Form I-918 - Petition For U Nonimmigrant Status Page 6

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Part 3. Processing information.
(Continued.)
11. Have you EVER been present or nearby when any person was:
a. Intentionally killed, tortured, beaten, or injured?
Yes
No
b. Displaced or moved from his or her residence by force, compulsion or duress?
Yes
No
c. In any way compelled or forced to engage in any kind of sexual contact or relations?
Yes
No
If you answer “Yes,” please describe the circumstances on a separate sheet(s) of paper.
12. Have you (or has any member of your family) EVER served in, been a member of, or been involved in any way with:
a. Any military unit, paramilitary unit, police unit, self-defense unit, vigilante unit, rebel group,
Yes
No
guerrilla group, or insurgent organization?
b. Any prison, jail, prison camp, detention camp, labor camp, or any other situation that
Yes
No
involved guarding prisoners?
c. Any group, unit, or organization of any kind in which you or other persons possessed,
Yes
No
transported, or used any type of weapon?
If you answer “Yes,” please describe the circumstances on a separate sheet(s) of paper.
Yes
No
13. Have your EVER received any type of military, paramilitary or weapons training? (If you
answer “Yes,” please describe the circumstances on a separate sheet(s) of paper.)
14.
a. Are removal, exclusion, rescission or deportation proceedings pending against you?
Yes
No
b. Have removal, exclusion, rescission or deportation proceedings EVER been initiated against you?
Yes
No
Yes
No
c. Have you EVER been removed, excluded or deported from the United States?
d. Have you EVER been ordered to be removed, excluded or deported from the United States?
Yes
No
e. Have you EVER been denied a visa or denied admission to the United States? (If a visa was
Yes
No
denied, explain why on a separate sheet of paper.)
f. Have you EVER been granted voluntary departure by an immigration officer or an
Yes
No
immigration judge and failed to depart within the allotted time?
15. Are you under a final order or civil penalty for violating section 274C (producing and/or using
Yes
No
false documentation to unlawfully satisfy a requirement of the Immigration and Nationality
Act)?
16. Have you ever, by fraud or willful misrepresentation of a material fact, sought to procure, or
Yes
No
procured, a visa or other documentation, for entry into the United States or any immigration
benefit?
17. Have you ever left the United States to avoid being drafted into the U.S. Armed Forces?
Yes
No
Form I-918 (Rev. 11/23/10) Y Page 6

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