I918 and SuppA-INS-014-EXT-30Day-05232023

Instructions for Petition for U Nonimmigrant Status
and Supplement A, Petition for Qualifying
Family Member of U-1 Recipient
Department of Homeland Security
U.S. Citizenship and Immigration Services

USCIS
Form I-918

OMB No. 1615-0104
Expires 06/30/2023

What Is the Purpose of Form I-918 and Supplement A?
You should use Form I-918, Petition for U Nonimmigrant Status, to request temporary immigration benefits if you are
a victim of certain qualifying criminal activity. You should also use Form I-918 if you received interim relief prior to
publication of regulations regarding these benefits.

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You should use Supplement A, Petition for Qualifying Family Member of U-1 Recipient, if you want to include your
qualifying family members in your request of temporary immigration benefits.

Who May File Form I-918 and Supplement A?

You, the victim, should file Form I-918. You may include your qualifying family members by filing Supplement A with
your original Form I-918. You can also file Supplement A at a later date for any qualifying family members not included
with your original Form I-918.
1. Principal Petitioner. You must demonstrate all of the following:

A. You are a victim of criminal activity designated in section 101(a)(15)(U)(iii) of the Immigration and Nationality
Act (INA). Such activity is defined as being the victim of one or more of the following or any similar activity in
violation of Federal, state, or local criminal law:
(1) Abduction
(2) Abusive Sexual Contact
(3) Attempt to Commit Any of the
Named Crimes
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)

Being Held Hostage
Blackmail
Conspiracy to Commit Any of the Named
Crimes

Domestic Violence
Extortion
False Imprisonment
Felonious Assault
Female Genital Mutilation
Fraud in Foreign Labor Contracting
Incest
Involuntary Servitude
Kidnapping

Form I-918 Instructions 12/06/21

(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
(25)
(26)

Manslaughter
Murder
Obstruction of Justice
Peonage
Perjury
Prostitution
Rape
Sexual Assault
Sexual Exploitation
Slave Trade
Solicitation to Commit Any of the
Named Crimes

(27)
(28)
(29)
(30)
(31)

Stalking
Torture
Traffiking
Unlawful Criminal Restraint
Witness Tampering

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B. You have suffered substantial physical or mental abuse as a result of having been a victim of qualifying criminal
activity;
C. You possess information concerning the qualifying criminal activity of which you are a victim;
D. A Federal, state, or local government official investigating or prosecuting a qualifying criminal activity certifies
(using Supplement B, U Nonimmigrant Status Certification) that you were, are, or are likely to be helpful to the
official in the investigation or prosecution of the criminal act of which you are a victim; and
E. The criminal activity of which you are a victim violated the laws of the United States or occurred in the United
States (including Indian country and military installations) or the territories and possessions of the United States.
(1) United States means the continental United States, Alaska, Hawaii, Puerto Rico, Guam, the Virgin Islands of
the United States, and the Commonwealth of the Northern Mariana Islands.

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(2) Indian country refers to all land within the limits of any Indian reservation under the jurisdiction of the
United States Government, notwithstanding the issuance of any patent, and including rights-of-way running
through the reservation; all dependent Indian communities within the borders of the United States, whether
within the original or subsequently acquired territory thereof, and whether within or without the limits of a
state; and all Indian allotments, the Indian titles to which have not been extinguished, including rights-of-way
running through such allotments.
(3) Military installation means any facility, base, camp, post, encampment, station, yard, center, port, aircraft,
vehicle, or vessel under the jurisdiction of the Department of Defense, including any leased facility, or any
other location under military control.
(4) Territories and possessions of the United States means American Samoa, Swains Island, Bajo Nuevo (the
Petrel Islands), Baker Island, Howland Island, Jarvis Island, Johnston Atoll, Kingman Reef, Midway Atoll,
Navassa Island, CNMI, Palmyra Atoll, Serranilla Bank, and Wake Atoll.
2. Principal Petitioner filing for a qualifying family member, or currently holding U-1 status and filing for a qualifying
family member. You must also demonstrate that:
A. If you are under 21 years of age on the date your petition is received by USCIS, the qualifying family members
for whom you are filing are your:
(1) Spouse;

(2) Unmarried children under 21 years of age;
(3) Parents; and/or

(4) Unmarried siblings under 18 years of age.
B. If you are over 21 years of age on the date your petition is received by USCIS, the qualifying family members for
whom you are filing are your:
(1) Spouse; and/or
(2) Unmarried children under 21 years of age.

General Instructions
U.S. Citizenship and Immigration Services (USCIS) provides forms free of charge through the USCIS website. In order
to view, print, or fill out our forms, you should use the latest version of Adobe Reader, which you can download for free
at http://get.adobe.com/reader/. If you do not have internet access, you may order USCIS forms by calling the USCIS
Contact Center at 1-800-375-5283. The USCIS Contact Center provides information in English and Spanish. For TTY
(deaf or hard of hearing) call: 1-800-767-1833.

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Signature. Each petition must be properly signed in black or blue ink and filed. For all signatures on this petition, USCIS
will not accept a stamped or typewritten name in place of a signature. If you are under 14 years of age, your parent or
legal guardian may sign the petition on your behalf. A legal guardian may also sign for a mentally incompetent person.
Filing Fee. There is no filing fee for Form I-918 or Supplement A.
Evidence. At the time of filing, you must submit all evidence and supporting documentation listed in the Specific
Instructions and General Requirements sections of these Instructions.
Biometric Services Appointment. USCIS may require that you appear for an interview or provide fingerprints,
photograph, and/or signature at any time to verify your identity, obtain additional information, and conduct background
and security checks, including a check of criminal history records maintained by the Federal Bureau of Investigation
(FBI), before making a decision on your application, petition, or request. After USCIS receives your petition and ensures
it is complete, we will inform you in writing if you need to attend a biometric services appointment. If an appointment is
necessary, the notice will provide you the location of your local or designated USCIS Application Support Center (ASC)
and the date and time of your appointment or, if you are currently overseas, instruct you to contact a U.S. Embassy, U.S.
Consulate, or USCIS office outside the United States to set up an appointment.

