Form I-129F Edition 04/01/24 Page 1 of 13

Petition for Alien Fiancé(e) 

Department of Homeland Security 

U.S. Citizenship and Immigration Services 

Resubmitted

Initial Receipt

For USCIS Use Only

USCIS 

Form I-129F 

OMB No. 1615-0001 

Expires 02/28/2026

► START HERE - Type or print in black ink.

Part 1. Information About You

6.a. Family Name 

(Last Name) 

6.b. Given Name 

(First Name) 

6.c. Middle Name

Completed

Sent

Received Approved

Returned

Case ID Number

Personal Interview

Document Check

Previously Forwarded

Field Investigation

A-Number

G-28 Number

The petition is approved for status 

under Section 101(a)(15)(K). It is 

valid for 4 months and expires on:

AMCON:

General Waiver

Remarks

Action Block

Relocated

Fee Stamp

Approved Reason

Denied

Approved

Denied

Yes

Extraordinary Circumstances Waiver

Reason

Mandatory Waiver

Approved Reason

Denied

No

 IMBRA disclosure to the beneficiary required? 

► A1. Alien Registration Number (A-Number) (if any)

3. U.S. Social Security Number (if any)

►

Your Full Name

Select one box below to indicate the classification you are 

requesting for your beneficiary:

Fiancé(e) (K-1 visa)

Spouse (K-3 visa)

4.a.

4.b.

If you are filing to classify your spouse as a K-3, have 

you filed Form I-130?

5.

Yes No

2. USCIS Online Account Number (if any)

►

7.b. Given Name 

(First Name) 

Your Mailing Address (USPS ZIP Code Lookup)

8.b. 

8.d. 

8.e.

8.g.

8.i.

8.a. 

8.c.

8.h.

7.c. Middle Name

Other Names Used

Provide all other names you have ever used, including aliases, 

maiden name, and nicknames. If you need extra space to 

complete this section, use the space provided in Part 8. 

Additional Information.

7.a. Family Name 

(Last Name) 

8.j. Is your current mailing address the same as your physical 

address? Yes No

If you answered "No," provide your physical address in 

Item Numbers 9.a. - 9.h.

City or Town

Province

Country 

Postal Code 

State 8.f. ZIP Code

Street Number 

and Name

Apt. Ste. Flr.

In Care Of Name 
Form I-129F Edition 04/01/24 Page 2 of 13

Your Address History

9.a. 

9.c. 

9.d.

9.b.

9.f.

Part 1. Information About You (continued)

9.h.

10.a.

10.b. Date To (mm/dd/yyyy)

9.g.

City or Town

Province

Country 

Postal Code 

State 9.e. ZIP Code

Street Number 

and Name

Provide your physical addresses for the last five years, whether 

inside or outside the United States. Provide your current address 

first if it is different from your mailing address in Item Numbers 

8.a. - 8.i. If you need extra space to complete this section, use the 

space provided in Part 8. Additional Information.

Physical Address 1

Date From (mm/dd/yyyy)

11.a. 

11.c. 

11.d.

11.b.

11.f.

11.h.

12.a.

12.b. Date To (mm/dd/yyyy)

11.g.

City or Town

Province

Country 

Postal Code 

State 11.e. ZIP Code

Street Number 

and Name

Apt. Ste. Flr.

Physical Address 2

Date From (mm/dd/yyyy)

Your Employment History

Provide your employment history for the last five years, 

whether inside or outside the United States. Provide your 

current employment first. If you need extra space to complete 

this section, use the space provided in Part 8. Additional 

Information.

13. Full Name of Employer

14.a. 

14.c. 

14.d.

14.b.

14.f.

14.h.

16.a.

16.b.

14.g.

City or Town

Province

Country 

Postal Code 

State 14.e. ZIP Code

Street Number 

and Name

Apt. Ste. Flr.

Employment Start Date (mm/dd/yyyy)

Employment End Date (mm/dd/yyyy)

Employer 2

15. Your Occupation (specify)

Employer 1

17. Full Name of Employer

18.a. 

