Part 1. Information about you. (Person filing this application)
Family Name (Last name)
Part 2. Reason for request (check one):
START HERE - Please type or print in black ink.
Given Name (First Name) Middle Name
State or Province
Attorney or Representative, if any.
To Be Completed by
Fill in box if G-28 is attached to
represent the applicant.
ATTY State License #
For USCIS Use Only
Mailing Address - Street Number and Name
Country of Birth
I am requesting: (Check one box.)
A duplicate approval notice.
C/O (in care of):
Home or Business Address - Street Number and Name
Daytime Phone # (Area/Country Codes)
State or Province
Country of Citizenship
Company or Organization Name
A # (if any)
U.S. Social Security # (if any)
Date of Birth (mm/dd/yyyy)
IRS Tax # (if any)
USCIS to notify the U.S. Department of State of my U.S. citizenship status.
Form I-824 (Rev. 07/30/07) Y
OMB No. 1615-0044: Expires 07/31/08
USCIS to notify a U.S. Consulate that my status has been adjusted to permanent
resident. Please notify the U.S. Consulate at:
USCIS to send my approved immigrant visa to the National Visa Center (NVC).
I-824, Application for Action on an
Approved Application or Petition
Department of Homeland Security
U.S. Citizenship and Immigration Services
USCIS to notify a different U.S. Consulate or Port-of-Entry about the approval of an
application or petition. Please notify the U.S. Consulate or Port-of-Entry at:
Part 5. Signature of person preparing form, if other than above. (Sign below.)
Part 3. Additional information.
1. Give the following information about the original petition or application.
Give the following information about the petitioner or applicant for the original petition or application.
I declare that I prepared this at the request of the applicant and it is based on all information of whic