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If you are required to provide biometrics, at your appointment you must sign an oath reaffirming that:
1. You provided or authorized all information in the petition;

2. You reviewed and understood all of the information contained in, and submitted with, your petition; and
3. All of this information was complete, true, and correct at the time of filing.

Copies. You may submit legible photocopies of documents requested, unless the Instructions specifically state that you
must submit an original document. USCIS may request an original document at the time of filing or at any time during
processing of an application, petition, or request. If you submit original documents when not required, the documents
may remain a part of the record, and USCIS will not automatically return them to you.
Translations. If you submit a document with information in a foreign language, you must also submit a full English
translation. The translator must sign a certification that the English language translation is complete and accurate, and that
he or she is competent to translate from the foreign language into English. The certification must include the translator’s
signature, should contain the translator’s printed name and the date, and it may also contain the translator’s contact
information.
How To Fill Out Form I-918 and Supplement A
1. Type or print legibly in black or blue ink.
2. If you need extra space to complete any item within Form I-918, use the space provided in Part 8. Additional
Information or attach a separate sheet of paper; type or print your name and Alien Registration Number (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.
3. If you need extra space to complete any item within Supplement A, use the space provided in Part 11. Additional
Information or attach a separate sheet of paper; type or print your name (Principal’s) and A-Number (if any) or the
A-Number of the Qualifying Family Member 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.
4. Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been
married and the question asks “Provide the name of your current spouse”), type or print “N/A,” unless otherwise
directed. If your answer to a question which requires a numeric response is zero or none (for example, “How many
children do you have” or “How many times have you departed the United States”), type or print “None,” unless
otherwise directed.

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Specific Instructions for Form I-918
This petition is divided into Parts 1. - 8. The following information should help you fill out the petition.
You must also file Form I-918, Supplement B that was completed and signed by a certifying official. (See the Supplement
B Instructions for more information on how to file Supplement B.) You must submit Supplement B with the original Form
I-918 petition package. If it is not attached, USCIS will deny your Form I-918.
Part 1. Information About You (Person filing this petition as a victim)
Item Numbers 1.a. - 1.c. Provide your full legal name. Do not provide a nickname.

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Item Numbers 2.a. - 2.c. Other Names Used. Provide all the names you have used, including your maiden name,
nicknames, and aliases, if applicable.
Item Numbers 3.a. - 3.h. Home Address. Provide your physical street address. You must include a street number and
name or a rural route number. Do not provide a post office box (PO Box) number here.
Item Numbers 4.a. - 4.i. Safe Mailing Address (if other than Home Address). Provide a “safe mailing address” if you
do not feel secure in receiving correspondence regarding this petition at your home address. You may provide a PO Box
or the address of a friend, attorney, a community-based organization that is helping you, or any other address where you
can safely and punctually receive mail.
Item Number 5. Alien Registration Number (A-Number) (if any). This is your USCIS file number. If you do not have
an A-Number or do not know it, leave this space blank.
Item Number 6. U.S. Social Security Number. Provide your U.S. Social Security Number. If you do not have a U.S.
Social Security Number or do not know it, leave this space blank.
Item Number 7. USCIS Online Account Number (if any). If you have previously filed an application, petition, or
request using the USCIS online filing system (previously called USCIS Electronic Immigration System (USCIS ELIS)),
provide the USCIS Online Account Number you were issued by the system. You can find your USCIS Online Account
Number by logging in to your account at www.uscis.gov/file-online and going to the profile page. If you previously filed
certain applications, petitions, or requests on a paper form via a USCIS Lockbox facility, you may have received a USCIS
Online Account Access Notice issuing you a USCIS Online Account Number. If you received such a notice, your USCIS
Online Account Number can be found at the top of the notice. If you were issued a USCIS Online Account Number, enter
it in the space provided. The USCIS Online Account Number is not the same as an A-Number.
Item Number 8. Marital Status. Select the appropriate box.
Item Number 9. Gender. Select the appropriate box.
Item Number 10. Date of Birth (mm/dd/yyyy). Provide your date of birth. (For example, type or print May 1, 1979 as
05/01/1979.)
Item Number 11. Country of Birth. Provide the name of the country where you were born.
Item Number 12. Country of Citizenship or Nationality. Provide the name of the country where you are a citizen or
national. This is not necessarily the country where you were born.

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Item Numbers 13. - 18. Form I-94 Arrival-Departure Record. If U.S. Customs and Border Protection (CBP) or
USCIS issued you a Form I-94, Arrival-Departure Record, provide your Form I-94 number and date that your authorized
period of stay expires or expired (as shown on Form I-94). The Form I-94 number is also known as the Departure
Number on some versions of Form I-94.
NOTE: If you were admitted to the United States by CBP at an airport or seaport after April 30, 2013, you may have
been issued an electronic Form I-94 by CBP, instead of a paper Form I-94. You may visit the CBP Website at
www.cbp.gov/i94 to obtain a paper version of an electronic Form I-94. CBP does not charge a fee for this service. Some
travelers admitted to the United States at a land border, airport, or seaport after, April 30, 2013 with a passport or travel
document, who were issued a paper Form I-94 by CBP, may also be able to obtain a replacement Form I-94 from the CBP
website, it may be obtained by filing Form I-102, Application for Replacement/Initial Nonimmigrant Arrival-Departure
Record, with USCIS. USCIS does charge a fee for this service.