18.c. 

18.d.

18.b.

18.f.

18.h.

18.g.

City or Town

Province

Country 

Postal Code 

State 18.e. ZIP Code

Street Number 

and Name

Apt. Ste. Flr.

19. Your Occupation (specify)

Apt. Ste. Flr.
Form I-129F Edition 04/01/24 Page 3 of 13

Part 1. Information About You (continued)

20.a.

20.b.

Employment Start Date 

(mm/dd/yyyy)

Employment End Date 

(mm/dd/yyyy)

24. City/Town/Village of Birth 

25.

26. Country of Birth

Province or State of Birth

23. Marital Status

Single Married Divorced Widowed

22. Date of Birth (mm/dd/yyyy)

21. Gender Male Female

Other Information

Information About Your Parents

27.a. Family Name 

(Last Name) 

27.b. Given Name 

(First Name) 

27.c. Middle Name

Parent 1's Information

28. Date of Birth (mm/dd/yyyy) 

29. Gender Male Female

31.b. Country of Residence

30. Country of Birth

31.a. City/Town/Village of Residence

32.a. Family Name 

(Last Name) 

32.b. Given Name 

(First Name) 

32.c. Middle Name

Parent 2's Information

33. Date of Birth (mm/dd/yyyy) 

34. Gender Male Female

36.b. Country of Residence

35. Country of Birth

36.a. City/Town/Village of Residence

If you answered "Yes" to Item Number 37., provide the names 

of each spouse and the date that each prior marriage ended in 

Item Numbers 38.a. - 39. If you need extra space to complete 

this section, use the space provided in Part 8. Additional 

Information.

37. Have you ever been previously married? 

Yes No

Name of Previous Spouse

38.a. Family Name 

(Last Name) 

38.b. Given Name 

(First Name) 

38.c. Middle Name

39. Date Marriage Ended (mm/dd/yyyy)

Your Citizenship Information

You are a U.S. citizen through (select only one box):

40.a. Birth in the United States

40.b. Naturalization

40.c. U.S. citizen parents

Have you obtained a Certificate of Naturalization or a 

Certificate of Citizenship in your own name?

41.

Yes No

If you answered "Yes" to Item Number 41., complete Item 

Numbers 42.a. - 42.c.
Form I-129F Edition 04/01/24 Page 4 of 13

Part 1. Information About You (continued)

Certificate Number

Place of Issuance

42.a.

42.b.

42.c. Date of Issuance (mm/dd/yyyy)

45.a. Family Name 

(Last Name) 

45.b. Given Name 

(First Name) 

45.c. Middle Name

46. Date of Filing (mm/dd/yyyy)

What action did USCIS take on Form I-129F (for 

example, approved, denied, revoked)?

47.

If you answered "Yes" to Item Number 43., provide the 

responses to Item Number 44. - 46. for each previous 

beneficiary. If you need to provide information for more than 

one beneficiary, use the space provided in Part 8. Additional 

Information.

44. A-Number (if any) ►AHave you ever filed Form I-129F for any other 

beneficiary?

43.

Yes No

Additional Information

If you answered "Yes" to Item Number 48., provide the ages for 

your children under 18 years of age in Item Numbers 49.a. - 49.b.

48. Do you have any children under 18 years of age?

Yes No

Provide the ages for your children under 18 years of age. If you 

need extra space to complete this section, use the space 

provided in Part 8. Additional Information.

49.a. Age

49.b. Age

Provide all U.S. states and foreign countries in which you have 

resided since your 18th birthday. 

Residence 1

50.b. Country 

50.a. State

Residence 2

51.b. Country 

51.a. State

Part 2. Information About Your Beneficiary

1.a. Family Name 

(Last Name) 

1.b. Given Name 

(First Name) 

1.c. Middle Name

► A2. A-Number (if any)

8. Country of Birth

9. Country of Citizenship or Nationality

7. City/Town/Village of Birth 

6. Marital Status

Single Married Divorced Widowed

3. U.S. Social Security Number (if any)

►

4. Date of Birth (mm/dd/yyyy)

5. Gender Male Female

10.a. Family Name 

(Last Name) 

10.b. Given Name 

(First Name) 

10.c. Middle Name

Provide all other names you have ever used, including aliases, 

maiden name, and nicknames. If you need extra space to 

complete this section, use the space provided in Part 8. 

