❶ 浜插睘縐繪皯I-130琛ㄦ牸鎬庝箞濉鍐
I-130琛ㄦ牸濉鍐欏叾瀹炲苟涓嶅嶆潅錛屾誨叡灝變袱欏點傜涓欏墊渶涓婃柟鏈変竴涓澶ф嗭紝鍐欑潃鈥淒O NOT WRITE IN THIS BLOCK-FOR USCIS OFFICE ONLY鈥濄備綔涓虹敵璇蜂漢鏈浜猴紝涓嶇敤綆¤繖涓妗嗛噷鐨勫唴瀹癸紝閭ｆ槸縐繪皯瀹樺～鍐欑殑鍦版柟銆傛帴涓嬫潵錛屾墠鏄鐢寵蜂漢闇瑕佸～鍐欑殑淇℃伅銆
A. Relationship.
榪欎竴閮ㄥ垎鏄濉鍐欎綘鍜屼綘鍗沖皢涓哄叾鐢寵風豢鍗＄殑閭ｄ釜浜蹭漢(涓嬫枃綆縐扳滀翰浜衡)鐨勫叧緋匯備婦涓渚嬶紝濡傛灉浣犳槸緹庡浗鍏姘戱紝浣犳兂涓轟綘鍦ㄤ腑鍥界殑濡誨瓙鐢寵風豢鍗★紝閭ｄ箞浣犲氨鏄痯etitioner錛屼綘鐨勫誨瓙灝辨槸榪欎釜鈥滀翰浜衡濓紝涔熷氨鏄痓eneficiary.
1. I am filing this petition for my:
Husband/Wife (濡傛灉鏄涓鴻嚜宸辯殑閰嶅伓鐢寵風豢鍗★紝鍒欏嬀閫夎繖涓欏)
Parent (濡傛灉鏄涓鴻嚜宸辯殑鐖舵瘝鐢寵風豢鍗★紝鍒欏嬀閫夎繖涓欏)
Brother/Sister (濡傛灉鏄涓鴻嚜宸辯殑鍏勫紵濮愬圭敵璇風豢鍗★紝鍒欏嬀閫夎繖涓欏)
Child (濡傛灉鏄涓鴻嚜宸辯殑瀛愬コ鐢寵風豢鍗★紝鍒欏嬀閫夎繖涓欏)
2. Are you related by adoption?
Yes (濡傛灉浣犲拰浣犵殑浜蹭漢涓嶆槸浜茬敓琛緙樺叧緋伙紝鑰屾槸閫氳繃鏀跺吇鍏崇郴寤虹珛鐨勶紝鍒欓夎繖涓欏)
No (濡傛灉浣犲拰浣犵殑浜蹭漢鏄浜茬敓琛緙樺叧緋伙紝鍒欓夎繖涓欏廣傚ぇ閮ㄥ垎鐢寵蜂漢閫傜敤浜庤繖涓欏)
3. Did you gain permanent residence through adoption?
Yes (濡傛灉浣犳湰浜哄綋鍒濇槸閫氳繃鏀跺吇鍏崇郴鑾峰緱緇垮崱鐨勶紝閭ｄ箞閫夎繖涓欏)
No (濡傛灉浣犳湰浜哄綋鍒濅笉鏄閫氳繃鏀跺吇鍏崇郴鑾峰緱緇垮崱鐨勶紝閭ｄ箞閫夎繖涓欏廣傚ぇ閮ㄥ垎鐢寵蜂漢閫傜敤浜庤繖涓欏)
B. Information about you
榪欎竴閮ㄥ垎鏄濉鍐欏叧浜庝綘鏈浜(緹庡浗鍏姘戞垨鑰呯豢鍗)鐨勪俊鎮銆
1-5欏瑰垎鍒鏄濉鍐欎綘鐨勫悕瀛椾付閫氫俊鍦板潃涓跺嚭鐢熷湴涓跺嚭鐢熸棩鏈熶付鎬у埆錛屽傚疄濉鍐欏氨鏄浜嗐
絎6欏規槸闂浣犵殑濠氬Щ鐘跺喌銆傚叾涓錛孧arried鏄宸插氾紝Single鏄鏈濠氾紝Widowed鏄涓у伓錛孌ivorced鏄紱誨氥
絎7欏規槸闂浣犳槸鍚︾敤榪囨浘鐢ㄥ悕銆傚傛灉娌℃湁錛屽氨絀虹潃涓嶅～銆
絎8欏光淒ate and Place of Present Marriage鈥濇槸闂浣犲綋鍓嶅氬Щ(濡傛灉浣犲綋鍓嶆槸鈥滃凡濠氣濈姸鎬佺殑璇)鐨勭粨濠氭椂闂村拰鍦扮偣銆傚傛灉浣犳槸鏈濠氭垨鑰呯誨氱姸鎬侊紝榪欓」涓嶇敤濉銆
絎9欏瑰～浣犵殑紺句細瀹夊叏鍙稴ocial Security Number.
