Form I-600a - Application For Advance Processing Of An Orphan Petition Page 10
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12Part 7. Spouse's Statement, ASC Acknowledgement (if applicable), Certification, Signature, and
Contact Information (continued)
Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS may
require that I submit original documents to USCIS at a later date. Furthermore, I authorize the release of any information from my
records that USCIS may need to determine my suitability and eligibility as an adoptive parent.
I furthermore authorize release of information contained in this application, in supporting documents, and in my USCIS records, to
other entities and persons where necessary for the administration of U.S. immigration laws.
Spouse's Signature
3.
Spouse's Signature
Date of Signature
►
(mm/dd/yyyy)
Spouse's Contact Information
4.
Spouse's Daytime Telephone Number
5.
Spouse's Mobile Telephone Number (if any)
6.
Spouse's Email Address (if any)
Part 8. Spouse's Duty of Disclosure
Certification: I understand the ongoing duty to disclose information concerning my suitability and eligibility as an adoptive parent,
as described in the Form I-600A and/or Form I-600 instructions, and I agree to notify the home study preparer and USCIS of any new
information that I am required to disclose.
Spouse's Signature
Date of Signature
►
(mm/dd/yyyy)
Part 9. Interpreter's Name, Contact Information, Certification, and Signature
If you and/or your spouse (if married) used an interpreter to read and complete this application, the interpreter must provide the
following information:
Interpreter's Full Name
1.
Interpreter's Family Name (Last Name)
Interpreter's Given Name (First Name)
2.
Interpreter's Business or Organization Name (if any)
Interpreter's Mailing Address
3.
Street Number and Name
Apt.
Ste.
Flr.
Number
City or Town
State
ZIP Code
Province
Postal Code
Country
Form I-600A 12/23/16 N
Page 10 of 12
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