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Passport and Travel Document Numbers. If you used a passport or travel document to travel to the United States,
provide either the passport or travel document information in the appropriate space on the petition, even if the passport or
travel document is currently expired.
Item Numbers 19.a. - 21. Place and Date of Last Entry into the United States and Date Authorized Stay Expired.
Provide the place and date (mm/dd/yyyy) where you last entered the United States, how you entered the United States,
and the date your authorized stay expired.
Item Number 22. Current Immigration Status. Provide your current immigration status, regardless of how you
entered the United States or if you have overstayed any legal status (as a visitor, student, etc.).
Part 2. Additional Information About You

Item Numbers 1. - 7.a. You must answer each question. If you answer “Yes” to any of the questions, you must provide
an explanation in the space provided in Part 8. Additional Information.
Item Numbers 7.b. - 7.f. If you answer “Yes,” to Item Number 7.a., select the type of proceedings. If you were in
proceedings in the past and are no longer in proceedings, provide the date of action. If you are currently in proceedings,
type or print “Current” in the appropriate date field. Select all applicable boxes. Use the space provided in Part 8.
Additional Information to provide an explanation.
Item Numbers 8.a. - 10.d. Provide the date of entry, place of entry, and status under which you entered the United States
for each entry during the five years preceding the filing of this petition. If your last entry occurred more than five years
ago, write “N/A” or “none .”
Item Numbers 11.a. - 12.f. If you are outside the United States, provide the U.S. Consulate or inspection facility or a
safe foreign mailing address you want notified if this petition is approved.
Part 3. Processing Information
Item Numbers 1.a. - 29.c. You must answer each question. If you answer “Yes” to any of the questions, you must
provide an explanation in the space provided in Part 8. Additional Information.
Part 4. Information About Your Spouse and/or Children
Item Numbers 1.a. - 25. Provide the requested information about your family members included in this petition.
Item Number 26. Answer this question to indicate whether you are petitioning for one or more qualifying family
members at this time. If you answer “Yes,” see information below on completing Supplement A on behalf of your
qualifying family members.

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Part 5. Petitioner’s Statement, Contact Information, Declaration, and Signature
Item Numbers 1.a. - 7.b. Select the appropriate box to indicate whether you read this petition yourself or whether you
had an interpreter assist you. If someone assisted you in completing the petition, select the box indicating that you used
a preparer. Further, you must sign and date your petition and provide your daytime telephone number, mobile telephone
number (if any), and email address (if any). If you do not feel secure in receiving telephone calls regarding this petition
at your home telephone number, provide a “safe telephone number” in this space. This number may be for a friend, your
attorney, a community-based organization that is helping you, or any other number where you can safely and punctually
receive a call or a message. Every petition MUST contain the signature of the petitioner (or parent or legal guardian, if
applicable). A stamped or typewritten name in place of a signature is not acceptable.
Part 6. Interpreter’s Contact Information, Certification, and Signature

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Item Numbers 1.a. - 7.b. If you used anyone as an interpreter to read the Instructions and questions on this petition 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 petition.
Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Petition, if Other Than the
Petitioner
Item Numbers 1.a. - 8.b. This section must contain the signature of the person who completed your petition, if other
than you, the petitioner. If the same individual acted as your interpreter and your preparer, that person should complete
both Part 6. and Part 7. If the person who completed this petition 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 petition MUST sign and date the petition. A stamped or typewritten name in place of a signature is not acceptable. If
the person who helped you prepare your petition is an attorney or accredited representative whose representation extends
beyond preparation of this petition, he or she may be obliged to also submit a completed Form G-28, Notice of Entry of
Appearance as Attorney or Accredited Representative, along with your petition.
Part 8. Additional Information

Item Number 1.a. - 7.d. If you need extra space to provide any additional information within this petition, use the
space provided in Part 8. Additional Information. If you need more space than what is provided in Part 8., you may
make copies of Part 8. to complete and file with your petition or attach a separate sheet of paper. Include 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.
We recommend that you print or save a copy of your completed petition to review in the future and
for your records. We recommend that you review your copy of your completed petition before you
come to your biometric services appointment at a USCIS ASC. At your appointment, USCIS will permit
you to complete the petition process only if you are able to confirm, under penalty of perjury, that all of the
information in your petition is complete, true, and correct. If you are not able to make that attestation in good
faith at that time, USCIS will require you to return for another appointment.

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Specific Instructions for Supplement A, Petition for Qualifying Family Member of U-1 Recipient
If you are filing for a qualifying family member, you must complete Supplement A for each family member for whom you
are filing. You may file Supplement A with your initial Form I-918 or at any time thereafter. If you are filing Supplement
A after filing your initial Form I-918, you do not need to resubmit evidence that you submitted with the original petition.
Part 1. Family Member’s Relationship To You (Principal)
Item Number 1. Select the appropriate box.
Part 2. Information About You (Principal)

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Item Numbers 1.a. - 1.c. Provide your full legal name. Do not provide a nickname.

Item Number 2. Date of Birth (mm/dd/yyyy). Provide your date of birth. (For example, type or print May 1, 1979 as
05/01/1979.)
Item Number 3. Alien Registration Number (A-Number) (if any). This is your USCIS file number. If you do not have
an A-Number or do not know it, leave this space blank.
Item Number 4. USCIS Online Account Number (if any). If you have previously filed an application, petition, or
request using the USCIS online filing system (previously called USCIS Electronic Immigration System (USCIS ELIS)),
provide the USCIS Online Account Number you were issued by the system. You can find your USCIS Online Account
Number by logging in to your account and going to the profile page. If you previously filed certain applications, petitions,
or requests on a paper form via a USCIS Lockbox facility, you may have received a USCIS Online Account Access Notice
issuing you a USCIS Online Account Number. If you received such a notice, your USCIS Online Account Number can be
found at the top of the notice. If you were issued a USCIS Online Account Number, enter it in the space provided. The
USCIS Online Account Number is not the same as an A-Number.
Item Number 5. Status of Your Form I-918. Select the appropriate box.

