Instructions For Annual Certification Of Regional Center (Form I-924a) (Page 2 of 9) in pdf

How To Fill Out Form I-924A

1. Type or print clearly in black ink.

2. If you need extra space to complete any item within this form, use the space provided in Part 11. Additional

Information or attach a separate sheet of paper; type or print the name of the regional center entity at the top of each

attached sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign

and date each sheet.

3. Answer all questions fully and accurately. If a question does not apply to you (for example, if the new commercial

enterprise does not serve as a vehicle for investment into other job creating entities and the question asks for

information about those entities), type or print “N/A,” unless otherwise directed. If your answer to a question which

requires a numeric response is zero or none (for example, “Aggregate Non-EB-5 Capital Investment”), type or print

“None,” unless otherwise directed.

Specific Instructions

Part 1. Information About the Regional Center

Item Numbers 1. - 4. Information About the Regional Center Entity. Provide the name of the regional center entity,

the name of the regional center (if different from the regional center entity), regional center identification number, and the

receipt number for the Form I-924 filing. The regional center entity is the legal entity previously designated as a regional

center in order to promote economic growth through investment in a limited geographic area.

Item Numbers 5.a. - 5.f. Regional Center Mailing Address. Provide the mailing address where the regional center

entity can receive a printed notice from USCIS. If the mailing address of the regional center entity is different from its

physical address, provide the physical address of the regional center entity in the space provided in Part 11. Additional

Information.

Item Numbers 6. - 9. Regional Center Contact Information. Provide the daytime telephone number, fax number,

email address (if any), and website address (if any) for the regional center entity.

Part 2. Information About the Managing Company or Agency (if different from the regional center entity)

A “managing company or agency” is any entity, agent, individual, group, or other organization, which is not a principal

(as that term is defined in Part 4. of the Specific Instructions section) of the regional center entity, that is or will be

involved in the management, oversight, or administration of the regional center.

Item Number 1. Name of the Managing Company or Agency. Provide the name of the managing company or agency.

Item Numbers 2.a. - 2.f. Managing Company or Agency Mailing Address. Provide the mailing address of the

managing company or agency.

Item Numbers 3. - 6. Contact Information for Managing Company or Agency. Provide the daytime telephone

number, fax number, email address (if any), and website address (if any) for the regional center’s managing company or

agency.

NOTE: If more than one managing company or agency is associated with the regional center, provide the above

information for all other managing companies or agencies in the space provided in Part 11. Additional Information.

Part 3. Reporting Period for the Regional Center Activity

Item Numbers 1. - 2. Reporting Period. Indicate whether you are filing this form for a single federal Fiscal year or for

a series of Federal fiscal years. Confirm the period of time the form is meant to cover regarding reporting for the regional

center.

Form I-924A Instructions 12/23/16 N

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Instructions For Annual Certification Of Regional Center (Form I-924a) Page 2