Form I-918 - Supplement A - Petition For Qualifying Family Member Of U-1 Recipient Page 9

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Qualifying Family Member's Signature
Part 8. Qualifying Family Member's Statement,
Contact Information, Declaration, and Signature
6.a.
Qualifying Family Member's Signature (sign in ink)
(continued)
Qualifying Family Member's Contact Information
6.b. Date of Signature (mm/dd/yyyy)
3.
Qualifying Family Member's Daytime Telephone Number
NOTE TO ALL QUALIFYING FAMILY MEMBERS: If
you do not completely fill out this supplement or fail to submit
required documents listed in the Instructions, USCIS may deny
4.
Qualifying Family Member's Mobile Telephone Number
your supplement.
(if any)
Part 9. Interpreter's Contact Information,
Certification, and Signature
Qualifying Family Member's Email Address (if any)
5.
Provide the following information about the interpreter.
Qualifying Family Member's Declaration and
Interpreter's Full Name
Certification
1.a. Interpreter's Family Name (Last Name)
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
1.b. Interpreter's Given Name (First Name)
USCIS at a later date. Furthermore, I authorize the release of
any information from any of my records that USCIS may need
to determine my eligibility for the immigration benefit I seek.
2.
Interpreter's Business or Organization Name (if any)
I further authorize release of information contained in this
supplement, in supporting documents, and in my USCIS records
to other entities and persons where necessary for the
Interpreter's Mailing Address
administration and enforcement of U.S. immigration laws. Any
disclosure shall be in accordance with 8 U.S.C. section 1367
3.a.
Street Number
and Name
and 8 CFR 214.14(e).
3.b.
Apt.
Ste.
Flr.
I understand that USCIS may require me to appear for an
appointment to take my biometrics (fingerprints, photograph,
3.c. City or Town
and/or signature) and, at that time, if I am required to provide
biometrics, I will be required to sign an oath reaffirming that:
3.d. State
3.e. ZIP Code
1) I provided or authorized all of the information
contained in, and submitted with, my supplement;
3.f.
Province
2) I reviewed and understood all of the information in,
and submitted with, my supplement; and
3.g.
Postal Code
3) All of this information was complete, true, and
correct at the time of filing.
3.h. Country
I certify, under penalty of perjury, that all of the information in
my supplement and any document submitted with it were
provided or authorized by me, that I reviewed and understand
Interpreter's Contact Information
all of the information contained in, and submitted with, my
4.
supplement, and that all of this information is complete, true,
Interpreter's Daytime Telephone Number
and correct.
5.
Interpreter's Mobile Telephone Number (if any)
6.
Interpreter's Email Address (if any)
Page 9 of 12
Form I-918 Supplement A 02/07/17 N

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