Table of Changes (Form I-914 instructions) T Rule

Table of Changes – INSTRUCTIONS

Form I-914, Application for T Nonimmigrant Status

OMB Number: 1615-0099

Submission Date 01/11/2017

Reason for Revision: TRule Rev

Current Section and Page Number	Current Text	Proposed Text
Page 1, Who May File This Form	[Page 1] Form I-914 should be filed by you, the victim of a severe form of trafficking in persons, and may include qualifying family members. It can also be used at a later date to file for qualifying family members not included on the original application. 1. Principal Applicant… B. You are 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 in persons; C. You have complied with any reasonable request for assistance in a Federal, State, or local investigation or prosecution of acts of trafficking or the investigation of crime where acts of trafficking are at least one central reason for the commission of that crime, unless you are under the age of 18; and… 2. Principal Applicant concurrently filing for qualifying family member, or currently holding T-1 nonimmigrant status and filing for a qualifying family member. You must also demonstrate that: A. If you are under the age of 21, qualifying family … B. If you are over the age of 21, qualifying family …	[Page 1] Who May File This Form? Form I-914 should be filed by you, the victim of a severe form of trafficking in persons, and may include eligible family members. It can also be used at a later date to file for eligible family members not included on the original application. 1. Principal Applicant… B. You are deemed physically present if you meet one of the criteria below: (1) You are 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 in persons; or (2) You were allowed entry into the United States to participate in investigative or judicial processes associated with an act or a perpetrator of trafficking; C. You have complied with any reasonable request for assistance in a Federal, state, or local investigation or prosecution of acts of trafficking or the investigating of a crime where the acts of trafficking are at least one central reason for the commission of that crime, unless: (1) You are under 18 years of age; (2) You are unable to cooperate with a request due to physical or psychological trauma; and… 2. Principal Applicant filing for eligible family member at the same time, or currently holding T-1 nonimmigrant status and filing for an eligible family member. You must also demonstrate that: A. If you are under 21 years of age, eligible family … B. If you are over 21 years of age, eligible family … [Page 2] C. Regardless of your age at the time of filing, if your family member faces a present danger of retaliation, as a result of your escape from the severe form of trafficking in persons or your cooperation with law enforcement, the eligible family members for whom you may file are your: (1) Parent(s); (2) Unmarried sibling(s) under 18 years of age; or (3) An adult or minor child of your derivative (your grandchild, your spouse’s child, your niece or nephew, or your sibling).
Page 1-4, General Instructions	[Page 1] Fill Out Form I-914, Form I-914, Supplement A, and Form I-914, Supplement B (strongly encouraged). Completing Form I-914 Part B. General Information About You (person filing this application as a victim of a severe form of trafficking in persons) 1. Family Name (Last Name) - Give your legal name. If you have two last names, include both and use a hyphen (-) between the names, if appropriate. [Page 2] 2. Given Name (First Name) - Give your full first name; do not use "nicknames." (Example: If your name is Albert, do not use Al.) 3. Other Names Used - 4. Home Address - 5. Safe Mailing Address - 6. Home Telephone Number - 7. Safe Daytime Telephone Number - 8. E-Mail Address – 9. A-Number – 10. U.S. Social Security Number - 11. Gender and Marital Status - 12. Date of Birth - 13. Country of Birth 14. Country of Citizenship - 15. Passport - 16. Last Entry Into the United States - 17. Form I-94, Arrival-Departure Document, Number - 18. Current Immigration Status – Give your current status, regardless of how you entered the United States (visitor, student, entry without inspection, etc.) Part C. Additional Information You must answer each question. You must explain relevant information about your claim. Attach documents in support of your claim and the specific facts on which you are relying to support your claim. Complete Question 11 to indicate whether you are applying for one or more qualifying family members at this time. See the next section below for information on completing an application on behalf of your qualifying family member… Part D. Processing Information You must answer each question. If you answer “Yes” to any of the questions, explain on a separate sheet of paper. Explain if any of the acts or circumstances relate to your having been a victim of a severe form of trafficking in persons. Part E. Information about Your Family Members Even if you are not applying to bring your family members to the United States, you must provide the requested information about your spouse and children, if any. Part E. Attestation, Release, and Signature. First read the information below regarding penalties. Then you, the applicant, must sign and date the form. If you do not sign the form, the application will be returned as incomplete. Part F. Preparer and/or Interpreter Certification. If you, the applicant, did not fill out Form I-914, the preparer must also sign, date, and give his or her address. Part H. Checklist Fill out the checkboxes. This will ensure that you have completed the form properly. [Page 3] Completing Form I-914, Supplement A, Application for Immediate Family Member of T-1 Recipient If you are filing for a