I 130 Form Details

Every year, around the world, people are forced to flee their homes due to conflict or persecution. These refugees often end up in camps, hoping for a better life. Unfortunately, many refugees never make it out of these camps. This is because they don't have the necessary documentation to leave. Thankfully, there is a solution. The Form I130A allows refugees to apply for legal residency in the United States. This form is simple to fill out and only takes a few minutes. So, if you know someone who is a refugee, be sure to help them fill out this form. It could be the difference between life and death.

Below is the information concerning the PDF you were seeking to fill in. It can tell you the time you'll need to finish form i130a, what parts you will need to fill in, and so forth.

QuestionAnswer
Form NameForm I130A
Form Length6 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 30 sec
Other namesi130a form, form i130a, i30 form, formi130

Form Preview Example

 

Supplemental Information for Spouse Beneficiary

USCIS

 

 

Department of Homeland Security

Form I-130A

 

 

OMB No. 1615-0012

 

 

 

 

 

U.S. Citizenship and Immigration Services

Expires 02/28/2021

 

 

 

 

 

 

 

 

 

 

 

 

 

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

Select this box if Form G-28 is attached.

Volag Number

(if any)

Attorney State Bar Number

(if applicable)

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

START HERE - Type or print in black ink.

The purpose of this form is to collect additional information for a spouse beneficiary of Form I-130, Petition for Alien Relative. If your spouse is a U.S. citizen, lawful permanent resident, or non-citizen U.S. national who is filing Form I-130 on your behalf, you must complete and sign Form I-130A, Supplemental Information for Spouse Beneficiary, and submit it with the Form I-130 filed by your spouse. If you reside overseas, you still must complete Form I-130A, but you do not need to sign the form.

Part 1. Information About You (Spouse

Beneficiary)

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

5.a. Date From (mm/dd/yyyy)

5.b. Date To (mm/dd/yyyy)

A-

2.USCIS Online Account Number (if any)

Your Full Name

3.a. Family Name

(Last Name)

3.b. Given Name

(First Name)

3.c. Middle Name

Address History

Provide your physical addresses for the last five years, whether inside or outside the United States. Provide your current address first. If you need extra space to complete this section, use the space provided in Part 7. Additional Information.

Physical Address 1

4.a. Street Number

and Name

4.b. Apt. Ste. Flr.

4.c. City or Town

4.d. State

 

4.e. ZIP Code

 

 

 

4.f. Province

4.g. Postal Code

4.h. Country

Physical Address 2

6.a. Street Number

and Name

6.b. Apt. Ste. Flr.

6.c. City or Town

6.d. State

 

6.e. ZIP Code

 

 

 

6.f. Province

6.g. Postal Code

6.h. Country

7.a. Date From (mm/dd/yyyy)

7.b. Date To (mm/dd/yyyy)

Last Physical Address Outside the United States

Provide your last address outside the United States of more than one year (even if listed above).

8.a. Street Number

and Name

8.b. Apt. Ste. Flr.

8.c. City or Town

8.d. Province

8.e. Postal Code

8.f. Country

Form I-130A 02/13/19

Page 1 of 6

Part 1. Information About You (The Spouse

Beneficiary)

9.a. Date From (mm/dd/yyyy)

9.b. Date To (mm/dd/yyyy)

Information About Parent 1

Full Name of Parent 1

10.a. Family Name

(Maiden Name)

10.b. Given Name

(First Name)

10.c. Middle Name

11.Date of Birth (mm/dd/yyyy)

12. Sex

Male

Female

13.City/Town/Village of Birth

14.Country of Birth

15.City/Town/Village of Residence

16.Country of Residence

Information About Parent 2

Full Name of Parent 2

17.a. Family Name

(Last Name)

17.b. Given Name

(First Name)

17.c. Middle Name

18.Date of Birth (mm/dd/yyyy)

19. Sex

Male

Female

20.City/Town/Village of Birth

21.Country of Birth

22.City/Town/Village of Residence

23.Country of Residence

Part 2. Information About Your Employment

Provide your employment history for the last five years, whether inside or outside the United States. Provide your current employment first. If you are currently unemployed, type or print "Unemployed" in Item Number 1. below. If you need extra space to complete this section, use the space provided in Part 7. Additional Information.

Employment History

Employer 1

1.Name of Employer/Company

2.a.

Street Number

 

 

 

 

 

and Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.b.

Apt.

Ste.

Flr.

 

 

2.c.

City or Town

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.d.

State

 

 

 

2.e.

ZIP Code

 

 

 

 

 

 

 

 

 

 

2.f.

Province

 

 

 

 

 

 

 

 

 

 

 

 

2.g.

Postal Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.h.

Country

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.Your Occupation

4.a. Date From (mm/dd/yyyy)

4.b. Date To (mm/dd/yyyy)

Employer 2

5.Name of Employer/Company

6.a.

Street Number

 

 

 

 

 

and Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.b.

Apt.

Ste.

Flr.

 

 

6.c.

City or Town

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.d.

State

 

 

 

6.e.

ZIP Code

 

 

 

 

 

 

 

 

 

 

6.f.

Province

 

 

 

 

 

 

 

 

 

 

 

 

6.g.

Postal Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.h.

Country

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Form I-130A 02/13/19

Page 2 of 6

Part 2. Information About Your Employment

(continued)

7.Your Occupation

8.a. Date From (mm/dd/yyyy)

8.b. Date To (mm/dd/yyyy)

Part 3. Information About Your Employment Outside the United States

Provide your last occupation outside the United States if not shown above. If you never worked outside the United States, provide this information in the space provided in Part 7.

