Form I-829 Petition by Entrepreneur to Remove Conditions on Permane

Petition by Entrepreneur to Remove Conditions

I829-FRM-83C-03242015

Petition by Entrepreneur to Remove Conditions

OMB: 1615-0045

Document [pdf]
Download: pdf | pdf
Petition by Entrepreneur to Remove Conditions
on Permanent Resident Status

USCIS
Form I-829

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

OMB No. 1615-0045
Expires: 03/31/2017

Fee Receipt

Received (mm/dd/yyyy)

Action Block

Resubmitted (mm/dd/yyyy)
Relocated (mm/dd/yyyy)

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For Received (mm/dd/yyyy)
USCIS Sent (mm/dd/yyyy)
Use
Petitioner Interviewed
Only
(mm/dd/yyyy)

Remarks

Immigrant Classification
DOE/A

To be completed by an
attorney or accredited
representative (if any).

Select this box if
Form G-28 is
attached to represent
the petitioner.

Attorney State Bar Number
(if applicable)

Attorney or Accredited Representative
USCIS ELIS Account Number (if any)

► START HERE - Type or print legibly in black ink.

Part 1. Information About Regional Center

Part 3. Information About You

1.

1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)

Was the investment by the entrepreneur associated with
an approved regional center?
Yes
No

If you answered “Yes” to Item Number 1., please complete
Item Numbers 2.a. - 2.c.
2.a. Name of Regional Center

2.b. Regional Center Identification Number

2.c. Receipt number for the approved Form I-924, Application
For Regional Center Under the Immigrant Investor
Program, upon which the related Form I-526, Immigrant
Petition by Alien Entrepreneur, was based
►

Part 2. Basis for Petition
Select only one box.
1.

I am a conditional permanent resident based on my
investment in a commercial enterprise.

2.

I am a conditional permanent resident who is the
spouse, former spouse, or child of an entrepreneur,
and I am filing separately from the entrepreneur's
Form I-829.

3.

I am a conditional permanent resident spouse or child
of an entrepreneur who has died.

1.c. Middle Name

2.

Alien Registration Number (A-Number) (if any)
► A-

3.

USCIS ELIS Account Number (if any)
►

4.

U.S. Social Security Number (if any)
►

5.

Form I-526 Receipt Number on which this petition is based
►

Other Names You Have Used (including maiden name,
nicknames, and aliases, if any)
6.a. Family Name
(Last Name)
6.b. Given Name
(First Name)
6.c. Middle Name
7.a. Family Name
(Last Name)
7.b. Given Name
(First Name)
7.c. Middle Name

Form I-829 03/11/15 N

Page 1 of 11

Part 3. Information About You (continued)

Criminal History
15.

Your U.S. Mailing Address
8.a. In Care Of Name (if any)
8.b. Street Number
and Name
8.c.

Apt.

Flr.

8.d. City or Town
8.e. State
9.

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16.

Ste.

8.f.

ZIP Code

Is your mailing address the same as your physical address?
Yes
No

If your mailing address and the address where you currently live
(physical address) are not the same, you MUST provide your
current physical address in the Item Numbers 10.a. - 10.h.
Your Physical Address
10.a. Street Number
and Name
10.b.

Apt.

Ste.

10.c. City or Town
10.d. State

Flr.

10.e. ZIP Code

10.f. Province
10.g. Postal Code

Since becoming a conditional permanent resident, have
you EVER been arrested, cited, charged, indicted,
convicted, fined, or imprisoned for violating any law or
ordinance (excluding minor traffic violations)?
Yes
No
Since becoming a conditional permanent resident, have
you EVER committed any crime for which you were not
arrested?
Yes
No

If you answered “Yes” to Item Number 15., you must provide
certified court dispositions, arrest reports, statements of charges,
indictment information, or any other charging documents that
were issued. If you answered “Yes” to Item Number 16.,
provide the date and location (town or city/state or province/
country) of the events and provide an explanation in Part 11.
Additional Information.