qualifying family member, you must complete Form I-914, Supplement A, Application for Immediate Family Member of T-1 Recipient. Form I-914, Supplement A, must be submitted for each family member for whom you are filing. Form I-914, Supplement A, may be filed concurrently with the principal applicant’s initial Form I-914 or at any time thereafter. However, any Form I-914, Supplement A, submitted subsequently must have the appropriate boxes checked in Part A., and must be accompanied by a copy of the principal applicant’s Form I-914. Evidence submitted with the original application, however, need not be resubmitted. This form is divided into Parts A through F. The following information should help you fill out the form. Part A. Family Member Relationship to You (the principal) Check the appropriate box. Part B. Information About You 1. Family Name (Last Name) - Give your legal name. If you have two last names, include both and use a hyphen (-) between the names, if appropriate. 2. Given Name (First Name) - Give your full first name; do not use "nicknames." (Example: If your name is Albert, do not use Al.) 3. Date of Birth … 4. A-Number … 5. Status of your Form I-914… Part C. Information About Your Family Member (the derivative) 1. Family Name (Last Name) - Give his or her legal name. If he or she has two last names, include both and use a hyphen (-) between the names, if appropriate. 2. Given Name (First Name) - Give his or her full first name; do not use "nicknames." (Example: If his or her name is Albert, do not use Al.) 3. Other Names Used … 7. Intended Address … 8. Safe Mailing Address … 12. Home Telephone Number … 13. Safe Daytime Telephone Number … 9. A Number … 10. U.S. Social Security Number … 14. Gender and Marital Status … 4. Date of Birth … 5. Country of Birth … 6. Country of Citizenship … 15. Passport … 16. Last Entry Into the United States … 11. Form I-94… 17. Immigration History. Give your family member’s immigration proceedings history, if any. 18. Employment Authorization - Mark the box whether you are applying for employment authorization for your family member. If "Yes," also submit Form I-765, Application for Employment Authorization, for your family member. Part D. Processing Information… Part E. Attestation, Release, and Signature. First read the information below regarding penalties. Then you, the applicant, must sign and date the form. If you do not sign the form, the application will be returned as incomplete. Part F. Preparer and/or Interpreter Certification. If you, the applicant, did not fill out Form I-914, the preparer must also sign, date, and give his or her address. Completing Form I-914, Supplement B, Declaration of Law Enforcement Officer for Victim of Trafficking in Persons Form I-914, Supplement B, is used by Federal, State, or local law enforcement authorities to certify that you are a victim of a severe form of trafficking in persons. You are not required to file Form I-914, Supplement B, to prove your claim. However, the endorsement of a Federal, State, or local law enforcement authority is primary evidence that you are a victim of a severe form of trafficking in persons and that you have complied with any reasonable request for assistance in the investigation or prosecution. These elements of your claim may be difficult to establish otherwise, and submission of Form I-914, Supplement B, is strongly advised. Follow the additional instructions on Form I-914, Supplement B.	[Page 2] General Instructions Fill Out Form I-914, Form I-914, Supplement A, and Form I-914, Supplement B (optional). Completing Form I-914 This form is divided into Parts A. – H. The following information will help you fill out the form. Part B. General Information About You (person filing this application as a victim of a severe form of trafficking in persons). 1. Your Full Name. Provide your legal name, as shown on your birth certificate or legal name change document. If you have two last names, include both and use a hyphen (-) between the names, if appropriate. Write your last, first, and middle names in each appropriate field. 2. Other Names Used. 3. Home Address. 4. Safe Mailing Address. 5. Home Telephone Number. [Page 3] 6. Safe Daytime Telephone Number. 7. E-Mail Address. 8. A-Number. 9. U.S. Social Security Number. 10. Gender and Marital Status. 11. Date of Birth. 12. Country of Birth. 13. Country of Citizenship. 14. Passport. 15. Last Entry Into the United States. 16. Form I-94, Arrival-Departure Document Number. 17. Current Immigration Status. Give your current status, regardless of how you entered the United States (visitor, student, entry without inspection, etc.). Part C. Additional Information You must answer each question. You must explain relevant information about your claim. Attach documents in support of your claim and the specific facts on which you are relying to support your claim. Complete Question 10 to indicate whether you would like an Employment Authorization Document (EAD). If your application is approved, you will be authorized to work. USCIS will send you an EAD as evidence of your authorization to work if you indicate "Yes" for Question 10. As the principal applicant you do not need to file a Form I-765, Application for Employment Authorization Document. Complete Question 11 to indicate whether you are applying for one or more eligible family members at this time. See the section below entitled "Completing Form I-914 Supplement A, Application for a Family Member of T-1 Recipient," for information on completing an application on behalf of your eligible family member… [No change] [Page 4] Part F. Applicant’s Statement, Contact Information, Declaration, Certification, and Signature Select the appropriate box to indicate whether you read this application yourself or