Part 3. Information About Your Qualifying Family Member (Derivative)

Item Numbers 1.a. - 1.c. Provide his or her full legal name. Do not provide a nickname.

Item Numbers 2.a. - 2.c. Other Names Used. Provide all the names he or she has used, including his or her maiden
name, nicknames, and aliases, if applicable. If you need extra space to complete this section, use the space provided in
Part 11. Additional Information.
Item Numbers 3.a. - 3.e. Residence or Intended Residence in the United States. Provide his or her intended physical
street address. This must include a street number and name or a rural route number. Do not provide a PO Box number
here.
Item Numbers 4.a. - 4.i. Safe Mailing Address (if other than Residence). Provide his or her “safe mailing address”
if he or she does not feel secure in receiving correspondence regarding this supplement at his or her home address. You
may provide a PO Box or the address of his or her friend, attorney, a community-based organization, or any other address
where he or she can safely and punctually receive mail.
Item Number 5. A-Number (if any). This is his or her USCIS file number. If he or she does not have an A-Number or
does not know it, leave this space blank.
Item Number 6. U.S. Social Security Number. Provide his or her U.S. Social Security Number. If he or she does not
have a U.S. Social Security number, leave this blank.

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Item Number 7. USCIS Online Account Number (if any). If you have previously filed an application, petition, or
request using the USCIS online filing system (previously called USCIS Electronic Immigration System (USCIS ELIS)),
provide the USCIS Online Account Number you were issued by the system. You can find your USCIS Online Account
Number by logging in to your account and going to the profile page. If you previously filed certain applications, petitions,
or requests on a paper form via a USCIS Lockbox facility, you may have received a USCIS Online Account Access Notice
issuing you a USCIS Online Account Number. If you received such a notice, your USCIS Online Account Number can be
found at the top of the notice. If you were issued a USCIS Online Account Number, enter it in the space provided. The
USCIS Online Account Number is not the same as an A-Number.
Item Number 8. Date of Birth (mm/dd/yyyy). Provide his or her date of birth. (For example, type or print May 1, 1979
as 05/01/1979.)

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Item Number 9. Country of Birth. Provide the name of the country where he or she was born.

Item Number 10. Country of Citizenship or Nationality. Provide the name of the country where he or she is a citizen
or national. This is not necessarily the country where he or she was born.
Item Number 11. Marital Status. Select the appropriate box.
Item Number 12. Gender. Select the appropriate box.

Item Number 13. Form I-94 Arrival-Departure Record. If your family member is physically present in the United
States, provide the number on his or her Form I-94 issued at the time of entry. If CBP or USCIS issued your family
member a Form I-94, Arrival-Departure Record, provide his or her Form I-94 number and date that your authorized period
of stay expires or expired (as shown on Form I-94). The Form I-94 number is also known as the Departure Number on
some versions of Form I-94.
NOTE: If your family member was admitted to the United States by CBP at an airport or seaport after April 30, 2013,
they may have been issued an electronic Form I-94 by CBP, instead of a paper Form I-94. You may visit the CBP
website at www.cbp.gov/i94 to obtain a paper version of an electronic Form I-94. CBP does not charge a fee for this
service. Some travelers admitted to the United States at a land border, airport, or seaport, after April 30, 2013 with a
passport or travel document, who were issued a paper Form I-94 by CBP, may also be able to obtain a replacement Form
I-94 from the CBP website without charge. If your family member’s Form I-94 cannot be obtained from the CBP
website, it may be obtained by filing Form I-102 with USCIS. USCIS does charge a fee for this service.
Item Numbers 14. - 18. Passport and Travel Document Numbers. If your family member used a passport or travel
document to travel to the United States, enter either the passport or travel document information in the appropriate space
on the supplement, even if the passport or travel document is currently expired.
Part 4. Additional Information About Your Qualifying Family Member
Item Numbers 1.a. - 1.d. Provide the date of last entry, place of last entry, and current immigration status for your family
member if he or she is currently in the United States.
Item Numbers 2.a. - 2.e. Provide the date of entry, place of entry, and status at entry for your family member’s last entry
if he or she has previously traveled to the United States but is not currently in the United States.
Item Numbers 3.a. - 4.f. If your family member is outside the United States, provide the U.S. Consulate or inspection
facility or a safe foreign mailing address you want notified if this supplement is approved.
Item Numbers 5.a. - 6.f. If your family member was previously married, list the names of your family member’s prior
spouses and the dates his or her marriages were terminated. You must attach documentation such as divorce decrees or
death certificates.

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Item Numbers 7.a. - 7.f. Indicate whether your family member was or is in immigration proceedings. If you answer
“Yes,” select the type of proceedings. If your family member was in proceedings in the past and is no longer in
proceedings, provide the date of action. If your family member is currently in proceedings, type or print “Current” in the
appropriate date field. Select all applicable boxes. Use the space provided in Part 11. Additional Information.
Item Number 8. Answer “Yes” if your family member is living in the United States and would like an Employment
Authorization Document. If you answer “Yes,” submit Form I-765, Application for Employment Authorization
Document, separately.
NOTE: If your family member is living outside the United States, he or she is not eligible to receive employment
authorization until he or she is lawfully admitted to the United States. Do not file Form I-765, Application for
Employment Authorization, for a family member living outside the United States.