Additional Information. 

Other Names Used
Form I-129F Edition 04/01/24 Page 5 of 13

Part 2. Information About Your Beneficiary 

(continued)

Mailing Address for Your Beneficiary

11.b. Street Number 

and Name

11.d. City or Town

11.e. State 11.f. ZIP Code

11.g. Province

11.a. In Care Of Name

11.i. Country

11.c. Apt. Ste. Flr.

11.h. Postal Code

Your Beneficiary's Address History

12.a. 

12.c. 

12.d.

12.b.

12.f.

12.h.

13.a.

13.b. Date To (mm/dd/yyyy)

12.g.

City or Town

Province

Country 

Postal Code 

State 12.e. ZIP Code

Street Number 

and Name

Apt. Ste. Flr.

Provide your beneficiary's physical addresses for the last five 

years, whether inside or outside the United States. Provide your 

beneficiary's current address first if it is different from the 

mailing address in Item Numbers 11.a. - 11.i. If you need 

extra space to complete this section, use the space provided in

Part 8. Additional Information.

Beneficiary's Physical Address 1

Date From (mm/dd/yyyy)

14.a. 

14.c. 

14.d.

14.b.

14.f.

14.h.

15.a.

15.b. Date To (mm/dd/yyyy)

14.g.

City or Town

Province

Country 

Postal Code 

State 14.e. ZIP Code

Street Number 

and Name

Apt. Ste. Flr.

Beneficiary's Physical Address 2

Date From (mm/dd/yyyy)

Your Beneficiary's Employment History

Provide your employment history for the last five years, 

whether inside or outside the United States. Provide your 

current employment first. If you need extra space to complete 

this section, use the space provided in Part 8. Additional 

Information.

16. Full Name of Employer

17.a. 

17.c. 

17.d.

17.b.

17.f.

17.h.

19.a.

19.b.

17.g.

City or Town

Province

Country 

Postal Code 

State 17.e. ZIP Code

Street Number 

and Name

Apt. Ste. Flr.

Employment Start Date (mm/dd/yyyy)

Employment End Date (mm/dd/yyyy)

18. Beneficiary's Occupation (specify)

Beneficiary's Employer 1
Form I-129F Edition 04/01/24 Page 6 of 13

Part 2. Information About Your Beneficiary 

(continued)

20. Full Name of Employer

21.a. 

21.c. 

21.d.

21.b.

21.f.

21.h.

23.a.

23.b.

21.g.

City or Town

Province

Country 

Postal Code 

State 21.e. ZIP Code

Street Number 

and Name

Apt. Ste. Flr.

Employment Start Date (mm/dd/yyyy)

Employment End Date (mm/dd/yyyy)

22. Beneficiary's Occupation (specify)

Beneficiary's Employer 2

Information About Your Beneficiary's Parents

24.a. Family Name 

(Last Name) 

24.b. Given Name 

(First Name) 

24.c. Middle Name

Parent 1's Information

25. Date of Birth (mm/dd/yyyy) 

26. Gender Male Female

28.b. Country of Residence

27. Country of Birth

28.a. City/Town/Village of Residence

29.a. Family Name 

(Last Name) 

29.b. Given Name 

(First Name) 

29.c. Middle Name

Parent 2's Information

30. Date of Birth (mm/dd/yyyy) 

31. Gender Male Female

33.b. Country of Residence

32. Country of Birth

33.a. City/Town/Village of Residence

Other Information About Your Beneficiary

If you answered "Yes" to Item Number 34., provide the names 

of each prior spouse and the date each prior marriage ended in 

Item Numbers 35.a. - 36. If you need to provide information 

for more than one spouse, use the space provided in Part 8. 