whether you had an interpreter assist you. If someone assisted you in completing the application, select the box indicating that you used a preparer. Further, you must sign and date your application and provide your daytime telephone number, mobile telephone number (if any), and email address (if any). Every application MUST contain the signature of the applicant (or parent or legal guardian, if applicable). A stamped or typewritten name in place of a signature is not acceptable. Part G. Interpreter’s Contact Information, Certification, and Signature If you used anyone as an interpreter to read the instructions and questions on this application to you in a language in which you are fluent, the interpreter must fill out this section, provide his or her name, the name and address of his or her business or organization (if any), his or her daytime telephone number, his or her mobile telephone number (if any), and his or her email address (if any). The interpreter must sign and date the application. Part H. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant This section must contain the signature of the person who completed your application, if other than you, the applicant. If the same individual acted as your interpreter and your preparer, that person should complete both Part G. and Part H. If the person who completed this application is associated with a business or organization, that person should complete the business or organization name and address information. Anyone who helped you complete this application MUST sign and date the application. A stamped or typewritten name in place of a signature is not acceptable. If the person who helped you prepare your application is an attorney or accredited representative, he or she may be obliged to also submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative, along with your application. [Deleted] Completing Form I-914, Supplement A, Application for Family Member of T-1 Recipient If you are filing for an eligible family member, you must complete Form I-914, Supplement A, Application for Family Member of T-1 Recipient. Form I-914, Supplement A, must be submitted for each family member for whom you are filing. [no change] This form is divided into Parts A. - G. The following information should help you fill out the form. Part A. Family Member Relationship to You (the principal) Check the appropriate box if you are filing for your spouse, child(ren), parent(s), or sibling(s) based on your age. This part can be left blank if you are only applying for your derivative's adult or minor child (see Part B.). Part B. Family Member Relationship to Your Derivative Check the box if you are filing for the adult or minor child of your derivative (your grandchild, your spouse’s child, your niece or nephew, or your sibling) who faces a present danger of retaliation as a result of your escape from the severe form of trafficking in persons or your cooperation with law enforcement. Part C. General Information About You (the principal) 1. Your Full Name. Provide your legal name, as shown on your birth certificate or legal name change document. If you have two last names, include both and use a hyphen (-) between the names, if appropriate. Write your last, first, and middle names in each appropriate field. [Page 5] 2. Date of Birth 3. A-Number 4. Status of your Form I-914, Application for T Nonimmigrant Status. Part D. Information About Your Family Member (the derivative) 1. Full Name. Provide the name of the family member, as shown on his or her birth certificate or legal change of name document. If the person has two last names, include both and use a hyphen (-) between the names, if appropriate. Write the person’s last, first, and middle names in each appropriate field. 2. Other Names Used … 3. Residence or Intended Address in the United States. Give his or her intended…. 4. Safe Mailing Address. Give his or her…. 5. Home Telephone Number. Give the telephone… 6. Safe Daytime Telephone Number. If he or she…. 7. E-Mail Address. This is optional… 8. A-Number. This is his or her…. 9. U.S. Social Security Number. 10. Gender and Marital Status. 11. Date of Birth. 12. Country of Birth. 13. Country of Citizenship. 14. Passport. [Page 6] 15. Last Entry Into the United States 16. Form I-94, Arrival-Departure Document Number. 17. Current Immigration Status. Give your family member’s current status, regardless of how you entered the United States (visitor, student, entry without inspection (etc.). 18. Previously Traveled to the United States. Give the following information about your family member if he or she has previously traveled to the United States. 19. Family Member’s Prior Marriage(s) Information. If your family member was previously married, list the names of his or her prior spouse(s), the dates the previous marriage terminated, the location where and how the marriage(s) terminated. 20. U.S. Consulate or Inspection Facility Where You Want Notification Sent. If your family member is outside the United States, indicate the U.S. Consulate or inspection facility you want notified if the Form I-914, Supplement A, is approved. 21 Foreign Address Where You Want Notification Sent. If your family member is outside the United States, indicate the address where you want notification sent if the Form I-914, Supplement A, is approved. 