I-942 Form - Table of Changes

TABLE OF CHANGES – FORM

Form I-942, Request for Reduced Fee

OMB Number: 1615-0133

08/03/2023

Reason for Revision: Limited Rev

Project Phase: OMBReview

Legend for Proposed Text:

• Black font = Current text

• Red font = Changes

Expires 12/31/2023

Edition Date 12/02/2021

Current Page Number and Section	Current Text	Proposed Text
Page 1, Part 2. Information About Family Member Filing This Request With You	[Page 1] Part 2. Information About Family Member Filing This Request With You 1. In the table below, add the family members filing this request with you [Table, 4 columns x 4 rows] Full Name A-Number (if any) Date of Birth Relationship to You	Part 2. Information About Family Member Filing This Request With You 1. In the table below, add the family members filing this request with you. [Table, 4 columns x 4 rows] Full Name A-Number (if any) Date of Birth Relationship to You
Pages 3-4, Part 4. Requestor’s Statement, Contact Information, Certification, and Signature	[Page 3] Part 4. Requestor’s Statement, Contact Information, Certification, and Signature NOTE: Read the Penalties section of the Form I-942 Instructions before completing this part. Each person applying for a reduced fee must complete, sign, and date Form I-942 and provide the required documentation. This includes family members identified in Part 2., Item Number 1. Signature fields for family members are at the end of this part. A legal guardian may sign the request on behalf of the applicant. USCIS rejects any Form I-942 that is not signed by all individuals requesting a reduced fee and may deny a request that does not provide the required documentation. If the information provided by the requestor in Part 4. is not applicable to a family member identified in Part 2., that individual should complete Part 5. Requestor’s Statement NOTE: Select the box for either Item A. or B. in Item Number 1. If applicable, select the box for Item Number 2. 1. Requestor's Statement Regarding the Interpreter A. I can read and understand English, and I have read and understand every question and instruction on this request, and my answer to every question. B. The interpreter named in Part 6. read to me every question and instruction on this request, and my answer to every question in [Fillable field], a language in which I am fluent, and I understood everything. 2. Requestor's Statement Regarding the Preparer At my request, the preparer named in Part 7., [Fillable field] prepared this request for me based only upon information I provided or authorized. Requestor’s Contact Information 3. Requestor's Daytime Telephone Number 4. Requestor's Mobile Telephone Number (if any) 5. Requestor’s Email Address (if any) Requestor’s Certification 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 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 request, 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. [Page 4] I understand that USCIS may require me to appear for an appointment to take my biometrics (fingerprints, photograph, and/or signature) and, at that time, if I am required to provide biometrics, I will be required to sign an oath reaffirming that: 1) I reviewed and provided or authorized all of the information in my request; 2) I understood all of the information contained in, and submitted with, my request; and 3) All of this information was complete, true, and correct at the time of filing. I certify, under penalty of perjury, that I provided or authorized all of the information in my request, I understand all of the information contained in, and submitted with, my request, and that all of this information is complete, true, and correct. Requestor’s Signature 6. Requestor’s Signature Date of Signature (mm/dd/yyyy) Family Members’ Signature NOTE: Each family member must type or print their full name and sign in the spaces below. You can find additional family members' signature spaces in Item Numbers 7. - 10. below. All family members identified in Part 2., Item Number 1. must sign and date Form I-942. I certify that the information provided by the requestor in Part 4. applies to me. 7. Family Member 1 Family Member’s Name Family Member’s Signature Date of Signature (mm/dd/yyyy) 8. Family Member 2 Family Member’s Name Family Member’s Signature Date of Signature (mm/dd/yyyy) 9. Family Member 2 Family Member’s Name Family Member’s Signature Date of Signature (mm/dd/yyyy) 10. Family Member 2 Family Member’s Name Family Member’s Signature Date of Signature (mm/dd/yyyy) NOTE TO ALL REQUESTORS: If you do not completely fill out this request or fail to submit required documents listed in the Instructions, USCIS may deny your request.	Part 4. Requestor’s Contact Information, Certification, and Signature [delete] Requestor’s Contact Information Provide your daytime telephone number, mobile telephone number (if any), and email address (if any). 