Form I-129F Petition for Alien Fiance(e)

USCIS
Form I-129F

Petition for Alien Fiancé(e)
Department of Homeland Security
U.S. Citizenship and Immigration Services

OMB No. 1615-0001
Expires 02/29/2012

Action Block

Fee Stamp

For USCIS Use Only
Case ID Number
A-Number
G-28 Number

DRAFT
NOT FOR
PRODUCTION
12/10/2012

The petition is approved for status
under Section 101(a)(5)(k). It is
valid for 4 months from the date
of action.

Extraordinary Circumstances Waiver

Approved

General Waiver

Approved
Denied

Mandatory Waiver

Reason

Approved
Denied

Relocated

Initial Receipt

Received
Sent

Resubmitted

Reason

Denied

Completed

AMCON:

Reason

Personal Interview

Remarks

Previously Forwarded
Field Investigation

Document Check
Yes (DOS disclosure to
the beneficiary required)

Approved
Returned

IMBRA
Applies?

No

► START HERE - Type or print in black ink.

Part 1. Information About You
1.a

Family Name
(Last Name)
1.b. Given Name
(First Name)

6.

Date of Birth

7.

Gender

8.

1.c. Middle Name

Widowed

Single

Divorced

9.a. Family Name
(Last Name)
9.b. Given Name
(First Name)

2.b. Street Number
and Name

Ste.

Flr.

9.c. Middle Name
10.

U.S. Social Security Number (if any)

2.d. City or Town
2.e. State

Female

Other Names Used

2.a. In Care of Name

2.c. Apt.

Male

Marital Status
Married

Your Mailing Address

(mm/dd/yyyy) ►

►

2.f.

Zip Code

Name of Prior Spouse 1
2.g. Postal Code

11.a. Family Name
(Last Name)
11.b. Given Name
(First Name)

2.h. Province
2.i.

Country

3.

Alien Registration Number (A-Number)

11.c. Middle Name
► A-

4.

5.

11.d. Date Marriage Ended
(mm/dd/yyyy) ►

City/Town/Village of Birth

Name of Prior Spouse 2

Country of Birth

12.a. Family Name
(Last Name)
12.b. Given Name
(First Name)

Form I-129F 12/10/12 N

Page 1 of 6

Part 1. Information About You (continued)
14.

12.c. Middle Name
12.d. Date Marriage Ended
(mm/dd/yyyy) ►
My citizenship was acquired through (Select only one box):
13.a.
13.b.
13.c.

Have you ever filed for this or any other alien fiancé(e) or
husband/wife before?
Yes

No

If you answered "Yes," provide the following for each alien
(attach additional sheets as necessary)

DRAFT
NOT FOR
PRODUCTION
12/10/2012
Birth in the United States

14.a. Alien Registration Number (A-Number)
► A-

Naturalization

Parents

13.d. Have you obtained a Certificate of Naturalization or a
Certificate of Citizenship in your name?
Yes
No
If "Yes," complete the following:
13.d.1. Certificate Number

14.b. Family Name
(Last Name)
14.c. Given Name
(First Name)

14.d. Middle Name

14.e. Date of Filing (mm/dd/yyyy) ►
14.f. City or Town

13.d.2. Place of Issuance

14.g. State

13.d.3. Date of Issuance
(mm/dd/yyyy) ►

14.h. Result

Part 2. Information About Your Alien Fiancé(e)
1.

Identify the classification sought for your beneficiary
(select one):

Other Information About Your Alien Fiancé(e)

4.

City/Town/Village of Birth

5.

Country of Birth

6.

Date of Birth

7.

Country of Citizenship

8.

Gender

9.

Marital Status
Married

K-1 Fiancé

K-3 Spouse

2.a. Family Name
(Last Name)
2.b. Given Name
(First Name)

2.c. Middle Name

(mm/dd/yyyy) ►

Alien Fiancé(e)'s Mailing Address
3.a. In Care of Name

3.b. Street Number
and Name
3.c. Apt.

Ste.

Flr.

3.d. City or Town
3.e. State

3.f.

3.g. Postal Code

Zip Code

3.i.

Widowed

Female

Single

Divorced

Other Names Used (Including Maiden Name)
10.a. Family Name
(Last Name)
10.b. Given Name
(First Name)
10.c. Middle Name
11.

3.h. Province

Male

Alien Registration Number (A-Number)
► A-

Country

Form I-129F 12/10/12 N

Page 2 of 6

Part 2. Information About Your Alien Fiancé(e) (continued)
12.

Complete the following for all children of your alien
fiancé(e) (if any).

U.S. Social Security Number (if any)
►

Child 1 of Alien Fiancé(e)
16.a. Family Name
(Last Name)
16.b. Given Name
(First Name)

Name of Prior Spouse 1
13.a. Family Name
(Last Name)
13.b. Given Name
(First Name)

DRAFT
NOT FOR
PRODUCTION
12/10/2012
16.c. Middle Name

13.c. Middle Name

13.d. Date Marriage Ended
(mm/dd/yyyy) ►

Country of Birth

18.

