Form I-290B Notice of Appeal or Motion

Notice of Appeal or Motion

USCIS
Form I-290B

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

For
USCIS
Use
Only

Reloc Sent

OMB No. 1615-0095
Expires 12/31/2018

Receipt

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

DRAFT
Not For
Production
04/19/2018
Select this box if
Form G-28 is
attached.

Attorney State Bar Number
(if applicable)

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

Please visit www.uscis.gov/i-290b/jurisdiction for information on the immigration benefit types that are eligible for an appeal
or motion using this form.
► START HERE - Type or print in black ink.

Part 1. Information About the Applicant or
Petitioner

If you are an individual filing this appeal or motion, complete
Item Number 1. If you are a business or organization,
complete Item Number 2.
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)

5.a. In Care Of Name (if any)

5.b. Street Number
and Name
5.c.

Apt.

Ste.

Flr.

5.d. City or Town

1.c. Middle Name
2.

Mailing Address (or Military APO/FPO Address,
if applicable)
(USPS ZIP Code Lookup)

Business or Organization (if applicable)

5.e. State

5.f.

ZIP Code

5.g. Province

3.

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

4.

5.h. Postal Code
5.i.

Country

USCIS Online Account Number (if any)
►

Part 2. Information About the Appeal or Motion
Please indicate whether you are filing an appeal to the
Administrative Appeals Office (AAO) or a motion. You are not
allowed to file both an appeal and a motion on a single form. If
you select more than one box, your filing may be rejected.
NOTE: DO NOT use this form if you are filing an appeal
relating to a Form I-130, Petition for Alien Relative, or a
Form I-360, Self-Petition for a Widow(er) of a U.S. Citizen.
You must file those appeals with the Board of Immigration
Appeals using Form EOIR-29.

Form I-290B 01/23/14 N

Page 1 of 6

Part 2. Information About the Appeal or Motion
(continued)

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

1.a.

I am filing an appeal to the AAO. My brief and/or
additional evidence is attached.

1.b.

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

1.c.

I am filing an appeal to the AAO. I will not be
submitting a brief and/or additional evidence.

1.d.

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

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

1.e.

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

Section A

1.f.

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

2.

3.

4.

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

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USCIS Form for the Application or Petition That is the
Subject of This Appeal or Motion (for example, Form
I-140, I-360, I-129, I-485, I-601)

Receipt Number for the Application or Petition

Requested Nonimmigrant or Immigrant Classification (for
example, H-1B, R-1, O-1, EB-1, EB-2, if applicable)

5.

Date of the Adverse Decision (mm/dd/yyyy)

6.

Office That Issued the Adverse Decision

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

Applicant's or 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.

Part 3. Basis for the Appeal or Motion
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. If you 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.
Appeal: Provide a statement that specifically identifies
an erroneous conclusion of law or fact in the decision
being appealed. You must provide this information
with your Form I-290B even if you intend to submit a
brief later.

Applicant's or Petitioner's Contact Information
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)

Motion to Reopen: A motion to reopen must state new facts
and be supported by documentary evidence demonstrating
eligibility for the requested immigration benefit at the time you
filed the application or petition.
Form I-290B 01/23/14 N

Page 2 of 6

Part 4. Applicant's or Petitioner's Statement,
Contact Information, Certification, and Signature
(continued)
Applicant's or 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 of my records that USCIS may need
to determine my eligibility for the immigration benefit that I
seek.

I certify, under penalty of perjury, that all of the information in
my form and any document submitted with it were provided or
authorized by me, that I reviewed and understand all of the
information contained in, and submitted with, my form, and that
all of this information is complete, true, and correct.

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

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

If you are filing an appeal or motion based on a PETITION
FILED BY A BUSINESS OR ORGANIZATION (NOT AN
INDIVIDUAL), 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.

Form I-290B 01/23/14 N

Provide the following information about the petitioner's
authorized signatory.
3.a. Family Name
(Last Name)
3.b. Given Name
(First Name)
3.c. Middle Name
4.

Title

5.

Daytime Telephone Number

6.

Mobile Telephone Number (if any)

7.

Email Address (if any)

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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 law.

Section B

Petitioner's Contact Information

Petitioner's Certification

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.

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.
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
8.a.

Petitioner's Signature

8.b. Date of Signature (mm/dd/yyyy)
NOTE TO ALL APPLICANTS AND 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.
Page 3 of 6

Part 5. Interpreter's Contact Information,
Certification, and Signature

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

Provide the following information about the interpreter.

Interpreter's Full Name

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

1.a. Interpreter's Family Name (Last Name)

Part 6. Contact Information, Declaration, and
Signature of the Person Preparing this Form, if
Other Than the Applicant or Petitioner

1.b. Interpreter's Given Name (First Name)

2.

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Interpreter's Business or Organization Name (if any)

Provide the following information about the preparer.

Preparer's Full Name

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

Apt.

Ste.

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

1.a. Preparer's Family Name (Last Name)

1.b. Preparer's Given Name (First Name)

Flr.

2.

Preparer's Business or Organization Name (if any)

3.e. ZIP Code

Province

3.g. Postal Code
3.h. Country

Preparer's Mailing Address

3.a. Street Number
and Name
3.b.

Apt.

Ste.

Flr.

3.c. City or Town

Interpreter's Contact Information
4.

3.d. State

Interpreter's Daytime Telephone Number

3.f.

5.

Interpreter's Mobile Telephone Number (if any)

6.

Interpreter's Email Address (if any)

3.e. ZIP Code

Province

3.g. Postal Code
3.h. Country

Preparer's Contact Information
Interpreter's Certification

4.

Preparer's Daytime Telephone Number

5.

Preparer's Mobile Telephone Number (if any)

6.

Preparer's Email Address (if any)

I certify, under penalty of perjury, that:
I am fluent in English and

,

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.
Form I-290B 01/23/14 N

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Part 6. Contact Information, Declaration, and
Signature of the Person Preparing this Form, if
Other Than the Applicant or Petitioner
(continued)
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.

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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.

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

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

Form I-290B 01/23/14 N

Page 5 of 6

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 01/23/14 N

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