Form I-829 03/11/13 Y Page 1
I am a conditional permanent resident spouse or child of an entrepreneur who is deceased.
I-829, Petition by Entrepreneur
to Remove Conditions
Part 1. Information About You
START HERE - Type or print in black ink.
Middle
Name
Family
Name
Given
Name
Address:
In Care Of
Street Number
and Name
Apt. No
State or
Province
Daytime
Phone No
Date of Birth
(mm/dd/yyyy)
Country
of Birth
U.S. Social Security No
(if any)
Country
Zip/Postal
Code
Part 3. Information About Your Husband or Wife
Current
Immigration Status
Part 2. Basis for Petition (Check one)
My conditional permanent residence is based on an investment in a commercial enterprise.
d.
I am a conditional permanent resident spouse or child of an entrepreneur, and I am unable to be included in a Petition by
Entrepreneur to Remove Conditions (Form I-829) filed by my conditional resident spouse or parent.
e.
A-Number (if any)
Form I-526 Receipt Number
a.
Family
Name
Given
Name
Middle
Name
Other names used (including maiden name or aliases)
Date of Birth (mm/dd/yyyy)
Date of Marriage (mm/dd/yyyy)
A-Number
(if any)
Is your current immigration status based
on the petitioner's current status?
Gender
Since becoming a conditional permanent resident, have you ever been arrested, cited, charged, indicted, convicted, fined, or
imprisoned for breaking or violating any law or ordinance (excluding traffic regulations), or committed any crime for which you were
not arrested?
OMB No. 1615-0045; Expires 12/31/2014
(If yes, explain on separate sheet(s) of paper, including disposition, if any.)
Reserved.
b.
c.
Reserved.
Department of Homeland Security
U.S. Citizenship and Immigration Services
Yes
No
Male
Female
Yes
No
For
USCIS
Use
Only
Action Block
Fee Receipt
To Be Completed by an
Attorney/Representative,
if any.
Fill in box if G-28
is attached to
represent the
Attorney State
License Number:
Resubmitted
Received
Sent
Received
Relocated
Remarks
Applicant
Interviewed
Form I-829 03/11/13 Y Page 2
New commercial enterprise resulting from the reorganization of an existing business.
Part 4. Children (List all your children. Attach another sheet(s) of paper, if necessary.)
Family
Name
Given
Name
Middle
Name
A-Number
(if any)
Current Immigration
Status
Date of Birth
(mm/dd/yyyy)
Living
with you?
Part 5. Information About Your Commercial Enterprise
New commercial enterprise resulting from the creation of a new business.
New commercial enterprise resulting from a capital investment in an existing business.
Kind of Business (Be as specific as possible):
Date Business Established (mm/dd/
yyyy)
How many of these new jobs were created by your investment?
At the time of your initial investment:
Amount of Initial Investment
Date of Initial Investment (mm/dd/yyyy)
% of Enterprise You Own
Difference:
Presently:
Type of Enterprise (Check one):
Number of full-time employees in enterprise in United States (excluding you, your spouse, sons, and daughters):
No
Yes
Family
Name
Given
Name
Middle
Name
A-Number
(if any)
Current Immigration
Status
Date of Birth
(mm/dd/yyyy)
Living
with you?
No
Yes
Family
Name
Given
Name
Middle
Name
A-Number
(if any)
Current Immigration
Status
Date of Birth
(mm/dd/yyyy)
Living
with you?
No
Yes
Family
Name
Given
Name
Middle
Name
A-Number
(if any)
Current Immigration
Status
Date of Birth
(mm/dd/yyyy)
Living
with you?
No
Yes
Family
Name
Given
Name
Middle
Name
A-Number
(if any)
Current Immigration
Status
Date of Birth
(mm/dd/yyyy)
Living
with you?
No
Yes
Family
Name
Given
Name
Middle
Name
A-Number
(if any)
Current Immigration
Status
Date of Birth
(mm/dd/yyyy)
Living
with you?
No
Yes
Form I-829 03/11/13 Y Page 3
No
Part 6. Signature (Read the information on penalties in the instructions before completing this section.)
I certify, 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 further certify that the investment was made in accordance with the laws of the United States and was not for
the purpose of evading United States immigration laws. I also authorize the release of any information from my records that the U.S.
Citizenship and Immigration Services needs to determine eligibility for the benefit being sought.
Print Name
Part 7. Signature of Person Preparing Form, If Other Than Above
I declare that I prepared this petition at the request of the above person and it is based on all information of which I have knowledge.
Firm Name and Address (Include Telephone Number with Area Code and E-Mail Address.)
Part 5. Information About Your Commercial Enterprise (continued)
Subsequent Investment in the Enterprise:
Date of Investment
Amount of Investment
Type of Investment
Provide the gross and net incomes generated annually by the commercial enterprise since your initial investment. Include all income
generated up to date during the present year.
Year
Net Income
Gross Income
Has your commercial enterprise filed for bankruptcy, ceased business operations, or have any changes in its business organization or
ownership occurred since the date of your initial investment?
Yes (Explain on separate sheet)
Has your commercial enterprise sold any corporate assets, shares, property, or had any capital withdrawn since the date of your initial
investment?
Yes (Explain on separate sheet)
No
Signature of Applicant
Date
NOTE: If you do not completely fill out this form or fail to submit any required documents listed in the instructions, you may
not be found eligible for the requested benefit and this petition may be denied.
Signature
Print Name
Date
$
$
$
$
$
$