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Cbp 3461 sample Form: What You Should Know

Signature Name: __________________ Date (MM-DD-YYYY): ________________ Form 5129 — Information to be furnished by non-U.S. person applying for U.S. resident alien status, Form 6059B — Application for permanent resident status (including non-immigrant visas) for immediate family members of U.S. citizens or permanent resident aliens residing in the United States, and Form I-94 — Application for admission as a nonimmigrant to the United States Date: October 15, 2018, I, _______, the undersigned citizen, resident alien of the United States, and the spouse and children of _______, citizen of the United States residing in the United States (collectively, the _________ family members) certify that my name is _______ (as stated on the Application for Nonimmigrant Visa). I certify that I am applying for a nonimmigrant visa under the following provisions of the Immigration and Nationality Act: Section 201; Section 202 of the Immigration and Nationality Act; Section 203(c) of the Immigration and Nationality Act; Section 207(a) of the Immigration and Nationality Act; and Section 212(a) and (b) of the Immigration and Nationality Act and that I am not a National of the People's Republic of China. I am at least twenty-one years of age. Furthermore, I have sufficient funds to support myself while awaiting my application review. Furthermore, I understand and acknowledge that all funds received by my representative before my visa application review will be used for processing fees only. Furthermore, I understand and acknowledge that my application must be processed without any delay and that I shall not receive any other form of benefit from a Federal Government agency unless I have completed the approved application process. Furthermore, I am an applicant in process who is not an alien admitted under the above-referenced Section 202(b)(1)/(2) and (4) of the Immigration and Nationality Act. Furthermore, I have successfully completed the online form and submitted all required information to the U.S. Department of State in order to obtain a Nonimmigrant Visa (U.S. Department of State, Visa Bulletin, 2017-02). Furthermore, I understand that my application is the responsibility of _______ (name and signature on the form).

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