The I 821D Form is a form used to provide notice to the United States Citizenship and Immigration Services (USCIS) of an impending Marriage to a U.S. Citizen. The form is also used to request expedited processing of the marriage-based green card application. This form must be completed and submitted by the foreign national seeking a green card through marriage to a U.S. citizen. If you are planning on marrying a U.S. citizen, be sure to complete this form and submit it to USCIS as soon as possible! Failure to do so may delay your ability to obtain a green card through marriage.
These are some information regarding i 821d. There, you will locate the information about the form you intend to fill out, including the likely time for you to complete it along with other details.
Question | Answer |
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Form Name | I 821D |
Form Length | 7 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 1 min 45 sec |
Other names | forms daca, 821d form, daca application form, i821d |
Consideration of Deferred Action |
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for Childhood Arrivals |
USCIS |
Department of Homeland Security |
Form |
OMB No. |
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U.S. Citizenship and Immigration Services |
Expires 04/30/2021 |
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For
USCIS Case ID:
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Only Requestor interviewed on
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Receipt
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Remarks |
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Action Block
To Be Completed by an Attorney or Accredited Representative, if any.
Select this box if Form
Attorney State Bar Number (if any):
►START HERE - Type or print in black ink. Read Form
Part 1. Information About You (For Initial and
Renewal Requests)
I am not in immigration detention and I have included Form
I am requesting:
1. Initial Request - Consideration of Deferred Action for Childhood Arrivals
OR
2. Renewal Request - Consideration of Deferred Action for Childhood Arrivals
AND
For this Renewal request, my most recent period of Deferred Action for Childhood Arrivals expires on
(mm/dd/yyyy) ►
Full Legal Name
3.a. Family Name
(Last Name)
3.b. Given Name
(First Name)
3.c. Middle Name
U.S. Mailing Address (Enter the same address on Form
4.a. In Care Of Name (if applicable)
4.b. Street Number
and Name
4.c. Apt. |
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Flr. |
Removal Proceedings Information
5.Are you NOW or have you EVER been in removal proceedings, or do you have a removal order issued in any other context (for example, at the border or within the United States by an immigration agent)?
Yes No
NOTE: The term “removal proceedings” includes exclusion or deportation proceedings initiated before April 1, 1997; an Immigration and Nationality Act (INA) section 240 removal proceeding; expedited removal; reinstatement of a final order of exclusion, deportation, or removal; an INA section 217 removal after admission under the Visa Waiver Program; or removal as a criminal alien under INA section 238.
If you answered "Yes" to Item Number 5., you must select a box below indicating your current status or outcome of your removal proceedings.
Status or outcome:
5.a. |
Currently in Proceedings (Active) |
5.b. |
Currently in Proceedings (Administratively Closed) |
5.c. |
Terminated |
5.d. |
Subject to a Final Order |
5.e. |
Other. Explain in Part 8. Additional Information. |
5.f. Most Recent Date of Proceedings
(mm/dd/yyyy) ►
5.g. Location of Proceedings
4.d. City or Town
4.e. State
4.f. ZIP Code
Form |
Page 1 of 7 |
Part 1. Information About You (For Initial and
Renewal Requests) (continued)
Other Information
6.Alien Registration Number
► A-
7.U.S. Social Security Number (if any)
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8.Date of Birth (mm/dd/yyyy) ►
9. |
Gender |
Male |
Female |
10.a. |
City/Town/Village of Birth |
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10.b. Country of Birth
11.Current Country of Residence
12.Country of Citizenship or Nationality
13.Marital Status
Married Widowed Single Divorced
Other Names Used (If Applicable)
If you need additional space, use Part 8. Additional
Information.
14.a. Family Name
(Last Name)
14.b. Given Name
(First Name)
14.c. Middle Name
Processing Information
15.Ethnicity (Select only one box)
Hispanic or Latino
Not Hispanic or Latino
16.Race (Select all applicable boxes)
White
Asian
Black or African American
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
17. |
Height |
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18. |
Weight |
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19.Eye Color (Select only one box)
Black |
Blue |
Brown |
Gray |
Green |
Hazel |
Maroon |
Pink |
Unknown/Other |
20.Hair Color (Select only one box)
Bald (No hair) |
Black |
Blond |
Brown |
Gray |
Red |
Sandy |
White |
Unknown/ |
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Other |
Part 2. Residence and Travel Information (For
Initial and Renewal Requests)
1.I have been continuously residing in the U.S. since at least
June 15, 2007, up to the present time. |
Yes |
No |
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NOTE: If you departed the United States for some period of time before your 16th birthday and returned to the United States on or after your 16th birthday to begin your current period of continuous residence, and if this is an initial request, submit evidence that you established residence in the United States prior to 16 years of age as set forth in the instructions to this form.