1. Requestor’s Daytime Telephone Number 2. Requestor’s Mobile Telephone Number (if any) 3. Requestor’s Email Address (if any) Requestor’s Certification and Signature I certify, under penalty of perjury, that I provided or authorized all of the responses and information contained in and submitted with my request, I read and understand or, if interpreted to me in a language in which I am fluent by the interpreter listed in Part 5., understood, all of the responses and information contained in, and submitted with, my request and that all of the responses and the information are complete, true, and correct. Furthermore, I authorize the release of any information from any and all of my records that USCIS may need to determine my eligibility for an immigration request and to other entities and persons where necessary for the administration and enforcement of U.S. immigration law. [delete] 4. Requestor’s Signature Date of Signature (mm/dd/yyyy) [delete]
Page 5, Part 5. Family Member’s Statement, Contact Information, Certification, and Signature	[Page 5] Part 5. Family Member’s Statement, Contact Information, Certification, and Signature NOTE: Read the information on penalties in the Penalties section of the Form I-942 Instructions before completing this part. If the information provided by the requestor in Part 4. is not applicable to a family member identified in Part 2., Item Number 1, (for example, the family member used an interpreter or speaks a different language) that individual should complete Part 5. USCIS rejects any Form I-942 that is not signed by all individuals requesting a reduced fee. Select the box for either Item A. or B. in Item Number 1. If applicable, select the box for Item Number 2. 1. Family Member's Statement Regarding the Interpreter for: [fillable field] A. [] A. I can read and understand English, and have read and understand every question, instruction, and answer on this request. B. [] B. The interpreter named in Part 6. has also read to me every question, instruction, and answer on this request in [Fillable Field], a language in which I am fluent. I understand every question and instruction on this request as translated to me by my interpreter, and have provided complete, true, and correct responses in the language indicated above. 2. Family Member's Statement Regarding the Preparer for: [Fillable field] I have requested the services of and consented to [Fillable Field], who [] is [] is not an attorney or accredited representative, preparing this request for me. Family Member’s Contact Information 3. Family Member’s Daytime Telephone Number 4. Family Member's Mobile Telephone Number (if any) 5. Family Member's Email Address (if any) Family Member’s Certification I certify, under penalty of perjury, that the information in my request and any document submitted with my request were provided by me and are complete, true, and correct. 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. Family Member’s Signature 6. Family Member's Signature Date of Signature (mm/dd/yyyy) NOTE TO ALL FAMILY MEMBERS: If you do not completely fill out this request or fail to submit required documents listed in these Instructions, USCIS may deny your request.	[delete]
Page 6, Part 6. Interpreter’s Contact Information, Certification, and Signature	[Page 6] Part 6. Interpreter’s Contact Information, Certification, and Signature 1. Did any person filing this request use an interpreter? Yes, (complete this section). No, (skip to Part 7.) Yes/No 2. Was the same interpreter used for all individuals requesting a reduced fee (as listed in Part 2.) Yes/No NOTE for Family Members: If you used a different interpreter than the one used by the requestor, make additional copies of Part 6., provide the following information, indicate the family member for whom he or she interpreted, and include the pages with your completed Form I-942. Provide the following information about the interpreter. Interpreter’s Full Name 3. Interpreter's Family Name (Last Name) Interpreter's Given Name (First Name) 4. Interpreter's Business or Organization Name (if any) Interpreter's Mailing Address 5. Street Number and Name [] Apt. [] Ste. [] Flr. Number [Fillable field] City or Town State Zip Code Province Postal Code Country Interpreter’s Contact Information 6. Interpreter's Daytime Telephone Number 7. Interpreter's Mobile Telephone Number (if any) 8. Interpreter's Email Address (if any) Interpreter’s Certification I certify, under penalty of perjury, that: I am fluent in English and [fillable field], which is the same language specified in Part 4., Item B. in Item Number 1., and I have read to this requestor in the identified language every question and instruction on this request and his or her answer to every question. The requestor informed me that he or she understands every instruction, question, and answer on the request, including the Requestor's