Form I-907
Edition
09/30/20
Page 3 of 7
1.
Requestor's Statement Regarding the Interpreter
Requestor's Statement Regarding the Preparer
A.
B.
I can read and understand English, and I have read and understand every question and instruction on this request and
my answer to every question.
question in
The interpreter named in
Part 4.
read to me every question and instruction on this request and my answer to every
, a language in which I am fluent, and
prepared this request for me based only upon information I provided or authorized.
At my request, the preparer named in
Part 5.
,
,
2.
Requestor's Statement
Part 3.
Requestor's Statement, Contact Information, Declaration, Certification, and Signature
NOTE:
Read the
Penalties
section of the Form I-907 Instructions before completing this section.
I understand that U.S. Citizenship and Immigration Services (USCIS) will refund the Premium Processing Service fee to the person
listed in
Part 1.
of this request if USCIS does not take an action on the related case within 15 calendar days after the appropriate
USCIS office physically receives this request.
I understand that case actions include a referral for investigation of suspected fraud,
misrepresentation, or the issuance of an approval notice, a request for evidence, a notice of intent to deny, or a denial notice.
NOTE
:
Select the box for either
Item A.
or
B.
in
Item Number 1.
If applicable, select the box for
Item Number 2.
Ste.
Number
Flr.
Apt.
ZIP Code
State
City or Town
Province
Postal Code
Country
Street Number and Name
8.
Address of Petitioner, Applicant, Company, or Organization Named in Related Case
Part 2.
Information About the Request
(continued)
Requestor's Declaration and Certification
I furthermore authorize release of information contained in this request, in supporting documents, and in my USCIS records, to other
entities and persons where necessary for the administration and enforcement of U.S. immigration law.
Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS may
require that I submit original documents to USCIS at a later date.
Furthermore, I authorize the release of any information from any
and all of my records that USCIS may need to determine my eligibility for the immigration benefit that I seek.
I understood everything.
Requestor's Contact Information
Requestor's Daytime Telephone Number
Requestor's Mobile Telephone Number (if any)
3.
4.
Requestor's Email Address (if any)
6.
Requestor's Fax Number (if any)
5.
Form I-907
Edition
09/30/20
Page 4 of 7
3.
Interpreter's Mailing Address
City or Town
State
ZIP Code
Postal Code
Province
Street Number and Name
Apt.
Flr.
Number
Ste.
Country
Interpreter's Contact Information
Interpreter's Daytime Telephone Number
Interpreter's Email Address (if any)
4.
6.
Part 4.
Interpreter's Contact Information, Certification, and Signature
Interpreter's Given Name (First Name)
Interpreter's Family Name (Last Name)
1.
Interpreter's Full Name
Interpreter's Business or Organization Name (if any)
2.
Provide the following information about the interpreter.
Requestor's Signature
Requestor's Signature
Date of Signature (mm/dd/yyyy)
7.
Interpreter's Certification
I certify, under penalty of perjury, that:
I am fluent in English and
, which is the same language specified in
Part 3.
,
Item B.
in
Item Number 1.
, and I have read to this requestor in the identified language every question and instruction on this request
and his or her answer to every question.
The requestor informed me that he or she understands every instruction, question, and answer
on the request, including the
Requestor's Declaration and Certification
, and has verified the accuracy of every answer.
Part 3.
Requestor's Statement, Contact Information, Declaration, Certification, and Signature
(continued)
I certify, under penalty of perjury, that all of the information in my request and any document submitted with it were provided or
authorized by me, that I reviewed and understand all of the information contained in, and submitted with, my request and that all of
this information is complete, true, and correct.
NOTE TO ALL REQUESTORS:
If you do not completely fill out this request or fail to submit required documents listed in the
Instructions, USCIS may deny your request.
Interpreter's Mobile Telephone Number (if any)
5.
Form I-907
Edition
09/30/20
Page 6 of 7
Preparer's Signature
Date of Signature (mm/dd/yyyy)
Preparer's Certification
Preparer's Signature
By my signature, I certify, under penalty of perjury, that I prepared this request at the request of the requestor.
The requestor then
reviewed this completed request and informed me that he or she understands all of the information contained in, and submitted with,
his or her request, including the
Requestor's Declaration and Certification
, and that all of this information is complete, true, and
correct.
I completed this request based only on information that the requestor provided to me or authorized me to obtain or use.
8.
Part 5.
Contact Information, Declaration, and Signature of the Person Preparing this Request, if Other
Than the Requestor
(continued)