Form I-290B Notice of Appeal or Motion

Notice of Appeal or Motion

USCIS
Form I-290B

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

For
USCIS
Use
Only

Reloc Sent

OMB No. 1615-0095
Expires 08/31/2021

Receipt

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Remarks

DRAFT

Reloc Rec'd

Resubmitted
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Select this box if
Form G-28 is
attached.

To be completed by an
attorney or accredited
representative.

Attorney State Bar Number

Attorney or Accredited Representative
USCIS Online Account Number

NOT FOR

Please visit www.uscis.gov/i-290b/jurisdiction for information on the immigration benefit types that are eligible for an appeal
or motion using this form.
► START HERE - Type or print in black ink.
If you do not properly complete this form or fail to submit required documents listed in the Instructions, we may dismiss or reject your
appeal or motion.

PRODUCTION

Part 1. Information About the Applicant or
Petitioner

If a business or organization is filing this appeal or motion, skip
to Item Number 3. and do not complete Item Numbers 1. or 2.
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)

Mailing Address (or Military APO/FPO Address)

6.a. In Care Of Name

(USPS ZIP Code Lookup)

6.b. Street Number
and Name
6.c.

Apt.

Ste.

08/19/2020

Flr.

6.d. City or Town

1.c. Middle Name

6.e. State

2.

Date of Birth (mm/dd/yyyy)

3.

Business or Organization Name

6.f.

ZIP Code

6.g. Province
6.h. Postal Code

4.

Alien Registration Number (A-Number)

6.i.

Country

► A5.

USCIS Online Account Number
►

Form I-290B 08/15/20

Page 1 of 6

I am filing a motion.

Part 1. Information About the Applicant or
Petitioner (continued)

2.a.

I am filing a motion to reopen. I have attached a
brief and/or additional evidence.

Alternate or Safe Mailing Address

2.b.

I am filing a motion to reconsider. I have attached a
brief.

DRAFT

If you are filing an appeal or motion related to a decision on a
Violence Against Women Act (VAWA) petition, human
trafficking victim (T nonimmigrant) application, or victim of a
qualifying crime (U nonimmigrant) petition, and you do not
want USCIS to send notices about the appeal or motion to your
home, you may provide a safe mailing address. If you are filing
an appeal or motion related to a decision in a Special Immigrant
Juvenile petition, you may provide an alternate mailing address.
7.a. In Care Of Name (if any)

7.b. Street Number
and Name
7.c.

Apt.

Ste.

2.c.

3.

I am filing a motion to reopen and a motion to
reconsider. I have attached a brief and/or additional
evidence.

Immigration Form That is the Subject of This Appeal or
Motion (for example, Form I-140, I-360, I-129, I-485,
I-601) (list only one form number)

NOT FOR

Flr.

4.

Receipt Number for the Application, Petition, or Other
Request (list only one Receipt Number)

5.

Requested Immigrant or Nonimmigrant Classification
(for example, H-1B, R-1, O-1, EB-1, EB-2)

6.

Date of the Unfavorable Decision (mm/dd/yyyy)

7.d. City or Town
7.e. State
7.g. Province
7.h. Postal Code
7.i.

7.f.

ZIP Code

PRODUCTION
7.

Office That Issued the Unfavorable Decision

Country

Part 3. Basis for the Appeal or Motion
Part 2. Information About the Appeal or Motion

You must provide a statement regarding the basis for your
appeal or motion in the space provided on the next page. If
you need additional space to provide your explanation, use Part
7. Additional Information or a separate sheet of paper.

08/19/2020

Please indicate whether you are filing an appeal to the
Administrative Appeals Office (AAO) or a motion. You cannot
file both an appeal and a motion on a single form. If you select
both an appeal and a motion, we may dismiss or reject your
filing.

NOTE: DO NOT use this form to file an appeal with the
Board of Immigration Appeals (BIA). You must instead use
Form EOIR-29.
I am filing an appeal to the AAO.
1.a.