22. Immigration History. Give your family member’s immigration proceedings history, if any. 23. Employment Authorization. If the Form I-914, Supplement A, is approved for your family member, he or she is authorized to work. Check the box to indicate if you are applying for an Employment Authorization Document (EAD) as evidence of your family member's authorization to work. If you indicate "Yes," each family member must also file Form I-765 with the appropriate fee or request for fee waiver. The Form I-765 can be filed with the Form I-914, Supplement A, or at a later time. If your family member is living outside of the United States, he or she is not eligible to receive employment authorization until he or she is lawfully admitted to the United States. Do not file Form I-765 for a family who is living outside of the United States. \ Part E… Part F. Applicant’s Statement, Contact Information, Declaration, Certification, and Signature Select the appropriate box to indicate whether you read this application yourself or whether you had an interpreter assist you. If someone assisted you in completing the application, select the box indicating that you used a preparer. Further, you must sign and date your application and provide your daytime telephone number, mobile telephone number (if any), and email address (if any). Every application MUST contain the signature of the applicant (or parent or legal guardian, if applicable). A stamped or typewritten name in place of a signature is not acceptable. NOTE: If the family member for whom you are filing is in the United States, he or she must sign and date the application. If he or she does not sign or date the application, then Form I-914, Supplement A, will be returned as incomplete. Part G. Interpreter’s Contact Information, Certification, and Signature If you used anyone as an interpreter to read the instructions and questions on this application to you in a language in which you are fluent, the interpreter must fill out this section, provide his or her name, the name and address of his or her business or organization (if any), his or her daytime telephone number, his or her mobile telephone number (if any), and his or her email address (if any). The interpreter must sign and date the application. [Page 7] Part H. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant This section must contain the signature of the person who completed your application, if other than you, the applicant. If the same individual acted as your interpreter and your preparer, that person should complete both Part G. and Part H. If the person who completed this application is associated with a business or organization, that person should complete the business or organization name and address information. Anyone who helped you complete this application MUST sign and date the application. A stamped or typewritten name in place of a signature is not acceptable. If the person who helped you prepare your application is an attorney or accredited representative, he or she may be obliged to also submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative, along with your application. Completing Form I-914, Supplement B, Declaration of Law Enforcement Officer for Victim of Trafficking in Persons Form I-914, Supplement B, is completed by Federal, State, or local law enforcement authorities and is then given to you to submit to USCIS. You are not required to file Form I-914, Supplement B, to prove your claim. However, the endorsement of a Federal, State, or local law enforcement authority is one form of evidence that you are a victim of a severe form of trafficking in persons and that you have complied with any reasonable request for assistance in the investigation or prosecution. Follow the additional instructions on Form I-914, Supplement B.
Page 4-5, Initial Evidence	[Page 4] You must submit: 1. A completed and signed Form I-914; 2. Evidence to establish each eligibility requirement (see next section for details); and 3. Three identical color photographs of yourself taken within 30 days of the filing of this application. The photos must have a white to off-white background, be printed on thin paper with a glossy finish, and be unmounted and unretouched. NOTE: Because of the current USCIS scanning process, if a digital photo is submitted, it needs to be produced from a high resolution camera, which has at least a 3.5 mega pixel. Passport-style photos must be 2" x 2." The photos must be in color with full face, frontal view on a white to off-white background. Head height should measure 1" to 1 3/8" from top of hair to bottom of chin, and eye height is between 1 1/8" to 1 3/8" from bottom of photo. Your head must be bare unless you are wearing a headdress as required by a religious order of which you are a member. Using pencil or felt pen, lightly print your name and A-Number on the back of the photo. If applying for your family member, you must also submit: 1. A completed and signed Form I-914, Supplement A, Application for Immediate Family Member of a T-1 Nonimmigrant, for each family member for whom you are applying. You may file Form I-914, Supplement A, concurrently with your initial application or at a later time. [Page 5] Any Form I-914, Supplement A, submitted subsequent to the principal applicant's initial filing, however, must be accompanied by: A. A new Form I-914 with the appropriate boxes checked in Part A with an original signature in Part F; and B. A copy of the original Form I-914. 2. Evidence to establish each eligibility requirement for each family member (see next section for details). NOTE: Evidence submitted with the original Form I-914 does not need to be resubmitted. 3. Three photographs of each family member (to comply with the same requirements as the photographs of you).	[Page 6] Initial Evidence You must submit: 1. A completed and signed Form I-914; 2. A personal narrative statement; 3. Evidence to establish each eligibility requirement (see next section for details); and [Deleted] If applying for your family member, you must also submit: 1. A completed and signed Form I-914, Supplement A, for each family member for whom you are applying. You may file Form I-914 Supplement A, at the same time with your initial application or at a later time. Any Form I-914, Supplement A, submitted subsequent to the principal applicant's initial filing, however, must be accompanied by: A. A new Form I-914, Supplement A, with the appropriate boxes checked in Part A. and with an original signature in Part F.; and B. A copy of the original Form I-914. 2. Evidence to establish eligibility for each family member (see next section for details). NOTE: Evidence submitted with the original Form I-914 does not need to be resubmitted. [Deleted]
