EFTA01134231.pdf

i 4Aft liortAPtr) t- typist instill ni Homeland Security Form 1-294B.\of ik I .ittl Immivrati(ln Services of /tiv i.4.:;! or ", tifprl k Number ink WI %MI keturhttl Infos matism t It Given Name Middle Name NAM. . . t Hp MC'. )t garrization (ii applicable) Resulnaitfrit Mailing Add, « street Number and Name Apt. tree 1 1 ('/t ) (in care or) Helix Sent State or Pros ince Zip/Postal Code Date Country Daytime Phone # (AreaJCour !r: Code) Date Fax # (Aren'( 'onntry Code) C Mail Address (if anv) Refry( lux a CI I am an anorney err reprem:ntatlye If you check this box. you must provide the !Aiming information about the person or organization for whom you are appearing. (NOTE: You must attach a Form G-28, Notice of Entry of Appearance ac Attorney or Representative.) Date Family Name Given Name Middle Name L Complete Name of I3usiness/Organization/School (if applicable) A # (if any) Daytime Phone # (Area/Country Code) Fax // (Areaituuntcy Code) Addrcn (if any) motion. Part 2. I am iiiatitm about the appeal or your request. (Check one box.) Check the box below that the best dcscribe5 I dill filing an appeal. My brief and/or additional evidence is attached. d to the AAO within 30 days. I am filing an appeal. My brief and/or additional evidence will be submitte evidence will be sabenned, I ain tiling an appeal. No supplemental brie) anti as additional attached. I am filing a motion to reopen a decision My brief and/or additional evidmce is I am filing a motion to reconsider a decision. My brief is attached add*iortal evidence rs Ar I am filing a motion to reopen and a motion to reconsider a decision. My brief antVor EFTA01134231