Date of Birth

(mm/dd/yyyy) ►

19.a. Street Number
and Name

Name of Prior Spouse 2
14.a. Family Name
(Last Name)
14.b. Given Name
(First Name)

19.b. Apt.

Ste.

Flr.

19.c. City or Town

14.c. Middle Name

19.d. State

14.d. Date Marriage Ended
(mm/dd/yyyy) ►
15.

17.

Has your fiancé(e) ever been in
the United States?

19.e. Zip Code

19.f. Postal Code

Yes

No

19.g. Province
19.h. Country

If your fiancé(e) is currently in the United States, complete
the following:
15.a. He or she last arrived as a: (visitor, student, exchange
alien, crewman, stowaway, temporary worker, without
inspection, etc.)

15.b. I-94 Arrival/Departure Record Number
►

Child 2 of Alien Fiancé(e)
20.a. Family Name
(Last Name)
20.b. Given Name
(First Name)

20.c. Middle Name
21.

Country of Birth

22.

Date of Birth

(mm/dd/yyyy) ►

15.c. Date of Arrival

15.d. Date authorized stay expired or will expire as shown on
I-94 or I-95.
(mm/dd/yyyy) ►

(mm/dd/yyyy) ►

23.a. Street Number
and Name

15.e. Passport Number

23.b. Apt.

15.f. Travel Document Number

23.c. City or Town

15.g. Country of Issuance for Passport or Travel Document

23.d. State

Ste.

Flr.

23.e. Zip Code

23.f. Postal Code
15.h. Expiration Date for Passport or Travel Document
(mm/dd/yyyy) ►

23.g. Province
23.h. Country

Form I-129F 12/10/12 N

Page 3 of 6

Part 2. Information About Your Alien Fiancé(e) (continued)
If your fiancé(e)'s native alphabet uses other than Roman
letters, write his or her name and address abroad in the
native alphabet.
31.a. Family Name
(Last Name)
31.b. Given Name
(First Name)

Child 3 of Alien Fiancé(e)
24.a. Family Name
(Last Name)
24.b. Given Name
(First Name)
24.c. Middle Name
25.

DRAFT
NOT FOR
PRODUCTION
12/10/2012
31.c. Middle Name

Country of Birth

Your fiancé(e)'s address abroad. (Native Alphabet)

26.

Date of Birth

32.a. Street Number
and Name

(mm/dd/yyyy) ►

32.b. Apt.

27.a. Street Number
and Name
27.b. Apt.

Ste.

Flr.

32.c. City or Town

Flr.

32.d. Postal Code

27.c. City or Town
27.d. State

Ste.

32.e. Province

27.e. Zip Code

32.f. Country

27.f. Postal Code

33.

27.g. Province

Is your fiancé(e) related to you?

Yes

No

33.a. If you are related, state the nature and degree of
relationship, e.g., third cousin or maternal uncle, etc.

27.h. Country

Address in the United States where your fiancé(e) intends to live.

34.

28.a. Street Number
and Name
28.b. Apt.

Ste.

Yes

Flr.

28.e. Zip Code

Your fiancé(e)'s address abroad.
29.a. Street Number
and Name
29.b. Apt.

Ste.

No

34.a. Describe the circumstances under which you met. If you
have not personally met each other, explain how the
relationship was established. If you met your fiancé(e) or
spouse though an international marriage broker, please
explain those circumstances in number 36. Explain in
detail any reasons you may have for requesting that the
requirement that you and your fiancé(e) must have met
should not apply to you.

28.c. City or Town
28.d. State

Has your fiancé(e) met and seen you within the 2-year
period immediately preceding the filing of this petition?

Flr.

29.c. City or Town
35.

29.d. Postal Code

Yes

29.e. Province
29.f. Country
30.

Daytime Phone Number

(

Did you meet your fiancé(e) or spouse through the
services of an international marriage broker?

)

Form I-129F 12/10/12 N

-

Extension

No

35.a. If you answered “Yes,” provide the Internet and/or Street
Address below. In additional, attach a copy of the signed,
written consent form the IMB obtained from your
beneficiary authorizing the release of your beneficiary's
personal contact information to you. If additional space is
needed, attach a separate sheet of paper.

Page 4 of 6

Part 2. Information About Your Alien Fiancé(e) (continued)
Your fiancé(e) will apply for a visa abroad at the American
embassy or consulate at:
36.a. City or Town

NOTE: Designation of a U.S. embassy or consulate outside the
country of your fiancé(e)'s last residence does not guarantee
acceptance for processing by that foreign post. Acceptance is at
the discretion of the designated embassy or consulate.

36.b. Country

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PRODUCTION
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Part 3. Other Information

1. If you are serving overseas in the Armed Forces of the United
States, please answer the following:
I presently reside or am stationed overseas and my current
mailing address is:
1.a. Street Number
and Name
1.b. Apt.

Ste.

