I-730, Refugee/Asylee Relative Petition (United States)
This form is a refugee/asylee relative petition for immigration to the United States. The form provided here is simply a sample of what the actual Form I-730 looks like.
Department of Homeland Security
U.S. Citizenship and Immigration Services
I-730, Refugee/Asylee Relative Petition
START HERE - Please Print or Type in Black Ink.
Part 1. Information about you.
Family Name (Last Name) ____________________________
Given Name (First Name) ____________________________
Middle Name ____________________________
Address - C/O
Street Number and Name ____________________________
Apt. # ____________________________
City ____________________________
State or Province ____________________________
Country ____________________________
Zip/Postal Code ____________________________
Gender a. ____ Male b. ____ Female
Date of Birth (mm/dd/yyyy) ____________________________
Country of Birth ____________________________
Country of Citizenship/Nationality ____________________________
E-Mail Address (if any) ____________________________
Telephone Number (with area code) ____________________________
Alien Registration Number (A#) ____________________________
U.S. Social Security # (if applicable) ____________________________
Other names used (including maiden name) ____________________________
Present Status (check one)
1a. ____ Refugee 2a. ____ Lawful Permanent Resident based on previous Refugee status
1b. ____ Asylee 2b. ____ Lawful Permanent Resident based on previous Asylee status
Date (mm/dd/yyyy) and Place Refugee or Asylee status was granted: ____________________________
If Granted Refugee Status, Date (mm/dd/yyyy) and Place Admitted to the United States: ____________________________
If Married, Date (mm/dd/yyyy) and Place of Present Marriage: ____________________________
If Previously Married, Name(s) of Prior Spouse(s): ____________________________
Date(s) Previous Marriage(s) Ended:(mm/dd/yyyy) ____________________________
Part 2. Information about the relationship.
The alien relative is my: a. ____ Spouse b. ____ Unmarried child under 21 years of age
Number of relatives I am filing for ________________________ (_____________ of ______________)
Part 3. Information about your alien relative.
(If you are petitioning for more than one family member, you must complete and file a separate Form I-730 for each additional family member.)
Family Name ____________________________
Given Name ____________________________
Middle Name ____________________________
Address - C/O ____________________________
Street Number and Name ____________________________
Apt. # ____________________________
City ____________________________
State or Province ____________________________
Country ____________________________
Zip/Postal Code ____________________________
Gender a. ____ Male b. ____ Female
Date of Birth (mm/dd/yyyy) ____________________________
Country of Birth ____________________________
Country of Citizenship/Nationality ____________________________
E-Mail Address (if any) ____________________________
Telephone Number (with area code) ____________________________
Alien Registration Number (A#) ____________________________
U.S. Social Security # (if applicable) ____________________________
Other names used (including maiden name) ____________________________
If Married, Date (mm/dd/yyyy) and Place of Present Marriage ____________________________
If Previously Married, Name(s) of Prior Spouse(s) ____________________________
Date(s) Previous Marriage(s) Ended: (mm/dd/yyyy) ____________________________
Name and address of your alien relative in the alphabet of the language (if other than Roman letters) spoken in the country where he or she now lives.
Family Name ____________________________
Given Name ____________________________
Middle Name ____________________________
Address - C/O ____________________________
Street Number and Name/Apt. #____________________________
City/State or Province ____________________________
Country/Zip/Postal Code ____________________________
Part 4. Processing Information.
1. Check One:
a. ____ The person named in Part 3 is now in the United States.
b. ____ The person named in Part 3 is now outside the United States. (Please indicate the location of the American Consulate or Embassy where your relative will apply for a visa.)
American Consulate/Embassy at: ____________________________ City and County
Is the person named in Part 3 in deportation or removal proceedings in the United States?
a. ____ No
b. ____ Yes (Please explain below or on a separate sheet(s) of paper.)
Part 5. Signature. Read the information on penalties in the instructions before completing this section and sign below. If someone helped you to prepare this petition, he or she must complete Part 6.
I certify or, if outside the United States, I swear or affirm, under penalty of perjury under the laws of the United States of America, that this petition and the evidence submitted with it, is all true and correct. I authorize the release of any information from my record which the U.S. Citizenship and Immigration Services needs to determine eligibility for the benefit I am seeking.
Signature ____________________________
Print Name ____________________________
Date ____________________________
Daytime Telephone Number ____________________________
NOTE: If you do not completely fill out this form or fail to submit the required documents listed in the instructions, your relative may not be found eligible for the requested benefit and this petition may be denied.
Part 6. Signature of person preparing form, if other than petitioner above. (Sign below.)
I declare that I prepared this petition at the request of the above person and it is based on all of the information of which I have knowledge.
Signature ____________________________
Print ____________________________
Date ____________________________
Daytime Telephone Number ____________________________
Firm Name and Address ____________________________
E-Mail Address (If any.) ____________________________