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Part 5. Processing Information

Item Numbers 1.a. - 29.c. You must answer each question on behalf of your family member. If you answer “Yes” to any
of the questions, you must provide an explanation in the space provided in Part 11. Additional Information.
Part 6. Information About Your Qualifying Family Member’s Spouse and/or Children

Item Numbers 1.a. - 12. Provide the requested information about your family member’s spouse and/or children. If you
need extra space to complete this section, use the space provided in Part 11. Additional Information.
Part 7. Petitioner’s Statement, Contact Information, Declaration, and Signature

Item Numbers 1.a. - 7.b. Select the appropriate box to indicate whether you read this supplement yourself or whether
you had an interpreter assist you. If someone assisted you in completing the supplement, select the box indicating that
you used a preparer. Further, you must sign and date your supplement and provide your daytime telephone number,
mobile telephone number (if any), and email address (if any). Every supplement MUST contain the signature of the
petitioner (or parent or legal guardian, if applicable). A stamped or typewritten name in place of a signature is not
acceptable.
Part 8. Qualifying Family Member’s Statement, Contact Information, Declaration, and Signature

Item Numbers 1.a. - 6.b. If your family member is in the United States, he or she must verify the accuracy of the
information recorded on this supplement and must also complete this section of the supplement. He or she must select
the appropriate box to indicate that he or she either read this supplement himself or herself or whether he or she had an
interpreter assist him or her. If someone assisted him or her in completing the supplement, select the box indicating
that he or she used a preparer. Further, he or she must sign and date the supplement and provide his or her daytime
telephone number, mobile telephone number (if any), and email address (if any). Every supplement MUST contain the
signature of the qualifying family member (or parent or legal guardian, if applicable). A stamped or typewritten name
or a scanned, faxed, or emailed copy in place of an original signature is not acceptable. A legal guardian may sign for a
mentally incompetent person. If the qualifying family member does not sign or date the supplement, USCIS may return
Supplement A as incomplete.
Part 9. Interpreter’s Contact Information, Certification, and Signature
Item Numbers 1.a. - 7.b. If you and your family member used anyone as an interpreter to read the instructions and
questions on this supplement 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
supplement.

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Part 10. Contact Information, Declaration, and Signature of the Person Preparing this Supplement, if Other Than
the Petitioner or Qualifying Family Member
Item Numbers 1.a. - 8.b. This section must contain the signature of the person who completed your supplement, if
other than you, the petitioner or your family member. If the same individual acted as your interpreter and your preparer,
that person should complete both Part 9. and Part 10. If the person who completed this supplement 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 supplement MUST sign and date the supplement. A stamped or typewritten name in
place of a signature is not acceptable. If the person who helped you prepare your supplement is an attorney or accredited
representative whose representation extends beyond preparation of this supplement, he or she may be obliged to also
submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative, along with your
supplement.

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Part 11. Additional Information

Item Numbers 1.a. - 7.d. If you need extra space to provide any additional information within this supplement, use the
space provided in Part 11. Additional Information. If you need more space than what is provided in Part 11., you may
make copies of Part 11. to complete and file with your supplement or attach a separate sheet of paper. Include your name
(Principal) 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.

General Requirements

Required Initial Evidence to Support Form I-918

You must include the following initial evidence with your Form I-918.

If you, the petitioner, requested and received interim relief, USCIS will consider the evidence you submitted in
conjunction with your request for interim relief as part of the petition package. In this instance, you may choose to file
additional evidence with Form I-918 to add to the evidence submitted with the request for interim relief.
NOTE: You may use one document to demonstrate more than one element of your claim.

1. Supplement B. You must submit an original, properly and timely executed Supplement B certification with your
Form I-918. However, petitioners who requested and received U interim relief are not required to file Supplement B.
USCIS will give this certification significant weight as evidence demonstrating that you are a victim; that you possess
information about the criminal activity; that the criminal activity violated the laws of the United States or occurred in
the United States (including Indian country and military installations) or the territories and possessions of the United
States; and that you were, are, or are likely to be helpful in the investigation or prosecution of the qualifying criminal
activity of which you are a victim. You must also provide any additional relevant evidence to help meet these
eligibility requirements.
2. Evidence You Are the Victim of Qualifying Criminal Activity. You must demonstrate you have suffered direct and
proximate harm as a result of the commission of qualifying criminal activity. You must include with your Form I-918
evidence establishing you are a victim of qualifying criminal activity. You may use Supplement B to help establish
this eligibility requirement and include additional evidence you want USCIS to consider. A non-exhaustive list of the
types of evidence you may submit includes, but is not limited to:
A. Trial transcripts;
B. Court documents;

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C. Police reports;
D. News articles;
E. Affidavits; and
F. Orders of protection.
3. Evidence You Have Suffered Substantial Physical or Mental Abuse. You must present credible evidence that
demonstrates you suffered substantial physical or mental abuse as a result of having been a victim of qualifying
criminal activity. You may use Supplement B to help establish this eligibility requirement and include additional
evidence you want USCIS to consider.
The evidence must show the nature and severity of the abuse you suffered. Factors USCIS will consider to determine
whether the abuse is substantial include:

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A. The nature of the injury inflicted;