Part 4. Information About Your Current Spouse
or Your Former Conditional Permanent
Resident Spouse

1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)

1.c. Middle Name
2.

Gender

3.

A-Number (if any)

Male

Female

► A-

10.h. Country

4.

USCIS ELIS Account Number (if any)
►

Other Information About You

5.

Date of Birth

11.

Date of Birth

12.

Gender

13.

Country of Birth

6.a. Family Name
(Last Name)
6.b. Given Name
(First Name)

14.

Country of Citizenship or Nationality

6.c. Middle Name

(mm/dd/yyyy) ►
Male

Female

(mm/dd/yyyy) ►

Other Names Used (if applicable)

7.a. Family Name
(Last Name)
7.b. Given Name
(First Name)
7.c. Middle Name

Form I-829 03/11/15 N

Page 2 of 11

Part 4. Information About Your Current Spouse
or Your Former Conditional Permanent
Resident Spouse (continued)
Mailing Address

Apt.

Ste.

8.c. City or Town
8.d. State
8.f.

8.g. Postal Code
8.h. Country

Other Information
9.

Current Spouse

Child 1

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Flr.

1.c. Middle Name

8.e. ZIP Code

Province

Provide the following information about your children.
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)

8.a. Street Number
and Name
8.b.

Part 5. Information About Your Children

2.

Gender

3.

A-Number (if any)
► A-

4.

USCIS ELIS Account Number (if any)
►

5.

Date of Birth

(mm/dd/yyyy) ►

6.a. Family Name
(Last Name)
6.b. Given Name
(First Name)

10.

Date of Marriage (mm/dd/yyyy) ►

6.c. Middle Name

11.

Date Marriage Terminated

Mailing Address

(mm/dd/yyyy) ►
12.

Is this spouse currently living with you?

Yes

No

13.

Is this spouse applying with you?

Yes

No

14.

Current Immigration Status (for example, conditional
resident, tourist/visitor, entered without inspection)

Is the current immigration status of your spouse or former
spouse based on your current immigration status?
Yes
No

NOTE: If you have both a current spouse and a former
conditional permanent resident spouse, use Part 11. Additional
Information to provide this same information about your current
spouse or former conditional permanent resident spouse who you
did not already include in Part 4. above.

Form I-829 03/11/15 N

Female

Other Names Used (if applicable)

Former Conditional Permanent Resident Spouse

15.

Male

7.a. Street Number
and Name

7.b.

Apt.

Ste.

Flr.

7.c. City or Town
7.d. State
7.f.

7.e. ZIP Code

Province

7.g. Postal Code
7.h. Country

8.

Is this child currently living with you?

Yes

No

9.

Is this child applying with you?

Yes

No

10.

Current Immigration Status (for example, conditional
resident, tourist/visitor, entered without inspection)

Page 3 of 11

Child 3

Part 5. Information About Your Children
(continued)

21.a. Family Name
(Last Name)
21.b. Given Name
(First Name)

Child 2
11.a. Family Name
(Last Name)
11.b. Given Name
(First Name)

21.c. Middle Name

11.c. Middle Name
12.

Gender

13.

A-Number (if any)

22.

Gender

23.

A-Number (if any)
► A-

24.

USCIS ELIS Account Number (if any)
►

25.

Date of Birth

Female

► A14.

USCIS ELIS Account Number (if any)
►

15.

Date of Birth

26.a. Family Name
(Last Name)
26.b. Given Name
(First Name)

26.c. Middle Name
Mailing Address

16.c. Middle Name

27.a. Street Number
and Name

Mailing Address

27.b.

17.a. Street Number
and Name
Apt.

Apt.

Ste.

Flr.

27.c. City or Town

Ste.