I have attached a brief and/or additional evidence.

1.b.

I will submit a brief and/or additional evidence
directly to the AAO within 30 calendar days of filing
this appeal.

1.c.

I will not be submitting any brief or additional
evidence in support of this appeal.

Form I-290B 08/15/20

Appeal: Provide a statement that specifically identifies an
erroneous conclusion of law or statement of fact in the decision
you are appealing. You MUST provide this information with
your Form I-290B even if you intend to submit a brief later.
NOTE: Your appeal must address all grounds of
ineligibility identified in the unfavorable decision. If you do
not address an issue in a statement on this form or in a
supporting brief, we may deem it waived for the appeal. A
waived ground of ineligibility may be the sole basis for a
dismissed appeal.
Motion to Reopen: A motion to reopen must state new facts
and must be supported by documentary evidence demonstrating
eligibility for the requested immigration benefit at the time you
filed the application or petition.
Motion to Reconsider: A motion to reconsider must state the
reasons for reconsideration and must be supported by any
pertinent precedent decisions to establish that the decision was
based on an incorrect application of law or service policy, if
applicable. A motion to reconsider must also establish that the
decision was incorrect based on the evidence of record at the
time of the decision.
Page 2 of 6

Part 3. Basis for the Appeal or Motion
(continued)

7.

Title

Applicant's or Petitioner's Certification

DRAFT
Part 4. Applicant's or Petitioner's Statement,
Contact Information, Certification, and Signature
NOTE: Read the Penalties section of the Form I-290B
Instructions before completing this part.

If you are filing an appeal or motion based on an application or
petition filed by an individual (not a business or
organization), complete this section:

Applicant's or Petitioner'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.b.

If filing this petition on behalf of someone else, I certify that I
am authorized to do so by that person.

PRODUCTION

Applicant's or Petitioner's Signature

8.a. Applicant's or Petitioner's Signature

The interpreter named in Part 5. read to me every
question and instruction on this form, and my answer
to every question, in
,

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

Section B

08/19/2020

At my request, the preparer named in Part 6.
prepared this form for me based only upon
information I provided or authorized.

Applicant's or Petitioner's Contact Information
3.

Daytime Telephone Number

4.

Mobile Telephone Number (if any)

5.

I certify, under penalty of perjury, that I provided or authorized
all of the information in my form. I understood all of the
information contained in, and submitted with, my form, and that
all of this information is complete, true, and correct.

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.

a language in which I am fluent, and I understood
everything.
2.

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 law.

NOT FOR

Section A

1.a.

Copies of any documents I have submitted are exact photocopies
of unaltered, original documents, and I understand that USCIS
may require that I submit original documents to USCIS at a later
date. Furthermore, I authorize the release of any information
from any and all of my records that USCIS may need to
determine my eligibility for the immigration benefit that I seek.

If you are filing an appeal or motion based on a petition filed
by a business or organization (not an individual), complete
this section:

Petitioner'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.

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
,

Email Address (if any)

a language in which I am fluent, and I understood all
of this information as interpreted.

If an authorized signatory is completing Part 4., Section A.,
provide the following information:
6.a. Family Name
(Last Name)
6.b. Given Name
(First Name)

2.

At my request, the preparer named in Part 6.
prepared this form for me based only upon
information I provided or authorized.

6.c. Middle Name
Form I-290B 08/15/20

Page 3 of 6

Part 4. Applicant's or Petitioner's Statement,
Contact Information, Certification, and Signature
(continued)
Petitioner's Contact Information

Signature of Authorized Signatory
8.a.

Petitioner's Signature

DRAFT

Provide the following information about the petitioner's
authorized signatory.
3.a. Family Name
(Last Name)
3.b. Given Name
(First Name)

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

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

Provide the following information about the interpreter.

Interpreter's Full Name

3.c. Middle Name

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

NOT FOR

4.

