Form I-907 Request for Premium Processing Service

OMB No. 1615-0048; Expires 08/31/2011

Form I-907, Request for
Premium Processing Service

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

For USCIS Use Only

START HERE - Type or Print (Use black ink)

Request Physically
Received by USCIS

Part 1. Information About You (Person filing this petition)
Family Name (Last Name)

Given Name (First Name)

Receipt

Full Middle Name
Date

If filed on behalf of a company: Company or Business Named in the Related Case

Date
Returned
Date

Mailing Address - Street Number and Name / P.O. Box Number

Date
Resubmitted

Company Contact Information:
Name of Company Contact

Title/Position

Date
Date

City

State/Province

Zip/Postal Code Country
To Be Completed by
Attorney or Representative, if any

IRS Tax # (if any)

Fill in box if Form G-28 is attached
to represent the applicant.
ATTY State License #

You (the person submitting this request):
Are the petitioner who is filing or has filed a petition eligible for Premium Processing.
Are the attorney or accredited representative for the petitioner who is filing or has filed a petition eligible for Premium
Processing. (Complete and submit Form G-28, if Form G-28 has not been submitted with the petition.)
Are the applicant who is filing or has filed an application eligible for Premium Processing.
Are the attorney or accredited representative for the applicant who is filing or has filed an application eligible for Premium
Processing. (Complete and submit Form G-28, if Form G-28 has not been submitted with the application.)
Phone Number (Area/Country Code)

Fax Number (Area/Country Code)

E-Mail Address (if any)

2. Receipt Number of Related
Petition/Application

3. Classification/Eligibility
Requested

Part 2. Information About Request
1. Form Number of Related
Petition/Application

4. Petitioner/Applicant in the Relating Case

5. Beneficiary in the Relating Case

Form I-907 (Rev. 11/23/10) Y

Part 3. Original Signature
I understand that U.S. Citizenship and Immigration Services (USCIS) will issue a refund of the Premium Processing fee to the
addressee above in Part 1 of this request if USCIS does not take an action on the relating premium processing eligible case within 15
calendar days after this request has been physically received at the appropriate USCIS office. Case actions include a referral for
investigation of suspected fraud or misrepresentation, or:
The issuance of:
1. An approval notice;
2. A request for evidence; or
3. A notice of intent to deny.
I certify, under penalty of perjury under the laws of the United States of America, that the information provided with this request is all
true and correct. USCIS may obtain any information from the records of the related case that USCIS needs to determine eligibility for
the benefit being sought.
Signature

Title (if applicable)

Print Your Name

Date (mm/dd/yyyy)

Company Name and Address

Daytime Phone Number (Area Code and Number)

Part 4. Original Signature of Attorney or Accredited Representative (Note if attorney is signing above in Part 3)
I declare that I prepared this application at the request of the above person, and it is based on all information of which I have
knowledge.
Same individual as signing above in Part 3. (If this box is checked, provide your firm name and address and daytime phone
number below and submit Form G-28, if Form G-28 has not been submitted with the petition or application. If this box is not
checked, provide the requested information below.)
Signature

Print Your Name

Date (mm/dd/yyyy)

Firm Name and Complete Address

Daytime Phone Number (Area Code and Number)

Form I-907 (Rev. 11/23/10) Y Page 2