Form I-730 Form I-730 Refugee/Asylee Relative Petition

OMB No.1615-0037; Expires 12/31/09

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

I-730, Refugee/Asylee Relative Petition

DO NOT WRITE IN THIS BLOCK - FOR USCIS OFFICE ONLY
Section of Law

Action Stamp

Receipt

207 (c)(2) Spouse
207 (c)(2) Child
208 (b)(3) Spouse
208 (b)(3) Child

Remarks

Reviewed For
Material
Support
Date:

START HERE - Type or print legibly in black ink.
My Status:

Refugee

Lawful Permanent Resident based on previous Refugee status

Asylee

Lawful Permanent Resident based on previous Asylee status

Spouse

The beneficiary is my:

Adopted Child

Unmarried child who is a (n):
Number of relatives for whom I am filing separate Form I-730s:

Biological Child

Part 1. Information About You, the Petitioner

Part 2. Information About Your Alien Relative, the Beneficiary

Family Name (Last name), Given Name (First name), Middle Name:

Address of Residence (Where you physically reside)

Stepchild
(

)

of

Family Name (Last name), Given Name (First name), Middle Name:

Address of Residence (Where the beneficiary physically resides)

Street Number and Name:

Apt. #

Apt. #

Street Number and Name:

City:

State or Province:

City:

Country:

Zip/Postal Code:

Country:

Mailing Address (If different from residence) - C/O:

State or Province:
Zip/Postal Code:

Mailing Address (If different from residence) - C/O:
Apt.#:

Street Number and Name:

Apt.#:

Street Number and Name:

City:

State or Province:

City:

State or Province:

Country:

Zip/Postal Code:

Country:

Zip/Postal Code:

Telephone Number Including Country and City/Area Code:

Telephone Number Including Country and City/Area Code:

Your E-Mail Address, if Available:

The Beneficiary's E-Mail Address, if Available:

Gender:
a.

Gender:
a.
b.

Male

Date of Birth (mm/dd/yyyy):

b.

Male

Date of Birth (mm/dd/yyyy):

Female
Country of Birth:

Country of Citizenship/Nationality:

Female
Country of Birth:

U.S. Alien Regristration # (A#):

U.S. Social Security # (If applicable):

U.S.Alien Registration Number(A#): U.S. Social Security # (If applicable):

Country of Citizenship/Nationality:

Form I-730 (Rev. 01/07/09) Y

Part 1. Information About You, the Petitioner (Continued)

Part 2. Information About Your Alien Relative, the
Beneficiary (Continued)

Other Name(s) Used (Including maiden name):

Other Name(s) Used (Including maiden name):

If Married, Name of Spouse, Date (mm/dd/yyyy), and Place of Present Marriage:

If Married, Name of Spouse, Date (mm/dd/yyyy), and Place of Present Marriage:

If Previously Married, Name(s) of Prior Spouse(s):

If Previously Married, Name(s) of Prior Spouse(s):

Date(s) (mm/dd/yyyy) and Place(s) Previous Marriage(s) Ended:

Date(s) (mm/dd/yyyy) and Place(s) Previous Marriage(s) Ended:

If You Were Approved for Refugee Status, Provide Date (mm/dd/yyyy)
and Place Admitted to the United States as a Refugee:

Beneficiary is currently in the United States.
Beneficiary is outside the United States and will apply for travel
authorization at a USCIS Office or a U.S. Embassy or consulate in:

Date (mm/dd/yyyy) and Place Asylee Status was Granted in the United States:

City and Country
To Be Completed By
Attorney or Representative, if any.
Fill in box if G-28 is attached to represent the petitioner.

OR
Date (mm/dd/yyyy) and Place You Received Your Approval for Refugee Status
While Living Abroad:

Volag #

Atty State License #

Part 2. Information About the Beneficiary (Continued)
Name and mailing address of the beneficiary written in the language of the country where he or she now resides:
Given Name:

Family Name:

Middle Name:

Address - C/O:

Street Number and Name:

Apt. #:

City/State or Province:

Zip/Postal Code/Country:

Check the box, a through d, that applies:
a.
b.

The beneficiary has never been in the U.S.
The beneficiary is now in immigration court proceedings in the U.S. Where?

c.