Page 5-6, Evidence to Establish T Nonimmigrant Status	[Page 5] You must file Form I-914 with evidence sufficient to demonstrate that you satisfy each of the eligibility requirements. If you have in your possession, or have access to, a document showing how you entered the United States, you must submit a copy of that document with your application. To qualify for T-1 nonimmigrant status, you must demonstrate that you: 1. Are or have been a victim of a severe form of trafficking in persons; 2. Are physically present in the United States, American Samoa, or the Commonwealth of the Northern Mariana Islands, or at a port of entry, as a result of trafficking; 3. Have complied with any reasonable request for assistance in a Federal, State, or local law enforcement investigation or prosecution of acts of trafficking in persons, unless you are under 18 years old; and 4. Would suffer extreme hardship involving unusual and severe harm upon removal. To establish that you… 1. For the purpose… 2. For recruiting, harboring, transportation, provision, or obtaining of a person for labor or services induced by force, fraud, or coercion to subject you to involuntary servitude, peonage, debt bondage, or slavery…	[Page 8] Evidence to Establish T Nonimmigrant Status [No change] 2. Are physically present in the United States, American Samoa, or the Commonwealth of the Northern Mariana Islands, or at a port of entry, as a result of trafficking, including physical presence based on your having been allowed entry into the United States to participate in investigative or judicial processes associated with an act or a perpetrator of trafficking; 3. Have complied with any reasonable request for assistance in a Federal, State, or local law enforcement investigation or prosecution of acts of trafficking in persons, unless you are under 18 years of age, or you are unable to cooperate with a request due to physical or psychological trauma; and… [no change] To establish that you are or have been a victim of a severe form of trafficking in persons, you must demonstrate that you have been a victim of either: 1. Sex trafficking in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such act is under 18 years of age; or 2. The recruitment, harboring, transportation, provision, or obtaining of a person for labor or services through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.
	Primary Evidence Form I-914, Supplement B, Declaration of Law Enforcement Officer for Victim of Trafficking in Persons The primary evidence of your claim to be a victim of a severe form of trafficking in persons shall be Form I-914, Supplement B, Declaration of Law Enforcement Officer for Victim of Trafficking in Persons. That declaration is appended to this form. You are not required to file Form I-914, Supplement B, to prove your claim. However, the endorsement of a Federal, State, or local law enforcement officer on Form I-914, Supplement B, constitutes primary evidence that you are a victim and that you have complied with any reasonable request from a Federal, State, or local law enforcement authority for assistance in the investigation or prosecution of the acts of trafficking. These elements of your claim may be difficult to establish otherwise, and submission of Form I-914, Supplement B, is strongly advised. Instructions pertinent to Form I-914, Supplement B, are appended to that form. If you do not provide a completed Form I-914, Supplement B, you must submit an explanation, describing your attempts to obtain the certification and why it does not exist or is unavailable. If you did not attempt to obtain the certification, you must explain why you did not. Secondary Evidence If you do not provide a completed Form I-914, Supplement B, Declaration of Law Enforcement Officer for Victim of Trafficking in Persons, in addition to the explanation described above, you must also submit credible secondary evidence to establish that you are or have been a victim of a severe form of trafficking in persons and that you complied with any reasonable request from law enforcement. Such evidence may include, but is not limited to: police reports, newspaper articles, witness affidavits, or any other form of evidence. Even if you do provide Form I-914, Supplement B, you may submit additional evidence. [Page 6] Personal Statement Including a personal narrative statement is strongly encouraged. That statement should describe the trafficking crime of which you were a victim, including: 1. The circumstances of your entry into the United States; 2. The purpose for which you were brought to the United States; 3. How you were recruited or otherwise became involved in the trafficking situation; 4. When these events took place; 5. Who was responsible; 6. How long you were detained by the traffickers; 7. How and when you escaped, were rescued, or otherwise became separated from the traffickers; 8. What you have been doing since you were separated from the traffickers; 9. Why you were unable to leave the United States after you were separated from the traffickers; 10. What harm or mistreatment you fear if you are removed from the United States; and 11. Why you fear you would be harmed or mistreated.	