Form I-130 - Petition For Alien Relative Page 3
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1227.
Country of Birth
Part 2. Information About You (Petitioner)
(continued)
South Africa
18.
Date of Current Marriage (if currently married)
28.
City/Town/Village of Residence
(mm/dd/yyyy)
08/17/2012
Deceased
29.
Country of Residence
Place of Your Current Marriage (if married)
Deceased
19.a. City or Town
Austin
Parent 2's Information
19.b. State
TX
Full Name of Parent 2
30.a.
Family Name
19.c. Province
N/A
Moodley
(Last Name)
19.d. Country
30.b.
Given Name
Thandolwethu
(First Name)
United States
30.c.
Middle Name
Amahle
Names of All Your Spouses (if any)
31.
Date of Birth (mm/dd/yyyy)
11/19/1959
Provide information on your current spouse (if currently married)
32.
Sex
Male
Female
first and then list all your prior spouses (if any).
33.
Country of Birth
Spouse 1
South Africa
20.a. Family Name
Moodley
(Last Name)
34.
City/Town/Village of Residence
20.b. Given Name
Thandolwethu
(First Name)
Cape Town
20.c. Middle Name
Amahle
35.
Country of Residence
South Africa
21.
Date Marriage Ended (mm/dd/yyyy)
N/A
Additional Information About You (Petitioner)
Spouse 2
22.a.
Family Name
36.
I am a (Select only one box):
N/A
(Last Name)
U.S. Citizen
Lawful Permanent Resident
22.b.
Given Name
N/A
(First Name)
If you are a U.S. citizen, complete Item Number 37.
22.c.
Middle Name
N/A
37.
My citizenship was acquired through (Select only one
box):
23.
Date Marriage Ended (mm/dd/yyyy)
N/A
Birth in the United States
Naturalization
Information About Your Parents
Parents
Parent 1's Information
38.
Have you obtained a Certificate of Naturalization or a
Full Name of Parent 1
Certificate of Citizenship?
Yes
No
24.a.
Family Name
Moodley
If you answered "Yes" to Item Number 38., complete the
(Last Name)
following:
24.b.
Given Name
John
39.a.
Certificate Number
(First Name)
24.c.
Middle Name
N/A
12345678
39.b.
Place of Issuance
25.
Date of Birth (mm/dd/yyyy)
10/16/1955
Austin, TX
26.
Sex
Male
Female
39.c. Date of Issuance (mm/dd/yyyy)
06/01/2010
Form I-130 02/27/17 N
Page 3 of 12
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