Part 1. Information About You (continued)
14.
Have you ever filed for this or any other alien fiancé(e) or
12.c. Middle Name
husband/wife before?
12.d. Date Marriage Ended
Yes
No
(mm/dd/yyyy) ►
If you answered "Yes," provide the following for each alien
My citizenship was acquired through (Select only one box):
(attach additional sheets as necessary)
13.a.
Birth in the United States
14.a.
Alien Registration Number (A-Number)
13.b.
Naturalization
►
A-
13.c.
Parents
14.b. Family Name
(Last Name)
13.d.
Have you obtained a Certificate of Naturalization or a
Certificate of Citizenship in your name?
14.c. Given Name
Yes
No
(First Name)
If "Yes," complete the following:
14.d. Middle Name
13.d.1.
Certificate Number
Date of Filing (mm/dd/yyyy) ►
14.e.
14.f.
City or Town
13.d.2.
Place of Issuance
14.g.
State
13.d.3.
Date of Issuance
14.h.
Result
(mm/dd/yyyy) ►
Part 2. Information About Your Alien Fiancé(e)
1.
Other Information About Your Alien Fiancé(e)
Identify the classification sought for your beneficiary
(select one):
4.
City/Town/Village of Birth
K-1 Fiancé
K-3 Spouse
5.
Country of Birth
2.a. Family Name
(Last Name)
2.b. Given Name
(mm/dd/yyyy) ►
6.
Date of Birth
(First Name)
7.
Country of Citizenship
2.c. Middle Name
Alien Fiancé(e)'s Mailing Address
8.
Gender
Male
Female
3.a.
In Care of Name
9.
Marital Status
Married
Widowed
Single
Divorced
3.b. Street Number
and Name
Other Names Used (Including Maiden Name)
3.c. Apt.
Ste.
Flr.
10.a. Family Name
3.d. City or Town
(Last Name)
10.b. Given Name
(First Name)
3.e. State
3.f.
Zip Code
10.c. Middle Name
3.g. Postal Code
11.
Alien Registration Number (A-Number)
3.h. Province
►
A-
3.i.
Country
Form I-129F 06/13/13 N
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