Notice Of Entry Of Appearance As Attorney In Matters Outside {G-28I}

Form G-28I 05/23/18 Page 1 of 4Notice of Entry of Appearance as Attorney In Matters Outside the Geographical Confines of the United States Department of Homeland Security Part 1. Information About Attorney 4. 6.5.Email Address (if any) 2.a.Family Name (Last Name) 2.b. Given Name (First Name) 2.c. Middle Name Daytime Telephone Number 3.a.3.b.3.c.3.d.3.e.3.f. DHS Form G-28I OMB No. 1615-0105 Expires 05/31/20211.USCIS Online Account Number (if any) Name of Attorney Postal CodeCountryCity or Town Street Number and Name Ste. Flr. Apt. Province 1.c.I (select only one box)subject to any order suspending, enjoining, restraining, disbarring, or otherwise restricting me in the practice of law. If you are subject to any orders, use the space provided in Part 6. Additional Information to provide an explanation. am notam 2. I am associated with the attorney of record who previously filed Form G-28I in this case, and my appearance as an attorney for a limited purpose is at his or her request., Contact Information of AttorneyLicense Number (if applicable) 1.b.Mobile Telephone Number (if any) Address of Attorney Name of Law Firm or Organization (if applicable)1.d.Licensing Authority 7. Fax Number (if any)Select all applicable items. Part 2. Eligibility Information for Attorney1.a.I am an attorney licensed to practice law in, and in good standing of, a court of general jurisdiction in the following country where I reside and I am regularly engaged in such practice. If you need extra space to complete this section, use the space provided in Part 6. Additional Information. Part 3. Notice of Appearance as Attorney Admitted to Practice Outside the United StatesThis appearance relates to immigration matters before (select only one box):1.a. U.S. Citizenship and Immigration Services (USCIS)List the form numbers or specific matter in which appearance is entered.1.b. If you need extra space to complete this section, use the space provided in Part 6. Additional Information.2.a. U.S. Immigration and Customs Enforcement (ICE)List the specific matter in which appearance is entered.2.b. American LegalNet, Inc. www.FormsWorkFlow.com Form G-28I 05/23/18 Page 2 of 4 Part 3. Notice of Appearance as Attorney Admitted to Practice Outside the United States (continued)3.a. U.S. Customs and Border Protection (CBP)List the specific matter in which appearance is entered.3.b. 4.Receipt Number (if any) I enter my appearance as an attorney at the request of the (select only one box):5.ApplicantPetitionerRespondent (ICE, CBP) Beneficiary/Derivative9.Client's Alien Registration Number (A-Number) (if any)8.Client's USCIS Online Account Number (if any) 6.a.Family Name (Last Name)6.b.Given Name (First Name)6.c.Middle Name Information About Client (Applicant, Petitioner, Beneficiary or Derivative, Respondent, or Authorized Signatory for an Entity)7.a.Name of Entity (if applicable) A- Title of Authorized Signatory for Entity (if applicable)7.b.10.Daytime Telephone Number12.Email Address (if any) Client's Contact Information Mobile Telephone Number (if any)11.13.f.13.e.Postal CodeCountry NOTE: Provide the client's mailing address. Do not provide the business mailing address of the attorney unless it serves as the safe mailing address on the application or petition being filed with this Form G-28I.13.a. 13.c. 13.b. Mailing Address of ClientCity or Town Street Number and Name Ste. Flr. Apt.13.d.Province Part 4. Client's Consent to Representation and SignatureI request that USCIS send original notices on an application or petition to the business address of my attorney as listed in this form.1. I have requested the representation of and consented to being represented by the attorney named in Part 1. of this form. According to the Privacy Act of 1974 and U.S. Department of Homeland Security (DHS) policy, I also consent to the disclosure to the named attorney of any record pertaining to me that appears in any system of records of USCIS, ICE, or CBP. Consent to Representation and Release of InformationUSCIS will send notices to both a represented party (the client) and his, her, or its attorney or accredited representative either through mail or electronic delivery. If you want to have notices sent to your attorney rather than to you, please select Item Number 1. below. You may change this election through written notice to USCIS. Options Regarding Receipt of USCIS Notices Signature of Client or Authorized Signatory for an Entity2.a.2.b.Date of Signature (mm/dd/yyyy) Signature of Client or Authorized Signatory for an Entity American LegalNet, Inc. www.FormsWorkFlow.com Form G-28I 05/23/18 Page 3 of 4 Part 5. Signature of Attorney I have read and understand the regulations and conditions contained in 8 CFR 103.2 and 292 governing appearances and representation before DHS. I declare under penalty of perjury under the laws of the United States that the information I have provided on this form is true and correct.1.a.Signature of Attorney 1.b. Date of Signature (mm/dd/yyyy) American LegalNet, Inc. www.FormsWorkFlow.com Form G-28I 05/23/18 Page 4 of 4 Part 6. Additional InformationIf you need extra space to provide any additional information within this form, use the space below. If you need more space than what is provided, you may make copies of this page to complete and file with this form or attach a separate sheet of paper. Type or print your name at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet. 2.d.1.aFamily Name (Last Name) 1.b.Given Name (First Name) 1.c.Middle Name 2.a.2.b.2.c.Page Number Part Number 3.d.3.a.3.b.3.c.Page Number Part Number Item Number Page Number Part Number Item Number Item Number Part Number Page Number Page Number Part Number Item Number Item Number4.c.4.b.4.d.4.a.5.d.5.b.5.a.5.c.6.c.6.b.6.d.6.a. American LegalNet, Inc. www.FormsWorkFlow.com