Certification, and has verified the accuracy of every answer. Interpreter’s Signature 9. Interpreter’s Signature Date of Signature (mm/dd/yyyy)	Part 5. Interpreter’s Contact Information, Certification, and Signature [delete] Interpreter’s Full Name 1. Interpreter’s Family Name (Last Name) Interpreter’s Given Name (First Name) 2. Interpreter’s Business or Organization Name [delete] Interpreter’s Contact Information 3. Interpreter’s Daytime Telephone Number 4. Interpreter’s Mobile Telephone Number (if any) 5. Interpreter’s Email Address (if any) Interpreter’s Certification and Signature I certify, under penalty of perjury, that I am fluent in English and [Fillable language field], and I have interpreted every question on the request and Instructions and interpreted the requestor’s answers to the questions in that language, and the requestor informed me that they understood every instruction, question, and answer on the request. [delete] 6. Interpreter’s Signature Date of Signature (mm/dd/yyyy)
Page 7, Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Request, if Other Than the Requestor	[Page 7] Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Request, if Other Than the Requestor 1. Did any person prepare this request on your behalf? Yes, (complete this section). No, (skip). Yes/No 2. Was the same preparer used for all individuals requesting a reduced fee (as listed in Part 2.) Yes/No NOTE for Family Members: If you used a different preparer than the one used by the requestor, provide the following information, and include the pages with your completed Form I-942. Provide the following information about the preparer. Preparer’s Full Name 3. Preparer’s Family Name (Last Name) Preparer's Given Name (First Name) 4. Preparer's Business or Organization (if any) Preparer’s Mailing Address 5. Street Number and Name [] Apt. [] Ste. [] Flr. Number [Fillable field] City or Town State Zip Code Province Postal Code Country Preparer’s Contact Information 6. Preparer’s Daytime Telephone Number 7. Preparer’s Mobile Telephone Number (if any) 8. Preparer’s Email Address (if any) Preparer’s Statement 9. A. I am not an attorney or accredited representative but have prepared this request on behalf of the requestor and with the requestor’s consent. B. I am an attorney or accredited representative and my representation of the requestor in this case extends/does not extend beyond the preparation of this request. NOTE: If you are an attorney or accredited representative, you may be obliged to submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative, or G-28I, Notice of Entry of Appearance as Attorney In Matters Outside the Geographical Confines of the United States, with this request. [Page 8] Preparer’s Certification By my signature, I certify, under penalty of perjury, that I prepared this request at the request of the requestor. The requestor then reviewed this completed request and informed me that he or she understands all of the information contained in, and submitted with, his or her request, including the Requestor's Certification, and that all of this information is complete, true, and correct. I completed this request based only on information that the requestor provided to me or authorized me to obtain or use. Preparer’s Signature 8. Preparer’s Signature Date of Signature (mm/dd/yyyy)	Part 6. Contact Information, Declaration, and Signature of the Person Preparing this Request, if Other Than the Requestor [delete] Preparer’s Full Name 1. Preparer’s Family Name (Last Name) Preparer’s Given Name (First Name) 2. Preparer’s Business or Organization Name [delete] Preparer’s Contact Information 3. Preparer’s Daytime Telephone Number 4. Preparer’s Mobile Telephone Number (if any) 5. Preparer’s Email Address (if any) [delete] Preparer’s Certification and Signature I certify, under penalty of perjury, that I prepared this request for the requestor at their request and with express consent and that all of the responses and information contained in and submitted with the request are complete, true, and correct and reflects only information provided by the requestor. The requestor reviewed the responses and information and informed me that they understand the responses and information in or submitted with the request. [delete] 6. Preparer’s Signature Date of Signature (mm/dd/yyyy)
Page 9, Part 8. Additional Information	[Page 9] Part 8. Additional Information If you need extra space to provide any additional information within this request, 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 request 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. …	[Page 9] Part 7. Additional Information If you need extra space to provide any additional information within this request, 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 request 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. …

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