I-956H Bona Fides of Persons Involved with Regional Center Prog

Bona Fides of Persons Involved with Regional Center Program
Department of Homeland Security
U.S. Citizenship and Immigration Services

Receipt

For
USCIS
Use
Only

USCIS
Form I-956H

OMB No. 1615-XXXX
Expires MM/DD/YYYY

Action Block

Remarks

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To be completed by an
Attorney or Accredited
Representative (if any).

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)

Each person involved with a regional center, new commercial enterprise (NCE) or affiliated job-creating entity (JCE) must answer the
questions below. A person involved with a JCE that is not an affiliated JCE may, at the Secretary’s discretion, be required to answer
the questions below. A person is involved with a regional center, NCE or affiliated JCE if the person is, directly or indirectly, in a
position of substantive authority to make operational or managerial decisions over pooling, securitization, investment, release,
acceptance or control or use of any funding. A person may be in a position of substantive authority if they serve as a principal, a
representative, an administrator, an owner, an officer, a board member, a manager, an executive, a general partner, a fiduciary, an
agent or in a similar position at the regional center, NCE, or JCE, respectively. Each person must complete a Form I-956H for each
entity with which they are involved for submission with any related form, as applicable.
► START HERE - Type or print in black ink. Answer all questions fully and accurately.

Part 1. Filing Type
1.

Select whether this is an initial filing of Form I-956H or whether this is an additional filing of Form I-956H:
Initial Filing of Form I-956H

Additional Filing of Form I-956H

NOTE: If you selected "Initial Filing of Form I-956H, "skip to Part 2.
2.

If this is an additional filing of Form I-956H, provide the receipt number of your most recent Form I-956H filing:

3.

If this is an additional filing of Form I-956H, are your answers to the following parts of this form the same as in the Form
I-956H filing indicated in Part 1., Item Number 2.:
A.

Part 3., Information About the Person Involved with Regional Center Program
Yes (Complete only Part 3., Item Number 1. (for individuals) or Item Number 10. (for organizations))
No (Complete all of Part 3.)

B.

Part 4., Bona Fides of Person Involved with Regional Center Program
Yes (Skip Part 4.)
No (Complete all of Part 4.)

C.

Part 5., Foreign Involvement in Regional Center Program
Yes (Skip Part 5.)
No (Complete all of Part 5.)

Form I-956H Edition 05/13/22

Part 2. Information About the EB-5 Entity and Your Involvement
Provide the following information in the table below based on the entity(ies) with which you are involved. Based on the entity(ies)
you are involved with, complete only the applicable fields below.

Involvement in Entity
Other Name(s) Entity is
Name of Entity
Authorize to Use

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Entity Involved With
Regional Center
NCE
Affiliated JCE
Non-Affiliated JCE

Entity ID Number

Not Applicable
Not Applicable

Provide the following information in the table below based on your role(s) with the entity(ies). If you have more than one role,
complete all role(s) that apply based on the entity(ies) you are involved with. The following information should be provided for each
applicable field in the table below:
- Owner: Provide the Percentage of Ownership in the Entity
- Director, Manager, or Similar Position: Provide Title
- Executive, Office, or Similar Position: Provide Title
- Representative, Fiduciary, Agent, or Similar Position: Provide Title
- Other: If other, describe your involvement in the Entity. If you need additional space, use the space provided in Part 9.
Additional Information.

Role in the Entity

Entity Involved
With

Director, Manager,
or Similar Position

Owner

Representative,
Executive, Officer,
Fiduciary, Agent,or
or Similar Position
Similar Position

Regional Center
NCE
Affiliated JCE
Non-Affiliated JCE

Part 3. Information About the Person Involved with Regional Center Program
Indicate if you are filing Form I-956H as an Individual or Organization.
Individual

Organization

For Individuals
1.

Full Legal Name
Family Name (Last Name)

Given Name (First Name)

2.

Provide all other names the person has used, including aliases, maiden name, and nicknames.

3.

Date of Birth (mm/dd/yyyy)

5.

Country(ies) of Citizenship or Nationality (current and relinquished)

Form I-956H Edition 05/13/22

4.

Country of Birth

Middle Name

Other

Part 3. Information About the Person Involved with Regional Center Program (continued)
6.

Passport Number(s) and Countries

7.

If not U.S citizen, are you a U.S. national or lawful permanent resident (LPR)?

8.

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

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9.

► A-

Yes

No

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

For Organizations
10.

Name of the Organization

11.

In Care Of Name (if any)

12.

