EFTA01200802.pdf
dataset_9 pdf 279.0 KB • Feb 3, 2026 • 2 pages
Department ofHomeland Security
US. Citizenship and Immigration Serviccs
Form I-797C, Notice of Action
THIS NOTICE DOES NOT GRANT ANY IMMIGRATION STATUS OR BENEFIT.
REQUEST FOR APPUCANT TO APPEAR FOR INITIAL INTEKUTENt Decear
i 11 2014
dee me
FORM 5485. APPLICATION TO REGISTER PERMANENT RESIDENCE OR ADJUST STATUS A 260176 39•J
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KARYNA SHIRIAK
du M ARDA BESKARDES
M ARDA BESKARDES ESQ
417 BERGH.' sTREET
ltillIMIIIIIMIII
BROOKLYN NY 11217
You me hereby notified to appear for the interview appointment. as scheduled haw, toe the completion of your Application to Register
Permanent Residence or Adjust Status (Form )-48.5) and any supporting applications or pettier*. Falk* to *hear for this /Menem and/or Wu( e
fo Ivies? Me /Taw fisted gen)sugtrie_soft lea the denial 0:Vie andication RCERICLL20)(i311 __ — —
Who shouid come whit situ?
▪ Now ellotlittv Is based on vour marriage. your husband or we& mind cOMM_VajayOU to the idetview.
0 If you do not speak English fluently, you should bring an intepreter.
LI Your attorney or authorized repaisentare may come with you lo the interview
o it your oregblity is basalon a pa-adrift relatienship and the tthild is a minor the palliating Parent awl the chid must appear to the ;nterrievo.
WOTE: Every ague(over 18 yeas el age) vitio comes to die Mervireer oust ang Government-issued dieto identification, such as a threes licensea ID cad,
in order In entor the Wiring and to verey hisiter identity al the lime of the interiew You do na need to bring your chidnyi unless eternise insOucted
Piease been lime, huh tin not arrive more Ryon 30 minutes early. We may record a videotape your interview.
YOU MIST BRING DEFOLLOWINGITEMS WITH VOW (Please . use as a chedest to pupae for your iterviw)
R This Interview Notice and you Gemintent issued photo Wenficaticn.
O A ciallatetsd tednaleamillatign vin 1-60744eriniaciieation,supplement in a sealed envelope (unless dreary Sutiddee).
o A compieliscl Affidaiiii(s) of Support (Form 1864)wth ail requited evidence, incbaing the Idiciiving, for Wadi el y artspensont (unities akeady sitatitted):
C Fedetal Wane Tar returns and W-25. or SAKIIRS printout% fix the most mime tax year,
o Letters hem each curient employer, verifying current rue d pay aid average *eddy hours. aid pay stubs for the past 2 months:
Evidence et your sponsors ander co-sponsor's United Stales Otizenship or Lawful Permanent:Resident status,
0 All doeumeniatiogieltablisling you; digitally for Lavitel Pawned Resident status. •
LI My immigration-related documentatioo evor issued to you, including any Enployment Adhothertion Debuted (EAD) and any Automation fa gramme
Parole (Form 5512).
U All travel documents used to enter the United Stales, including Paespuis, Advance Parole dna:meats (1.512) and kits (AutivaiDeparare Cocemeni).
Yaw Birth Certificate.
U Your petitioner's Beth Certificate aid your petitioner's evidence et United Slates Cities/tale or Lade! Paranent Resident Status.
O II you have children, bring a Birth Cortina* for each of your dilater.
o d your eligsbety is based on yotr marriage, in akiten twee spouse ccrithg m the inter/few with you, brig:
O A certified copy el your Manage Document issued by the approp*iale civil authority.
o your spouse's um CestIcale aid your ezi-use's evidenced United Rates Citizenship or Lawful Rammed Resident status;
Fl It either you or your spouse were ewe mantel before, al &race deaeesideath certificates to eadi par maniagefiamer spouse;
o Birth Certlicates for al children of Ns manage, and =NM papers kr your children and for your spouse's enCten nor living with you;
D Simporling evidenced your relationship, such as copies ol any doennentation wading joint *sets or lanes you aid your spouse may have lancet.
