Notice of Entry of Appearance as Attorney or Accredited Representative

Legal Form NumberG-28
SectionCitizenship and Immigration Services (United States of America)
IssuerCitizenship and Immigration Services (United States of America)
Form G-28 09/17/18 Page 1 of 4
Notice of Entry of Appearance
as Attorney or Accredited Representative
Department of Homeland Security
Part 1. Information About Attorney or
Accredited Representative
Name of Attorney or Accredited Representative
4.
5.
2.a. Family Name
(Last Name)
2.b. Given Name
(First Name)
2.c. Middle Name
Daytime Telephone Number
DHS
Form G-28
OMB No. 1615-0105
Expires 05/31/2021
1. USCIS Online Account Number (if any)
Street Number
and Name
3.a.
3.b. Ste. Flr.Apt.
3.c. City or Town
3.d. State 3.e. ZIP Code
3.f. Province
3.g. Postal Code
3.h. Country
Email Address (if any)
7. Fax Number (if any)
6.
2.b. Name of Recognized Organization
2.c. Date of Accreditation (mm/dd/yyyy)
2.a. I am an accredited representative of the following
qualified nonprofit religious, charitable, social
service, or similar organization established in the
United States and recognized by the Department of
Justice in accordance with 8 CFR part 1292.
1.c. I (select only one box) am not am
subject to any order suspending, enjoining, restraining,
disbarring, or otherwise restricting me in the practice of
law. If you are subject to any orders, use the space
provided in Part 6. Additional Information to provide
an explanation.
1.b. Bar Number (if applicable)
Part 2. Eligibility Information for Attorney or
Accredited Representative
Select all applicable items.
1.a. I am an attorney eligible to practice law in, and a
member in good standing of, the bar of the highest
courts of the following states, possessions, territories,
commonwealths, or the District of Columbia. If you
need extra space to complete this section, use the
space provided in Part 6. Additional Information.
Contact Information of Attorney or Accredited
Representative
3. I am associated with
the attorney or accredited representative of record
who previously filed Form G-28 in this case, and my
appearance as an attorney or accredited representative
for a limited purpose is at his or her request.
,
4.a. I am a law student or law graduate working under the
direct supervision of the attorney or accredited
representative of record on this form in accordance
with the requirements in 8 CFR 292.1(a)(2).
4.b. Name of Law Student or Law Graduate
Licensing Authority
Mobile Telephone Number (if any)
Address of Attorney or Accredited Representative
1.d. Name of Law Firm or Organization (if applicable)
(USPS ZIP Code Lookup)

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