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pdfDRAFT - Not For ProductionI-829, Petition by Entrepreneur
OMB No. 1615-0045; Expires 04/30/2011
Department of Homeland Security
U.S. Citizenship and Immigration Services
to Remove Conditions
Do not write in this block - For USCIS use only (Except G-28 Block Below)
Applicant Interviewed
Action Block
Fee Receipt
To be completed by Attorney or Representative, if any
G-28 is attached
Attorney's State License No.
Remarks:
START HERE - Type or print in black ink.
Part 1.
Information About You
Form I-526 Receipt Number
A # (if any)
Given
Name
Family
Name
Address:
Middle
Name
In care of
Number and
Street
Apt. #
State or
Province
City
Daytime
Phone #
Zip/Postal
Code
Country
U.S. Social Security #
(if any)
Country
of Birth
Date of Birth
(mm/dd/yyyy)
Since becoming a conditional permanent resident, have you ever been arrested, cited, charged, indicted, convicted, fined, or imprisoned
for breaking or violating any law or ordinance (excluding traffic regulations), or committed any crime for which you were not arrested?
(If yes, explain on separate sheet(s) of paper, including disposition, if any.)
Yes
No
Part 2. Basis for Petition (Check one)
a.
b.
c.
d.
e.
My conditional permanent residence is based on an investment in a commercial enterprise.
Reserved.
Reserved.
I am a conditional permanent resident spouse or child of an entrepreneur, and I am unable to be included in a Petition by
Entrepreneur to Remove Conditions (Form I-829) filed by my conditional resident spouse or parent.
I am a conditional permanent resident spouse or child of an entrepreneur who is deceased.
Part 3. Information About Your Husband or Wife
Family
Name
Gender
Given
Name
Male
Female
Date of Birth
(mm/dd/yyyy)
Other names used (including maiden name or aliases)
A#
Current
(If any)
Immigration Status
Middle
Name
Date of Marriage
(mm/dd/yyyy)
Is your current immigration status based
on the petitioner's current status?
Yes
No
RECEIVED: ________________ RESUBMITTED:__________________________ RELOCATED: SENT _____________________REC'D ____________________
Form I-829 (Rev. 08/20/10)Y
DRAFT - Not For Production
Part 4. Children
(List all your children. Attach another sheet(s) of paper, if necessary.)
Family
Name
A#
(if any)
Given
Name
Current Immigration
Status
A#
(if any)
A#
(if any)
A#
(if any)
Living with
you?
Living with
you?
Date of Birth
(mm/dd/yyyy)
Given
Name
Yes
No
Yes
No
Middle
Name
Current
Immigration Status
Date of Birth
(mm/dd/yyyy)
Given
Name
Living with
you?
Yes
No
Middle
Name
Current
Immigration Status
Family
Name
No
Middle
Name
Current
Immigration Status
Family
Name
A#
(if any)
Date of Birth
(mm/dd/yyyy)
Given
Name
Family
Name
Yes
Middle
Name
Current
Immigration Status
Family
Name
Living with
you?
Date of Birth
(mm/dd/yyyy)
Given
Name
Family
Name
A#
(if any)
Middle
Name
Date of Birth
(mm/dd/yyyy)
Given
Name
Living with
you?
Yes
Living with
you?
Yes
No
Middle
Name
Current
Immigration Status
Date of Birth
(mm/dd/yyyy)
No
Part 5. Information About Your Commercial Enterprise
Type of Enterprise (Check one):
New commercial enterprise resulting from the creation of a new business.
New commercial enterprise resulting from the reorganization of an existing business.
New commercial enterprise resulting from a capital investment in an existing business.
Kind of Business (Be as specific as possible):
Date Business Established (mm/dd/yyyy)
Amount of
Initial Investment
Date of Initial Investment (mm/dd/yyyy)
% of Enterprise You Own
Number of full-time employees in enterprise in United States (excluding you, your spouse, sons, and daughters):
At the time of your initial investment:
Presently:
Difference:
How many of these new jobs were created by your investment?
Form I-829 (Rev. 08/20/10)Y Page 2
DRAFT - Not For Production
Part 5. Information About Your Commercial Enterprise
(continued)
Subsequent Investment in the Enterprise:
Date of Investment
Amount of Investment
Type of Investment
Provide the gross and net incomes generated annually by the commercial enterprise since your initial investment. Include all income
generated up to date during the present year.
Year
Gross Income
Net Income
Has your commercial enterprise filed for bankruptcy, ceased business operations, or have any changes in its business organization
No
or ownership occurred since the date of your initial investment?
Yes (Explain on separate sheet)
Has your commercial enterprise sold any corporate assets, shares, property, or had any capital withdrawn since the date of your initial
investment?
Yes (Explain on separate sheet)
No
Part 6. Signature (Read the information on penalties in the instructions before completing this section.)
I certify, under penalty of perjury under the laws of the United States of America, that this petition and the evidence submitted with it is
all true and correct. I further certify that the investment was made in accordance with the laws of the United States and was not for the
purpose of evading United States immigration laws. I also authorize the release of any information from my records that the U.S.
Citizenship and Immigration Services needs to determine eligibility for the benefit being sought.
Signature of Applicant
Print Name
Date
NOTE: If you do not completely fill out this form or fail to submit any required documents listed in the instructions, you may
not be found eligible for the requested benefit and this petition may be denied.
Part 7. Signature of Person Preparing Form, If Other Than Above
I declare that I prepared this petition at the request of the above person and it is based on all information of which I have knowledge.
Signature
Print Name
Date
Firm Name and Address (Include Telephone Number with Area Code and E-Mail Address.)
Form I-829 (Rev. 08/20/10)Y Page 3
File Type | application/pdf |
File Modified | 2010-08-18 |
File Created | 2007-08-28 |