Additional Information.

1.Name of Employer/Company

2.a. Street Number

and Name

2.b. Apt. Ste. Flr.

2.c. City or Town

1.b.

The interpreter named in Part 5. 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.

2.

At my request, the preparer name in Part 6.,

 

 

 

 

,

 

 

 

prepared this form for me based only upon information I provided or authorized.

Spouse Beneficiary's Contact Information

3.Spouse Beneficiary's Daytime Telephone Number

4.Spouse Beneficiary's Mobile Telephone Number (if any)

5.Spouse Beneficiary's Email Address (if any)

Spouse Beneficiary's Certification

Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS

2.d. State

2.f. Province

2.g. Postal Code 2.h. Country

2.e. ZIP Code

may require that I submit original documents to USCIS at a later date. Furthermore, I authorize the release of any information from any of my records that USCIS may need to determine my eligibility for the immigration benefit I seek.

I further authorize release of information contained in this form, in supporting documents, and in my USCIS records to other entities and persons where necessary for the administration and enforcement of U.S. immigration laws.

3.Your Occupation

4.a. Date From (mm/dd/yyyy)

4.b. Date To (mm/dd/yyyy)

Part 4. Spouse Beneficiary's Statement, Contact Information, Certification, and Signature

NOTE: Read the Penalties section of the Form I-130 and Form I-130A Instructions before completing this part.

Spouse Beneficiary's Statement

NOTE: Select the box for either Item Number 1.a. or 1.b. If applicable, select the box for Item Number 2.

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

I certify, under penalty of perjury, that I provided or authorized all of the information in this 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.

Spouse Beneficiary's Signature

6.a. Spouse Beneficiary's Signature (sign in ink)

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

NOTE TO ALL SPOUSE BENEFICIARIES: If you do not completely fill out this form or fail to submit required documents listed in the Instructions, USCIS may deny the Form I-130 filed on your behalf.

Form I-130A 02/13/19

Page 3 of 6

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

Provide the following information about the interpreter you used to complete Form I-130A if he or she is different from the interpreter used to complete the Form I-130 filed on your behalf.

Interpreter's Full Name

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

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

2.Interpreter's Business or Organization Name (if any)

Interpreter's Mailing Address

3.a. Street Number

and Name

3.b. Apt. Ste. Flr.

3.c. City or Town

Interpreter's Certification

I certify, under penalty of perjury, that:

I am fluent in English and

 

,

 

 

 

which is the same language provided in Part 4., Item Number 1.b., and I have read to this spouse beneficiary in the identified language every question and instruction on this form and his or her answer to every question. The spouse beneficiary informed me that he or she understands every instruction, question, and answer on the form, including the Spouse Beneficiary's Certification, and has verified the accuracy of every answer.

Interpreter's Signature

7.a. Interpreter's Signature (sign in ink)

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

Part 6. Contact Information, Declaration, and Signature of the Person Preparing this Form, if Other Than the Spouse Beneficiary

Provide the following information about the preparer you used to complete Form I-130A if he or she is different from the

3.d. State

3.f. Province

3.g. Postal Code 3.h. Country

3.e. ZIP Code

preparer used to complete the Form I-130 filed on your behalf.

Preparer's Full Name

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

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

Interpreter's Contact Information

4.Interpreter's Daytime Telephone Number

5.Interpreter's Mobile Telephone Number (if any)

6.Interpreter's Email Address (if any)

2.Preparer's Business or Organization Name (if any)

Preparer's Mailing Address

3.a. Street Number

and Name

3.b. Apt. Ste. Flr.

3.c. City or Town

3.d. State

3.f. Province

3.g. Postal Code 3.h. Country

3.e. ZIP Code

Form I-130A 02/13/19

Page 4 of 6

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

Preparer's Contact Information

4.Preparer's Daytime Telephone Number

5.Preparer's Mobile Telephone Number (if any)

6.Preparer's Email Address (if any)

Preparer's Statement

7.a.

7.b.

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

I am an attorney or accredited representative and my representation of the spouse beneficiary in this case extends does not extend beyond the preparation

of this form.

NOTE: If you are an attorney or accredited representative whose representation extends beyond preparation of this form, you may be obliged 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 spouse beneficiary. The spouse beneficiary then reviewed this completed form and informed me that he or she understands all of the information contained in, and submitted with, his or her form, including the Spouse Beneficiary's Certification, and that all of this information is complete, true, and correct. I completed this form based only on information that the spouse beneficiary provided to me or authorized me to obtain or use.

Preparer's Signature

8.a. Preparer's Signature (sign in ink)

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

Form I-130A 02/13/19

Page 5 of 6

Part 7. Additional Information

If you need extra space to provide any additional information within this form, use the space below. If you need more space than what is provided, you may make copies of this page to complete and file with this form or attach a separate sheet of paper. Type or print your name and A-Number (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.

1.a. Family Name

(Last Name)

1.b. Given Name

(First Name)

1.c. Middle Name

2. A-Number (if any) A-

3.a. Page Number 3.b. Part Number 3.c. Item Number

3.d.

4.a. Page Number 4.b. Part Number 4.c. Item Number

4.d.

5.a. Page Number 5.b. Part Number 5.c. Item Number

5.d.

6.a. Page Number 6.b. Part Number 6.c. Item Number

6.d.

7.a. Page Number 7.b. Part Number 7.c. Item Number

7.d.

Form I-130A 02/13/19

Page 6 of 6

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