Additional Information.

34. Has your beneficiary ever been previously married?

Yes No

Name of Previous Spouse

35.a. Family Name 

(Last Name) 

35.b. Given Name 

(First Name) 

35.c. Middle Name

36. Date Marriage Ended

(mm/dd/yyyy)

37. Has your beneficiary ever been in the United States? 

Yes No

If your beneficiary is currently in the United States, complete 

Item Numbers 38.a. - 38.h.

He or she last entered as a (for example, visitor, student, 

exchange alien, crewman, stowaway, temporary worker, 

without inspection):

38.a.

38.b. I-94 Arrival-Departure Record Number 

►

38.c. Date of Arrival (mm/dd/yyyy)
Form I-129F Edition 04/01/24 Page 7 of 13

Part 2. Information About Your Beneficiary 

(continued)

38.g. Country of Issuance for Passport or Travel Document

38.h. Expiration Date for Passport or Travel Document 

(mm/dd/yyyy)

38.e. Passport Number

38.f. Travel Document Number

Date authorized stay expired or will expire as shown on 

Form I-94 or I-95 (mm/dd/yyyy)

38.d.

If you answered "Yes" to Item Number 39., provide the 

following information about each child. If you need to provide 

information for more than one child, use the space provided in 

Part 8. Additional Information.

39. Does your beneficiary have any children?

Yes No

40.a. Family Name 

(Last Name) 

40.b. Given Name 

(First Name) 

40.c. Middle Name

Children of Beneficiary

41. Country of Birth 

42. Date of Birth (mm/dd/yyyy)

43. Does this child reside with your beneficiary?

Yes No

Address in the United States Where Your 

Beneficiary Intends to Live

45.a. Street Number 

and Name

45.c. City or Town

45.d. State 45.e. ZIP Code

45.b. Apt. Ste. Flr.

46. Daytime Telephone Number

Your Beneficiary's Physical Address Abroad

47.a. Street Number 

and Name

47.c. City or Town

47.d. Province

47.f. Country

48.

47.b. Apt. Ste. Flr.

Daytime Telephone Number

47.e. Postal Code

44.a. Street Number 

and Name

44.c. City or Town

44.d. State 44.e. ZIP Code

44.f.

44.g.

Province

44.h. Country

44.b. Apt. Ste. Flr.

Postal Code

If the child does not reside with your beneficiary, provide the 

child's physical residence.

Your Beneficiary's Name and Address in His or 

Her Native Alphabet

49.a. Family Name 

(Last Name) 

49.b. Given Name 

(First Name) 

49.c. Middle Name

50.a. Street Number 

and Name

50.e. Postal Code

50.f. Country

50.c. City or Town

50.b. Apt. Ste. Flr.

50.d. Province
Form I-129F Edition 04/01/24 Page 8 of 13

Part 2. Information About Your Beneficiary 

(continued)

51. Is your fiancé(e) related to you? 

Yes No

Provide the nature and degree of relationship (for example, 

third cousin or maternal uncle).

52.

Have you and your fiancé(e) met in person during the two 

years immediately before filing this petition?

53.

N/A, beneficiary is my spouse

Yes No N/A, beneficiary is my spouse

If you answered "Yes" to Item Number 53., describe the 

circumstances of your in-person meeting in Item Number 54. 

Attach evidence to demonstrate that you were in each other's 

physical presence during the required two year period. 

54.

60.a. Street Number 

and Name

60.c. City or Town

60.d.

60.e.

Province

60.f. Country

60.b. Apt. Ste. Flr.

Postal Code

Organization Name of IMB

59. Website of IMB

58.

61. Daytime Telephone Number

City or Town

Your beneficiary will apply for a visa abroad at the U.S. 

Embassy or U.S. Consulate at:

62.a.

