Form I-817 - Application For Family Units Benefits Page 5
Download a blank fillable Form I-817 - Application For Family Units Benefits in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form I-817 - Application For Family Units Benefits with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5
6Part 4. Information About Your Spouse or Parent (Your spouse or parent must be either a legalized
alien or an alien eligible for adjustment pursuant to the LIFE Act)
1. Provide the following information about the alien through whom you are claiming your eligibility.
Family Name (Last Name)
Given Name (First Name)
Full Middle Name
Date of Birth (mm/dd/yyyy)
A-Number (if any)
U.S. Social Security No. (if any) Class of Admission
Gender
Male
Female
Home Address: Street Number and Name (include apartment number)
City
State
Zip Code
Daytime Phone No. (Area Code)
2. List all other names used, including maiden name.
Part 5. Complete Only If You Are Applying Based on a Marital Relationship
1. Provide the following information about you and your spouse.
Number of times you have been married
Number of times your spouse has been married
2. Provide the following information about your current marriage.
Date of marriage (mm/dd/yyyy)
Place of marriage (City, State or province, and country)
3. Type of ceremony.
4. We are:
Religious
Civil
None
Living together
Not living together
Part 6. Complete Only If You Are Applying Based on a Child/Parent Relationship
1. Indicate how your parent is related to you.
Biological mother
Biological father who was married to my mother when I was born
Biological father who was not married to my mother when I was born.
Stepparent - based on marriage to my parent which occurred before my 18th birthday
Adoptive parent and:
Yes
No
a. The adoption occurred before my 16th birthday
b. My adoptive parent had legal custody of me for at least two years prior to May 5,
Yes
No
1988 or December 1, 1988, as appropriate
c. I lived with my adoptive parent for at least two years prior to May 5, 1988 or
Yes
No
December 1, 1988, as appropriate
Parent based on circumstances not described above (Explain in detail on a seperate sheet of paper.)
2. Give the following information about your marital status.
Single
Married
Divorced
Widowed
3. Provide the following information if you are married, divorced, or widowed.
Date of marriage (mm/dd/yyyy)
Place of marriage (City, State or province, and country)
4. Type of ceremony.
5. We are:
Religious
Civil
None
Living together
Not living together
6.
If divorced or widowed:
Date marriage ended (mm/dd/yyyy)
Place marriage ended (City, State or province, and country)
Form I-817 (Rev. 02/28/12) Y Page 5
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Tc-817 - Application For Personalized Plates And Replacement Of Existing Personalized Plates
Legal
Form Tc-817 - Application For Personalized Plates And Replacement Of Existing Personalized License Plates
Financial
Form Tc-817 - Application For Personalized Plates And Replacement Of Existing Personalized Plates
Financial
Form I-212 - Application For Permission To Reapply For Admission Into The United States After Deportation Or Removal - 2005
Legal
Related Categories
Parent category: Legal