Application for immigrant visa and alien registration part II sworn statement instructions: C
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INSTRUCTIONS: Complete one copy of this form for yourself and each member of your family, regardless of age, who will immigrate with you. Please print or type your answer to all questions. Questions that are not applicable should be so marked. If there is insufficient room on the form, answer on a separate sheet using the same numbers as appear on the form. Attach the sheet to this form. DO NOT sign this form until instructed to do so by the consular officer. The fee for filing this application is listed under tariff item No. 20. The fee should be paid in United States dollars or local currency equivalent, or by bank draft, when you appear before the consular officer. WARNING: Any false statement or concealment of a material fact may result in your permanent expulsion from the United States. Even though you should be admitted to the United States, a fraudulent entry could be grounds for your prosecution and/or deportation. This form is a continuation of Form OF-230 Part I, which together, constitute the complete Application for Immigrant Visa and Alien Registration. 24. FAMILY NAME FIRST NAME MIDDLE NAME 25. ADDRESS (Local) 26. FINAL ADDRESS TO WHICH YOU WILL TRAVEL IN THE UNITED STATES (Street Address including ZIP code) 27. PERSON YOU INTEND TO JOIN (Name, address, and relationship) 28. NAME AND ADDRESS OF SPONSORING PERSON AND EMPLOYER Telephone No. Telephone No. 29. PURPOSE IN GOING TO THE UNITED STATES 30. LENGTH OF INTENDED STAY (If permanently, so state) 31. INTENDED PORT OF ENTRY 32. DO YOU HAVE A TICKET TO FINAL DESTINATION? No Yes
33. United States laws governing the issuance of visas require each applicant to state whether or not he or she is member of an class individuals excluded from admission into the United States. The excludable classes are described below in general terms. You should read carefully the following list and answer YES or NO to each category. The answers you give will assist the consular officer to reach a decision on your eligibility to receive a visa. EXCEPT AS OTHERWISE PROVIDED BY LAW, ALIENS WITHIN THE FOLLOWING CLASSIFICATIONS ARE INELIGIBLE TO RECIEVE A VISA. DO ANY OF THE FOLLOWING CLASSES APPLY TO YOU? a. An alien who has a communicable disease of public health significance, or has or has had a physical or mental disorder that poses, or is likely to pose a threat to the safety or welfare of the alien or others; an alien who is a drug abuser or addict. [212(a)(1)] b. An alien convicted of, or who admits committing a crime involving moral turpitude, or violation of any law relating to a controlled substance; an alien convicted of 2 of more offenses of which the aggregate sentences were 5 years or more; an alien coming to the United States to engage in prostitution or commercialized vice, or has engaged in prostitution or procuring within the past 10 years; an alien who is or has been an illicit trafficker in any controlled substance; an alien who has committed a serious criminal offense in the United States and who has asserted immunity from prosecution. [212(a)(2)] c. An alien who seeks to enter the United States in espionage, sabotage, export control violations, overthrow of the Govern- ment of the United States, or other unlawful activity; an alien who seeks to enter the United States to engage an terrorist activities; an alien who has been a member or affiliated with the Communist or any other totalitarian party; an alien who under the direction of the Nazi government of Germany, or any are occupied by, or allied with the Nazi government of Germany, ordered, incited, assisted, or otherwise participated in the persecution of any person because of race, religion, national origin, or political opinion; an alien who has engaged in geno- cide. [212(a)(3)] d. An alien who has become a public charge. [212 (a)(4)] e. An alien who seeks to enter for the purpose of performing skilled or unskilled labor who has not been certified by the Secretary of Labor; an alien graduate of a foreign medical school seeking to perform medical services who has not passed the NMBE exam or its equivalent. [212(a)(5)] f. An alien previously deported within one year, or arrested and deported within 5 years; an alien who seeks or has sought a visa, entry into the United States, or any U.S. Immigration benefit by fraud or misrepresentation; an alien who knowingly assisted any other alien to enter or try to enter into the United States in violation of the law; an alien who is in violation of Section 274C of the Immigration Act. [212(a)(6)] YES NO
NO YES
NO YES
NO YES
NO Not Applicable
NO REVISED 4-91 DEPT. OF STATE THIS FORM MAY BE OBTAINED GRATIS AT CONSULAR OFFICES OF THE UNITED STATES OF AMERICA OPTIONAL FORM 230 II (English) Previous editions obsolete g. An alien who is permanently ineligible to U.S. citizenship; a person who has departed the United States to evade military service in time of war. [212(a)(8)] h. An alien who is coming to the United States to practice polygamy; an alien is to a guardian required to accompany an excluded alien; an alien who withholds custody of a child outside the United States from a United States citizen granted legal custody. [212(a)(9)] An alien who is a former exchange visitor who has not fulfilled the 2-year foreign residence requirement. [212(e)] If the answer to any of the foregoing questions is YES or if unsure, explain in the following space on a separate piece of paper. Yes No
No Yes
No Yes
No 34. Have you ever been arrested, convicted, or ever been in a prison or jailhouse; have you ever been the beneficiary of a pardon or
an amnesty; have you ever been treated in an institution or hospital or other place for insanity or other mental disease? [222(a)] 35. I am unlikely to become a public charge because of the following:
Personal financial resources (describe) Employment (attach) Affidavit of Support (attach) 36. Have you ever applied for a visa to enter the United States?
