Form I-918 - Supplement A - Petition For Qualifying Family Member Of U-1 Recipient Page 6
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12Has your family member EVER:
Part 5. Processing Information (continued)
13.a.
Served in, been a member of, assisted in, or participated
9.
Has your family member EVER, during the period of
in any military unit, paramilitary unit, police unit, self-
March 23, 1933 to May 8, 1945, in association with either
defense unit, vigilante unit, rebel group, guerilla group,
the Nazi Government of Germany or any organization or
militia, or other insurgent organization?
government associated or allied with the Nazi Government
Yes
No
of Germany, ordered, incited, assisted or otherwise
participated in the persecution of any person because of
13.b.
Served in any prison, jail, prison camp, detention facility,
race, religion, nationality, membership in a particular
labor camp, or any other situation that involved detaining
social group or political opinion?
Yes
No
persons?
Yes
No
Has your family member EVER ordered, incited, called for,
13.c.
Served in, been a member of, assisted in, or participated
committed, assisted, helped with, or otherwise participated in any
in any group, unit, or organization of any kind in which
of the following:
you or other persons transported, possessed, or used any
type of weapon?
Yes
No
10.a.
Acts involving torture or genocide?
Yes
No
NOTE: If you answered "Yes" to any question in Item
10.b.
Killing any person?
Yes
No
Numbers 13.a. - 13.c., please describe the circumstances in
Part 11. Additional Information.
10.c.
Intentionally and severely injuring any person?
Yes
No
Has your family member EVER:
10.d.
Engaging in any kind of sexual conduct or relations with
14.a.
Received any type of military, paramilitary, or weapons
any person who was being forced or threatened?
training?
Yes
No
Yes
No
14.b.
Been a member of, assisted in, or participated in any
10.e.
Limiting or denying any person's ability to exercise
group, unit, or organization of any kind in which you or
religious beliefs?
other persons used any type of weapon against any person
Yes
No
or threatened to do so?
Yes
No
10.f.
The persecution of any person because of race, religion,
14.c.
Assisted or participated in selling or providing weapons to
national origin, membership in a particular social group,
or political opinion?
any person who to your knowledge used them against
Yes
No
another person, or in transporting weapons to any person
10.g.
Displacing or moving any person from their residence by
who to your knowledge used them against another
force, threat of force, compulsion, or duress?
person?
Yes
No
Yes
No
NOTE: If you answered "Yes" to any question in Item
Numbers 14.a. - 14.c., please describe the circumstances in
NOTE: If you answered "Yes" to any question in Item
Part 11. Additional Information.
Numbers 10.a. - 10.g., please describe the circumstances in the
spaces provided in Part 11. Additional Information.
Has your family member EVER:
11.
Has your family member EVER advocated that another
15.a.
Recruited, enlisted, conscripted, or used any person under 15
person commit any of the acts described in Item
years of age to serve in or help an armed force or group?
Numbers 10.a. - 10.g., urged, or encouraged another
Yes
No
person, to commit such acts?
Yes
No
15.b.
Used any person under 15 years of age to take part in
Has your family member EVER been present or nearby when
hostilities, or to help or provide services to people in
any person was:
combat?
Yes
No
12.a.
Intentionally killed, tortured, beaten, or injured?
16.
Is your family member NOW in removal, exclusion,
Yes
No
rescission, or deportation proceedings?
Yes
No
12.b.
Displaced or moved from his or her residence by force,
compulsion, or duress?
Yes
No
17.
Has your family member EVER had removal, exclusion,
rescission, or deportation proceedings initiated against
12.c.
In any way compelled or forced to engage in any kind of
him or her?
Yes
No
sexual contact or relations?
Yes
No
Page 6 of 12
Form I-918 Supplement A 02/07/17 N
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