62.b. Country

Consular Processing Information

If you answered "No," explain your reasons for requesting an 

exemption from the in person meeting requirement in Item 

Number 54. and provide evidence that you should be exempt 

from this requirement. Refer to Part 2., Item Numbers 53. - 54.

of the Specific Instructions section of the Instructions for 

additional information about the requirement to meet. If you 

need extra space to complete this section, use the space 

provided in Part 8. Additional Information.

If you answered "Yes" to Item Number 55., provide the IMB's 

contact information and Website information below. In 

addition, attach a copy of the signed, written consent form the 

IMB obtained from your beneficiary authorizing your 

beneficiary's personal contact information to be released to you.

International Marriage Broker (IMB) Information

Did you meet your beneficiary through the services of an 

IMB?

55.

Yes No

57.a. Family Name of IMB (Last Name)

57.b. Given Name of IMB (First Name)

56. IMB's Name (if any)

Part 3. Other Information

Have you EVER been subject to a temporary or 

permanent protection or restraining order (either civil or 

criminal)? 

1.

Yes No

Criminal Information

NOTE: These criminal information questions must be 

answered even if your records were sealed, cleared, or if 

anyone, including a judge, law enforcement officer, or attorney, 

told you that you no longer have a record. If you need extra 

space to complete this section, use the space provided in Part 8. 

Additional Information.

Have you EVER been arrested or convicted of any of the 

following crimes:

Domestic violence, sexual assault, child abuse, child 

neglect, dating violence, elder abuse, stalking or an 

attempt to commit any of these crimes? (See Part 3. 

Other Information, Item Numbers 1. - 3.c. of the 

Instructions for the full definition of the term "domestic 

violence.")

2.a. 

Yes No
Form I-129F Edition 04/01/24 Page 9 of 13

Part 3. Other Information (continued)

Homicide, murder, manslaughter, rape, abusive sexual 

contact, sexual exploitation, incest, torture, trafficking, 

peonage, holding hostage, involuntary servitude, slave 

trade, kidnapping, abduction, unlawful criminal restraint, 

false imprisonment, or an attempt to commit any of these 

crimes?

2.b. 

Yes No

Three or more arrests or convictions, not from a single 

act, for crimes relating to a controlled substance or 

alcohol?

2.c. 

Yes No

NOTE: If you were ever arrested or convicted of any of the 

specified crimes, you must submit certified copies of all court 

and police records showing the charges and disposition for 

every arrest or conviction. You must do so even if your records 

were sealed, expunged, or otherwise cleared, and regardless of 

whether anyone, including a judge, law enforcement officer, or 

attorney, informed you that you no longer have a criminal 

record. If you need extra space to complete this section, use the 

space provided in Part 8. Additional Information. 

If you have provided information about a conviction for a crime 

listed in Item Numbers 2.a. - 2.c. and you were being battered 

or subjected to extreme cruelty at the time of your conviction, 

select all of the following that apply to you:

3.a. I was acting in self-defense.

3.b. I violated a protection order issued for my own 

protection.

3.c. I committed, was arrested for, was convicted of, or 

pled guilty to a crime that did not result in serious 

bodily injury and there was a connection between the 

crime and me having been battered or subjected to 

extreme cruelty.

Multiple Filer Waiver Request Information

Refer to Part 3. Types of Waivers in the Specific Instructions 

section of the Instructions for an explanation of the filing 

waivers.

Multiple Filer, No Permanent Restraining Orders or 

Convictions for a Specified Offense (General 

Waiver)

Indicate which one of the following waivers you are requesting:

Multiple Filer, Prior Permanent Restraining Orders or 

Criminal Conviction for Specified Offense 

(Extraordinary Circumstances Waiver)

Multiple Filer, Prior Permanent Restraining Order or 

Criminal Convictions for Specified Offense Resulting 

from Domestic Violence (Mandatory Waiver)

Not applicable, beneficiary is my spouse or I am not 

a multiple filer 

5.a.

5.b.

5.c.

5.d.

Part 4. Biographic Information

1.

2.

