I-290B Notice of Appeals or Motion

Notice of Appeal or Motion
Department of Homeland Security
U.S. Citizenship and Immigration Services
Select this box if
Form G-28 or
Form G-28I is
attached.

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

Attorney State Bar Number
(if applicable)

USCIS
Form I-290B
OMB No. 1615-0095
Expires 01/31/2017

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

Please see the USCIS Web site at www.uscis.gov/i-290b to view appeal and/or motion eligibility by form type.
► START HERE - Type or print in black ink.

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Part 1. Information About the Applicant or
Petitioner
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
2.

Complete Name of Business/Organization (if applicable)

3.

Alien Registration Number (A-Number, if any)

Part 2. Information About the Appeal or Motion

You must select only one box indicating that you are filing an
appeal or a motion, not both. If more than one box is selected,
your filing may be rejected.
NOTE: DO NOT use this form if you are filing an appeal of
a denial or a revocation of an approved Form I-130, Petition
for Alien Relative, or a Form I-360, Petition for Widow(er).
Those appeals must be filed with the BIA using Form
EOIR-29, Notice of Appeal to the Board of Immigration
Appeals from a Decision of an Immigration Officer.
1.a.

I am filing an appeal to the Administrative Appeals
Office (AAO). My brief and/or additional evidence
is attached.

1.b.

I am filing an appeal to the AAO. My brief and/or
additional evidence will be submitted to the AAO
within 30 calendar days of filing the appeal.

1.c.

I am filing an appeal to the AAO. No supplemental
brief and/or additional evidence will be submitted.

1.d.

I am filing a motion to reopen a decision. My brief
and/or additional evidence is attached.

1.e.

I am filing a motion to reconsider a decision. My
brief is attached.

1.f.

I am filing a motion to reopen and a motion to
reconsider a decision. My brief and/or additional
evidence is attached.

► A4.

Receipt Number

5.

USCIS Online Account Number (if any)
►

Mailing Address (or Military APO/FPO Address,
if applicable)
6.a. In Care Of Name (if any)

6.b. Street Number
and Name
6.c.

Apt.

Ste.

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2.

USCIS Form for Which You Are Filing an Appeal or
Motion to Reopen/Reconsider (for example, Form I-140,
I-360, I-129, I-485, I-601)

3.

Specific Classification Requested (for example, H-1B,
R-1, O-1, EB-1, EB-2, EB-3, if applicable)

4.

Date of Adverse Decision (mm/dd/yyyy)

5.

Office Where Last Decision Was Issued

6.d. City or Town
6.e. State

6.f.

ZIP Code

6.g. Province
6.h. Postal Code
6.i.

Country

Form I-290B 06/26/17 N

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Part 3. Basis for Appeal or Motion

Applicant's or Petitioner's Contact Information

In Part 7. Additional Information, or on a separate sheet of
paper, you must provide a statement regarding the basis for the
appeal or motion. 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.

3.

Applicant's or Petitioner's Daytime Telephone Number

4.

Applicant's or Petitioner's Mobile Telephone Number
(if any)

5.

Applicant's or Petitioner's Email Address (if any)

Appeal: Provide a statement that specifically identifies an
erroneous conclusion of law or fact in the decision being
appealed.

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Motion to Reopen: The motion must state new facts and must
be supported by affidavits and/or documentary evidence that
establish eligibility at the time the underlying application or
petition was filed.

Applicant's or Petitioner's Certification

Motion to Reconsider: The motion must be supported by
citations to appropriate statutes, regulations, or precedent
decisions and must establish that the decision was based on an
incorrect application of law or policy, and that the decision was
incorrect based on the evidence of record at the time of
decision.

Part 4. Applicant's or Petitioner's Statement,
Contact Information, Certification, and Signature

I further authorize release of information contained in this form,
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.
I certify, under penalty of perjury, that I provided or authorized
all of the information in my form, I understand all of the
information contained in, and submitted with, my form, and that
all of this information is complete, true, and correct.

NOTE: Read the Penalties section of the Form I-290B
Instructions before completing this part.

Section A

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 of my records that USCIS may need
to determine my eligibility for the immigration benefit I seek.

Applicant's or Petitioner's Signature

If you are filing an appeal or motion based on an APPLICATION
or PETITION FILED BY AN INDIVIDUAL (NOT AN
ENTITY SUCH AS A COMPANY OR BUSINESS), complete
this section:

6.a. Applicant's or Petitioner's Signature

6.b. Date of Signature (mm/dd/yyyy)

Applicant's or Petitioner's Statement

Section B

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 I have read
and understand every question and instruction on this
form and my answer to every question.

1.b.

The interpreter named in Part 5. has read to me every
question and instruction on this form, and my answer
to every question, in
,

If you are filing an appeal or motion for a PETITION FILED
BY AN ENTITY, complete this section:

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 I have read
and understand every question and instruction on this
form and my answer to every question.

1.b.

