Petition for Amerasian, Widow(er), or Special Immigrant

• Legal Form Number: I-360
• Section: Citizenship and Immigration Services (United States of America)
• Issuer: Citizenship and Immigration Services (United States of America)

Form I-360 Edition 07/15/22 Page 1 of 19

For USCIS Use Only

Petition for Amerasian, Widow(er), or Special Immigrant

Department of Homeland Security

U.S. Citizenship and Immigration Services

USCIS

Form I-360

OMB No. 1615-0020

Expires 04/30/2024

START HERE - Type or print in black ink.►

Remarks:

Action Block

Sent

Received

Relocated

Fee Stamp

Resubmitted

Petitioner/Applicant

Interviewed

Interviewed Beneficiary

Interviewed

Bene "A" File Reviewed

I-485 Filed Concurrently

Returned

Priority Date

Consulate

Classification

Part 1. Information About Person or Organization Filing This Petition

Family Name (Last Name)

Your Full Name

NOTE: You must complete Part 1. as the petitioner if you are filing this petition on behalf of another person. If you are a Violence

Against Women Act (VAWA) self-petitioner or special immigrant juvenile, skip to Part 1., Item Number 7.

Mailing Address

Given Name (First Name) Middle Name

City or Town State ZIP Code

Street Number and Name Apt. Flr. NumberSte.

Postal Code CountryProvince

In Care Of Name (if any)

Organization Name (if applicable)

U.S. Social Security Number (if any)

Individual IRS Tax Number (if any)

►

►

Alien Registration Number (A-Number) (if any)

►A-

1.

2.

4. 5.

3.

6.

USCIS Online Account Number (if any)

►

Select this box if

Form G-28 or

G-28I is attached.

Attorney State Bar Number

(if applicable) Attorney or Accredited Representative

USCIS Online Account Number (if any)

To be completed by an

Attorney or Accredited

Representative (if any).

(USPS ZIP Code Lookup)

Form I-360 Edition 07/15/22 Page 2 of 19

Alternate and/or Safe Mailing Address

City or Town State ZIP Code

In Care Of Name (if any)

Street Number and Name Apt. Flr. NumberSte.

Postal Code CountryProvince

If you are a VAWA self-petitioning spouse, child, parent, or a special immigrant juvenile and do not want U.S. Citizenship and

Immigration Services (USCIS) to send notices about this petition to your home, you may provide an alternate and/or safe mailing

address.

Part 1. Information About Person or Organization Filing This Petition (continued)

Part 2. Classification Requested

Will the beneficiary be working as a minister?

1.

(1)

Amerasian

Select only one box.

Special Immigrant Religious Worker

Special Immigrant Juvenile

Widow(er) of a U.S. citizen

Special Immigrant based on employment with the Panama Canal Company, Canal Zone Government, or U.S.

Government in the Canal Zone

Self-Petitioning Spouse of Abusive U.S. citizen or Lawful Permanent Resident

Special Immigrant G-4 International Organization Employee or Family Member or NATO-6 Employee or Family

Member

Special Immigrant Armed Forces Member

Special Immigrant Physician

K. VAWA Self-Petitioning Parent of a U.S. citizen son or daughter

Special Immigrant Afghanistan or Iraq National who worked with the U.S. Armed Forces as a translator

Self-Petitioning Child of Abusive U.S. citizen or Lawful Permanent Resident

Special Immigrant Iraq National who was employed by or on behalf of the U.S. Government

Broadcasters

P. Other

Special Immigrant Afghanistan National who was employed by or on behalf of the U.S. Government or the

International Security Assistance Force (ISAF) in Afghanistan

O.

Yes No

7.

A.

B.

C.

D.

E.

F.

G.

H.

I.

J.

L.

M.

N.

Provide the name of the classification below.