I-956K Registration for Direct and Third-Party Promoters

Registration for Direct and Third-Party Promoters
Department of Homeland Security
U.S. Citizenship and Immigration Services
Receipt

For
USCIS
Use
Only

USCIS
Form I-956K
OMB No. 1615-XXXX
Expires MM/DD/YYYY

Action Block

Remarks

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To be completed
Select this box if
by an Attorney or
Form
G-28 is
Accredited Representative
attached.
of the Regional Center
(if any).

Attorney State Bar Number
(if applicable)

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

Each direct or third-party promoter (including migration agents) of a regional center, any new commercial enterprise, an affiliated jobcreating entity, or an issuer of securities to be offered to immigrant investors in connection with a particular capital investment project
must register with U.S. Citizenship and Immigration Services (USCIS) by providing the information below.
► START HERE - Type or print in black ink. Answer all questions fully and accurately.

Part 1. Type of Registration
Select one box:
1.

This is an initial registration for a (select all that apply):
Direct Promoter

Third-party Promoter
Migration Agent

2.

This is being filed to amend a previously filed registration.
Registration Number:

3.

If you are amending to edit information in Part 3. below, select the appropriate box to indicate the type of amendment.
Select all that apply:
Amendment to add a new written agreement with an entity not identified on the initial Form I-956K registration.
Amendment to remove a written agreement with an entity identified on the initial Form I-956K registration.
Amendment to revise an existing written agreement.

NOTE: You must identify all entities with which you maintain a written agreement at the time of filing the amendment in the table in
Part 3., Item Number 2. below.

Form I-956K Edition 05/13/22

Part 2. Registrant Information
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)

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)

4.

Middle Name (if applicable)

Country of Birth

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Yes

No

► A-

For Organizations
9.

A.

B.

10.

Legal Name of the Business Entity

Other Name(s) the Entity is Authorized to Use or Do Business as (d/b/a)

Select the organizational structure. If the organizational structure is different from the examples listed below, select “Other” and
describe the nature of the organizational structure in Part 9. Additional Information.
Corporation

Partnership (including Limited Partnerships)
Limited Liability Company
Other (Describe below. If you need extra space to complete this section, use the space provided in Part 9. Additional
Information.)

11.

Date the Entity Was Established

12.

State, Territory, Province, or Country Where the Entity Was Established

(mm/dd/yyyy)
13.

Other States, Territories, Provinces, or Countries Where the Entity is Registered to do Business

14.

For organizations established within the United States, provide the entity's Federal Employer Identification Number.

Form I-956K Edition 09/07/22

Part 2. Registrant Information (continued)
15.

For entities established outside the United States, provide the relevant tax identification number.

Registrant Contact Information
16.

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

Street Number and Name

Apt. Ste. Flr. Number

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City or Town

Province

State

Postal Code

17.

Telephone Number

19.

Website Address (if any)

ZIP Code

Country

18.

Email Address (if any)

Registrant Employment or Association
20.

A.
B.

C.

D.

Are you employed to work as a promoter or otherwise engaged as a promoter on behalf of another
promoter?

Yes

No

Yes

No

Promoter Name

Promoter Registration Number

In what capacity are you employed by or otherwise associated with the promoter? (Select all that apply)
Executive, Officer, or Similar Position. Provide title:
Employee, Agent, or Similar Position. Provide title:
Contract, Sub-Contract, or Similar Arrangement. Describe:
Other. If other, describe:

Part 3. Written Agreement(s)
1.

Have you entered into a written agreement for each regional center, new commercial enterprise, and affiliated
job-creating entity on whose behalf you are operating as required under under the Immigration and
Nationality Act (INA) section 203(b)(5)(K)(iii)?

Form I-956K Edition 09/07/22

Part 3. Written Agreement(s) (continued)
2.

