Form I-290b - Notice Of Appeal Or Motion
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2OMB No. 1615-0095; Expires 05/31/2012
Form I-290B, Notice
Department of Homeland Security
of Appeal or Motion
U.S. Citizenship and Immigration Services
In the Matter of:
File Number: A -
For USCIS Use Only
START HERE - Please Type or Print (Use black ink)
Part 1.
Information About Petitioner/Applicant
(Individual/Business/
Returned
Receipt
Organization/Attorney/Representative filing appeal or motion)
Date
Family Name
Given Name
Middle Name
Date
Name of Business/Organization (if applicable)
Resubmitted
Mailing Address - Street Number and Name
Apt. #
Date
Date
C/O (in care of):
Reloc Sent
City
State or Province
Zip/Postal Code
Date
Country
Daytime Phone # (Area/Country Code)
Date
(
)
Reloc Rec'd
Fax # (Area/Country Code)
E-Mail Address (if any)
(
)
Date
I am an attorney or representative. If you check this box, you must provide the
Date
following information about the person or organization for whom you are
Remarks
appearing. (NOTE: You must attach a Form G-28, Notice of Entry of Appearance
as Attorney or Representative.)
Family Name
Given Name
Middle Name
Complete Name of Business/Organization/School (if applicable)
A # (if any)
Daytime Phone # (Area/Country Code)
(
)
Fax # (Area/Country Code)
E-mail Address (if any)
(
)
Part 2. Information About the Appeal or Motion
(Check one box below that best describes your request)
NOTE: If you indicate that you are filing an appeal, it may be considered by USCIS as a motion before it is forwarded to the AAO.
A.
I am filing an appeal. My brief and/or additional evidence is attached.
B.
I am filing an appeal. My brief and/or additional evidence will be submitted to the AAO within 30 days.
C.
I am filing an appeal. No supplemental brief and/or additional evidence will be submitted.
D.
I am filing a motion to reopen a decision. My brief and/or additional evidence is attached.
E.
I am filing a motion to reconsider a decision. My brief is attached.
I am filing a motion to reopen and a motion to reconsider a decision. My brief and/or additional evidence is attached.
F.
Form I-290B (Rev. 12/02/11) Y
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