B. The severity of the perpetrator’s conduct;
C. The severity of the harm you suffered;

D. The duration of the infliction of the harm; and

E. The extent to which there is permanent or serious harm to your appearance, health, or physical or
mental soundness.

No single factor is a prerequisite to establish that the abuse suffered was substantial, nor does the existence of one
or more of the factors automatically create a presumption that the abuse was substantial. If the criminal activity
caused the aggravation of a pre-existing physical or mental injury, USCIS will consider that aggravation in evaluating
whether the harm constitutes substantial physical or mental abuse. If the criminal activity involved a series of acts
or occurred repeatedly over a period of time, document the pattern of abuse. USCIS will consider the abuse in its
totality. USCIS may consider a series of acts taken together to have caused substantial physical or mental abuse even
where no single act alone rises to that level.
You are encouraged to provide and document all credible evidence, particularly when documenting a pattern of abuse.
A non-exhaustive list of suggested forms of evidence includes, but is not limited to:
A. Reports and/or affidavits from judges and other court officials, medical personnel, school officials, clergy, social
workers, and other social service personnel;
B. Orders of protection and related legal documents;

C. Photos of your visible injuries supported by affidavits; and
D. Affidavits from witnesses, acquaintances, or family members who have personal knowledge of the facts regarding
the criminal activity.
4. Evidence You Possess Information Concerning Qualifying Criminal Activity. You must submit evidence
demonstrating you possess information concerning the qualifying criminal activity of which you were a victim.
You must demonstrate that you have knowledge of details concerning the criminal activity that would assist in the
investigation or prosecution of that criminal activity.
You may use Supplement B to help establish this eligibility requirement and include additional evidence you want
USCIS to consider. Additional evidence to establish you possess information about the qualifying criminal activity
may include, but is not limited to, reports and affidavits from police, judges, and other court officials.

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In cases where the petitioner is a child under 16 years of age or is incapacitated or incompetent, the parent, guardian,
or “next friend” can satisfy this requirement by submitting the evidence on behalf of the petitioner. “Next friend”
is a person who appears in a lawsuit to act for the benefit of a victim under 16 years of age or incapacitated or
incompetent, who has suffered substantial physical or mental abuse as a result of being a victim of qualifying criminal
activity. The next friend is not a party to the legal proceeding and is not appointed as a guardian. Evidence to meet
this eligibility requirement must include documents establishing the age, incapacity, or incompetence of the victim.
Examples of such evidence include, but are not limited to:
A. Birth certificate of the petitioner;
B. Court documents demonstrating recognition of an individual as the petitioner’s next friend;
C. Medical records; or

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D. Reports of licensed medical professionals demonstrating the incapacity or incompetence of the petitioner.
5. Evidence of Helpfulness. You must submit evidence demonstrating that you were, are, or are likely to be helpful to a
certifying official in the investigation or prosecution of the qualifying criminal activity of which you are a victim.
You may use Supplement B to help establish this eligibility requirement and include additional evidence you want
USCIS to consider. Examples of such evidence include, but are not limited to:
A. Trial transcripts;

B. Court documents;
C. Police reports;
D. News articles;

E. Copies of reimbursement forms for travel to and from court; and
F. Affidavits of other witnesses or officials.

In cases where the petitioner is a child under 16 years of age or is incapacitated or incompetent, the parent, guardian,
or next friend can satisfy this requirement by submitting the evidence on behalf of the victim. Evidence to meet
this eligibility requirement must include documents establishing the age, incapacity, or incompetence of the victim.
Examples of such documentation include, but are not limited to:
A. Birth certificate of the petitioner;

B. Court documents demonstrating recognition of an individual as the petitioner’s next friend;
C. Medical records; or

D. Reports of licensed medical professionals demonstrating the incapacity or incompetence of the petitioner.
6. Evidence that Criminal Activity is Qualifying and Violated United States Law or Occurred in the United States.
You must submit evidence that the criminal activity of which you are a victim is included in the list of criminal
activities contained in section 101(a)(15)(U)(iii) of the INA and included in these Instructions, and that the criminal
activity violated a U.S. Federal law that provides for extraterritorial jurisdiction, or occurred in the United States
(including in Indian country and military installations) or the territories and possessions of the United States.
You may use Supplement B to help establish this eligibility requirement and include additional evidence you want
USCIS to consider. An example of such additional evidence includes, but is not limited to:
A. A copy of the statutory provisions showing the elements of the offense or factual information about the criminal
activity demonstrating that it is similar to a crime contained in the list of qualifying criminal activity contained at
section 101(a)(15)(U)(iii) and in these Instructions; or
B. If the criminal activity occurred outside the United States, the additional evidence may include a copy of the
statutory provisions providing for the extraterritorial jurisdiction and documentation showing that the criminal
activity violated Federal law and is prosecutable in a Federal court.
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7. Personal Statement. You must provide a personal narrative statement. This statement should describe the qualifying
criminal activity of which you are a victim and must include the following information:
A. The nature of the criminal activity;
B. When the criminal activity occurred;
C. Who was responsible;
D. The events surrounding the criminal activity;
E. How the criminal activity came to be investigated or prosecuted; and
F. What substantial physical and/or mental abuse you suffered as a result of having been the victim of the criminal
activity.

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When the petitioner is under 16 years of age, incapacitated, or incompetent, a parent, guardian, or next friend may
submit a statement in lieu of the victim. The statement should contain as much information surrounding the criminal
activity and physical and/or mental abuse as possible.
8. Waiver of Grounds of Inadmissibility. To be eligible for U nonimmigrant status, you must be admissible to the
United States. If you or your qualifying family members answered “Yes” to any of the questions in Part 3. of Form
I-918 or Part 5. of Supplement A, USCIS may deem you or your qualifying family members as inadmissible.
If you and/or your qualifying family members are or become inadmissible for conduct that occurs while the petition
for U nonimmigrant status is pending, you and/or your family members are not eligible for U nonimmigrant status
unless the ground of inadmissibility is waived by USCIS.
Petitioners seeking a waiver of inadmissibility must submit Form I-192, Application for Advance Permission to Enter
as a Nonimmigrant. You may file your Form I-192 with your Form I-918. You must submit the appropriate I-192 fee
or a request for a fee waiver (Form I-912, Request for Fee Waiver, or a written request). If you request a fee waiver
you must also submit any required evidence of your inability to pay the fee. You can review the fee waiver guidance
at www.uscis.gov/feewaiver. USCIS will decide eligibility for the fee waiver.