[Page 8] Evidence of Cooperation with Reasonable Requests from Law Enforcement [Section heading] Form I-914, Supplement B, Declaration of Law Enforcement Officer for Victim of Trafficking in Persons (optional) One type of evidence of your claim to be a victim of a severe form of human trafficking in persons is Form I-914, Supplement B. That declaration and instructions are appended to this form. You are not required to file Form I-914, Supplement B, to prove your claim. However, the endorsement of a Federal, State, or local law enforcement officer on Form I-914, Supplement B, is one type of evidence that you are a victim and that you have complied with any reasonable request from Federal, State, or local law enforcement authority for assistance in the investigation or prosecution of the acts of trafficking. USCIS (not the Federal, State, or local law enforcement authority) will make the decision if you meet the eligibility requirements for T nonimmigrant status. [Deleted] [Deleted] If you do not provide a completed Form I-914, Supplement B, you must submit credible evidence to establish that you are or have been a victim of a severe form of trafficking in persons and that you complied with any reasonable request from law enforcement. Such evidence may include, but is not limited to: trial transcripts, court documents, police reports, news articles, copies of reimbursement forms for travel to and from court, affidavits, or any other form of evidence. Even if you do provide Form I-914, Supplement B, you may submit additional evidence. Personal Statement A personal narrative statement is required. That statement should describe, to the best of your recollection, the trafficking crime of which you were a victim, including: [No change]
Page 6-7, Evidence to Establish Derivative T Nonimmigrant Status	[Page 6] If you are under the age of 21, qualifying family members for whom you are filing must be your: 1. Spouse; or 2. Unmarried child(ren) under the age of 21. 3. Parent(s); or 4. Unmarried sibling(s) under the age of 18. If you are over the age of 21, eligible family members for whom you are filing are your: 1. Spouse; or 2. Unmarried child(ren) under the age of 21. You must include: 1. A completed Form I-914, Supplement A, Application for Immediate Family Member of T-1 Recipient, for each qualifying family member you want included on your application… 2. Credible documentation of the claimed relationship. Documents acceptable for this purpose are: A. Husband or Wife - B. Child and you are the mother - C. Child and you are the father - D. Mother - E. Father - F. Brother and Sister - G. Stepparent/Stepchild - H. Adoptive parent or adopted child - If you and the person you are filing for are related by adoption, you must submit a copy of the adoption decree(s) showing that the adoption took place before the child became 16 years of age. If the relationship was created by the adoption of the sibling of a child already adopted, then you must submit a copy of the adoption decree(s) showing that the adoption of the sibling took place before the child became 18 years of age. In either case, you also must submit copies of evidence showing that each child was in the legal custody of and resided with the parent(s) who adopted him or her for at least two years before or after the adoption. Legal custody may only be granted by a court or recognized government entity and is usually granted at the time the adoption is finalized. However, if legal custody is granted by a court or recognized government agency prior to the adoption, that time may count to fulfill the two-year legal custody requirement. In either case, you also must submit copies of evidence showing that each child was in the legal custody of and resided with the parent(s) who adopted him or her for at least two years before or after the adoption. Legal custody may only be granted by a court or recognized government entity and is usually granted at the time the adoption is finalized. However, if legal custody is granted by a court or recognized government agency prior to the adoption, that time may count to fulfill the two-year legal custody requirement. I. Your unmarried sibling under age 18 - Submit a certified copy of your birth certificate and a copy of your brother's or sister's birth certificate showing that you have at least one common parent.	[Page 9] Evidence to Establish Derivative T Nonimmigrant Status If you are under 21years of age, eligible family members for whom you are filing must be your: 1. Spouse; 2. Unmarried child(ren) under 21 years of age; [No change] 4. Unmarried sibling(s) under 18 years of age. [No change] 2. Unmarried child(ren) under 21 years of age. If a family member faces a present danger of retaliation as a result of your escape from the severe form of trafficking in persons or cooperation with law enforcement, you may file for the following eligible family members, regardless of your age: A. Parent(s); B. Unmarried sibling(s) under 18 years of age; or C. Adult or minor child of your derivative (your grandchild, your spouse’s child, your niece or nephew, or your sibling). You must include: 1. A completed Form I-914, Supplement A, for each eligible family member you want included on your application… 2. Credible documentation of the claimed relationship. Documents acceptable for this purpose are listed below. [No change] B. Child, and you are the mother. [Page 10] C. Child, and you are the father… D. Mother. E. Father. F. Brother and Sister. G. Stepparent/Stepchild. [No change] In either case, you also must submit copies of evidence showing that each child was in the legal custody of and resided with the parent(s) who adopted him or her for some time within two years before or after the adoption. Legal custody may only be granted by a court or recognized government entity and is usually granted at the time the adoption is finalized. However, if legal custody is granted by a court or recognized government agency prior to the adoption, that time may count to fulfill the two-year legal custody requirement. I. Your unmarried sibling under 18 years of age. Submit a certified copy of your birth certificate and a copy of your brother's or sister's birth certificate showing that you have at least one common parent. 