Date the Organization Was Established

13.

State or Territory Where the Organization Was Established

(mm/dd/yyyy)
14.

Organization Federal Employer Identification Number

Mailing Address
15.

Person's Mailing Address
In Care Of Name (if any)

Street Number and Name

Apt. Ste. Flr. Number

City or Town
Province

State

Postal Code

Country

Contact Infomation
16.

Person's Contact Information
Telephone Number

Form I-956H Edition 05/13/22

Email Address (if any)

ZIP Code

Part 4. Bona Fides of Person Involved with Regional Center Program
For Item Numbers 1. - 13., you should answer “Yes” to any question that applies, even if the records were sealed or otherwise
cleared, or if anyone, including a judge, law enforcement officer, or attorney, told you that you no longer have a record. You should
also answer “Yes” to the following questions whether it occurred here in the United States or anywhere else in the world. If you
answer “Yes” to Item Numbers 1. - 13., use the space provided in Part 9. Additional Information to provide an explanation and
include all relevant documentation that includes why you were arrested, cited, detained, or charged; and the outcome or disposition
(for example, no charges filed, charges dismissed, jail, probation, community service).

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1.

Have you committed a criminal or civil offense involving fraud or deceit within the previous 10 years?

Yes

No

2.

Have you ever committed a criminal or civil offense involving fraud or deceit that resulted in a liability in
excess of $1,000,000?

Yes

No

3.

Have you ever committed a criminal or civil offense for which you were convicted and sentenced to a term
of imprisonment of more than 1 year?

Yes

No

4.

Are you subject to a final order of a State securities commission (or an agency or officer of a State
performing similar functions); a State authority that supervises or examines banks, savings associations, or
credit unions; a State insurance commission (or an agency or officer of a State performing similar
functions); a Federal banking agency; the Commodities Futures Trading Commission; the Securities and
Exchange Commission, a financial self-regulatory organization recognized by the Securities and Exchange
Commission, or the National Credit Union Administration?

Yes

No

B. Is the final order based on a violation of any law or regulation that prohibits fraudulent, manipulative,
or deceptive conduct?

Yes

No

C. Is the final order based on a violation of any law or regulation that bars you from associating with any
entity regulated by such commission, authority, agency, or officer?

Yes

No

D. Is the final order based on a violation of any law or regulation that bars you from appearing before
such commission, authority, agency, or officer?

Yes

No

E. Is the final order based on a violation of any law or regulation that bars you from engaging in the
business of securities, insurance, or banking?

Yes

No

F. Is the final order based on a violation of any law or regulation that bars you from engaging in savings
association or credit union activities?

Yes

No

5.

Are you engaged in, or have you ever been engaged in, or do you seek to engage in any illicit trafficking in
any controlled substance or in any listed chemical (as defined in section 102 of the Controlled Substances
Act)?

Yes

No

6.

Are you engaged in, or have you ever been engaged in, or do you seek to engage in any activity relating to
espionage, sabotage, or theft of intellectual property?

Yes

No

7.

Are you engaged in, or have you ever been engaged in, or do you seek to engage in any activity related to
money laundering (as described in section 1956 or 1957 of title 18, United States Code)?

Yes

No

8.

Are you engaged in, or have you ever been engaged in, or do you seek to engage in any terrorist activity (as
defined in INA section 212(a)(3)(B))?

Yes

No

9.

Are you engaged in, or have you ever been engaged in, or do you seek to engage in any activity
constituting or facilitating human trafficking or a human rights offense?

Yes

No

10.

Are you engaged in, or have you ever been engaged in, or do you seek to engage in any activity described
in INA section 212(a)(3)(E) (such as participating in Nazi persecutions or genocide)?

Yes

No

11.

Are you engaged in, or have you ever been engaged in, or do you seek to engage in a violation of any
statute, regulations, or Executive order regarding foreign financial transactions or foreign asset control?

Yes

No

If you answered “Yes” to the above, answer the follwing questions:
A. What is the duration of penalty imposed by the final order?

Form I-956H Edition 05/13/22

Part 4. Bona Fides of Person Involved with Regional Center Program (continued)
12.

Are you, or during the preceding 10 years have you been, included on the Department of Justice’s List of
Currently Disciplined Practitioners?

Yes

No

13.

During the preceding 10 years, have you received a reprimand or otherwise been publicly disciplined for
conduct related to fraud or deceit by a State bar association of which you are or were a member?

