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Who is requesting this information?

Information for person filing the request:

Information of Applicant/Petitioner:

DHS Privacy Notice

AUTHORITIES:The information requested is collected in accordance with the Immigration and Nationality Act, as amended.

PURPOSE: The primary purpose for completing is to respond to your request for assistance with an immigration benefit application, petition, and document.

ROUTINE USES: The information provided may be used by and disclosed to DHS personnel and contractors or other agents who need the information to assist in activities related to your inquiry. The information will be shared in accordance with approved routine uses, as described in the associated published system of records notices, available at

DISCLOSURE: Furnishing this information is voluntary. However, failure to provide the requested information may delay or prevent USCIS from responding to your inquiry. Please note that the system will record user information such as Internet Protocol Address and Web Browser type and version upon submission.