3. If you are filing for your parents, unmarried siblings under 18 years of age, and/or the adult minor child of another derivative because of a present danger of retaliation based on your escape from the severe form of trafficking in persons or cooperation with law enforcement, you should include the following: A. A description of the danger the family member faces and how the danger is linked to your escape or cooperation with law enforcement; B. Documentation of a previous grant of advance parole to a family member, if available; and C. Any other credible evidence describing the danger of retaliation, which may include a signed statement from a law enforcement official, trial transcripts, court documents, police reports, news articles, copies of reimbursement forms for travel to and from court, and affidavits from other individuals…
Page 7, Waiver of Ground(s) of Inadmissibility	To be eligible for T nonimmigrant status, you must be admissible to the United States. If you or your qualifying family member(s) answered "Yes" to one or more of the questions in Part D of Form I-914 or Form I-914, Supplement A, you or your qualifying family member(s) may be inadmissible. If you and/or your qualifying family member(s) is or becomes inadmissible under section 212(a) of the Immigration and Nationality Act, you and/or your family member(s) will not be eligible for T nonimmigrant status unless the ground of inadmissibility is waived by USCIS. Applicants seeking a waiver of inadmissibility must submit Form I-192, Application for Advance Permission to Enter as a Nonimmigrant (Pursuant to Section 212(d)(3) of the Immigration and Nationality Act). A separate fee or request for fee waiver must be filed with Form I-192. Form I-192 should be filed concurrently with Form I-914. USCIWS, in its discretion, will decide eligibility for the waiver.	[Page 11] Waiver of Ground(s) of Inadmissibility To be eligible for T nonimmigrant status, you must be admissible to the United States. If you or your eligible family member(s) answered "Yes" to one or more of the questions in Part D of Form I-914 or Form I-914, Supplement A, you or your eligible family member(s) may be inadmissible. If you and/or your eligible family member(s) is or becomes inadmissible under section 212(a) of the Immigration and Nationality Act, you and/or your family member(s) will not be eligible for T nonimmigrant status unless the ground of inadmissibility is waived by USCIS. [no change]
Page 8, Processing Information	…Employment Authorization If your application is approved, you will be authorized employment, and USCIS will send you an Employment Authorization Document as evidence of that authorization. Derivative family members are also authorized employment. If they wish to obtain an Employment Authorization Document as evidence of authorization, Form I-765, Application for Employment Authorization Document, with appropriate fee, may be filed concurrently with Form I-914 and Form I-914, Supplement A. Derivative family members living outside the United States are not eligible to receive employment authorization until they lawfully enter the United States. Do not file Form I-765 for a derivative family member who is outside the United States… Confidentiality Information provided in the application is confidential and protected from disclosure. It will be used to determine eligibility, to investigate fraudulent claims, to enforce penalties for false statements, to assist in the investigation and prosecution of trafficking and related crimes but for no other purpose. The information provided is subject to verification by USCIS. Adverse determination of admissibility or deportability cannot be made based on information obtained from the trafficker. The disclosure of information relating to a pending or approved application for T nonimmigrant status is prohibited except in certain circumstances, such as to investigative agencies who have a reason to know based on a legitimate law enforcement purpose.	[Page 12] Processing Information …Employment Authorization If your application is approved, you will be authorized to work. For a principal applicant, USCIS will send an Employment Authorization Document (EAD) as evidence of your authorization to work if you indicate “Yes” for Question 10 in Part C. As the principal applicant you do not need to file Form I-765, Application for Employment Authorization Document. Derivative family members are also authorized to work if Form I-914, Supplement A, is approved. If your derivative family member wants to obtain an EAD as evidence of his or her authorization to work, each family member must file Form I-765 with the appropriate fee or request for fee waiver. Form I-765 can be filed with Form I-914, Supplement A, or at a later time. If your family member is living outside the United States, he or she is not eligible to receive employment authorization until he or she is lawfully admitted to the United States. Do not file Form I-765 for a family member who is living outside of the United States… Confidentiality Information concerning T nonimmigrant status applicants and derivatives is protected under 8 USC section 1367. The disclosure of information relating to an individual with a pending or approved application for T nonimmigrant status is prohibited except in certain limited circumstances.