Yes

No

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Part 5. Foreign Involvement in Regional Center Program

For Item Numbers 1. - 5., you should answer “Yes” to any question that applies.
1.

If you are a person involved with a regional center, are you the subject of rescission or removal proceedings?

Yes

No

2.

Are you an agency, official, or other similar entity or representative of a foreign government entity?

Yes

No

3.

Have you provided capital to a regional center, new commercial enterprise, or job-creating entity derived
from an agency, official, or other similar entity or representative of a foreign government entity?

Yes

No

4.

Is your ownership or administration of a regional center, new commercial enterprise, or job-creating entity
subject to the direct or indirect involvement of an agency, official, or other similar entity or representative of
a foreign government entity?

Yes

No

5.

Are you a foreign or domestic investment fund or other investment vehicle that is wholly or partially owned,
direct or indirectly, by a bona fide foreign sovereign wealth fund or a foreign state-owned enterprise
permitted to do business in the United States?

Yes

No

A. If answered “Yes,“ are you involved only with the ownership, and not the administration, of a jobcreating entity that is not an affiliated job-creating entity?

Yes

No

Part 6. Statement, Contact Information, Declaration, Attestation, and Signature of the Person Involved
with the Regional Center Program or Authorized Individual
NOTE: Read the Penalties section of the Form I-956H Instructions before completing this part.

Statement by Person Involved with the Regional Center Program or Authorized Individual

Select the appropriate box to indicate whether you read this form yourself or whether you had an interpreter assist you. If someone
assisted you in completing the form, select the box indicating that you used a preparer.
NOTE: Select the box for either Item A. or B. in Item Number 1. If applicable, select the box for Item Number 2.
1.

2.

Statement Regarding the Interpreter
A.

I can read and understand English, and I have read and understand every question and instruction on this form, as well
as my answer to every question.

B.

The interpreter named in Part 7. 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, and I understood
everything.

Statement Regarding the Preparer
At my request, the preparer named in Part 8.,
prepared this form for me based only upon information I provided or authorized.

Form I-956H Edition 05/13/22

,

Part 6. Statement, Contact Information, Declaration, Attestation, and Signature of the Person Involved
with the Regional Center Program or Authorized Individual (continued)
Authorized Individual's Contact Information
If filing this form on behalf of an organization, provide contact information for the individual authorized to complete this form.

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3.

Authorized Individual's Family Name (Last Name)

4.

Authorized Individual's Title

Authorized Individual's Given Name (First Name)

Provide the daytime telephone number, mobile telephone number (if any), and email address (if any).
5.

Authorized Individual's Daytime Telephone Number

7.

Authorized Individual's Email Address (if any)

6.

Authorized Individual's Mobile Telephone Number (if any)

Certification by Person Involved with the Regional Center Program or Authorized Individual

Copies of any documents submitted are exact photocopies of unaltered, original documents, and I understand that U.S. Citizenship and
Immigration Services (USCIS) may require that I, as the person involved with the regional center program or authorized individual,
submit original documents to USCIS at a later date.
Furthermore, I authorize the release of any information from any and all of my records, and the organization’s USCIS records, to
USCIS where necessary for the administration and enforcement of U.S. immigration law.
I furthermore 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.
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 audits, and on-site visits, as authorized by 8 U.S.C. sections 1103, 1155, and 1184; the
EB-5, Reform and Integrity Act of 2022, Div. BB of the Consolidated Appropriations Act, 2022 (Pub. L. No. 117-103); and
8 CFR parts 103, 204, 205, and 214.
I understand that USCIS may require me to appear for an appointment to take my biometrics (fingerprints, photograph, and/or
signature) and, at that time, I will be required to sign an oath reaffirming that:
1) I reviewed and provided or authorized all of the information in my form;
2) I understood all of the information contained in, and submitted with, my form; and
3) All of this information was complete, true, and correct at the time of filing.
If filing this form on behalf of an organization, I certify that I am authorized to do so by the organization and that I am authorized to
make all representations, attestations, declarations, or certifications required of the organization on this form.
I also understand that USCIS may require biometrics, perform criminal record checks, and other background and database checks with
respect to this entity, and any individuals involved with this entity.
I certify and attest, 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.
Form I-956H Edition 05/13/22

Part 6. Statement, Contact Information, Declaration, Attestation, and Signature of the Person Involved
with the Regional Center Program or Authorized Individual (continued)
Signature by Person Involved with Regional Center Program (or Authorized Individual)
You must sign and date your form. Every form MUST contain the signature of the person involved with the regional center program
(or authorized individual, parent, or legal guardian, if applicable). A stamped or typewritten name in place of a signature is not
acceptable.
8.