Title

5.

Daytime Telephone Number

6.

Mobile Telephone Number (if any)

7.

Email Address (if any)

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

2.

Interpreter's Business or Organization Name (if any)

Interpreter's Mailing Address

PRODUCTION
3.a. Street Number
and Name

Petitioner's Certification

3.b.

Copies of any documents submitted are exact photocopies of
unaltered, original documents, and I understand that, as the
petitioner, I may be required to submit original documents to
USCIS at a later date.

3.c. City or Town

Apt.

3.d. State

Ste.

Flr.

3.e. ZIP Code

08/19/2020

I authorize the release of any information contained in this form,
in supporting documents, and in the petitioning organization's
USCIS records, to USCIS or other entities and persons where
necessary to determine eligibility for the immigration benefit
sought or where authorized by law. I recognize the authority of
USCIS to conduct audits of this form using publicly available
open source information. I also recognize that any supporting
evidence submitted in support of this form may be verified by
USCIS through any means determined appropriate by USCIS,
including but not limited to, on-site compliance reviews.

3.f.

Province

3.g. Postal Code
3.h. Country

Interpreter's Contact Information
4.

Interpreter's Daytime Telephone Number

If filing this form on behalf of an organization, I certify that I
am authorized to do so by the organization.

5.

Interpreter's Mobile Telephone Number (if any)

I certify, under penalty of perjury, that I provided or authorized
all of the information in my form. I understood all of the
information contained in, and submitted with, my appeal or
motion, and all of this information is complete, true, and correct.

6.

Interpreter's Email Address (if any)

Form I-290B 08/15/20

Page 4 of 6

Preparer's Contact Information

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

4.

Preparer's Daytime Telephone Number

5.

Preparer's Mobile Telephone Number (if any)

6.

Preparer's Email Address (if any)

Interpreter's Certification

DRAFT

I certify, under penalty of perjury, that:
I am fluent in English and

,

which is the same language specified in Part 4., Item Number
1.b. in Section A or Section B, and I have read to this applicant
or petitioner in the identified language every question and
instruction on this form and his or her answer to every question.
The applicant or petitioner informed me that he or she
understands every instruction, question, and answer on the
form, including the Applicant's or Petitioner's Certification,
and has verified the accuracy of every answer.

Preparer's Statement
7.a.

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

NOT FOR

Interpreter's Signature

7.b.

7.a. Interpreter's Signature

I am an attorney or accredited representative and my
representation of the applicant or petitioner in this case
does not extend beyond the
extends
preparation of this form.

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

Preparer's Certification

PRODUCTION

Part 6. Contact Information, Declaration, and
Signature of the Person Preparing This Form,
if Other Than the Applicant or Petitioner
Provide the following information about the preparer.

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

By my signature, I certify, under penalty of perjury, that I
prepared this form at the request of the applicant or petitioner.
The applicant or petitioner 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 Applicant's or Petitioner's Certification, and
that all of this information is complete, true, and correct. I
completed this form based only on information that the
applicant or petitioner provided to me or authorized me to
obtain or use.

08/19/2020

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

Preparer's Signature

2.

Preparer's Business or Organization Name (if any)

8.a. Preparer's Signature

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

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.

3.e. ZIP Code

Province

3.g. Postal Code
3.h. Country

Form I-290B 08/15/20

Page 5 of 6

5.a. Page Number

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 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.

5.b. Part Number 5.c. Item Number

5.d.

DRAFT

1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
2.

A-Number

3.a. Page Number

► A-

NOT FOR

3.b. Part Number

3.c. Item Number

3.d.

6.a. Page Number

6.b. Part Number 6.c. Item Number

6.d.

PRODUCTION
08/19/2020
4.a. Page Number

4.d.

Form I-290B 08/15/20

4.b. Part Number 4.c. Item Number

7.a. Page Number

7.b. Part Number 7.c. Item Number

7.d.

Page 6 of 6