U.S. Department of Justice
Executive Office for Immigration Review
Board of Immigration Appeals
OMB#1125-0005
Notice of Entry of Appearance as Attorney or
Representative Before the Board of Immigration Appeals
(Type or Print)
NAME AND ADDRESS OF REPRESENTED PARTY
____________________________________________________
(First) (Middle Initial) (Last)
____________________________________________________
(Number and Street) (Apt. No.)
____________________________________________________
(City) (State) (Zip Code)
ALIEN (“A”) NUMBER
(Provide A- number of the party represented or
the visa beneficiary in this case.)
_______________________________
USCIS Visa Appeal (Provide beneficiary
name)
______________________
Fine (Provide fine number)
______________________
Disciplinary case (Provide docket number)
______________________
Attorney or Representative (please check one of the following):
I am an attorney eligible to practice law in, and a member in good standing of, the bar of the highest court(s) of the following
states(s), possession(s), territory(ies), commonwealth(s), or the District of Columbia (use additional space on reverse side if
necessary) and I am not subject to any order disbarring, suspending, enjoining, restraining or otherwise restricting me in the
practice of law in any jurisdiction (if subject to such an order, do not check this box and explain on reverse).
Full Name of Court __________________________________ Bar Number (if applicable) __________________________
I am a representative accredited to appear before the Executive Office for Immigration Review as defined in 8 C.F.R. §
1292.1(a)(4) with the following recognized organization:
____________________________________________________________________
I am a law student or law graduate of an accredited U.S. law school as defined in 8 C.F.R. § 1292.1(a)(2).
I am a reputable individual as defined in 8 C.F.R. § 1292.1(a)(3).
I am an accredited foreign government official, as defined in 8 C.F.R. § 1291.1(a)(5), from _____________________ (country).
I am a person who was authorized to practice on December 23, 1952, under 8 C.F.R. § 1292.1(b).
Attorney or Representative (please check one of the following):
I hereby enter my appearance as attorney or representative for, and at the request of, the party named above.
EOIR has ordered the provision of a Qualified Representative for the party named above and I appear in that capacity.
I have read and understand
the statements provided on the reverse side of this form that set forth the regulations and conditions
governing appearances and representations before the Board of Immigration Appeals. I declare under penalty of perjury under the
laws of the United States of America that the foregoing is true and correct.
SIGNATURE OF ATTORNEY OR REPRESENTATIVE EOIR ID NUMBER DATE
X __________________________________________________________________________________________________
NAME OF ATTORNEY OR REPRESENTATIVE, ADDRESS, FAX & PHONE NUMBERS, & EMAIL ADDRESS
Name: ____________________________________________________________________________________________________
(First) (Middle Initial) (Last)
Address: __________________________________________________________________________________________________
(Number and Street)
__________________________________________________________________________________________________
(City) (State) (Zip Code)
Telephone: _________________ Facsimile: _________________ Email: ______________________________________________
Check here if new address
Form EOIR - 27
Rev. Oct. 2014