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Signature by Person Involved with Regional Center Program (or Authorized Individual)

Date of Signature (mm/dd/yyyy)

NOTE: If you do not completely fill out this form or fail to submit required documents listed in the Instructions, USCIS may
deny the underlying form and any related or underlying benefit.

Part 7. Interpreter's Contact Information, Certification, and Signature

If you used anyone as an interpreter to read the Instructions and questions on this form to you in a language in which you are fluent,
the interpreter must fill out this section.

Interpreter’s Full Name
1.

Interpreter's Family Name (Last Name)

2.

Interpreter's Business or Organization Name (if any)

Interpreter's Given Name (First Name)

Interpreter's Mailing Address
3.

Street Number and Name

Apt. Ste. Flr. Number

City or Town
Province

State

Postal Code

Country

Interpreter's Contact Information
4.

Interpreter's Daytime Telephone Number

6.

Interpreter's Email Address (if any)

Form I-956H Edition 05/13/22

5.

Interpreter's Mobile Telephone Number (if any)

ZIP Code

Part 7. Interpreter's Contact Information, Certification, and Signature (continued)
Interpreter's Certification
I certify, under penalty of perjury, that:
I am fluent in English and
, which is the same language specified in
Part 6., Item B. in Item Number 1., and I have read to the person involved with the regional center program or the authorized
individual in the identified language every question and instruction on this form and his or her answer to every question. The person
involved with the regional center program or authorized individual informed me that he or she understands every instruction, question,
and answer on the form, including the Certification by Person Involved with the Regional Center Program or Authorized
Individual, and has verified the accuracy of every answer.

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Interpreter's Signature

The interpreter must sign and date the form.
7.

Interpreter's Signature

Date of Signature (mm/dd/yyyy)

Part 8. Contact Information, Declaration, Certification, and Signature of the Person Preparing this
Form, if Other Than the Person Involved with Regional Center Program or Authorized Individual
Provide the following information about the preparer. If the same individual acted as your interpreter and your preparer, that person
should complete both Part 7. and Part 8.

Preparer's Full Name
1.

Preparer's Family Name (Last Name)

Preparer's Given Name (First Name)

If the person who completed this form is associated with a business or organization, that person should complete the business or
organization name and address information.
2.

Preparer's Business or Organization Name (if any)

Preparer's Mailing Address
3.

Street Number and Name

Apt. Ste. Flr. Number

City or Town
Province

State
Postal Code

Country

Preparer's Contact Information
4.

Preparer's Daytime Telephone Number

6.

Preparer's Email Address (if any)

Form I-956H Edition 05/13/22

5.

Preparer's Mobile Telephone Number (if any)

ZIP Code

Part 8. Contact Information, Declaration, Certification, and Signature of the Person Preparing this
Form, if Other Than the Person Involved with Regional Center Program or Authorized
Individual (continued)
Preparer's Statement
7.

A.
B.

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I am not an attorney or accredited representative but have prepared this form on behalf of the person involved with the
regional center program or authorized individual and with the individual's consent.
I am an attorney or accredited representative and my representation of the person involved with the regional center
extends
does not extend beyond the preparation of this form.
program or authorized individual in this case

NOTE: If you are an attorney or accredited representative, you may also need to submit a completed Form G-28, Notice of
Entry of Appearance as Attorney or Accredited Representative, with this form.

Preparer's Certification

By my signature, I certify, under penalty of perjury, that I prepared this form at the request of the person involved with the regional
center program or the authorized individual. The person involved with the regional center program or authorized individual has
reviewed this completed form, including the Certification by Person Involved with the Regional Center Program or Authorized
Individual, and informed me that all of this information in the form and in the supporting documents is complete, true, and correct.

Preparer's Signature

Anyone who helped you complete this form MUST sign and date the form. A stamped or typewritten name in place of a signature is
not acceptable.
8.

Preparer's Signature

Form I-956H Edition 05/13/22

Date of Signature (mm/dd/yyyy)

Part 9. Additional Information
If you need extra space to provide any additional information within this supplement from Part 4., 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 the individual’s name 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.
D.

2.

A.
D.

3.

A.
D.

4.

A.

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Page Number

B.

Part Number C.

Item Number

Page Number

B.

Part Number C.

Item Number

Page Number

B.

Part Number C.

Item Number

Page Number

B.

Part Number C.

Item Number

D.

Form I-956H Edition 05/13/22