Supplement A and Evidence to Support Supplement A

You must include the following evidence to establish derivative U nonimmigrant status on Supplement A.
1. A completed Supplement A for each qualifying family member you want included on your Form I-918.
2. Credible documentation of the claimed relationship. The documents acceptable for this purpose are below.
If you are filing for your:
A. Husband or wife. Submit a copy of your marriage certificate issued by a civil authority. If either you or your
spouse were married before, you must submit documents to show all previous marriages were legally terminated
(for example, provide a divorce decree or death certificate);
B. Child and you are the mother. Submit a copy of the child’s birth certificate showing your name and the name of
the child, issued by a civil authority;
C. Child and you are the father. Submit a copy of the child’s birth certificate issued by a civil authority showing
both parents’ names. If the child was born out of wedlock, give proof that a parent/child relationship exists
or existed (for example, provide the child’s birth certificate showing your name and evidence that you have
financially supported the child. In some cases, a blood test may be necessary);
D. Mother. Submit a copy of your birth certificate issued by a civil authority showing your name and your
mother’s name;

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E. Father. Submit a copy of your birth certificate showing the names of both parents. Also, provide a copy of your
parents’ marriage certificate establishing that your father was married to your mother before you were born and
copies of documents showing that any prior marriages of either your father or mother were legally terminated.
If you are filing for a stepparent or adoptive parent, or if you are filing for your father and were not legitimated
before you reached 18 years of age, also see Items C., G., and H. in this section;
F. Stepparent/stepchild. If your Form I-918 is based on a stepparent-stepchild relationship, you must file your
petition with a copy of the marriage certificate of the stepparent to the child’s natural parent, showing that the
marriage occurred before the child reached 18 years of age and copies of documents showing that any prior
marriages were legally terminated;
G. Adoptive parent or adopted child. If you and the person you are filing for are related by adoption, you must
submit a copy of the adoption decrees showing that the adoption took place before the child reached 16 years of
age. If you adopted the sibling of a child you already adopted, you must submit a copy of the adoption decrees
showing that the adoption of the sibling occurred before that child reached 18 years of age. In either case,
you must also submit copies of evidence that the child was in the legal custody of and jointly resided with the
adoptive parents for at least two years before or after the adoption. Only a court or recognized government entity
may grant legal custody and usually grants legal custody at the time the adoption is finalized. However, if legal
custody is granted by a court or recognized government entity prior to the adoption, that time will count to fulfill
the two-year legal custody requirement; or

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H. Your unmarried sibling under 18 years of age. Submit a copy of your birth certificate and a copy of your
sibling’s birth certificate showing that you have at least one common parent. If you and your sibling have a
common father but different mothers, submit copies of the marriage certificates of the father to each mother and
copies of documents showing that any prior marriages of either your father or mothers were legally terminated.
If you and your sibling are related through adoption or through a stepparent, or if you have a common father and
either of you were not legitimated before you reached 18 years of age, also see Items F. and G. in this section.
3. Unavailable Documents. If the required documents are not available, submit a statement of why the evidence is not
available and provide secondary evidence such as the following:
A. Church records. A certificate under the seal where the baptism, dedication, or comparable rite occurred within
two months after the birth, showing the date and place of the child’s birth, date of the religious ceremony, and the
names of the child’s parents;
B. Census records. State or Federal census records showing the names, places and dates of birth, or ages of the
persons listed;
C. School records. A letter from the authority of the school attended (preferably the first school) showing dates of
admission to the school, child’s date and place of birth, and the names and birthplaces of both parents, if shown in
the school records; and/or
D. Affidavits. Written statements sworn to or affirmed by two persons who were living at the time and who have
personal knowledge of the event you are trying to prove. (For example, provide the date and place of birth,
marriage, divorce, or death.) The person making the affidavit need not be a citizen of the United States. Each
affidavit should contain the following:
(1) The relationship, if any, between you and the person making the affidavit;
(2) Full information concerning the event; and
(3) Complete details concerning how the person acquired knowledge of the event.
NOTE: In a case where you or your family member’s name has changed from what is shown on the supporting
document, submit the legal document authorizing such name change. (For example, provide a marriage
certificate, adoption decree, or court order.)
NOTE: USCIS may require a statement from the appropriate civil authority certifying that the necessary document is
unavailable.
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What Is the Filing Fee?
There is no filing fee for Form I-918 or Supplement A. You are required to provide biometrics information, but are not
required to pay the biometrics services fee. After you submit Form I-918 and Supplement A (if applicable), USCIS will
notify you and your family member (if applicable) of when and where to go for biometrics services.

Where To File?
Please see our website at www.uscis.gov/I-918 or call our National Customer Service Center at 1-800-375-5283 for the
most current information about where to file Form I-918 and Supplement A. For TTY (deaf or hard of hearing) call:
1-800-767-1833.

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Address Change

An applicant, petitioner, or requester who is not a U.S. citizen must notify USCIS of his or her new address within 10 days
of moving from his or her previous residence. For information on filing a change of address, go to the USCIS Website at
www.uscis.gov/addresschange or contact the USCIS National Customer Service Center at 1-800-375-5283. For TTY
(deaf or hard of hearing) call: 1-800-767-1833.
NOTE: Do not submit a change of address request to the USCIS Lockbox facilities because the Lockbox does not
process change of address requests.