17.c. City or Town
17.d. State

(mm/dd/yyyy) ►

Other Names Used (if applicable)

(mm/dd/yyyy) ►

Other Names Used (if applicable)

17.b.

Female

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Male

16.a. Family Name
(Last Name)
16.b. Given Name
(First Name)

Male

Flr.

27.d. State

27.e. ZIP Code

27.f. Province

17.e. ZIP Code

27.g. Postal Code

17.f. Province

27.h. Country

17.g. Postal Code
17.h. Country

18.

Is this child currently living with you?

Yes

No

19.

Is this child applying with you?

Yes

No

20.

Current Immigration Status (for example, conditional
resident, tourist/visitor, entered without inspection)

Form I-829 03/11/15 N

28.

Is this child currently living with you?

Yes

No

29.

Is this child applying with you?

Yes

No

30.

Current Immigration Status (for example, conditional
resident, tourist/visitor, entered without inspection)

Page 4 of 11

If you need extra space to list additional children, use the space
provided in Part 11. Additional Information or attach a
separate sheet of paper; type or print your name and A-Number
(if any) at the top of each sheet; indicate the Page Number,
Part Number, and Item Number to which your answer refers;
and sign and date each sheet.

Part 5. Information About Your Children
(continued)
Child 4
31.a. Family Name
(Last Name)
31.b. Given Name
(First Name)

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Part 6. Your Biographic Information

31.c. Middle Name
32.

Gender

33.

A-Number (if any)

Male

1.

Ethnicity (Select only one box)
Hispanic or Latino
Not Hispanic or Latino

2.

Race (Select all applicable boxes)

Female

► A34.

USCIS ELIS Account Number (if any)
►

35.

Date of Birth

White
Asian
Black or African American

(mm/dd/yyyy) ►

American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander

Other Names Used (if applicable)
36.a. Family Name
(Last Name)
36.b. Given Name
(First Name)
36.c. Middle Name
Mailing Address
37.a. Street Number
and Name
37.b.

Apt.

Height

4.

Weight

5.

Eye Color (Select only one box)

6.

Ste.

37.c. City or Town
37.d. State

3.

Flr.

Feet

Inches
Pounds

Black
Gray

Blue

Brown

Green

Hazel

Maroon

Pink

Unknown/Other

Hair Color (Select only one box)
Bald (No hair)
Brown
Sandy

Black
Gray
White

Blond
Red
Unknown/Other

37.e. ZIP Code

Part 7. Information About the New Commercial
Enterprise (NCE)

37.f. Province
37.g. Postal Code

Type of Enterprise

37.h. Country

38.

Is this child currently living with you?

Yes

No

39.

Is this child applying with you?

Yes

No

40.

Current Immigration Status (for example, conditional
resident, tourist/visitor, entered without inspection)

Form I-829 03/11/15 N

1.

NCE formed after November 29, 1990.

2.

NCE resulting from the purchase of a business,
formed on or before November 29, 1990, that has
been restructured or reorganized.

3.

NCE resulting from a capital investment in, and
substantial expansion of, a business formed on or
before November 29, 1990.

Page 5 of 11

Part 7. Information About the New Commercial
Enterprise (NCE) (continued)
Additional Information About the NCE
4.

Name of the NCE

Subsequent Investments in the NCE
Provide the following information about how much the
entrepreneur has invested in the NCE since the entrepreneur's
initial investment.
17.a. Date of Subsequent Investment
(mm/dd/yyyy) ►

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17.b. Amount of Subsequent Investment $

Physical Address
5.a. Street Number
and Name
5.b.

Apt.

Ste.

5.c. City or Town
5.d. State

Flr.

5.e. ZIP Code

17.c. Type of Subsequent Investment (for example, cash,
equipment, inventory, other tangible property, cash
equivalents, or qualifying indebtedness as described in
8 CFR 204.6(e))
NOTE: If multiple investments have been made since the
entrepreneur's initial investment in the commercial enterprise,
use Part 11. Additional Information to list the dates, amounts,
and type of investments.

