Form I-918 - Supplement A - Petition For Qualifying Family Member Of U-1 Recipient Page 11
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12Part 10. Contact Information, Declaration, and
Signature of the Person Preparing this Petition, if
Other Than the Petitioner or Qualifying Family
Member (continued)
Preparer's Certification
By my signature, I certify, under penalty of perjury, that I
prepared this supplement at the request of the petitioner and
qualifying family member. The petitioner and qualifying family
member then reviewed this completed supplement and informed
me that they understand all of the information contained in, and
submitted with, this supplement, including the Petitioner's
Declaration and Certification, and the Qualifying Family
Member's Declaration and Certification, and that all of this
information is complete, true, and correct. I completed this
supplement based only on information that the petitioner and
qualifying family member provided to me or authorized me to
obtain or use.
Preparer's Signature
8.a.
Preparer's Signature (sign in ink)
8.b. Date of Signature (mm/dd/yyyy)
Page 11 of 12
Form I-918 Supplement A 02/07/17 N
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