EFTA01600314.pdf

P1130: ATTN: (For Staff Use Only) IMMIGRATION ASSISTANCE REQUEST FORM U.S. Senator Dianne Feinstein One Post Street, Suite 2450 San Francisco, CA 94104 Fax: 415-393-0710 PLEASE PRINT CLEARLY OR TYPE Please complete all sections that apply to your case and review instructions at the end oftheform. Title: s. o Miss o Dr. o Other Name: Date: 11/06/2018 Street Addres Apt #: City: San Francisco State: CA Zip Code: 94121 Primary Phone Alternate Phone It: ( ) E-mail Address If you have contacted another Congressional office about this case, please list the office(s) contacted and the date(s) of contact: SECTION 1: NOTE: The -beneficiary" is the alien who will receive the direct benefit of a filed petition (i.e. visa or green card). Please see funher instructions or waiver applications. Please use one form per beneficiary. A. Petitioner's Name: Alien Registratio Petitioner's relationship to benefici Date of Birth (M /YY Country ofBird= Beneficiary 's Name: Alien Registration Date of Birth (MM/DD/Y Country ofBirth B. Mark an 'X' to the right of orms For 1-130, 1-140, 1-485, waivers and appeals, see notes below. 0-639 1-131 1-730 x 1424 Other: 1-90 1-360 1-751 N-400 1-129 1-539 1-765 N-565 I-129F 1-600/A 1-821 N-600 1-130 1-140 1-485 1-212 1-2908 1-601 I-130/I-t40: Be sure to indicate the visa category of your petition and verify that a visa is available by checking the Department of State Visa Bulletin: hnp://travel.st ate.govivisaffi vi/bulletin/bull etin_1770.htm l OR by phone: 202- 6631541. Include case priority &nets) from your 1-797 Notice of Action below. For 1-45,1-601, I-290B, all appeals or waivers: Include case information on the related petitions (i.e. the 1140 or 1130 filed), as well as the visa category and priority date for those petitions. USCIS case information (from 1-797 Notice of Action): Please list all petitions you need help with, as well as the related visa petitions. Include case priority date for 1-140 petitions. Form filed: 1-130 Filing date: 09/19,2016 Receipt # EFTA01600314