Fillable G-28i Form G-28I

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G-28i Form G-28I

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The G-28i Form G-28I form is 4 pages long and contains:

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  • 65 other fields

Country of origin: US
File type: PDF

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U.S. Citizenship and Immigration Services (USCIS) is an office of the U.S. Branch of Homeland Security (DHS) that oversees the nation's naturalization and migration framework. It is a successor to the Immigration and Naturalization Service (INS), which was disintegrated by the Homeland Security Act of 2002 and supplanted by three segments inside the DHS: USCIS, Immigration and Customs Enforcement (ICE), and Customs and Border Protection (CBP).

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Form G-28I 05/23/18 Page 1 of 4
Notice of Entry of Appearance as Attorney In Matters
Outside the Geographical Confines of the United States
Department of Homeland Security
Part 1. Information About Attorney
4.
6.
5.
Email Address (if any)
2.a. Family Name
(Last Name)
2.b. Given Name
(First Name)
2.c. Middle Name
Daytime Telephone Number
3.a.
3.b.
3.c.
3.d.
3.e.
3.f.
DHS
Form G-28I
OMB No. 1615-0105
Expires 05/31/2021
1. USCIS Online Account Number (if any)
►
Name of Attorney
Postal Code
Country
City or Town
Street Number
and Name
Ste. Flr.Apt.
Province
1.c. I (select only one box)
subject to any order suspending, enjoining, restraining,
disbarring, or otherwise restricting me in the practice of
law. If you are subject to any orders, use the space
provided in Part 6. Additional Information to provide
an explanation.
am not am
2.
I am associated with
the attorney of record who previously filed Form
G-28I in this case, and my appearance as an attorney
for a limited purpose is at his or her request.
,
Contact Information of Attorney
License Number (if applicable)1.b.
Mobile Telephone Number (if any)
Address of Attorney
Name of Law Firm or Organization (if applicable)1.d.
Licensing Authority
7.
Fax Number (if any)
Select all applicable items.
Part 2. Eligibility Information for Attorney
1.a. I am an attorney licensed to practice law in, and in
good standing of, a court of general jurisdiction in
the following country where I reside and I am
regularly engaged in such practice. If you need extra
space to complete this section, use the space
provided in Part 6. Additional Information.
Part 3. Notice of Appearance as Attorney
Admitted to Practice Outside the United States
This appearance relates to immigration matters before
(select only one box):
1.a.
U.S. Citizenship and Immigration Services (USCIS)
List the form numbers or specific matter in which
appearance is entered.
1.b.
If you need extra space to complete this section, use the space
provided in Part 6. Additional Information.
2.a.
U.S. Immigration and Customs Enforcement (ICE)
List the specific matter in which appearance is entered.2.b.
Form G-28I 05/23/18 Page 2 of 4
Part 3. Notice of Appearance as Attorney
Admitted to Practice Outside the United States
(continued)
3.a. U.S. Customs and Border Protection (CBP)
List the specific matter in which appearance is entered.3.b.
4. Receipt Number (if any)
►
I enter my appearance as an attorney at the request of the
(select only one box):
5.
Applicant Petitioner
Respondent (ICE, CBP)Beneficiary/Derivative
9. Client's Alien Registration Number (A-Number) (if any)
8. Client's USCIS Online Account Number (if any)
►
6.a. Family Name
(Last Name)
6.b. Given Name
(First Name)
6.c. Middle Name
Information About Client (Applicant, Petitioner,
Beneficiary or Derivative, Respondent, or
Authorized Signatory for an Entity)
7.a. Name of Entity (if applicable)
►
A-
Title of Authorized Signatory for Entity (if applicable)7.b.
10. Daytime Telephone Number
12. Email Address (if any)
Client's Contact Information
Mobile Telephone Number (if any)11.
13.f.
13.e. Postal Code
Country
NOTE: Provide the client's mailing address. Do not provide
the business mailing address of the attorney unless it serves as
the safe mailing address on the application or petition being
filed with this Form G-28I.
13.a.
13.c.
13.b.
Mailing Address of Client
City or Town
Street Number
and Name
Ste. Flr.Apt.
13.d. Province
Part 4. Client's Consent to Representation and
Signature
I request that USCIS send original notices on an
application or petition to the business address of my
attorney as listed in this form.
1.
I have requested the representation of and consented to being
represented by the attorney named in Part 1. of this form.
According to the Privacy Act of 1974 and U.S. Department of
Homeland Security (DHS) policy, I also consent to the
disclosure to the named attorney of any record pertaining to me
that appears in any system of records of USCIS, ICE, or CBP.
Consent to Representation and Release of
Information
USCIS will send notices to both a represented party (the client)
and his, her, or its attorney or accredited representative either
through mail or electronic delivery. If you want to have notices
sent to your attorney rather than to you, please select Item
Number 1. below. You may change this election through
written notice to USCIS.
Options Regarding Receipt of USCIS Notices
Signature of Client or Authorized Signatory for an Entity2.a.
2.b. Date of Signature (mm/dd/yyyy)
Signature of Client or Authorized Signatory for an
Entity
Form G-28I 05/23/18 Page 3 of 4
Part 5. Signature of Attorney
I have read and understand the regulations and conditions
contained in 8 CFR 103.2 and 292 governing appearances and
representation before DHS. I declare under penalty of perjury
under the laws of the United States that the information I have
provided on this form is true and correct.
1.a. Signature of Attorney
1.b. Date of Signature (mm/dd/yyyy)
Form G-28I 05/23/18 Page 4 of 4
Part 6. Additional Information
If you need extra space to provide any additional information
within this form, use the space below. If you need more space
than what is provided, you may make copies of this page to
complete and file with this form or attach a separate sheet of
paper. Type or print your name at the top of each sheet;
indicate the Page Number, Part Number, and Item Number
to which your answer refers; and sign and date each sheet.
2.d.
1.a Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c.
Middle Name
2.a. 2.b. 2.c.Page Number Part Number
3.d.
3.a. 3.b. 3.c.Page Number Part Number Item Number
Page Number Part Number Item Number
Item NumberPart NumberPage Number
Page Number Part Number Item Number
Item Number
4.c.4.b.
4.d.
4.a.
5.d.
5.b.5.a. 5.c.
6.c.6.b.
6.d.
6.a.
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G-28i Form G-28I

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Completed 6 November 2019

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