3. If you have provided information about a conviction for a
crime listed above and you were being battered or subjected to
extreme cruelty by your spouse, parent, or adult child at the time
of your conviction, check all of the following that apply to you:
3.a.

I was acting in self-defense.

3.b.

I violated a protection order issued for my own
protection.

3.c.

I committed, was arrested for, was convicted of, or
plead guilty to committing a crime that did not result
in serious bodily injury, and there was a connection
between the crime committed and my having been
battered or subjected to extreme cruelty.

Flr.

1.c. City or Town
1.d. State
1.f.

1.e. Zip Code

Postal Code

1.g. Province
1.h. Country

2. Have you ever been convicted by a court of law (civil or
criminal) or court martialed by a military tribunal for any
of the following crimes:

2.a. Domestic violence, sexual assault, child abuse and
neglect, dating violence, elder abuse or stalking? (Please
refer to Page 3 of the instructions for the full definition of
the term "domestic violence").
Yes
No
2.b. Homicide, murder, manslaughter, rape, abusive sexual
contact, sexual exploitation, incest, torture, trafficking,
peonage, holding hostage, involuntary servitude, slave
trade, kidnapping, abduction, unlawful criminal restraint,
false imprisonment or an attempt to commit any of these
crimes?
Yes
No

2.c. Three or more convictions for crimes relating to a controlled
substance or alcohol not arising from a single act?
Yes

If your beneficiary is your fiancé(e) and: (a) this is the third (or
more) Form I-129F petition that you have filed; or (b) this is the
third (or more) Form I-129F petition you have filed and your
first Form I-129F petition was approved within the last 2 years,
then your petition cannot be approved unless a waiver of the
multiple filing restriction is granted. Attach a signed and dated
letter, requesting the waiver and explaining why a waiver is
appropriate under your circumstances, together with any
evidence in support of the waiver request.
4.

Indicate which waiver applies:

Multiple Filer, No Disqualifying Convictions
(General Waiver)

Multiple Filer, Prior Criminal Conviction for
Specified Offenses (Extraordinary Circumstances
Waiver)
Multiple Filer, Prior Criminal Convictions Resulting
from Domestic Violence (Mandatory Waiver)
Not applicable, beneficiary is my spouse

NOTE: See Page 3, question 3.b. of the filing instructions.

No

These questions must be answered even if your records were
sealed or otherwise cleared or if anyone, including a judge, law
enforcement officer, or attorney, told you that you no longer have
a record. Using a separate sheet(s) of paper, provide information
relating to the conviction(s), such as crime involved, date of
conviction and sentence.

Form I-129F 12/10/12 N

Page 5 of 6

Part 4. Signature of Petitioner
Penalties
You may by law be imprisoned for not more than 5 years, or
fined $250,000, or both, for entering into a marriage contract for
the purpose of evading any provision of the immigration laws,
and you may be fined up to $10,000 or imprisoned upon to five
years, or both, for knowingly and willfully falsifying or
concealing a material fact or using any false document in
submitting this petition.

Moreover, I understand that this petition, including any criminal
conviction information that I am required to provide with this
petition, as well as any related criminal background information
pertaining to me that U.S. Citizenship and Immigration Services
may discover independently in adjudicating this petition will be
disclosed to the beneficiary of this petition.

DRAFT
NOT FOR
PRODUCTION
12/10/2012

Your Certification
I certify that I am legally able to and intend to marry my alien
fiancé(e) within 90 days of his or her arrival in the United
States. I certify, under penalty of perjury under the laws of the
United States of America, that the foregoing is true and correct.
Furthermore, I authorize the release of any information from my
records that U.S. Citizenship and Immigration Services needs to
determine eligibility for the benefit that I am seeking.

1.a. Signature of Petitioner

1.b. Date of Signature (mm/dd/yyyy) ►
2.

Daytime Phone Number

(

)

-

3.

Mobile Phone Number

(

)

-

4.

E-mail Address (if any)

Part 5. Signature of Person Preparing This Petition, If Other Than the Petitioner
NOTE: If you are an attorney or representative, you must submit
a completed Form G-28, Notice of Entry of Appearance as
Attorney or Accredited Representative, along with this Petition.
Form G-28 submitted with this Petition.

Preparer's Mailing Address

5.a. Street Number
and Name
5.b. Apt.

Ste.

Flr.

G-28 ID Number

5.c. City or Town

Preparer's Full Name

5.d. State

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

5.f.

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

2.

5.e. Zip Code

Postal Code

5.g. Province
5.h. Country

Preparer's Business or Organization Name

Declaration

Preparer's Contact Information
3.

Preparer's Daytime Phone Number

(
4.

)

-

Preparer's E-mail Address (if any)

Extension

To be completed by all preparers, including attorneys and
authorized representatives: I declare that I prepared this benefit
request at the request of the Petitioner, that it is based on all the
information of which I have knowledge, and that the information
is true to the best of my knowledge.
6.a. Signature
of Preparer
6.b. Date of Signature (mm/dd/yyyy) ►

Form I-129F 12/10/12 N

Page 6 of 6