Provide the following information for each written agreement for active or planned promotional activities you have with a
regional center, new commercial enterprise, and affiliated job-creating entity as required under INA section 203(b)(5)(K)(iii).
If you need extra space, use the space provided in Part 9. Additional Information.
Title of Written Agreement

Date

Parties

Entity Type (Regional Center, RC ID(s) and NCE ID(s)
NCE, JCE, Issuer of Securities)
(if available)

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Part 4. Bona Fides of the Promoter

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 in the United States or anywhere in the world. 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), if applicable.
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

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

Form I-956K Edition 09/07/22

Part 4. Bona Fides of the Promoter (continued)
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

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. Required Certification

Certifier’s Contact Information
1.

Certifier's Family Name (Last Name)

2.

Certifier's Title

3.

Certifier's Daytime Telephone Number

5.

Certifier's Email Address (if any)

Certifier's Given Name (First Name)

4.

Certifier's Mobile Telephone Number (if any)

I certify, under penalty of perjury, that I am authorized to provide certification by the promoter named in this registration and that such
promoter is not ineligible under INA section 203(b)(5)(H)(i).

Certifier’s Signature
6.

Certifier's Signature

Date of Signature (mm/dd/yyyy)

Part 6. Statement, Contact Information, Declaration, Attestation, and Signature of the Promoter or
Authorized Individual
NOTE: Read the Penalties section of the Form I-956K Instructions before completing this section.
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.

Statement by Promoter or Authorized Individual
NOTE: Select the box for either Item A. or B. in Item Number 1. If applicable, select the box for Item Number 2.

Form I-956K Edition 09/07/22

Part 6. Statement, Contact Information, Declaration, Attestation, and Signature of the Promoter or
Authorized Individual (continued)
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.

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,

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.
3.

Authorized Individual's Family Name (Last Name)

4.

Authorized Individual's Title

5.

Authorized Individual's Daytime Telephone Number

7.

Authorized Individual's Email Address (if any)

Authorized Individual's Given Name (First Name)

6.

Authorized Individual's Mobile Telephone Number (if any)

Certification by Promoter or Authorized Individual

Copies of any documents submitted are exact photocopies of unaltered, original documents, and I understand that USCIS may require
that I, as the promoter 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 that USCIS may need to determine eligibility
for any related or underlying immigration benefit.
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 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.

Form I-956K Edition 09/07/22

IfPart
filing6.thisStatement,
form on behalf
of an organization,
I certify
that I am authorized
to do so by
theSignature
organizationof
and
thatPromoter
I am authorized
Contact
Information,
Declaration,
Attestation,
and
the
or to
make all representations, attestations, declarations, or certifications required of the organization on this form.

Authorized Individual (continued)

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.

Signature by Promoter or Authorized Individual
You must sign and date your form. Every form MUST contain the signature of the promoter or authorized individual (or 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 Promoter 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)

Interpreter's Given Name (First Name)

2.

Interpreter's Business or Organization Name (if any)

Interpreter's Mailing Address
3.

Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

Province

Postal Code

Country

Interpreter's Contact Information
4.

Interpreter's Daytime Telephone Number

6.

Interpreter's Email Address (if any)

Form I-956K Edition 09/07/22

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 promoter or authorized individual in the identified language every
question and instruction on this form and his or her answer to every question. The authorized individual informed me that he or she
understands every instruction, question, and answer on the form, including the Certification by Promoter or Authorized Individual,
and has verified the accuracy of every answer.

Interpreter's Signature

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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 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

State

Province

Postal Code

Country

Preparer's Contact Information
4.

Preparer's Daytime Telephone Number

6.

Preparer's Email Address (if any)

Form I-956K Edition 09/07/22

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 Authorized Individual (continued)
Preparer's Statement
7.

A.

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

B.

I am an attorney or accredited representative and my representation of the promoter or authorized individual in this
extends
does not extend beyond the preparation of this form.
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.

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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 promoter or authorized individual.
The promoter or authorized individual has reviewed this completed form, including the Certification by Promoter 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-956K Edition 09/07/22

Date of Signature (mm/dd/yyyy)

Part 9. 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
the registrant’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.

Page Number

B.

Part Number C.

Item Number

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

D.

Form I-956K Edition 09/07/22