絎10欏瑰～浣犵殑Alien Registration Number(綆縐癆 Number)銆備綘褰撳垵鐢寵風豢鍗℃椂錛岄掍氦I-485鍚庯紝縐繪皯灞灝變細緇欎綘涓涓獮 Number. 榪欎釜鍙風爜灝辨槸浣犵殑緇垮崱姝ｉ潰涓婇偅涓浠A#鎵撳ご鐨勫彿鐮侊紝姣斿傦細A# 123-456-789(鏁板瓧鍏9浣)銆
絎11欏瑰拰12欏規槸濉鍐欎綘鐨勫墠澶(鍓嶅)鐨勫悕瀛楋紝鍜岀誨氱殑鏃墮棿銆傚傛灉浠ュ墠娌℃湁紱昏繃濠氾紝榪欓」灝辯┖鐫涓嶅～銆
絎13欏規槸濉鍐欎綘鑾峰緱緹庡浗鍏姘戣韓浠界殑閫斿緞銆侭irth in the U.S. (濡傛灉浣犳槸鍥犱負鍑虹敓鍦ㄧ編鍥借岃幏寰楃編鍥藉叕姘戞潈鐨勶紝鍒欓夎繖涓欏)
Naturalization. Give the certificate number and date and place of issuance (濡傛灉浣犳槸閫氳繃縐繪皯鐢寵瘋幏寰楃編鍥藉叕姘戞潈鐨勶紝鍒欏～鍐欒繖涓欏廣傚悓鏃墮渶瑕佸～鍐欎綘鍏姘戣瘉鐨勭紪鍙蜂付鏃ユ湡鍜屽湴鐐)
Parents. Have you obtained a certificate of citizenship in your own name? (榪欎竴欏規槸闂浣犳槸涓嶆槸浠ヤ綘鑷宸卞悕涔夌敵璇峰埌緹庡浗鍏姘戠殑?濡傛灉鏄錛屽氨閫塝es,騫跺悓鏃跺～鍐欎綘鐨勫叕姘戣瘉鐨勭紪鍙蜂付鏃ユ湡鍜屽湴鐐;濡傛灉涓嶆槸錛屽氨濉玁o銆備負浠涔堜細鏈夎繖涓閫夐」鍛?瀵逛簬18宀佷互涓嬬殑瀛╁瓙錛屽傛灉鍦ㄦ嬁緇垮崱5騫村悗錛屼粛鐒惰繕涓嶆弧18宀侊紝灝變笉鑳戒互鑷宸卞悕涔夌敵璇峰姞鍏ョ編鍥藉浗綾嶏紝鍙鑳介氳繃鐖舵瘝鐢寵峰姞鍏ョ編鍥藉浗綾嶃傝繖縐嶆儏鍐典笅錛岃繖涓瀛╁瓙灝變笉鏄浠ヨ嚜宸卞悕涔夋嬁鍒扮編鍥藉叕姘戣瘉鐨勶紝鑰屾槸浠ョ埗姣嶅悕涔夋嬁鍒扮殑)
絎14欏癸紝濡傛灉浣犳槸緹庡浗緇垮崱鎸佹湁浜猴紝鍒欏～鍐欒繖涓欏廣傚傛灉浣犳槸鍦ㄧ編鍥藉冨栫敵璇風Щ姘戠捐瘉鏉ョ編鍥斤紝鑾峰緱緹庡浗緇垮崱鐨勶紝鍒欏～鍐欏叆澧冪編鍥界殑鏃ユ湡鍜屾搗鍏沖湴鐐(Date and place of admission).