Page 2-6,
Specific Instructions
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[Page 2]
Specific
Instructions
…
Part
4. Applicant’s Statement, Contact Information,
Certification, and Signature
Item
Numbers 1.a. - 6.b.
Select the appropriate box to indicate whether you read
this application yourself or whether you had an interpreter assist
you. If someone assisted you in completing the application,
select the box indicating that you used a preparer. Further, you
must sign and date your application and provide
your daytime
telephone number, mobile telephone number (if any), and email
address (if any). Every application MUST
contain the signature of the applicant (or parent or legal
guardian, if applicable). A stamped or typewritten name in place
of a signature is not acceptable.
Part
5. Interpreter’s Contact Information, Certification, and
Signature
Item
Numbers 1.a. - 7.b.
If you used anyone as an interpreter to read the Instructions and
questions on this application to you in a language in which you
are fluent, the interpreter must fill out this section; provide
his or her name, the name and address of his or her business or
organization (if any), his or her daytime telephone number, his or
her mobile telephone number (if any), and his or her email address
(if any). The interpreter must sign and date the application.
Part
6. Contact Information, Declaration, and Signature of the Person
Preparing this Application, if Other Than the Applicant
Item
Numbers 1.a. - 8.b.
This section must contain the signature of the person who
completed your application, if other than you, the applicant. If
the same individual acted as your interpreter and
your preparer, that person should complete both Part
5. and Part
6. If the
person who completed this application is associated with a
business or organization, that person should complete the business
or organization name and address information. Anyone who helped
you complete this application MUST
sign and date the application. A stamped or typewritten name in
place of a signature is not acceptable. If the person who helped
you prepare your application is an attorney or accredited
representative, he or she may also need to submit a completed Form
G-28, Notice of Entry of Appearance as Attorney or Accredited
Representative, along with your application.
Part
7. Additional Information
…
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[Page 2]
Specific
Instructions
…
Part
4. Applicant’s
Contact Information,
Certification, and Signature
Item
Numbers 1.
- 4.
You
must sign and date your application and, if applicable, provide
your daytime telephone number, mobile telephone number, and email
address. The signature of a parent or legal guardian, if
applicable, is acceptable. A stamped
or typewritten name in place of a signature is not acceptable.
Part
5. Interpreter’s Contact Information, Certification, and
Signature
Item
Numbers 1.
- 6.
If you used anyone as an interpreter to read the Instructions and
questions on this application to you in a language in which you
are fluent, the interpreter must fill out this section; provide
his or her name, the name and address of his or her business or
organization (if any), his or her daytime telephone number, his or
her mobile telephone number (if any), and his or her email address
(if any). The interpreter must sign and date the application.
Part
6. Contact Information, Declaration, and Signature of the Person
Preparing this Application, if Other Than the Applicant
Item
Numbers 1.
- 6.
The person
who completed your application, if other than
the applicant,
must sign this section. If the same individual acted as your
interpreter and your preparer, then that person should complete
both Part
5.
and Part
6.
A stamped or typewritten name in place of a signature is not
acceptable.
[no
change]
…
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Page 8-9,
DHS Privacy Notice
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[Page 8]
DHS
Privacy Notice
AUTHORITIES:
The information requested on this application, and the associated
evidence, is collected under the Immigration and Nationality Act
section 264, and 8 CFR 264.6.
…
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[Page 8]
DHS
Privacy Notice
AUTHORITIES:
The information
requested on this application, and the associated evidence, is
collected under the Immigration and Nationality Act section 264,
and 8 Code
of Federal Regulations
264.6.
…
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Page 9,
Paperwork
Reduction Act
|
[Page 9]
Paperwork
Reduction Act
An
agency may not conduct or sponsor an information collection, and a
person is not required to respond to a collection of information,
unless it displays a currently valid Office of Management and
Budget (OMB) control number. The public reporting burden for this
collection of information is estimated at 45 minutes per response,
including the time for reviewing instructions, gathering the
required documentation and information, completing the
application. Send comments regarding this burden estimate or any
other aspect of this collection of information, including
suggestions for reducing this burden, to: U.S. Citizenship and
Immigration Services, Office
of Policy and Strategy, Regulatory Coordination Division, 5900
Capital Gateway Drive, Mail Stop #2140, Camp Springs, MD
20588-0009; OMB No.
1615-0079. Do
not mail your completed Form I-102 application to this address.
|
[Page 9]
Paperwork
Reduction Act
An
agency may not conduct or sponsor an information collection, and a
person is not required to respond to a collection of information,
unless it displays a currently valid Office of Management and
Budget (OMB) control number. The public reporting burden for this
collection of information is estimated at 37
minutes per response, including the time for reviewing
instructions, gathering the required documentation and
information, completing the application. Send comments regarding
this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to:
U.S. Citizenship and Immigration Services, Office of Policy and
Strategy, Regulatory Coordination Division, 5900 Capital Gateway
Drive, Mail Stop #2140, Camp Springs, MD 20588-0009; OMB No.
1615-0079. Do
not mail your completed Form I-102 application to this address.
|