The interpreter named in Part 5. has read to me every
question and instruction on this form, and my answer
to every question, in

a language in which I am fluent. I understood all of
this information as interpreted.
2.

At my request, the preparer named in Part 6. prepared
this form for me based only upon information I
provided or authorized.

,
a language in which I am fluent. I understood all of
this information as interpreted.
Form I-290B 06/26/17 N

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Part 4. Applicant's or Petitioner's Statement,
Contact Information, Certification, and Signature
(continued)
2.

At my request, the preparer named in Part 6.
prepared this form for me based only upon
information I provided or authorized.

Petitioner's Contact Information
3.

Petitioner's Daytime Telephone Number

4.

Petitioner's Mobile Telephone Number (if any)

5.

Petitioner's Email Address (if any)

Part 5. Interpreter's Contact Information,
Certification, 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)

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2.

Interpreter's Business or Organization Name (if any)

Interpreter's Mailing Address

3.a. Street Number
and Name

Petitioner's Certification

3.b.

Copies of any documents submitted are exact photocopies of
unaltered, original documents, and I understand that, as the
petitioner, I may be required to submit original documents to
USCIS at a later date.

3.c. City or Town

I authorize the release of any information from my records, or
from the petitioning organization's records, to USCIS or other
entities and persons where necessary to determine eligibility for
the immigration benefit sought or where authorized by law. I
recognize the authority of USCIS to conduct audits of this form
using publicly available open source information. I also
recognize that any supporting evidence submitted in support of
this form may be verified by USCIS through any means
determined appropriate by USCIS, including but not limited to,
on-site compliance reviews.

3.f.

If filing this form on behalf of an organization, I certify that I
am authorized to do so by the organization.

I certify, under penalty of perjury, that I have reviewed this
form, I understand all of the information contained in, and
submitted with, my appeal or motion, and all of this information
is complete, true, and correct.

Petitioner's Signature
6.a.

Petitioner's Signature

Apt.

3.d. State

Ste.

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 Mobile Telephone Number (if any)

6.

Interpreter's Email Address (if any)

Interpreter's Certification
I certify, under penalty of perjury, that:
I am fluent in English and

6.b. Date of Signature (mm/dd/yyyy)
NOTE TO ALL APPLICANTS/PETITIONERS: If you do
not completely fill out this form or fail to submit required
documents listed in the Instructions, USCIS may dismiss, deny,
or reject your appeal or motion.

Form I-290B 06/26/17 N

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,

which is the same language specified in Part 4., Item Number
1.b. in Section A or Section B, and I have read to this applicant
or petitioner in the identified language every question and
instruction on this form and his or her answer to every question.
The applicant or petitioner informed me that he or she
understands every instruction, question, and answer on the
form, including the Applicant's or Petitioner's Certification,
and has verified the accuracy of every answer.
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Part 5. Interpreter's Contact Information,
Certification, and Signature (continued)

Preparer's Contact Information
4.

Preparer's Daytime Telephone Number

5.

Preparer's Mobile Telephone Number (if any)

6.

Preparer's Email Address (if any)

Interpreter's Signature
7.a. Interpreter's Signature

7.b. Date of Signature (mm/dd/yyyy)

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Part 6. Contact Information, Statement,
Certification, and Signature of the Person
Preparing This Form, if Other Than the
Applicant or Petitioner
Provide the following information about the preparer.

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)

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

Apt.

Ste.

Preparer's Statement

7.a.

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

7.b.

I am an attorney or accredited representative and
have prepared this form on behalf of the applicant or
petitioner and with the applicant's or petitioner's
consent.

Preparer's Certification

By my signature, I certify, under penalty of perjury, that I
prepared this form at the request of the applicant or petitioner.
The applicant or petitioner then reviewed this completed form
and informed me that he or she understands all of the
information contained in, and submitted with, his or her form,
including the Applicant's or Petitioner's Certification, and
that all of this information is complete, true, and correct. I
completed this form based only on information that the
applicant or petitioner provided to me or authorized me to
obtain or use.

Flr.

Preparer's Signature

3.c. City or Town

8.a. Preparer's Signature
3.d. State
3.f.

3.e. ZIP Code

Province

8.b. Date of Signature (mm/dd/yyyy)

3.g. Postal Code
3.h. Country

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5.a. Page Number

Part 7. Additional Information
If you need extra space to provide any additional information
within this form, 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 form or attach a separate sheet of
paper. Type or print your name and A-Number 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)

A-Number (if any) ► A-

3.a. Page Number

5.d.

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1.c. Middle Name
2.

5.b. Part Number 5.c. Item Number

3.b. Part Number

6.a. Page Number

6.b. Part Number 6.c. Item Number

3.c. Item Number

6.d.

3.d.

7.a. Page Number

4.a. Page Number

4.b. Part Number 4.c. Item Number

7.b. Part Number 7.c. Item Number

7.d.

4.d.

NOTE: Make sure your appeal or motion is complete before
filing.

Form I-290B 06/26/17 N

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