娉ㄦ剰錛歛dmission榪欎釜鍗曡瘝鏄涓撻棬鐢ㄤ簬閫氳繃鐢寵風Щ姘戠捐瘉鍏ュ冪編鍥芥嬁緇垮崱鐨勬柟寮忋傚湪緹庡浗澧冨唴閫扞-485榪欎釜鏂瑰紡錛岀О涓篴djustment of status錛屼笉鍙玜dmission.濡傛灉浣犳槸鍦ㄧ編鍥藉冨唴閫氳繃閫掍氦I-485鎷垮埌緇垮崱鐨勶紝鍒欏～鍐欎綘I-485鎵瑰噯鐨勯偅涓澶╃殑鏃ユ湡鍜屾壒鍑嗕綘鐨処-485鐨勯偅涓猆SCIS SERVICE CENTER鍚嶅瓧(渚嬪傦紝濡傛灉鏄疶SC錛屽氨濉玊EXASSERVICE CENTER;濡傛灉鏄疦SC錛屽氨濉玁EBRASKA SERVICE CENTER)銆
Class of admission鏄濉鍐欎綘鑾峰緱緇垮崱鐨勭被鍒銆傚傛灉鏄鍦ㄧ編鍥藉冨栭氳繃縐繪皯絳捐瘉縐繪皯緹庡浗鐨勶紝鍒欏～鍐欎綘鐨勭Щ姘戠捐瘉鐨勭被鍒(渚嬪傦紝濡傛灉浣犲綋鍒濇槸浣滀負緹庡浗鍏姘戠殑閰嶅伓鏉ョ編鍥界殑錛屽氨濉獻R-1錛岃繖閲岀殑IR-1灝辨槸浣犲綋鍒濆湪緹庡浗椹誨箍宸為嗕簨棣嗙敵璇峰埌鐨勭Щ姘戠捐瘉綾誨埆);濡傛灉浣犳槸鍦ㄧ編鍥藉冨唴閫氳繃閫掍氦I-485鑾峰緱緇垮崱鐨勶紝閭ｄ箞浣犲氨濉鍐欎綘鐨処-140鎴栬匢-130鐢寵風殑浼樺厛綾誨埆(姣斿傚傛灉浣犳槸EB1錛屼綘灝卞～鍐橢mployment-Based 1st Preference)銆
絎14b欏癸紝鏄闂浣犳槸涓嶆槸閫氳繃璺熺編鍥藉叕姘戞垨鑰呯豢鍗＄粨濠氭嬁鍒扮豢鍗＄殑?濡傛灉鏄錛屼綘灝卞～Yes;濡傛灉涓嶆槸錛屼綘灝卞～No銆
C. Information about your relative銆
榪欎竴閮ㄥ垎鏄濉鍐欏叧浜庝綘鍗沖皢涓哄叾鐢寵風豢鍗＄殑閭ｄ釜浜蹭漢(涓嬫枃綆縐扳滀翰浜衡)鐨勪俊鎮銆
1-12欏瑰熀鏈鍜屸淎. Information about you鈥濆畬鍏ㄤ竴鏍鳳紝闇瑕佹敞鎰忕殑鏄錛屽傛灉鏈変簺欏規病鏈夛紝灝辯┖鐫錛屼笉瑕佸～none,涔熶笉瑕佸～N/A涔嬬被鐨勶紝瀹規槗寮曡搗縐繪皯瀹樿浼氥備緥濡傜9欏癸紝紺句細瀹夊叏鍙鳳紝濡傛灉娌℃湁錛屽氨絀虹潃錛屼笉瑕佸～銆
絎13欏癸紝鏄闂浣犵殑浜蹭漢鏄鍚︽潵榪囩編鍥?濡傛灉鏄錛屽嬀閫墆es;濡傛灉涓嶆槸錛屽嬀閫塶o.
