Instructions For Supplement B, Declaration Of Law Enforcement Officer For Victim Of Trafficking In Persons (Form I-914b) (Page 3 of 4) in pdf

D. Not applicable. You do not believe this individual is a victim of trafficking.

E. Other. Attach additional sheets to explain.

8. Describe the victimization on which the applicant’s claim is based and identify the relationship of the victimization to

the crime under investigation or prosecution by attaching additional sheets. Attach the results of any name or database

inquiry and any relevant reports or findings. Attach additional sheets if necessary.

9. Explain if the individual has expressed any fear of retaliation or revenge if they are removed from the United States.

10. Provide the dates on which the acts of trafficking occurred.

11. List the statutory citations that are or were being investigated or prosecuted.

12. Provide the date on which the investigation or prosecution was initiated.

13. Provide the date on which the investigation or prosecution was completed, if any.

Part D. Cooperation of Victim

In order to qualify for T nonimmigrant status, the individual must show that he or she has complied with any reasonable

requests from Federal, State, or local law enforcement in the investigation or prosecution of the acts of trafficking of

which he or she was a victim (unless he or she is under 18 years of age or he or she is unable to cooperate with the request

due to physical or psychological trauma).

Mark the box that describes the individual’s cooperation with you and explain, attaching additional sheets if necessary.

Part E. Family Members Implicated in Trafficking

List whether any of the victim’s family members are believed to have been involved in the trafficking in persons of which

the individual is a victim.

An alien victim is prohibited from filing for derivative T nonimmigrant status on behalf of a family member who

participated in trafficking the alien victim that established his or her eligibility for T nonimmigrant status. Therefore,

USCIS will not grant an immigration benefit to a family member who committed trafficking.

Part F. Attestation

The law enforcement officer filling out this form (identified in Part B. of the form), and their supervisor, must sign and

date the form in this section.

The Form I-914, Supplement B, must have an original signature. A photocopy of a signed declaration or a type written

name in place of a signature is not acceptable.

How Can I Provide Further Information at a Later Date?

An agency can provide further information to USCIS or formally revoke Form I-914, Supplement B, at a later date,

even after this form is submitted to USCIS, if there is new information or if the victim is no longer cooperating with

a reasonable request for assistance in an investigation or prosecution. You should notify USCIS by sending a written

statement to:

USCIS

Vermont Service Center

75 Lower Welden Street

St. Albans, VT 05479-0001

An agency should send a letter on official agency letterhead to USCIS at the address above describing the reasons for

providing further information or the reasons for revoking the declaration. Include the victim’s name, date of birth, and

A-Number (if available) on all correspondence. USCIS will allow the victim to rebut this information.

Form I-914, Supplement B Instructions 02/27/17 Y

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Instructions For Supplement B, Declaration Of Law Enforcement Officer For Victim Of Trafficking In Persons (Form I-914b) Page 3