6.

Telephone Number

7.

Internet Web site Address (if established)

8.

Type of Business Organization (for example, corporation,
limited liability company, partnership)

18.a. At the time of the Entrepreneur's Initial Investment

9.

Nature of Business (for example, furniture manufacturer)

18.b. Currently Employed in the NCE

10.

Included Industries (select North American Industry
Classification System (NAICS) code or codes)

11.

IRS Tax Identification Number

12.

Date Business Established
(mm/dd/yyyy) ►

13.

Amount of the Entrepreneur's Initial Investment
in the NCE
$

14.

Date of the Entrepreneur's Initial Investment
(mm/dd/yyyy) ►

15.

What percentage of the NCE does the entrepreneur own?

16.

Is this petition based on investment in a troubled business?
Yes
No

Form I-829 03/11/15 N

Full-time Positions and Qualifying Employees
Provide the number of full-time positions for direct and
qualifying employees in the NCE in the United States
(excluding you, your spouse, and your children):

Job Creation

19.a. How many new direct jobs did the entrepreneur's
investment create?
19.b. How many new direct jobs will the entrepreneur's
investment create within a reasonable amount of time
after filing this petition?
20.a. If the NCE is associated with an approved regional center,
how many indirect jobs were created?
20.b. If the NCE is associated with an approved regional center,
how many indirect jobs will the NCE create within a
reasonable amount of time after filing this petition?

21.

If the investment was made into a troubled business, how
many jobs were maintained as a result of the investment?

Page 6 of 11

Gross and Net Incomes

Part 8. Petitioner's Statement, Contact
Information, Acknowledgement of Appointment
at USCIS Application Support Center,
Certification, and Signature

Provide the gross and net incomes generated annually by the
commercial enterprise since the entrepreneur's initial investment.
Include all income generated in the present year to date.

NOTE: Read the information on penalties in the Penalties
section of the Form I-829 Instructions before completing this
part.

Part 7. Information About the New Commercial
Enterprise (NCE) (continued)

22.a. Year (yyyy)
22.b. Gross Income
22.c. Net Income
23.a. Year (yyyy)
23.b. Gross Income
23.c. Net Income
24.a. Year (yyyy)
24.b. Gross Income
24.c. Net Income
25.

26.

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Petitioner's Statement

$

NOTE: Select the box for either Item Number 1.a. or 1.b. If
applicable, select the box for Item Number 2.

$

1.a.

I can read and understand English, and have read and
understand every question and instruction on this
petition, as well as my answer to every question. I
have read the Acknowledgement of Appointment at
USCIS Application Support Center.

1.b.

The interpreter named in Part 9. has read every
question and instruction on this petition, as well as
my answer to every question, in

$
$

,
a language in which I am fluent. I understand every
question and instruction on this petition as translated
to me by my interpreter, and have provided complete,
true, and correct responses in the language indicated
above. The interpreter named in Part 9. has also
read the Acknowledgement of Appointment at
USCIS Application Support Center to me, in the
language in which I am fluent, and I understand this
Application Support Center (ASC)
Acknowledgement as read to me by my interpreter.

$
$

Has the commercial enterprise filed for bankruptcy,
ceased business operations, materially changed the
nature of the business, or made any changes in its
organization or ownership since the date of the
entrepreneur's initial investment?
Yes

No

Has the commercial enterprise sold any corporate assets,
shares, or property, or had any capital withdrawn since
the date of the entrepreneur's initial investment?
Yes

2.

,
who
is
is not an attorney or accredited
representative, in preparing this petition for me. This
person who assisted me in preparing my petition has
reviewed the Acknowledgement of Appointment at
USCIS Application Support Center with me, and I
understand the ASC Acknowledgement.

No

NOTE: If you answered “Yes” to Item Number 25. or 26.,
provide an explanation in Part 11. Additional Information.
27.

