EFTA01600313

PID#: (For Staff Use Only) ATTN: IMMIGRATION ASSISTANCE REQUEST FORM U.S. Senator Dianne Feinstein One Post Street, Suite 2450 San Francisco, CA 94104 Fax: 415-393-0710 PLEASE PRINT CLEARLY OR TYPE Please complete all sections that apply to your case and review instructions at the end of the form. Title: o Mr. o Mrs. o Ms. o Miss o Dr. o Other Name: Vddoryia Vada Date: 11/06/2018 Street Address Apt. #: City: Primary Phone Alternate Phone #: ( ) E-mail Address If you have contacted another Congressional office about this case, please list the office(s) contacted and the date(s) of contact: State: CA Zip Code: SECTION 1: NOTE: The ••beneficiary" is the alien who will receive the direct benefit of a filed petition (i.e. visa or green card). Please see further instructions for waiver applications. Please use one form per beneficiary. A. Petitioner's Name: Vilaciryia Veda Alien Registration #: Petitioner's relationship to beneficia Date of Birth (M Country of Birth: Beneficiary's Name: Alien Registration #: Date of Birth (MM/DDNY). Country of Birth: B. Mark an 'X' to the right of the forms filed For 1-130, 1-140, 1-485, waivers and appeals, see notes below. G-639 1-131 1-730 x 1424 Other: 1-90 1-360 1-751 N-400 1-129 1-539 1-765 N-565 1-129F 1.600/A 1-821 N-600 1-130 1-140 1-485 1-212 1-2908 1-601 1-130/1.140: Be sure to indicate the visa category of your petition and verify that a visa is available by checking the Department of State Visa Bulletin: htm://travelstate.gov/visa/fivi/bulletin/bulletin_l770.html OR by phone: 202- 6631541. Include case priority date(s) from your I-797 Notice of Action below. For 1-485,1-601. I-290B, all appeals or waivers: Include case information on the related petitions (i.e. the 1140 or 1130 filed), as well as the visa category and priority date for those petitions. USCIS case information (from I-797 Notice of Action): Please list all petitions you need help with, as well as the related visa petitions. Include case priority date for 1-140 petitions. Form filed: 1-130 Filing date: 08/19/2016 Receipt #: SRC-16-226'50120 EFTA01600313