(If answer is yes, state where and when, whether you applied for a nonimmigrant or an immigrant visa, and whether the visa was issued or refused) Yes No 37. Have you ever been refused admission to the United States? (If answer is yes, explain) Yes No
(If the answer is yes, give name and address of person assisting you, indicating whether relative, friend, travel agent, attorney, or other)
Name
Address Relationship Yes No
Passport Military record Evidence of own assets Birth certificate Police certificate Affidavit of support Marriage certificate Medical records Offer of employment Death certificate Photographs Other (describe) Divorce decree Birth certificate of all children who will not
be immigrating at this time. (List those for
whom birth certificate is not available.) DO NOT WRITE BELOW THIS LINE The consular officer will assist you in answering items 40 and 41. 40. I claim to be exempt from ineligibility to receive a visa an exclusion under item ________ in part 33 for the following reasons: 212(a)(5) Beneficiary of a waiver under: Not applicable 212(a)(3)(D)(ii) 212(h)
Not required 212(a)(3)(D)(iii) 212(j) Attached
212(a)(3)(D)(iv) 212(e)
212(g)(1) 212(g)(2) 41. I claim to be: A Family-Sponsored Immigrant I derive foreign state chargeability
under Sec. 202(b) through my _______________ A diversity Immigrant A special category (Specify) __________________________________
(Return resident, Hong Kong, Tibetan, Private Legislation, etc.) I am subject to the following: Preference: ____________________ Numerical limitation: ________________
(foreign state) I understand that I am required to surrender my visa to the United States Immigration Officer at the place where I apply to enter the United States, and that the possession of a visa does not entitle me to enter the United States if at that time I am found to be inadmissible under the Immigration laws. I understand that any willfully false or misleading statement or willful concealment of a material fact made by me herein may subject me to permanent exclusion from the United States and, if I am admitted to the United States, may subject me to criminal prosecution and/or deportation. I, the undersigned applicant for a United States Immigrant visa, do solemnly swear (or affirm) that all statements which appear in this application, consisting of Optional Forms 230 PART I and 230 PART II combined, have been made by me, including the answers to items 1 through 41 inclusive, and that they are true and complete to the best of my knowledge and belief. I do further swear (or affirm) that, if admitted to the United States, I will not engage in activities which would be prejudicial to the public interest, or endanger the welfare, safety, or security of the United States; in activities which would be prohibited by the laws of the United States relating to espionage, sabotage, public disorder, or in other activities subversive to the national security; in any activity a purpose of which is the opposition to or the control, or overthrow of, the Government of the United States, by force, violence, or other unconstitutional means. I understand all the foregoing statements, having asked for and obtained an explanation on every point which was not clear to me. (Signature of applicant) The relationship claimed in Items 14 and 15 verified by documentation submitted to consular officer except as noted: Subscribed and sworn to before me this _____ day of _______________, 19_____ at:_________________________ (Consular Officer) TARIFF ITEM NO. 20 Yüklə 26,99 Kb. Dostları ilə paylaş:
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