Table of Changes (form)

I914-FRM-TOC-WIP-83C-02072017.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)

OMB: 1615-0099

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TABLE OF CHANGES – FORM

FORM I-914, Application for T Nonimmigrant Status

OMB Number: 1615-0099

Submission Date 02/07/2017


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



Current Section and Page Number

Current Text

Proposed Text

Page 1, Part A. Purpose for Filing the Application

[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…


[Page 1]


PART A. Purpose for Filing the Application


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 members to the United States.


[Delete]

Page 1, Part B. General Information About You

[Page 1]


PART B. General Information About You (Person filing this form as a victim)



Home Address – Street Number and Name / Apt. #



Safe Mailing Address…. / Apt. #



Home Telephone # (with area code)


Safe Daytime Phone # (with area code)




A # (if any)


U.S. Social Security # (if any)



Passport #



I-94 # (Arrival/Departure Document)

[Page 1]


PART B. General Information About You (Person filing this form as a victim)



Home Address – Street Number and Name / Apt. Number



Safe Mailing Address…. / Apt. Number



Home Telephone Number (with area code)


Safe Daytime Phone Number (with area code)



A-Number (if any)


U.S. Social Security Number (if any)



Passport Number



Form I-94 Number (Arrival-Departure Record)

Page 2, Part C. Additional Information

[Page 2]


PART C. Additional Information



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.)





[Page 2]


PART C. Additional Information



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 7, Part E., Information About Your Family Members

[Page 7]


PART E. Information About Your Family Members




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.


[Page 7]


PART E. Information About Your Family Members





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.






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File Typeapplication/msword
File TitleTABLE OF CHANGE – FORM I-687
Authorjdimpera
Last Modified ByHagigal, Evadne J
File Modified2017-02-07
File Created2017-02-07

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