This may include: fa: retemerbenketetertertaseMiumereedineurneetsieerr We, nediktrideepedrdueetrewbiter, elakreetaliageeements, teary bills,
credit meta contracts, leaser, photos, correspondence andlor any OthOr documents you Joel may suostaniato your n2lations
U Original and copy deadh upportog document that you subrreted with yeti application. Otherwise, we may keep your anginas for our reads.
O I you have ever been articled, being the related Police Report and the original a certified Final Court Disposition for each ant.it oval 11 the chages have
been dismissed or expunged. it no courtrecord is available, big a leiter from the court with (tradition irritating this.
n A certified English emulation la each kreign language document. The translator must certify that &he is fluent in both languages, and that the Vanslabon
in its entirely rs compiele and accurate.
.Cttzenship
MUST APPEAft 77105 piramay.If an onagers, sod' as your own illness or a dose relative's hospitaization, prevents you from appeseing. ihe
nu Immigiatien Service.,* (USCIS) National Ca/stoma Service Center all-MO-375-SM as soon as possible. Please be aimed that
rescheduling will Way processing of applicatiortipaion, and may requie sore steps ki be repeated It may also affect your eligthiftly for taker indigralion
benefits whips this application is pending.
if youhave questions, please call the USC1S National Customer Service Center at 1400.3754283 (hearing impaired TOO service is 1.806767-1833).
PLEASE COME TO: U.S. Citizenship and Immigration Services ON: Friday, January 16, 2015
26 FEDERAL PI IVA AT: 09:00 AM
4TH FLOOR ROOM 4-437
NEW YORK NY 10278
REPRESENTATIVE COPY
i.111 intr./Jiro <rblomelvic..aproIntnirnt wine-v. pivot urnhr bast of this notice fur Inipsrinat Information. Pont. I-797C 07/II/I4 Y
EFTA01200802
Notice to Applicant: If you have ever been arrested or detained by any law
enforcement officer for any reason, you must bring the following to your
adjustment of status interview.
NOTE
You do not need to bring any documentation relating to any traffic fines and incidents that were
not alcohol or drug related and did not involve an actual arrest if the only penalty was a fine of
less than $500 and/or points on your driver's license.
You do need to bring documentation if you were involved in any traffic incidents that were
alcohol or drug related or you were arrested for the incident, or if the penalty resulted in a fine of
more than $500 and/or points on your driver's license.
If you have ever been arrested or detained bluany_law enforeemrt officer for any reason and no
charges were filed, bring:
• An original official statement by the arresting agency or applicable court order
confirming that no charges were filed.
If you have ever been arrested or detained by a law enforcement officer for any reason, and
charges were filed, or if charges were filed against you without an am*, bring:
• An original or court-certified copy of the complete arrest record, and/or disposition for
each incident (e.g., dicrnissal order, conviction record or acquittpl order).
If you have ever been convicted or placed in an alternative sentencing grogram or rehabilitative
program (such as drug treatment or community service program), bring:
• An original or court-certified copy of the sentencing record for each incident, and
evidence that you completed your sentence, specifically.
o An original or certified copy of your probation or parole record, or
o Evidence that you completed an alternative sentencing program or rehabilitative
program.
— If you have ever.had-anyarrestar convietion.vantyt, se. asidersealod,.e.xpungezt or-otherwise . -
removed from your record, bring:
• An original or court-certified copy of the court order vacating, setting aside, sealing,
expunging or otherwise removing the arrest or conviction, or an original statement from
the court that no record exists of your arrest or conviction.
EFTA01200803
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Document Metadata
- Document ID
- 07770568-bb2e-4c94-bf62-97298ea87b2b
- Storage Key
- dataset_9/EFTA01200802.pdf
- Content Hash
- 4f281acb8bdbae07ec008e418d64a6c6
- Created
- Feb 3, 2026