Form I-290B Notice of Appeal to the Office of Administrative Appeals

OMB No. 1615-0095; Expires 10/31/08

Form, I-290B, Notice of Appeal to the
Administrative Appeals Office (AAO)

Department of Homeland Security
U. S. Citizenship and Immigration Services

Fee Stamp

In the Matter of:

1. I am filing an appeal from the decision dated:

File Number:

Person Filing Appeal
Signature
Name
Address
Number and Street
City

2. Please check the one block that applies:
I am not submitting a separate brief or evidence.
I am submitting a separate brief and/or evidence
with this form.
I am sending a brief and/or evidence to the AAO
within 30 days.
I need
days to submit a brief and/or
evidence to the AAO. (May be granted only for
good cause shown. Explain in a separate letter,
and attach the letter to your form.)

State

Zip Code

Telephone No.
E-Mail address, if any
Date
I am an attorney or representative, and I
represent:
Person and/or organization for whom you are appearing.

Telephone No.
E-Mail address, if any

You must attach a Notice of Entry of Appearance
(Form G-28) if you are an attorney or representative
and did not submit such a form before.

3. Briefly, state the reason(s) for this appeal:

Form I-290B (Rev. 07/30/07) Y