Form I-130 - Petition For Alien Relative Page 7
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1248.
Travel Document Number
Part 4. Information About Beneficiary
(continued)
N/A
49.
Country of Issuance for Passport or Travel Document
Person 4
South Africa
37.a.
Family Name
N/A
(Last Name)
50.
Expiration Date for Passport or Travel Document
37.b.
Given Name
N/A
(mm/dd/yyyy)
(First Name)
05/18/2020
37.c.
Middle Name
N/A
Beneficiary's Employment Information
38.
Relationship
N/A
Provide the beneficiary's current employment information (if
applicable), even if they are employed outside of the United
39.
Date of Birth (mm/dd/yyyy)
N/A
States. If the beneficiary is currently unemployed, type or print
40.
Country of Birth
"Unemployed" in Item Number 51.a.
N/A
51.a.
Name of Current Employer (if applicable)
Unemployed - Homemaker
Person 5
51.b.
Street Number
N/A
and Name
41.a. Family Name
N/A
(Last Name)
51.c.
Apt.
Ste.
Flr.
N/A
41.b. Given Name
N/A
(First Name)
51.d.
City or Town
N/A
41.c. Middle Name
N/A
51.e. State
51.f. ZIP Code
N/A
N/A
42.
Relationship
N/A
51.g. Province
N/A
43.
Date of Birth (mm/dd/yyyy)
N/A
51.h. Postal Code
N/A
44.
Country of Birth
51.i. Country
N/A
N/A
Beneficiary's Entry Information
52.
Date Employment Began (mm/dd/yyyy)
01/01/1980
45.
Was the beneficiary EVER in the United States?
Yes
No
Additional Information About Beneficiary
If the beneficiary is currently in the United States, complete
Items Numbers 46.a. - 46.d.
53.
Was the beneficiary EVER in immigration proceedings?
46.a.
He or she arrived as a (Class of Admission):
Yes
No
N/A
54.
If you answered "Yes," select the type of proceedings and
provide the location and date of the proceedings.
46.b. Form I-94 Arrival-Departure Record Number
►
Removal
Exclusion/Deportation
N / A
Rescission
Other Judicial Proceedings
46.c.
Date of Arrival (mm/dd/yyyy)
N/A
55.a.
City or Town
46.d.
Date authorized stay expired, or will expire, as shown on
N/A
Form I-94 or Form I-95 (mm/dd/yyyy) or type or print
"D/S" for Duration of Status
55.b. State
N/A
N/A
56.
Date (mm/dd/yyyy)
N/A
47.
Passport Number
SA123ABC
Form I-130 02/27/17 N
Page 7 of 12
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