絎14欏癸紝鏄闂浣狅紝濡傛灉浣犵殑浜蹭漢鐜板湪灝卞湪緹庡浗錛岄偅涔堜粬(濂)鏉ョ編鍥界殑鏂瑰紡鏄浠涔堛
濡傛灉鏄疛1錛屽氨鍦ㄢ淗e or she arrived as a:鈥濆悗闈㈠～Exchange visitor(J1).
濡傛灉鏄疕1-B錛屽氨鍦ㄢ淗e or she arrived as a:鈥濆悗闈㈠～Temporary worker(H1-B).
濡傛灉鏄疐1,灝卞湪鈥淗e or she arrived as a:鈥濆悗闈㈠～Student(F1).
濡傛灉鏄疊1錛屽氨鍦ㄢ淗e or she arrived as a:鈥濆悗闈㈠～Visitor (B1).絳夌瓑銆
鐒跺悗濉鍐欏綋鍒濆叆澧冪編鍥芥椂鐨処-94鍙鳳紝鍜屽叆澧冪編鍥界殑鏃ユ湡(Date Arrived).鐒跺悗濉鍐橧-94鍗＄殑榪囨湡鏃ユ湡(鍗矷-94鍗′笂valid stay鐨勬渶鍚庝竴澶)銆
絎15欏. 濉鍐欎綘鐨勪翰浜哄綋鍓嶉泧涓葷殑鍚嶅瓧涓跺湴鍧鍜岄泧浣ｅ紑濮嬫棩鏈熴傚傛灉鏄瀛︾敓錛屽氨絀虹潃涓嶅～銆
絎16欏. 鏄闂浣犵殑浜蹭漢鏄鍚﹁繘鍏ヨ繃緹庡浗縐繪皯灞閫掕В鍙告硶紼嬪簭?澶ч儴鍒嗙敵璇蜂漢閮借繖涓欏歸兘鏄濉玁o.
絎17欏(I-130琛ㄧ浜岄〉欏墮儴寮濮嬶紝浠庣17欏瑰埌絎22欏癸紝浠嶅睘浜"C. Information about your alien relative").
榪欎竴欏癸紝闇瑕佸垪鍑轟綘浜蹭漢鐨勯厤鍋朵付瀛╁瓙鐨勫撳悕涓惰窡浣犱翰浜虹殑鍏蜂綋鍏崇郴錛屽嚭鐢熸棩鏈燂紝鍑虹敓鍥藉躲傚傚疄濉鍐欏氨琛屻
絎18欏癸紝闇瑕佸～鍐欎綘浜蹭漢縐繪皯緹庡浗鍚庯紝鎷熷皢瑕佸眳浣忕殑鍦版柟銆傚傛灉浣犵殑榪欎釜鈥滀翰浜衡濇槸浣犵殑閰嶅伓鎴栬呭╁瓙錛屼竴鑸灝卞～浣犺嚜宸卞眳浣忓湴鍧錛屾瘮杈冨彲淇°
絎19欏廣傜敤鑻辨枃濉鍐欎綘浜蹭漢褰撳墠鍦ㄤ腑鍥(濡傛灉浣犱翰浜轟笉鏄鍦ㄤ腑鍥斤紝鍒欏～浠栫殑瀹為檯灞呬綇鍦板潃)鐨勫眳浣忓湴鍧(闇瑕佹彁渚涜楅亾鍙鳳紝琛楅亾錛屽煄甯傦紝鐪佷細鍜屽浗瀹)銆
絎20欏廣傜敤涓鏂囧～鍐欎綘浜蹭漢褰撳墠鍦ㄤ腑鍥(濡傛灉浣犱翰浜轟笉鏄鍦ㄤ腑鍥斤紝鍒欏～浠栫殑瀹為檯灞呬綇鍦板潃)鐨勫眳浣忓湴鍧(闇瑕佹彁渚涜楅亾鍙鳳紝琛楅亾錛屽煄甯傦紝鐪佷細鍜屽浗瀹)銆
絎21欏廣傚傛灉浣犳槸涓轟綘鐨勯厤鍋剁敵璇風豢鍗★紝閭ｄ箞闇瑕佸～鍐欒繖涓欏廣傚～鍐欐渶榪戜竴嬈′綘浠鍏卞悓鐢熸椿鍦ㄤ竴璧風殑鍦板潃鍜岃搗姝㈡椂闂淬