For Initial Requests: List your current address and, to the best of your knowledge, the addresses where you resided since the date of your initial entry into the United States to present.
For Renewal Requests: List only the addresses where you resided since you submitted your last Form
If you require additional space, use Part 8. Additional
Information.
Form |
Page 2 of 7 |
Part 2. Residence and Travel Information (For
Initial and Renewal Requests) (continued)
Present Address
2.a. Dates at this residence (mm/dd/yyyy)
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3.e. |
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Address 2 |
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4.a. |
Dates at this residence (mm/dd/yyyy) |
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Address 3 |
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5.a. |
Dates at this residence (mm/dd/yyyy) |
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Travel Information
For Initial Requests: List all of your absences from the United States since June 15, 2007.
For Renewal Requests: List only your absences from the United States since you submitted your last Form
If you require additional space, use Part 8. Additional
Information.
Departure 1
6.a. |
Departure Date |
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6.b. |
Return Date |
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6.c. |
Reason for Departure |
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Departure 2 |
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7.a. |
Departure Date |
(mm/dd/yyyy) ► |
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7.b. |
Return Date |
(mm/dd/yyyy) ► |
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7.c. |
Reason for Departure |
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8.Have you left the United States without advance parole on
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or after August 15, 2012? |
Yes |
No |
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9.a. |
What country issued your last passport? |
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9.b. |
Passport Number |
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9.c. |
Passport Expiration Date |
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10.Border Crossing Card Number (if any)
Part 3. For Initial Requests Only
1.I initially arrived and established residence in the U.S.
prior to 16 years of age. |
Yes |
No |
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2.Date of Initial Entry into the United States (on or about)
(mm/dd/yyyy) ►
3.Place of Initial Entry into the United States
Form |
Page 3 of 7 |
Part 3. For Initial Requests Only (continued)
4.Immigration Status on June 15, 2012 (e.g., No Lawful Status, Status Expired, Parole Expired)
5.a. Were you EVER issued an |
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(Form |
Yes |
No |
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5.b. If you answered "Yes" to Item Number 5.a., provide your Form
►
5.c. If you answered "Yes" to Item Number 5.a., provide the date your authorized stay expired, as shown on Form
(mm/dd/yyyy) ►
Education Information
6.Indicate how you meet the education guideline (e.g., Graduated from high school, Received a general educational development (GED) certificate or equivalent
7.Name, City, and State of School Currently Attending or Where Education Received
8.Date of Graduation (e.g., Receipt of a Certificate of Completion, GED certificate, other equivalent state- authorized exam) or, if currently in school, date of last
attendance. (mm/dd/yyyy) ►
Military Service Information
9.Were you a member of the U.S. Armed Forces or U.S.
Coast Guard? |
Yes |
No |
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If you answered "Yes" to Item Number 9., you must provide responses to Item Numbers 9.a. - 9.d.
9.a. Military Branch
9.b. |
Service Start Date (mm/dd/yyyy) ► |
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9.c. |
Discharge Date (mm/dd/yyyy) ► |
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9.d. |
Type of Discharge |
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Part 4. Criminal, National Security, and Public
Safety Information (For Initial and Renewal Requests)
If any of the following questions apply to you, use Part 8. Additional Information to describe the circumstances and include a full explanation.
1.Have you EVER been arrested for, charged with, or convicted of a felony or misdemeanor, including incidents handled in juvenile court, in the United States? Do not include minor traffic violations unless they were alcohol-
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Yes |
No |
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If you answered “Yes,” you must include a certified court disposition, arrest record, charging document, sentencing record, etc., for each arrest, unless disclosure is prohibited under state law.
2.Have you EVER been arrested for, charged with, or convicted of a crime in any country other than the United
States? |
Yes |
No |
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If you answered "Yes," you must include a certified court disposition, arrest record, charging document, sentencing record, etc., for each arrest.
3.Have you EVER engaged in, do you continue to engage in, or plan to engage in terrorist activities?
