of information contained in this application, in supporting documents, and in my USCIS records, to

other entities and persons where necessary for the administration and enforcement of U.S. immigration law.

I understand that USCIS may require me to appear for an appointment to take my biometrics (fingerprints, photograph, and/or

signature) and, at that time, if I am required to provide biometrics, I will be required to sign an oath reaffirming that:

I reviewed and understood all of the information contained in, and submitted with, my application; and

All of this information was complete, true, and correct at the time of filing.

I certify, under penalty of perjury, that all of the information in my application and any document submitted with it were provided or

authorized by me, that I reviewed and understand all of the information contained in, and submitted with, my application and that all

of this information is complete, true, and correct.

Applicant's Signature

Applicant's Signature (sign in ink)

Date of Signature (mm/dd/yyyy)

NOTE TO ALL APPLICANTS: If you do not completely fill out this application or fail to submit required documents listed in the

Instructions, USCIS may deny your application.

Page 8

Form I-914 02/27/17 Y

Form I-914 - Application For T Nonimmigrant Status Page 8

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