Table of Changes (Form I-914)

I914-FRM-TOC-WIP-TRule-07022013.doc

Application for T Nonimmigrant Status; Application for Immediate Family Member of T-1 Recipient; & Declaration of Law Enforcement Officer for Victim of Trafficking in Persons

Table of Changes (Form I-914)

OMB: 1615-0099

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TABLE OF CHANGES – FORM

FORM I-914, Application for T Nonimmigrant Status

Title of Form

OMB Number: 1615-0099

Submission Date 07/02/2013


Reason for Revision: Statutory and regulatory changes have necessitated revisions.




Current Section and Page Number

Current Text

Proposed Text




[Please remove the barcode from the bottom of all pages.]


Page 1, Part A. Purpose for Filing the Application

I am filing an application for T-1 nonimmigrant status, and have not previously filed for such status.


I have a T-1 application pending. EAC #:





I have received T-1 status.



I am applying to…


I am filing for T-1 nonimmigrant status and have not previously filed for such status.


I am filing for T-1 nonimmigrant status and have previously filed for such status.


[Indent.] Receipt Number (begins with EAC)


I have received T-1 status and am applying to bring family member(s) to the United States.


[Included above.]


Page 1, Part B. General Information About You

Home Address – Street Number and Name / Apt. #


Safe Mailing Address…. / Apt. #


Home Telephone #


Safe Daytime Phone #


E-Mail Address


A # (if any)


U.S. Social Security # (if any)


Gender….


Passport #...

Home Address – Street Number and Name / Apt. Number


Safe Mailing Address…. / Apt. Number


Home Telephone Number


Safe Daytime Phone Number


E-Mail Address


A-Number (if any)


U.S. Social Security Number (if any)


Gender….


Passport Number…


Page 2, Part C. Additional Information

Answers to the following questions about your claim require explanation and supporting documentation. You should attach documents in support of your claim that you are a victim of a severe form of trafficking in persons and the specific facts on which you are relying to support your claim. It is strongly encouraged that you attach a personal narrative statement…


3. I am physically present in the United States, American Samoa, or the Commonwealth of the Northern Mariana Islands, or at a port of entry, on account of trafficking. (If "Yes," explain in detail and attach evidence and documents supporting this claim.) Y/N





…..


7. I have complied with requests from Federal, State, or local law enforcement authorities for assistance in the investigation or prosecution of acts of trafficking. (If "No," explain the circumstances.)

Answers to the following questions about your claim require explanation and supporting documentation. You should attach documents in support of your claim that you are a victim of a severe form of trafficking in persons and the specific facts on which you are relying to support your claim. It is required that you attach a personal narrative statement…


3. I am physically present in the United States, American Samoa, or the Commonwealth of the Northern Mariana Islands, or at a port of entry, on account of trafficking, or have been allowed entry into the United States to participate in investigative or judicial processes associated with an act or perpetrator of trafficking. (If "Yes," explain in detail and attach evidence and documents supporting this claim.) Y/N


…..


7. I have complied with requests from Federal, State, or local law enforcement authorities for assistance in the investigation or prosecution of acts of trafficking, or am unable to cooperate with such requests due to physical or psychological trauma. (If "No," explain the circumstances.)


Page 4-6, Part D. Processing Information


2. Have you EVER received public assistance in the United States from any source, including U.S. Government or any State, county, city, or other municipality (other than emergency medical treatment), or are you likely to receive public assistance in the future?


3. Have you:…..


4. Have you EVER committed…


5. Have you EVER been a member…


6. Do you intend to engage….


7. Have you ever been or do you…


8. Have you, during the period of….


9. Have you EVER been present…


10. a. Are removal, exclusion….


11. Have you ever ordered….


12. Have you EVER….


13. Have you EVER been a member….


14. Have you EVER assisted or ….


15. Have you EVER received….


16. Are you under a final order…


17. Have you EVER, by fraud…


18. Have you EVER left the United….


19. Have you EVER been a J…..


20. Have you EVER detained….


21. Do you plan to practice….


22. Have you entered the….


23. a. Do you have a communicable….


[Delete.]







2. Have you:…..


3. Have you EVER committed…


4. Have you EVER been a member…


5. Do you intend to engage….


6. Have you ever been or do you…


7. Have you, during the period of….


8. Have you EVER been present…


9. a. Are removal, exclusion….


10. Have you ever ordered….


11. Have you EVER….


12. Have you EVER been a member….


13. Have you EVER assisted or ….


14. Have you EVER received….


15. Are you under a final order…


16. Have you EVER, by fraud…


17. Have you EVER left the United….


18. Have you EVER been a J…..


19. Have you EVER detained….


20. Do you plan to practice….


21. Have you entered the….


22. a. Do you have a communicable….


Page 7, Part E., Information About Your Family Members

  1. Spouse….

  2. Children…


Complete Form I-914, Supplement A, Application for Immediate Family Member of T-1 Recipient, for each family member listed above for whom you are now applying to have join you in the United States, and attach it to this application.


  1. Spouse….

  2. Children…


Complete Form I-914, Supplement A, Application for Family Member of T-1 Recipient, for each family member listed above for whom you are now applying to have join you in the United States, and attach it to this application.




Page 9, Part H. Checklist

Part H. Checklist

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