Yes No
4.Are you NOW or have you EVER been a member of a
gang? |
Yes |
No |
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5.Have you EVER engaged in, ordered, incited, assisted, or otherwise participated in any of the following:
5.a. Acts involving torture, genocide, or human trafficking?
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Yes |
No |
5.b. |
Killing any person? |
Yes |
No |
5.c. |
Severely injuring any person? |
Yes |
No |
5.d. |
Any kind of sexual contact or relations with any person |
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who was being forced or threatened? |
Yes |
No |
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6.Have you EVER recruited, enlisted, conscripted, or used any person to serve in or help an armed force or group
while such person was under age 15? |
Yes |
No |
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7.Have you EVER used any person under age 15 to take part in hostilities, or to help or provide services to people
in combat? |
Yes |
No |
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Form |
Page 4 of 7 |
Part 5. Statement, Certification, Signature, and Contact Information of the Requestor (For Initial
and Renewal Requests)
NOTE: Select the box for either Item Number 1.a. or 1.b.
1.a. I can read and understand English, and have read and understand each and every question and instruction on this form, as well as my answer to each question.
1.b. The interpreter named in Part 6. has read to me each and every question and instruction on this form, as well as my answer to each question, in
, a language in which I am fluent. I understand each and every question and instruction on this form as translated to me by my interpreter, and have provided true and correct responses in the language indicated above.
Requestor's Certification
I certify, under penalty of perjury under the laws of the United States of America, that the foregoing is true and correct and that copies of documents submitted are exact photocopies of unaltered original documents. I understand that I may be required to submit original documents to U.S. Citizenship and Immigration Services (USCIS) at a later date. I also understand that knowingly and willfully providing materially false information on this form is a federal felony punishable by a fine, imprisonment up to 5 years, or both, under 18 U.S.C. section 1001. Furthermore, I authorize the release of any information from my records that USCIS may need to reach a determination on my deferred action request.
2.a. Requestor's Signature
2.b. Date of Signature (mm/dd/yyyy) ►
Requestor's Contact Information
3.Requestor's Daytime Telephone Number
4.Requestor's Mobile Telephone Number
5.Requestor's Email Address
Part 6. Contact Information, Certification, and Signature of the Interpreter (For Initial and
Renewal Requests)
Interpreter's Full Name
Provide the following information concerning the interpreter: 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
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3.d. |
State |
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3.e. ZIP Code |
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3.f. |
Province |
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3.g. |
Postal Code |
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3.h. |
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Interpreter's Contact Information
4.Interpreter's Daytime Telephone Number
5.Interpreter's Email Address
Form |
Page 5 of 7 |
Part 6. Contact Information, Certification, and
Signature of the Interpreter (For Initial and
Renewal Requests) (continued)
Interpreter's Certification
I certify that: |
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I am fluent in English and |
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is the same language provided in Part 5., Item Number 1.b.;
I have read to this requestor each and every question and instruction on this form, as well as the answer to each question, in the language provided in Part 5., Item Number 1.b.; and
The requestor has informed me that he or she understands each and every instruction and question on the form, as well as the answer to each question.
6.a. Interpreter's Signature
6.b. Date of Signature (mm/dd/yyyy) ►
Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Request, If Other than the Requestor (For Initial and
Renewal Requests)
Preparer's Full Name
Provide the following information concerning the preparer: 1.a. Preparer's Family Name (Last Name)
1.b. Preparer's Given Name (First Name)
2.Preparer's Business or Organization Name
Preparer's Mailing Address
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3.d. |
State |
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3.f. |
Province |
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3.g. |
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3.h. |
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Preparer's Contact Information
4.Preparer's Daytime Telephone Number
5.Preparer's Fax Number
6.Preparer's Email Address
Preparer's Declaration
I declare that I prepared this Form
7.a. Preparer's Signature
7.b. Date of Signature (mm/dd/yyyy) ►
NOTE: If you need extra space to complete any item within this request, see the next page for Part 8. Additional
Information.
Form |
Page 6 of 7 |
Part 8. Additional Information (For Initial and
Renewal Requests)
If you need extra space to complete any item within this request, use the space below. You may also make copies of this page to complete and file with this request. Include your name and
4.a. Page Number 4.b. Part Number 4.c. Item Number
4.d.
Full Legal Name
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
2.
► A-
3.a. Page Number 3.b. Part Number 3.c. Item Number
3.d.
5.a. Page Number 5.b. Part Number 5.c. Item Number
5.d.
Form |
Page 7 of 7 |