Not Hispanic or Latino

Hispanic or Latino

Ethnicity (Select only one box)

Race (Select all applicable boxes)

Native Hawaiian or Other Pacific Islander

American Indian or Alaska Native

White

Asian

Black or African American

3. Height Feet Inches

Have you ever been arrested, cited, charged, indicted, 

convicted, fined, or imprisoned for breaking or violating 

any law or ordinance in any country, excluding traffic 

violations (unless a traffic violation was alcohol- or drugrelated or involved a fine of $500 or more)? 

4.a.

Yes No

If the answer to Item Number 4.a. is "Yes," provide 

information about each of those arrests, citations, charges, 

indictments, convictions, fines, or imprisonments in the 

space below. If you were the subject of an order of 

protection or restraining order and believe you are the 

victim, please explain those circumstances and provide 

any evidence to support your claims. Include the dates 

and outcomes. If you need extra space to complete this 

section, use the space provided in Part 8. Additional 

Information.

4.b.

4. Weight Pounds

Black Brown

Green

Maroon Pink

Gray Hazel

Blue

5. Eye Color (Select only one box) 

Unknown/Other

6. Hair Color (Select only one box) 

Black

Brown Red

White Unknown/ 

Other

Sandy

Gray

Bald (No hair) Blond
Form I-129F Edition 04/01/24 Page 10 of 13

I can read and understand English, and I have read 

and understand every question and instruction on this 

petition and my answer to every question.

1.a.

NOTE: Select the box for either Item Number 1.a. or 1.b. If 

applicable, select the box for Item Number 2.

Part 5. Petitioner's Statement, Contact 

Information, Declaration, Certification, and 

Signature 

1.b. The interpreter named in Part 6. read to me every 

question and instruction on this petition and my 

answer to every question in

,

a language in which I am fluent, and I understood 

everything.

NOTE: Read the Penalties section of the Form I-129F 

Instructions before completing this part. 

Petitioner's Statement

At my request, the preparer named in Part 7., 

,

2.

prepared this petition for me based only upon 

information I provided or authorized. 

Petitioner's Contact Information

4. Petitioner's Mobile Telephone Number (if any)

5. Petitioner's Email Address (if any)

3. Petitioner's Daytime Telephone Number

Petitioner's Signature

6.a. Petitioner's Signature

6.b. Date of Signature (mm/dd/yyyy)

NOTE TO ALL PETITIONERS: If you do not completely 

fill out this petition or fail to submit required documents listed 

in the Instructions, USCIS may deny your petition.

2) All of this information was complete, true, and 

correct at the time of filing.

I certify, under penalty of perjury, that all of the information in 

my petition and any document submitted with it were provided 

or authorized by me, that I reviewed and understand all of the 

information contained in, and submitted with my petition, and 

that all of this information is complete, true, and correct. 

Part 6. Interpreter's Contact Information, 

Certification, and Signature

1.b. Interpreter's Given Name (First Name)

1.a. Interpreter's Family Name (Last Name)

2. Interpreter's Business or Organization Name (if any)

Interpreter's Full Name

Provide the following information about the interpreter.

Petitioner's Declaration and Certification

Copies of any documents I have submitted are exact photocopies 

of unaltered, original documents, and I understand that USCIS 

may require that I submit original documents to USCIS at a later 

date. Furthermore, I authorize the release of any information 

from any and all of my records that USCIS may need to 

determine my eligibility for the immigration benefit that I seek.

I furthermore authorize release of information contained in this 

petition, in supporting documents, and in my USCIS records, to 

other entities and persons where necessary for the administration 

and enforcement of U.S. immigration law.

I understand that USCIS may require me to appear for an 

appointment to take my biometrics (fingerprints, photograph, 

and/or signature) and, at that time, if I am required to provide 

biometrics, I will be required to sign an oath reaffirming that:

1)

Interpreter's Mailing Address

3.c. City or Town

3.d. State 3.e. ZIP Code

3.f.

Postal Code

Street Number 

and Name

3.a.

3.b. Apt. Ste. Flr.

3.g.

