Instructions For Annual Certification Of Regional Center (Form I-924a) (Page 5 of 9) in pdf

4. Aggregate amount of non-EB-5 capital investment;

5. Aggregate number of direct, indirect, and/or induced jobs created;

6. Aggregate number of jobs that have been maintained for EB-5 purposes through investments into “troubled

businesses” (if applicable); and

7. Indicate whether the new commercial enterprise will serve as a vehicle for investment into job creating entities that

have or will create or maintain jobs for EB-5 purposes.

Item Numbers 11. - 18. Job Creating Entity. If any new commercial enterprise serves as a vehicle for investment into

other job creating entities, provide the following information for each job creating entity:

1. Name of each job creating entity;

2. Federal Employer Identification Number of each job creating entity;

3. Mailing address and physical address of each job creating entity;

4. Industries of each job creating entity;

5. Aggregate amount of EB-5 capital investment for each job creating entity;

6. Aggregate amount of non-EB-5 capital investment for each job creating entity;

7. Aggregate number of jobs created for each job creating entity; and

8. Aggregate number of jobs maintained for EB-5 purposes through investment into “troubled businesses” for each job

creating entity (if applicable).

NOTE: When providing the requested job creation data, please refer to NOTE in Part 5. in the Specific Instructions

section for reporting job creation contained in the note to Part 5. above. Additionally, if the reported jobs were not all

created during the Federal fiscal year covered by the form, use the space provided in Part 11. Additional Information to

report the number of jobs created by Federal fiscal year.

Part 7. Petitions Filed by EB-5 Investors

Item Numbers 1. - 2. Immigrant Petition by Alien Entrepreneur (Form I-526). Provide the name of each new

commercial enterprise associated with the regional center that has received EB-5 investment capital and the total number

of approved, denied, and revoked Form I-526 petitions filed by EB-5 investors for each new commercial enterprise. If

you need extra space to complete this section, use the space provided in Part 11. Additional Information.

Item Numbers 3. - 4. Petition by Entrepreneur to Remove Conditions (Form I-829). Provide the name of each new

commercial enterprise associated with the regional center that has received EB-5 investment capital and the total number

of approved and denied Form I-829 petitions filed by EB-5 investors for each new commercial enterprise. If you need

extra space to complete this section, use the space provided in Part 11. Additional Information.

NOTE: In certain instances, in order to verify the aggregate data provided in this form, USCIS may require case-specific

data relating to individual EB-5 petitions and the job creation and allocation methodologies used by a regional center.

Part 8. Statement, Contact Information, Declaration, Certification, and Signature of the Authorized Individual

This form must be signed and filed by an authorized individual of the regional center. An “authorized individual” of the

regional center is a principal of the entity previously designated to participate in the Immigrant Investor Program with the

executive managerial authority to complete and execute this form.

Item Numbers 1.a. - 8.b. Select the appropriate box to indicate whether you read this form yourself or whether

you had an interpreter assist you. If someone assisted you in completing the form, select the box indicating that you

used a preparer. Further, you must sign and date this form and provide your title or position held within the regional

center entity, daytime telephone number, mobile telephone number (if any), and email address (if any). Every form

MUST contain the signature of the authorized individual. A stamped or typewritten name in place of a signature is not

acceptable.

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

Page 5 of 9

Instructions For Annual Certification Of Regional Center (Form I-924a) Page 5