Processing Information

USCIS will reject any Form I-918 or Supplement A that is not signed with a notice that Form I-918 or Supplement A
is deficient. You may correct the deficiency and resubmit Form I-918 and/or Supplement A. A petition or supplement is
not considered properly filed until accepted by USCIS.
Initial Processing. Once USCIS accepts your Form I-918 or Supplement A, we will check it for completeness. If you do
not completely fill out this petition or supplement, you will not establish a basis for your eligibility and USCIS may reject
or deny your Form I-918 or Supplement A.
Requests for More Information. We may request that you provide more information or evidence to support your Form
I-918 or Supplement A. We also may request that you provide the originals of any copies you submit. USCIS will return
any requested originals when they are no longer needed.
Requests for Interview. We may request that you and/or your family member appear at a USCIS office for an interview
based on your petition or supplement. At the time of any interview or other appearance at a USCIS office, we may require
that you and/or your family member provide your fingerprints, photographs, and/or signatures to verify your identity and/
or update background and security checks.
Employment Authorization. If you are currently residing in the United States and your Form I-918 is approved,
you will receive employment authorization incident to status and USCIS will send you an Employment
Authorization Document as evidence of that authorization.
Derivative family members are also employment authorized incident to status, however an employment authorization
document is not automatically issued. If he or she wishes to obtain an Employment Authorization Document, as evidence
of authorization, he or she may file Form I-765, Application for Employment Authorization, with appropriate fees or
requests for fee waivers.
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NOTE: Derivative family members living outside the United States are not eligible to receive employment authorization
until they lawfully enter the United States. Do not file Form I-765 for a derivative family member who is outside the
United States.
Employment authorization can only be issued after the underlying U nonimmigrant status petition is approved, regardless
of when the Form I-765, Application for Employment Authorization, document is filed.
If the statutory cap is reached in a fiscal year and USCIS uses the waiting list process described at 8 CFR
214.14(d)(2), petitioners for U nonimmigrant status and derivatives in the United States can apply for employment
authorization using Form I-765, Application for Employment Authorization, based on deferred action. An application
for employment authorization based on deferred action can only be approved after DHS has deferred action in your case,
regardless of when the Form I-765 is filed.

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Decision. The decision on Form I-918 and Supplement A involves a determination of whether you have established
eligibility for the immigration benefit you are seeking. USCIS will notify you of the decision in writing.
Prohibition on Disclosure of Information. Information concerning U nonimmigrant status petitioners and derivatives
is protected under 8 U.S.C. Section 1367. The disclosure of information relating to a pending or approved Form I-918 or
Supplement A is prohibited except in certain limited circumstances.

USCIS Forms and Information

To ensure you are using the latest version of this request, visit the USCIS website at www.uscis.gov where you can obtain
the latest USCIS forms and immigration-related information.  If you do not have internet access, you may order USCIS
forms by calling the USCIS Contact Center at 1-800-375-5283.  The USCIS Contact Center provides information in
English and Spanish.  For TTY (deaf or hard of hearing) call:  1-800-767-1833.
Instead of waiting in line for assistance at your local USCIS office, you can schedule an appointment online at
www.uscis.gov.  Select “Tools,” then under “Self Service Tools,” select “Appointments” and follow the screen prompts to
set up your appointment.  Once you finish scheduling an appointment, the system will generate an appointment notice for
you

Penalties

If you knowingly and willfully falsify or conceal a material fact or submit a false document with your Form I-918 and/or
Supplement A, we will deny your Form I-918 and/or Supplement A and may deny any other immigration benefit. In
addition, you will face severe penalties provided by law and may be subject to criminal prosecution.

USCIS Privacy Act Statement
AUTHORITIES: The information requested on Form I-918 and Supplement A, and the associated evidence, is collected
under the Immigration and Nationality Act, sections 101(a)(15)(U), 214(p), 212(d)(14), 8 CFR 212.17 and 214.14.
PURPOSE: The primary purpose for providing the requested information on Form I-918 and Supplement A is to request
temporary immigration benefits if you or a qualifying family member are a victim of certain qualifying criminal activity.
DHS uses the information you provide to grant or deny the immigration benefit you are seeking.
DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information,
including your Social Security number (if applicable), and any requested evidence, may delay a final decision or result in
denial of your Form I-918 and/or Supplement A.
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ROUTINE USES: DHS may, where allowable under relevant confidentiality provisions, share the information you
provide on Form I-918 and Supplement A as well as any additional requested evidence with other Federal, state, local,
and foreign government agencies and authorized organizations. DHS follows approved routine uses described in
the associated published system of records notices [DHS/USCIS-001 - Alien File, Index, and National File Tracking
System, DHS/USCIS-007 - Benefits Information System, and DHS/USCIS-018 Immigration Biometric and Background
Check] and the published privacy impact assessment [DHS/USCIS/PIA-016a Computer Linked Application Information
Management System and Associated Systems] which you can find at www.dhs.gov/privacy. DHS may also share the
information, as appropriate, for law enforcement purposes or in the interest of national security.

Paperwork Reduction Act

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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 OMB control number. The public reporting burden for Form I-918 is
estimated at 5 hours per response, and the public reporting burden for Supplement A is estimated at 1 hour and 30 minutes
per response, including the time for reviewing instructions, gathering the required documentation and information,
completing the petition, preparing statements, attaching necessary documentation, and submitting the petition. The
collection of biometrics is estimated to require 1 hour and 10 minutes. 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. 1615-0104. Do not mail your completed Form I-918 or
Supplement A to this address.

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