The beneficiary has never been in immigration court proceedings in the U.S.

d.

The beneficiary is not now in immigration court proceedings in the U.S., but has been in the past. Where?

What is the beneficiary's native language?

Is the beneficiary fluent in English?
No

What other language(s) does the beneficiary speak fluently:

Yes

Form I-730 (Rev. 01/07/09) Y Page 2

Part 2. Information About the Beneficiary (Continued)
List each of the beneficiary's entries into the U.S., if any, beginning with the most recent entry (attach an additional sheet if the beneficiary has more than
two entries into the U.S.):
Date:

Place:

Status:

I-94#:

Date Status Expires/Expired:

Date:

Place:

Status:

I-94#:

Date Status Expires/Expired:

Part 3. Two-Year Filing Deadline
Are you filing this application more than two years after the date you were admitted to the U.S. as a refugee or granted asylee status?
No
Yes
If you answered "Yes" to the previous question, explain the delay in filing (Attach additional sheets of paper if necessary):

Form I-730 (Rev. 01/07/09) Y Page 3

Part 4. Warning
WARNING: Any beneficiary who is in the United States illegally are subject to removal if Form I-730 is not granted by USCIS. Any information
provided in completing this petition may be used as a basis for the institution of, or as evidence in, removal proceedings, even if the petition is
later withdrawn. Unexcused failure by the beneficiary to appear for an appointment to provide biometrics (such as fingerprints and
photographs) and biographical information within the time allowed may result in denial of Form I-730. Information provided on this form and
biometrics and biographical information provided by the beneficiary may also be used in producing an Employment Authorization Document if
the beneficiary is granted derivative refugee or asylee status.

Part 5. Signature of Petitioner

Read the information on penalties in the instructions and the warning in Part 4 before completing this section and
sign below. If someone other than the beneficiary helped you to prepare this petition, that person must complete
Part 7.

I certify or, if outside the United States, I swear or affirm, under penalty of perjury under the laws of the United States of America, that this petition and the evidence
submitted with it is all true and correct. I authorize the release of any information from my record which U.S. Citizenship and Immigration Services needs to
determine eligibility for the benefit I am seeking.

Signature

Print Full Name

Date

Daytime Telephone Number

NOTE: If you do not completely fill out this form or fail to submit the required documents listed in the instructions, your relative may not be found eligible for the
requested benefit and this petition may be denied.

Part 6. Signature of Beneficiary, if in the U.S.

Read the information on penalties in the instructions and the warning in Part 4 before
completing this section and sign below. If someone other than the petitioner helped
you to prepare this petition, that person must complete Part 7.

NOTE: If the beneficiary is not currently in the U.S., this section should be left blank.
I certify under penalty of perjury under the laws of the United States of America, that this petition and the evidence submitted with it is all true and correct. I authorize
the release of any information from my record which U.S. Citizenship and Immigration Services needs to determine eligibilty for the benefit I am seeking.

Signature

Print Full Name

Date

Daytime Telephone Number

NOTE: If you do not completely fill out this form or fail to submit the required documents and biometrics listed in the instructions, you may not be found eligible for
the requested benefit and this petition may be denied.

Part 7. Signature of Person Preparing Form, If Other Than Petitioner or Beneficiary Above
I declare that I prepared this petition at the request of
have knowledge.

Signature

Print Full Name

(name of person(s) above), and it is based on all of the information of which I

Date

Daytime Telephone Number
E-Mail Address (If any)

Firm Name and Address

Part 8. To Be Completed At Interview of Beneficiary, If Applicable (14 years of age or older)
Beneficiaries in the U.S. will be interviewed by USCIS officers. Their petitioners may also be interviewed. Beneficiaries living overseas will be interviewed
by a USCIS officer or a DOS consular officer.
I swear (affirm) that I know the contents of this petition that I am signing, including the attached documents and supplements, and that they are
all true or
not all true to the best of my knowledge and that correction(s) numbered
to
were made by me or at my request.
With these corrections, the information on this form is now true.
Signed and sworn before me by the beneficiary named herein on:

Signature of Beneficiary

Write your Name in your Native Alphabet

Date (mm/dd/yyyy)

Signature of USCIS Officer or DOS Consular Officer
Form I-730 (Rev.01/07/09) Y Page 4