Page 9, Privacy Act Notice	We ask for the information on this form, and associated evidence, to determine if you have established eligibility for the immigration benefit for which you are filing. Our legal right to ask for this information can be found in the Immigration and Nationality Act, as amended. We may provide this information to other government agencies. Failure to provide this information, and any requested evidence, may delay a final decision or result in denial of your Form I-914.	[Page 13] USCIS Privacy Act Statement AUTHORITIES: The information requested on this benefit application, and the associated evidence, is collected pursuant to Public Law106-386, sections 107(e) and 1513(c) and 8 USC 1101(a)(15)(T). PURPOSE: The primary purpose for providing the requested information on this application is to determine if you have established eligibility for temporary immigration benefits for which you are filing. The information you provide will be used to grant or deny the benefit sought. DISCLOSURE: The information you provide, including Social Security Number, is voluntary. However, failure to provide the requested information, and any requested evidence, may delay a final decision or result in denial of your benefit request. ROUTINE USES: Your information will be used to determine eligibility, to investigate fraudulent claims, to enforce penalties for false statements, and to assist in the investigation and prosecution of trafficking and related crimes. The information will be used by and disclosed to the Department of Homeland Security (DHS) personnel and contractors or other agents in accordance with approved routine uses, as described in the associated published system of records notices [DHS/USCIS-007 - Benefits Information System and DHS/USCIS-001 - Alien File, Index, and National File Tracking System], which can be found at www.dhs.gov/privacy. The information may also be made available, as appropriate for law enforcement purposes or in the interest of national security.
Page 9, Paperwork Reduction Act	An agency may not conduct or sponsor an information collection and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The public reporting burden for this collection of information is estimated at 3 hours and 15 minutes per response, including the time for reviewing instructions, completing and submitting the form. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services, Regulatory Coordination Division, Office of Policy and Strategy, 20 Massachusetts Avenue, N.W., Washington, DC 20529-2210. OMB No. 1615-0099. Do not mail your application to this address.	[Page 13] Paperwork Reduction Act An agency may not conduct or sponsor an information collection and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The public reporting burden for Form I-914 is estimated at 2 hours and 15 minutes per response, and an estimated 1 hour and 10 minutes for biometrics processing. The public reporting burden for Form I-914, Supplement A, is estimated to be 1 hour per response, including the time for reviewing instructions, completing and submitting the form. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services, Regulatory Coordination Division, Office of Policy and Strategy, 20 Massachusetts Ave NW, Washington, DC 20529-2140. OMB No. 1615-0099. Do not mail your completed Form I-914 and Form I-914 Supplement A to this address.
New		[Page 14] Checklist Fill out the checkboxes. This will ensure that you have completed the form properly. 1. I completely filled out and signed the form. 2. I have attached evidence that: A. I am or have been a victim of a severe form of trafficking; B. 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 I have been allowed entry into the United States to participate in investigative or judicial processes associated with the an act or perpetrator of trafficking; C. I am cooperating with any reasonable request by Federal, State, or local law enforcement authorities in the investigation or prosecution of the trafficker(s) (unless under age 18 or I am unable to cooperate with such requests due to physical or psychological trauma); and D. I would suffer extreme hardship involving unusual and severe harm upon removal from the United States. 3. I have included a personal narrative statement. If I am applying for one or more family members: 1. I have completed Form I-914, Supplement A for each family member for whom I am now applying and, if he or she is in the United States, each family member has signed that Form I-914, Supplement A. 2. I have submitted the required evidence, including evidence of: A. My relationship to the family member for whom I am applying; B. My age, if I am applying for my parent or unmarried sibling under the age of 18; C. My child's age, if I am applying for my child; and D. My sibling's age, if I am applying for my unmarried sibling; and E. If applicable, present danger of retaliation as a result of my escape from trafficking or my cooperation with law enforcement. 3. I will or have filed Form I-765 with the appropriate fee or request for fee waiver, for each family member requesting an Employment Authorization Document (EAD). WARNING: Applicants who are in the United States illegally are subject to removal if their claims are not granted. Any information provided in completing this application may be used as a basis for the institution of, or as evidence in, removal proceedings even if the application is later withdrawn.

19