OMB No. 1615-0048; Expires 10/31/2014
Form I-907, Request for
Premium Processing Service
Department of Homeland Security
U.S. Citizenship and Immigration Services
Form I-907 (Rev. 10/19/11) Y
For USCIS Use Only
Request Physically
Received by USCIS
Date
Date
Date
Date
Date
Date
Returned
Resubmitted
Receipt
START HERE - Type or Print (Use black ink)
Part 1. Information About You (Person filing this petition)
If filed on behalf of a company: Company or Business Named in the Related Case
Full Middle NameFamily Name (Last Name) Given Name (First Name)
State/Province
Mailing Address - Street Number and Name / P.O. Box Number
IRS Tax # (if any)
Name of Company Contact Title/Position
City CountryZip/Postal Code
Company Contact Information:
You (the person submitting this request):
5. Beneficiary in the Relating Case
Fax Number (Area/Country Code) E-Mail Address (if any)
Phone Number (Area/Country Code)
Are the attorney or accredited representative for the petitioner who is filing or has filed a petition eligible for Premium
Processing. (Complete and submit Form G-28, if Form G-28 has not been submitted with the petition.)
Are the attorney or accredited representative for the applicant who is filing or has filed an application eligible for Premium
Processing. (Complete and submit Form G-28, if Form G-28 has not been submitted with the application.)
Are the petitioner who is filing or has filed a petition eligible for Premium Processing.
Are the applicant who is filing or has filed an application eligible for Premium Processing.
Part 2. Information About Request
3. Classification/Eligibility
Requested
2. Receipt Number of Related
Petition/Application
4. Petitioner/Applicant in the Relating Case
1. Form Number of Related
Petition/Application
To Be Completed by
Attorney or Representative, if any
Fill in box if Form G-28 is attached
to represent the applicant.
ATTY State License #
Form I-907 (Rev. 10/19/11) Y Page 2
Part 3. Original Signature
I understand that U.S. Citizenship and Immigration Services (USCIS) will issue a refund of the Premium Processing fee to the
addressee above in Part 1 of this request if USCIS does not take an action on the relating premium processing eligible case within 15
calendar days after this request has been physically received at the appropriate USCIS office. Case actions include a referral for
investigation of suspected fraud or misrepresentation, or:
The issuance of:
1. An approval notice;
2. A request for evidence; or
3. A notice of intent to deny.
I certify, under penalty of perjury under the laws of the United States of America, that the information provided with this request is all
true and correct. USCIS may obtain any information from the records of the related case that USCIS needs to determine eligibility for
the benefit being sought.
Title (if applicable)Signature
Print Your Name
Company Name and Address
Daytime Phone Number (Area Code and Number)
Date (mm/dd/yyyy)
Part 4. Original Signature of Attorney or Accredited Representative (Note if attorney is signing above in Part 3)
I declare that I prepared this application at the request of the above person, and it is based on all information of which I have
knowledge.
Same individual as signing above in Part 3. (If this box is checked, provide your firm name and address and daytime phone
number below and submit Form G-28, if Form G-28 has not been submitted with the petition or application. If this box is not
checked, provide the requested information below.)
Print Your NameSignature
Date (mm/dd/yyyy)
Firm Name and Complete Address
Daytime Phone Number (Area Code and Number)