I-130, Petition for Alien Relative

In the case of wanting to file a petition for an alien relative, the following form has to be completed and submitted.

Extracted Text for Proper Search

Previously Forwarded	
Naturalization.  Give certificate number and date and place of issuance.	
DO NOT WRITE IN THIS BLOCK - FOR USCIS OFFICE ONLY	
Personal Interview	
Action Stamp	Fee Stamp	
Section of Law/Visa Category	
(priority date)	
201(b) Spouse - IR-1/CR-1	
Remarks:
1. I am filing this petition for my:	
Brother/Sister	Yes	No	Spouse	Child	
C.  Information about your relative	B.  Information about you	
(First)	1.  Name	 (Family name in CAPS) 	(Middle)	
(Town or City)	(State/Country)	
(State/Country)	
4.  Date of Birth 	4.   Date of Birth	5.  Gender 	5.  Gender 	
Male
Female	
Married
Widowed	
Single
Divorced	
7.  Other Names Used 	(including maiden name)	
8.  Date and Place of Present Marriage  	(if married)	 	
Yes	
Yes. Give certificate number, date and place of issuance.	
16.  Has your relative ever been under immigration proceedings?	
Removal	
14b.  Did you gain permanent resident status through marriage to a           U.S. citizen or lawful permanent resident?	
Yes	Rescission	Judicial Proceedings	
Married
Widowed	
Single
Divorced	
Date arrived	  	
Date and place of admission for or adjustment to lawful  permanent residence and class of admission.	
Petition was filed on:	
A.  Relationship 	
Parent	
2. Are you related by adoption?	
Yes	No	
RESUBMITTED	RELOCATED: Rec'd	Sent	COMPLETED: Appv'd	Denied	INITIAL RECEIPT	
Yes   Where	When	
Exclusion/Deportation	
13.  Has your relative ever been in the U.S.?	
(Town or City)	(State/Country)	(Zip/Postal Code)	
1.  Name	 (Family name in CAPS) 	(First)	(Middle)	
3. Did you gain permanent residence through adoption?	
My citizenship was acquired through (check one):	
You are the petitioner.   Your relative is the beneficiary.	
12. Date(s) Marriage(s) Ended	
203(a)(1) Unm. S or D - F1-1
203(a)(2)(A)Spouse - F2-1
203(a)(2)(A) Child - F2-2
203(a)(2)(B) Unm. S or D - F2-4
203(a)(3) Married  S or D - F3-1
203(a)(4) Brother/Sister - F4-1
201(b) Child - IR-2/CR-2
201(b) Parent - IR-5	
I-485 Filed Simultaneously
204(g) Resolved
203(g) Resolved	
Pet.
Field Investigation
203(a)(2)(A) Resolved	
Ben. " A" File Reviewed	
Male
Female	
He or she arrived as a:(visitor, student, stowaway, without inspection, etc.)	Birth in the U.S.
 Parents.  Have you obtained a certificate of citizenship in your own name?	
No	
Ret'd	
No	
I-130, Petition for Alien Relative	
OMB No. 1615-0012;  Expires 07/31/2018	
A#	
Form I-130 (12/23/16) N 	
2.  Address 	(Number and Street)	
3.  Place of Birth 	(Town or City)	3.  Place of Birth 	(Town or City)	
11.  Name(s) of Prior Spouse(s)	11.  Name(s) of Prior Spouse(s)	
13.  If you are a U.S. citizen, complete the following:
14.  If you are a lawful permanent resident alien, complete the following:	
Date authorized stay expired, or will expire,  as shown on Form I-94 or I-95
15.  Name and address of present employer 	(if any)	
Date this employment began 	
12.  Date(s) Marriage(s) Ended	
2.  Address 	(Number and Street)	(Apt. No.)	(Apt. No.)	
(Zip/Postal Code)	
(State/Country)	
6.  Marital Status	
7.   Other Names Used 	(including maiden name)	
8.  Date and Place of Present Marriage  	(if married)	 	
No	
Arrival/Departure Record (I-94)	
No	
Department of Homeland Security  
U.S. Citizenship and Immigration Services 	
6.   Marital Status	
14.   If your relative is currently in the U.S., complete the following:	
9.  U.S. Social Security Number	 (If any)	9.  U.S. Social Security Number 	(If any)	10.  Alien Registration Number	10.  Alien Registration Number

22.  Complete the information below if your relative is in the United States and will apply for adjustment of status.
C.  Information about your relative  (continued)	
(Name)	(Date of Birth)	(Country of Birth)	(Relationship)	
Phone Number (if any)	
(Name)	Address (Include street, city, province and country):	
From:	To:	
1. If separate petitions are also being submitted for other relatives, give names of each and relationship.	
(City)	(Country)	
NOTE: 	Designation 	of 	a U.S. 	embassy 	or 	consulate 	outside 	the 	country 	of 	your 	relative's 	last 	residence 	does 	not 	guarantee 	acceptance 	for 	
processing by that post.  Acceptance is at the discretion of the designated embassy or consulate. 	
D.  Other information	
Yes
Date	Phone Number	
F.  Signature of person preparing this form, if other than the petitioner
Print Name	Date	
G-28 ID or VOLAG Number, if any.	
I declare that I prepared this document at the request of the person above and that it is based on all information of which I have any knowledge.	
(State)	
Your relative is in the United States and will apply for adjustment of status to that of a lawful permanent resident at the USCIS office in:	
19. Your relative's address abroad. 	 (Include street, city, province and country)	
(Street Address)	
E.  Signature of petitioner
2.  Have you ever before filed a petition for this or any other alien?	
If "Yes," give name, place and date of filing and result.
Address	
Signature	
(City)	(State)	
Form I-130 (12/23/16) N Page 2
(           )	
17. List spouse and all children of your relative.
18. Address in the United States where your relative intends to live.
21. If filing for your spouse, give last address at which you lived together. 	 (Include street, city, province, if any, and country):	
WARNING:	 USCIS investigates claimed relationships and verifies the validity of documents.  USCIS seeks criminal prosecutions when family 	
relationships are falsified to obtain visas.	
(Town or City)	
20. If your relative's native alphabet is other than Roman letters, write his or her name and foreign address in the native alphabet.	
If your relative is not eligible for adjustment of status, he or she will apply for a 
visa abroad at the American consular post in:	
No	
PENALTIES: 	By law, you may be imprisoned for not more than five years or fined $250,000, or both, for entering into a marriage contract for the 	
purpose of evading any provision of the immigration laws.  In addition, you may be fined up to $10,000 and imprisoned for up to five years, or both, for 
knowingly and willfully falsifying or concealing a material fact or using any false document in submitting this petition.	 	
YOUR CERTIFICATION:	 I certify, under penalty of perjury under the laws of the United States of America, that the foregoing is true and correct.  	
Furthermore, I authorize the release of any information from my records that U.S. Citizenship and Immigration Services needs to determine eligiblity for 
the benefit that I am seeking.