USCIS
Petition for Alien Fiancé(e)
Form I-129F
Department of Homeland Security
OMB No. 1615-0001
U.S. Citizenship and Immigration Services
Expires 08/31/2018
Action Block
Fee Stamp
For USCIS Use Only
Case ID Number
A-Number
G-28 Number
The petition is approved for status
Extraordinary Circumstances Waiver
under Section 101(a)(15)(K). It is
Reason
valid for 4 months and expires on:
Approved
Denied
General Waiver
Mandatory Waiver
AMCON:
Reason
Reason
Approved
Approved
Denied
Denied
Personal Interview
Previously Forwarded
Document Check
Field Investigation
Relocated
Completed
Remarks
Initial Receipt
IMBRA disclosure to the beneficiary required?
Received
Approved
Resubmitted
Sent
Returned
Yes
No
►
START HERE - Type or print in black ink.
Part 1. Information About You
Other Names Used
Provide all other names you have ever used, including aliases,
1.
Alien Registration Number (A-Number) (if any)
maiden name, and nicknames. If you need extra space to
►
A-
1 2 3 4 5 6 7 8 9
complete this section, use the space provided in Part 8.
Additional Information.
2.
USCIS Online Account Number (if any)
►
7.a. Family Name
(Last Name)
3.
U.S. Social Security Number (if any)
7.b. Given Name
►
(First Name)
1 1 1 1 1 1 1 1 1
7.c. Middle Name
Select one box below to indicate the classification you are
requesting for your beneficiary:
Your Mailing Address
4.a.
Fiancé(e) (K-1 visa)
In Care Of Name
8.a.
4.b.
Spouse (K-3 visa)
5.
If you are filing to classify your spouse as a K-3, have
you filed Form I-130?
8.b.
Street Number
Yes
No
123 Main Street
and Name
8.c.
Apt.
Ste.
Flr.
Your Full Name
8.d.
City or Town
New York
6.a. Family Name
Doe
(Last Name)
8.e.
State
8.f.
ZIP Code
NY
10001
6.b. Given Name
John
(First Name)
8.g.
Province
6.c. Middle Name
Mid
8.h.
Postal Code
8.i.
Country
USA
Is your current mailing address the same as your physical
8.j.
address?
Yes
No
If you answered "No," provide your physical address in
Item Numbers 9.a. - 9.h.
Form I-129F 04/10/17 N
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