Form I-694 Notice of Appeal of Decision Under Section 210 oe 245A o

OMB No. 1615-0034; Expires 06/30/07

I-694, Notice of Appeal of Decision
Under Section 210 or 245A

Department of Homeland Security
U.S. Citizenship and Immigration Services

For USCIS use Only
Fee Stamp

Action Block

APPELLANT - START HERE: Please type or print in black ink.
File Number:

In the Matter of:

Application for:

APermanent Residence
Temporary Residence
Waiver of Grounds of Inadmissibility

I hereby appeal to the USCIS Director from the decision, dated

in the above entitled case.

My written brief or statement is attached.
I waive the right to submit a written brief or statement.
I will submit a brief within 30 calendar days.

Summarize the reasons for this appeal.

Appellant (or Attorney or Representative): Please complete the following.
Name (Type or Print in Black Ink.)
Address ( Street Name and Number)
(City or Town)

Telephone Number With Area Code
(State)

(Zip Code)

Title or Relationship to Appellant, If Other Than Appellant.

Signature

Date:
Form I-694 (Rev. 10/26/05) Y

Instructions
Filing an Appeal.
This form must be mailed to the address given on the "Notice of Denial" and must be received within 30 days of the date
noted on the U. S. Citizenship and Immigration Services (USCIS) letter of denial. The 30-day period for submitting an
appeal begins three days after the notice of denial is mailed. No extensions will be granted.

Briefs.
A brief in support of an appeal is not required, but may be desired. If a brief is to be submitted, it may be provided with
this appeal form or received up to 30 calendar days from the date of receipt of the appeal form at the USCIS Service
Center.

Oral Argument.
Oral argument before the USCIS Director or an officer designated by the Director may be requested by a letter attached to
this notice. The letter must set forth the reasons oral argument is desired in support of or in place of a brief. Oral
argument will be denied in any case where the appeal is found to be frivolous, where oral argument will serve no useful
purpose, or where written material or representations will appropriately serve the interests of the appellant. If oral
argument is granted, it must be held in person. The officer to whom the appeal is taken will designate in writing the time,
date and place of the oral argument. Oral argument in any case will be limited to 15 minutes, unless justification and
arrangements for additional time are made in advance.

Counsel.
In presenting and prosecuting this appeal, the appellant may, if he or she desires, be represented at no expense to the U.S.
Government by counsel or a duly authorized representative.

Fee.
A fee of $110.00 must be paid for filing this appeal. The fee will not be refunded regardless of the action taken on the
appeal. A separate cashier's check or money order must be submitted for each application. All fees must be submitted
in the exact amount. The fee must be in the form of a cashier's check or money order. No cash or personal checks will
be accepted. The cashier's check or money order must be payable to the Department of Homeland Security. Do not use
the initials USDHS or DHS.
How to Check If the Fee Is Correct.

The fee on this form is current as of the edition date appearing in the lower right corner of this page. However, because
USCIS forms change periodically, you can verify if the fee is correct by following one of the steps below:
Visit our website at www.uscis.gov and scroll down to "Forms and E-Filing" to check the appropriate fee, or
Review the Fee Schedule included in your form package, if you called us to request the form, or
Telephone our National Customer Service Center at 1-800-375-5283 and ask for the fee information.

USCIS Forms and Information.
To order USCIS forms, call our toll-free forms line at 1-800-870-3676. If you need information on immigration laws,
regulations or procedures, call our National Customer Service Center at 1-800-375-5283 or visit our internet website at
www.uscis.gov.

Need to Make an Appointment at a USCIS Office? Use InfoPass.
As an alternative to waiting in line for assistance at your local USCIS office, you can now schedule an appointment
through our internet-based system, InfoPass. To access the system, visit our website at www.uscis.gov. Use the InfoPass
appointment scheduler and follow the screen prompts to set up your appointment. InfoPass generates an electronic
appointment notice that appears on the screen. Print the notice and take it with you to your appointment. The notice gives
the time and date of your appointment, along with the address of the USCIS office.

Reporting Burden.
A person is not required to respond to a collection of information unless it displays a currently valid OMB control
number. This collection of information is estimated to average 30 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the
collection of information. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden to the: U.S. Citizenship and Immigration Services,
Regulations Management Division, 111 Massachusetts Avenue, N.W., Washington, DC 20529; OMB No. 1615-0034.Do
not mail your completed application to this address.
Form I-694 (Rev. 10/26/05) Y Page 2