絎22欏廣傚傛灉浣犵殑浜蹭漢鐜板湪灝卞湪緹庡浗錛屽垯縐繪皯灞璁や負浠(濂)浼氬湪緹庡浗澧冨唴璋冩暣韜浠斤紝鑾峰緱緇垮崱銆傝繖縐嶆儏鍐碉紝闇瑕佸～鍐欎綘鐨勪翰浜洪掍氦I-485鐨勯偅涓猆SICS OFFICE鍦扮偣(I-130琛ㄦ牸絎浜岄〉絎22欏逛笅闈㈠乏鍗婇儴鍒嗙殑City鍜孲tate)銆傚逛簬澶ч儴鍒嗗跺涵綾葷Щ姘戠敵璇鳳紝鏄疷SCIS Chicago Lockbox鍙楃悊錛屽洜姝City灝卞～錛欳hicago,State灝卞～錛欼llinois銆
絎22欏逛笅鏂瑰彸鍗婇儴鍒嗙殑City鍜孋ountry鏄璇達紝濡傛灉浣犵殑浜蹭漢涓嶅叿澶囧湪緹庡浗澧冨唴璋冩暣韜浠界殑璧勬牸(鍗充笉鑳介掍氦I-485)錛屾垨鑰呬綘鐨勪翰浜哄皢鍦ㄧ編鍥介┗嫻峰栫殑涓涓棰嗕簨棣嗙敵璇風Щ姘戠捐瘉鐒跺悗鏉ョ編鍥斤紝閭ｄ箞闇瑕佸～鍐欑22欏逛笅鏂瑰彸鍗婇儴鍒嗙殑City鍜孋ountry銆傚逛簬涓鍥藉ぇ闄嗙敵璇蜂漢鑰岃█錛屽跺涵綾葷Щ姘戜竴鑸鏄鐢辯編鍥介┗騫垮窞棰嗕簨棣嗗彈鐞嗭紝鍥犳City濉錛欸uangzhou, Country濉錛歅.R.China銆
D. Other information
絎1欏癸紝濡傛灉浣犲悓鏃惰繕涓哄叾浠栦翰浜洪掍氦浜嗗崟鐙鐨処-130錛屽垯鍦ㄨ繖閲屽垪鍑哄叾浠栦翰浜虹殑鍚嶅瓧鍜岃窡浣犵殑鍏崇郴銆
絎2欏規槸闂浣狅紝浣犱互鍓嶆浘緇忎負褰撳墠榪欎綅浜蹭漢鎴栧叾浠栦翰浜虹敵璇瘋繃I-130鍚?濡傛灉鏄錛屽嬀閫墆es(鍚屾椂鍦ㄤ笅鏂瑰～鍐欓偅鍚嶄翰浜虹殑鍚嶅瓧錛孖-130閫掍氦鐨勬椂闂村拰USCIS SERVICE CENTER鍦板潃);濡傛灉涓嶆槸錛屽垯鍕鵑塶o.
E. Signature of petitioner
濡傛灉榪欎喚I-130琛ㄦ槸浣犳湰浜哄～鍐欑殑錛屽垯鍦ㄨ繖涓欏歸噷絳句綘鏈浜虹殑濮撳悕錛屾棩鏈熷拰鐢佃瘽鍙風爜銆
F. Signature of person preparing this form, if other than the petitioner.
濡傛灉榪欎喚I-130涓嶆槸浣犳湰浜哄～鍐欑殑錛岃屾槸浣犲旀墭鍏朵粬浜哄～鍐欑殑錛屽垯鍙楀旀墭浜洪渶瑕佸湪榪欎竴欏歸噷絳句笂浠(濂)鐨勫悕瀛楋紝鏃ユ湡鍜屽湴鍧銆
浠ヤ笂鏄浜插睘縐繪皯I-130琛ㄦ牸濉鍐欐柟娉曞叏閮ㄥ唴瀹廣