3.h. Country 

Province

I reviewed and understood all of the information 

contained in, and submitted with, my petition; and 
Form I-129F Edition 04/01/24 Page 11 of 13

4. Interpreter's Daytime Telephone Number

6. Interpreter's Email Address (if any)

Interpreter's Contact Information

Interpreter's Certification

I certify, under penalty of perjury, that:

which is the same language specified in Part 5., Item Number 

1.b., and I have read to this petitioner in the identified language 

every question and instruction on this petition and his or her 

answer to every question. The petitioner informed me that he or 

she understands every instruction, question, and answer on the 

petition, including the Petitioner's Declaration and 

Certification, and has verified the accuracy of every answer. 

I am fluent in English and ,

7.b. Date of Signature (mm/dd/yyyy)

7.a. Interpreter's Signature

Interpreter's Signature

Part 6. Interpreter's Contact Information, 

Certification, and Signature (continued)

5. Interpreter's Mobile Telephone Number (if any)

Preparer's Mailing Address

3.c. City or Town

3.d. State 3.e. ZIP Code

3.f.

Postal Code

Street Number 

and Name

3.a.

3.b. Apt. Ste. Flr.

3.g.

3.h. Country 

Province

Preparer's Contact Information

5. Preparer's Mobile Telephone Number (if any)

4. Preparer's Daytime Telephone Number

6. Preparer's Email Address (if any)

Part 7. Contact Information, Declaration, and 

Signature of the Person Preparing this Petition, if 

Other Than the Petitioner

Preparer's Full Name

Provide the following information about the preparer.

1.a. Preparer's Family Name (Last Name)

1.b. Preparer's Given Name (First Name)

2. Preparer's Business or Organization Name (if any)

Preparer's Statement

I am not an attorney or accredited representative but 

have prepared this petition on behalf of the petitioner 

and with the petitioner's consent.

I am an attorney or accredited representative and my 

representation of the petitioner in this case 

does not extend beyond the 

7.a.

7.b.

preparation of this petition.

 extends

NOTE: If you are an attorney or accredited 

representative, you may need to submit a completed 

Form G-28, Notice of Entry of Appearance as 

Attorney or Accredited Representative, or Form 

G-28I, Notice of Entry of Appearance as Attorney In 

Matters Outside the Geographical Confines of the 

United States, with this petition.
Form I-129F Edition 04/01/24 Page 12 of 13

Part 7. Contact Information, Declaration, and 

Signature of the Person Preparing this Petition, if 

Other Than the Petitioner (continued)

8.a. Preparer's Signature

8.b. Date of Signature (mm/dd/yyyy)

Preparer's Certification

Preparer's Signature

By my signature, I certify, under penalty of perjury, that I 

prepared this petition at the request of the petitioner. The 

petitioner then reviewed this completed petition and informed 

me that he or she understands all of the information contained 

in, and submitted with, his or her petition, including the 

Petitioner's Declaration and Certification, and that all of this 

information is complete, true, and correct. I completed this 

petition based only on information that the petitioner provided 

to me or authorized me to obtain or use.
Form I-129F Edition 04/01/24 Page 13 of 13

Part 8. Additional Information 

3.d.

If you need extra space to provide any additional information 

within this petition, use the space below. If you need more 

space than what is provided, you may make copies of this page 

to complete and file with this petition or attach a separate sheet 

of paper. Type or print your name and A-Number (if any) at the 

top of each sheet; indicate the Page Number, Part Number, 

and Item Number to which your answer refers; and sign and 

date each sheet.

1.a Family Name 

(Last Name) 

1.b. Given Name 

(First Name) 

1.c. Middle Name

3.a. Page Number 3.b. Part Number 3.c. Item Number

2. A-Number (if any) ► A4.d.

4.a. Page Number 4.b. Part Number 4.c. Item Number

5.d.

5.a. Page Number 5.b. Part Number 5.c. Item Number

6.d.

6.a. Page Number 6.b. Part Number 6.c. Item Number

7.d.

7.a. Page Number 7.b. Part Number 7.c. Item Number