IMPORTANT: Do not sign the form before the interview. You and the interpreter must sign the form in the presence of the interviewing officer.
The interviewing officer uses this form to:
08/10/15 . You can find the edition date at the bottom of the page on the form and instructions.
Dates are listed in mm/dd/yy format.
If you complete and print this form to mail it, make sure that the form edition date and page numbers are visible at the bottom of all pages and that all pages are from the same form edition. If any of the form’s pages are missing or are from a different form edition, we may reject your form.
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Where to FileBring this form with you to your scheduled domestic interview.
IMPORTANT: Do not sign the form before the interview. You and the interpreter must sign the form in the presence of the interviewing officer.