Form I-129F Petition for Alien Fiance(e)

DRAFT
OMB No. 1615-0001; Expires 02/29/2012

I-129F, Petition
for Alien Fiancé(e)

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

Do not write in these blocks.

For USCIS Use Only

Case ID #

Action Block

Fee Stamp

A#
G-28 #
AMCON:

The petition is approved for status
under Section 101(a)(5)(k). It is
valid for four months from the date
of action.

Personal Interview

Previously Forwarded

Document Check

Field Investigation

Remarks:

Part A.

Start Here. Information
1. Name (Family name in CAPS) (First)

about you.

2. Address (Number and Street)
(Town or City)

(State or Country)

(Middle)

Apt. #

2. Address (Number and Street)

Apt. #

(State/Country)

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

Male

(Town or City)

(State or Country)

(Zip/Postal Code)

3a. Place of Birth (Town or City)

(State/Country)

3b. Country of Citizenship

5. Gender

Widowed

Information about your alien fiancé(e).

1. Name (Family name in CAPS) (First)

(Zip/Postal Code)

3. Place of Birth (Town or City)

6. Marital Status
Married
Single

Part B.

(Middle)

Female

Divorced

7. Other Names Used (including maiden name)

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

5. Gender

Male
Female
6. Marital Status
Married
Single
Widowed
Divorced
7. Other Names Used (including maiden name)

8a. U.S. Social Security Number 8b. A# (if any)
9. Names of Prior Spouses

8. U.S. Social Security #

9. A# (if any)

10. Names of Prior Spouses

Date(s) Marriage(s) Ended

Date(s) Marriage(s) Ended

10. My citizenship was acquired through (check one)
Birth in the U.S.
Naturalization
Give number of certificate, date and place it was issued.
Parents
Have you obtained a certificate of citizenship in your name?

11. Has your fiancé(e) ever been in the U.S.?
Yes
No
12. If your fiancé(e) is currently in the U.S., complete the
following:
He or she last arrived as a:(visitor, student, exchange alien,
crewman, stowaway, temporary worker, without inspection,
etc.)

Yes
No
If "Yes," give certificate number, date and place it was issued.
11. Have you ever filed for this or any other alien fiancé(e)
or husband/wife before?
Yes
No

Arrival/Departure Record (I-94) Number
Date of Arrival
(mm/dd/yy)

If "Yes," give name of all aliens, place and date of filing,
A# and result. (Attached additional sheets as necessary.)
INITIAL RECEIPT

RESUBMITTED

RELOCATED: Rec'd.

Sent

Date authorized stay expired, or
will expire as shown on I-94 or I-95

COMPLETED: Appv'd.

Denied

Ret'd.

Form I-129F (Rev. 08/20/10) Y

DRAFT

Part B.

Information about your alien fiancé(e).

(Continued.)

13. List all children of your alien fiancé(e) (if any)
Name (First/Middle/Last)

Date of Birth (mm/dd/yyyy) Country of Birth

Present Address

14. Address in the United States where your fiancé(e) intends to live.
(Number and Street)
(Town or City)

(State)

15. Your fiancé(e)'s address abroad.
(Number and Street)

(State or Province)

(Town or City)

(Country)

(Phone Number; Include Country, City and Area Codes)

16. If your fiancé(e)'s native alphabet uses other than Roman letters, write his or her name and address abroad in the
native alphabet.
(Name)
(Number and Street)
(Town or City)
17. Is your fiancé(e) related to you?

(State or Province)

Yes

(Country)

No

If you are related, state the nature and degree of relationship, e.g., third cousin or maternal uncle, etc.
18. Has your fiancé(e) met and seen you within the two-year period immediately receding the filing of this petition?
Yes
No
Describe the circumstances under which you met. If you have not personally met each other, explain how the relationship was
established. If you met your fiancé(e) or spouse though an international marriage broker, please explain those circumstances in
Question 19 below. Explain also in detail any reasons you may have for requesting that the requirement that you and your
fiancé(e) must have met should not apply to you.

19. Did you meet your fiancé(e) or spouse through the services of an international marriage broker?
Yes
No
If you answered yes, please provide the name and any contact information you may have (including internet or street address) of the
international marriage broker and where the international marriage broker is located. Attach additional sheets of paper if necessary.

20. Your fiancé(e) will apply for a visa abroad at the American embassy or consulate at:
(City)
(Country)

NOTE: (Designation of a U.S. embassy or consulate outside the country of your fiancé(e)'s last residence does not guarantee
acceptance for processing by that foreign post. Acceptance is at the discretion of the designated embassy or consulate.)
Form I-129F (Rev. 08/20/10) Y Page 2

DRAFT
Part C. Other information.
1. If you are serving overseas in the Armed Forces of the United States, please answer the following:
I presently reside or am stationed overseas and my current mailing address is:

2. Have you ever been convicted by a court of law (civil or criminal) or court martialed by a military tribunal for any of the
following crimes:
Domestic violence, sexual assault, child abuse and neglect, dating violence, elder abuse or stalking. (Please refer to page 3 of
the instructions for the full definition of the term "domestic violence.)
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, or
Three or more convictions for crimes relating to a controlled substance or alcohol not arising from a single act.
Yes
No
Answering this question is required even if your records were sealed or otherwise cleared or if anyone, including a judge, law
enforcement officer, or attorney, told you that you no longer have a record. Using a separate sheet(s) of paper, attach information
relating to the conviction(s), such as crime involved, date of conviction and sentence.
3. If you have provided information about a conviction for a crime listed above and you were being battered or subjected to
extreme cruelty by your spouse, parent, or adult child at the time of your conviction, check all of the following that apply to
you:
I was acting in self-defense.
I violated a protection order issued for my own protection.
I committed, was arrested for, was convicted of, or plead guilty to committing a crime that did not result in serious bodily
injury, and there was a connection between the crime committed and my having been battered or subjected to extreme cruelty.

Part D. Penalties, certification and petitioner's signature.
PENALTIES: You may by law 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, and you may be fined up to $10,000 or imprisoned 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 am legally able to and intend to marry my alien fiancé(e) within 90 days of his or her arrival in the United
States. 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 eligibility for the benefit that I am seeking.
Moreover, I understand that this petition, including any criminal conviction information that I am required to provide with this petition, as
well as any related criminal background information pertaining to me that U.S. Citizenship and Immigration Services may discover
independently in adjudicating this petition will be disclosed to the beneficiary of this petition.
Signature

Date (mm/dd/yyyy)

Daytime Telephone Number (with area code)

E-Mail Address (if any)

Part E. Signature of person preparing form, if other than above. (Sign below.)
I declare that I prepared this application at the request of the petitioner and it is based on all information of which I have knowledge.
Signature

Firm Name and Address

Print or Type Your Name

G-28 ID Number

Date (mm/dd/yyyy)

Daytime Telephone Number (with area code)

E-Mail Address (if any)

Form I-129F (Rev. 08/20/10) Y Page 3