Provide the total number of EB-5 investors associated
with the NCE.

28.

Provide the total amount of EB-5 capital invested into the
NCE.

If you need extra space to provide additional information for
any item in Part 7., use the space provided in Part 11.
Additional Information or attach a separate sheet of paper;
type or print your name and A-Number (if any) at the top of
each sheet; indicate the Page Number, Part Number, and Item
Number to which your answer refers; and sign and date each
sheet.

Form I-829 03/11/15 N

I have requested the services of and consented to

Petitioner's Contact Information
3.

Petitioner's Daytime Telephone Number

4.

Petitioner's Mobile Phone Number (if any)

5.

Petitioner's Email Address (if any)

Page 7 of 11

Part 8. Petitioner's Statement, Contact
Information, Acknowledgement of Appointment
at USCIS Application Support Center,
Certification, and Signature (continued)

Petitioner's Signature
6.a. Petitioner's Signature

6.b. Date of Signature (mm/dd/yyyy) ►

Acknowledgement of Appointment at USCIS
Application Support Center
I,

NOTE TO ALL PETITIONERS: If you do not completely
fill out this petition or fail to submit required documents listed
in the instructions, your petition may be denied.

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,

understand that the purpose of a USCIS ASC appointment is for
me to provide fingerprints, photograph, and/or signature and to
re-affirm that all of the information in my petition is complete,
true, and correct and was provided by me. I understand that I
will sign my name to the following declaration which USCIS
will display to me at the time I provide my fingerprints,
photograph, and/or signature during my ASC appointment.
By signing here, I declare under penalty of perjury that I
have reviewed and understand my application, petition, or
request as identified by the receipt number displayed on the
screen above, and all supporting documents, applications,
petitions, or requests filed with my application, petition, or
request that I (or my attorney or accredited representative)
filed with USCIS, and that all of the information in these
materials is complete, true, and correct.

I also understand that when I sign my name, provide my
fingerprints, and am photographed at the USCIS ASC, I will be
re-affirming that I willingly submit this petition; I have reviewed
the contents of this petition; all of the information in my petition
and all supporting documents submitted with my petition were
provided by me and are complete, true, and correct; and if I was
assisted in completing this petition, the person assisting me also
reviewed this Acknowledgement of Appointment at USCIS
Application Support Center with me.

Petitioner's Certification
Copies of any documents I have submitted are exact
photocopies of unaltered, original documents, and I understand
that USCIS may require that I submit original documents to
USCIS at a later date. Furthermore, I authorize the release of
any information from any and all of my records that USCIS
may need to determine my eligibility for the immigration
benefit that I seek.
I furthermore authorize release of information contained in this
petition, in supporting documents, and in my USCIS records, to
other entities and persons where necessary for the
administration and enforcement of U.S. immigration laws.

Part 9. Interpreter's Certification, Contact
Information, and Signature

Provide the following information about the interpreter.

Interpreter's Full Name

1.a. Interpreter's Family Name (Last Name)
1.b. Interpreter's Given Name (First Name)
2.

Interpreter's Business or Organization Name (if any)

Interpreter's Mailing Address

3.a. Street Number
and Name

3.b.

Apt.

Ste.

Flr.

3.c. City or Town
3.d. State
3.f.

3.e. ZIP Code

Province

3.g. Postal Code
3.h. Country

Interpreter's Contact Information
4.

Interpreter's Daytime Telephone Number

5.

Interpreter's Email Address (if any)

I certify, under penalty of perjury, that the information in my
petition and any document submitted with my petition were
provided by me and are complete, true and correct.

Form I-829 03/11/15 N

Page 8 of 11

Part 9. Interpreter's Certification, Contact
Information, and Signature (continued)

Preparer's Mailing Address
3.a. Street Number
and Name

Interpreter's Certification

3.b.

I certify that:

3.c. City or Town

Apt.

Ste.

