I-130A Application Form I-130A Supplemental Information For Spouse Beneficiary Back Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Information About You (Beneficiary) LayoutAlien Registration Number (A-Number) (if any)USCIS Online Account Number (if any)NameFirstMiddleLastPhysical Address LayoutStreet Number and NameCity or TownStateZip CodeLayoutProvincePostal Code CountryLayoutDate : From Date : ToInformation About Parent 1 Full Name of ParentFirstMiddleLastLayoutDate of Birth GenderMaleFemaleLayoutCity/Town/Village of BirthCountry of BirthCountry of ResidenceInformation About Parent 2 Full Name of ParentFirstMiddleLastLayout (copy)Date of BirthGenderMaleFemaleLayout (copy)City/Town/Village of BirthCountry of BirthCountry of ResidenceInformation About Your Employment Employer 1 Name of Employer/CompanyLayoutStreet Number and NameCity or Town StateZip CodeLayoutProvincePostal CodeCountryYour OccupationDate : FromDate : ToInformation About Your Employment Employer 2 Name of Employer/CompanyLayout (copy)Street Number and NameCity or TownStateZip CodeLayout (copy)ProvincePostal CodeCountryYour OccupationDate : FromDate : To Information About Your Employment Outside the United States Name of Employer/CompanyLayout (copy) (copy)Street Number and NameCity or TownStateZip CodeLayout (copy) (copy)ProvincePostal CodeCountryYour OccupationDate : FromDate : ToBeneficiary's Contact Information LayoutBeneficiary's Daytime Telephone NumberBeneficiary's Mobile Telephone Number (if any)Beneficiary's Email Address (if any)Interpreter's Contact Information, Certification, and Signature Interpreter's Full Name LayoutInterpreter's Family Name (Last Name)Interpreter's Given Name (First Name)Interpreter's Business or Organization Name (if any)Interpreter's Mailing Address LayoutStreet Number and NameCity or TownStateZip CodeLayoutProvincePostal CodeCountryInterpreter's Contact Information LayoutInterpreter's Daytime Telephone NumberInterpreter's Mobile Telephone Number (if any)Interpreter's Email Address (if any)Contact Information, Declaration, and Signature of the Person Preparing this Form, if Other Than the Spouse Beneficiary LayoutPreparer's Family Name (Last Name)Preparer's Given Name (First Name)Preparer's Business or Organization Name (if any)LayoutStreet Number and NameCity or TownStateZip CodeLayoutProvincePostal CodeCountryPreparer's Daytime Telephone NumberPreparer's Mobile Telephone Number (if any)Preparer's Email Address (if any)Preparer's Statement Multiple ChoiceI am not an attorney or accredited representative but have prepared this form on behalf of the spouse beneficiary and with the spouse beneficiary's consent.I am an attorney or accredited representative and my representation of the spouse beneficiary in this case extend beyond the preparation of this form.Evidence Layout Birth Certificate Of Petitioner Upload your file here Birth Certificate Of Beneficiary Upload your file here Green Card Or Certificate Of Citizenship Or US Birth Certificate Upload your file here If Prior Marriage (Divorce Certificate) Upload your file here Marriage Certificate (If Through Marriage) Upload your file hereBring the following evidence when you go to the U.S. Embassy or U.S. Consulate to submit your Form I-131A: Your original passport; One copy of your passport’s biographic page (showing your photograph and personal information); Evidence that you are a lawful permanent resident; A copy of your tickets, itinerary, or any other evidence indicating your most recent date of departure from the United States and the day you intend to return to the United States; and One passport-style photograph of yourself taken within 30 days of filing this application. Other DocumentsSubmit