Form I-824 - Application For Action On An Approved Application Or Petition
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3OMB No. 1615-0044: Expires 07/31/2012
I-824, Application for Action on an
Department of Homeland Security
Approved Application or Petition
U.S. Citizenship and Immigration Services
START HERE - Please type or print in black ink
For USCIS Use Only
Returned
Receipt
Part 1. Information About You
(Person filing this application)
Family Name (Last name)
Given Name (First name)
Middle Name
Date
Date
Company or Organization Name
Resubmitted
Date
Home or Business Address - Street Number and Name
Apt./Suite #
Date
City
State or Province
Reloc Sent
Date
Zip/Postal Code
Country
Date
Reloc Rec'd
Mailing Address - Street Number and Name
Apt./Suite #
Date
C/O (In care of):
Date
Remarks
City
State or Province
Zip/Postal Code
Country
Daytime Phone # (Area/country codes)
Country of Birth
Country of Citizenship
Date of Birth (mm/dd/yyyy)
IRS Tax # (If any)
Action Block
A # (If any)
U.S. Social Security # (If any)
Part 2. Reason for Request
I am requesting
(Check one box):
A.
A duplicate approval notice
B.
USCIS to notify a new U.S. Consulate, different from that originally requested, through the
U.S. Department of State's National Visa Center or Kentucky Consular Center about the
approval of a nonimmigrant visa petition or to notify a new Port-of-Entry, different from that
originally requested, about the approval of a waiver application. Please notify the U.S.
Consulate or Port-of-Entry at:
To Be Completed by
Attorney or Representative, if any.
Fill in box if G-28 is attached to
USCIS to notify a U.S. Consulate through the National Visa Center that my status has been
C.
represent the applicant.
adjusted to permanent resident based on an approved I-485 application. Please notify the U.S.
ATTY State License #
Consulate at:
D.
USCIS to send my approved immigrant visa petition to the National Visa Center (NVC)
E.
USCIS to notify the U.S. Department of State of my U.S. Citizenship status
Form I-824 (Rev. 11/23/10) Y
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