Flr.

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I am fluent in English and
, which
is the same language provided in Part 8., Item Number 1.b.;
I have read to this petitioner every question and instruction on
this petition, as well as the answer to every question, in the
language provided in Part 8., Item Number 1.b.; and

I have read the Acknowledgement of Appointment at USCIS
Application Support Center to the petitioner in the same
language provided in Part 8., Item Number 1.b.

The petitioner has informed me that he or she understands every
instruction and question on the petition, as well as the answer to
every question, and the petitioner verified the accuracy of every
answer; and
The petitioner has also informed me that he or she understands
the ASC Acknowledgement and that by appearing for a USCIS
ASC biometric services appointment and providing his or her
fingerprints, photograph, and/or signature, he or she is
re-affirming that the contents of this petition and all supporting
documentation are complete, true, and correct.

Interpreter's Signature
6.a. Interpreter's Signature

6.b. Date of Signature (mm/dd/yyyy) ►

Part 10. Contact Information, Statement,
Certification, and Signature of the Person
Preparing this Petition, If Other Than the
Petitioner
Provide the following information about the preparer.

3.d. State
3.f.

3.e. ZIP Code

Province

3.g. Postal Code
3.h. Country

Preparer's Contact Information

4.

Preparer's Daytime Telephone Number

5.

Preparer's Fax Number (if any)

6.

Preparer's Email Address (if any)

Preparer's Statement

7.a.

I am not an attorney or accredited representative but
have prepared this petition on behalf of the petitioner
and with the petitioner's consent.

7.b.

I am an attorney or accredited representative and my
representation of the petitioner in this case
extends
does not extend beyond
the preparation of this petition.

NOTE: If you are an attorney or accredited representative
whose representation extends beyond preparation of this
petition, you must submit a completed Form G-28, Notice of
Attorney or Accredited Representative, with this petition.

Preparer's Full Name
1.a. Preparer's Family Name (Last Name)
1.b. Preparer's Given Name (First Name)
2.

Preparer's Business or Organization Name (if any)

Form I-829 03/11/15 N

Page 9 of 11

Part 10. Contact Information, Statement,
Certification, and Signature of the Person
Preparing this Petition, If Other Than the
Petitioner (continued)
Preparer's Certification

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By my signature, I certify, swear, or affirm, under penalty of
perjury, that I prepared this petition on behalf of, at the request
of, and with the express consent of the petitioner. I completed
this petition based only on responses the petitioner provided to
me. After completing the petition, I reviewed it and all of the
petitioner's responses with the petitioner, who agreed with every
answer on the petition. If the petitioner supplied additional
information concerning a question on the petition, I recorded it
on the petition. I have also read the Acknowledgement of
Appointment at USCIS Application Support Center to the
petitioner and the petitioner has informed me that he or she
understands the ASC Acknowledgement.

Preparer's Signature
8.a. Preparer's Signature

8.b. Date of Signature (mm/dd/yyyy) ►

Form I-829 03/11/15 N

Page 10 of 11

5.a. Page Number

Part 11. Additional Information
If you need extra space to provide any additional information
within this petition, use the space below. If you need more
space than what is provided, you may make copies of this page
to complete and file with this petition or attach a separate sheet
of paper. Include your name and A-Number (if any) at the top
of each sheet; indicate the Page Number, Part Number, and
Item Number to which your answer refers; and sign and date
each sheet.
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
2.

A-Number (if any)

5.b. Part Number

5.c. Item Number

5.d.

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► A3.a. Page Number

3.b. Part Number

6.a. Page Number

6.b. Part Number

6.c. Item Number

6.d.

3.d.

4.a. Page Number

3.c. Item Number

4.b. Part Number

4.d.

Form I-829 03/11/15 N

4.c. Item Number

7.a. Petitioner's Signature

7.b. Date of Signature (mm/dd/yyyy) ►

Page 11 of 11


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