Petition for Alien Relative USCIS

Form I-130
Department of Homeland Security OMB No. 1615-0012
U.S. Citizenship and Immigration Services Expires 07/31/2024

For USCIS Use Only Fee Stamp Action Stamp

A-Number
► A-
Initial Receipt
Resubmitted
Relocated Section of Law/Visa Category
Received 201(b) Spouse - IR-1/CR-1 203(a)(1) Unm. S/D - F1-1 203(a)(2)(B) Unm.S/D - F2-4

Sent 201(b) Spouse - IR-2/CR-2 203(a)(2)(A) Spouse - F2-1 203(a)(3) Married S/D-F3-1

Completed 201(b) Parent -IR-5 203(a)(2)(A) Child - F2-2 203(a)(4) Brother/Sister-F4-1

Approved Petition was filed on (Priority Date mm/dd/yyyy): Field Investigation Personal Interview 204(a)(2)(A) Resolved
Previously Forwarded Pet. A-File Reviewed I-485 Filed Simultaneously
Returned PDR request granted/denied - New priority date (mm/dd/yyyy):
203(g) Resolved Ben. A-File Reviewed 240(g) Resolved
Remarks
At which USCIS office (e.g., NBC, VSC, LOS, CRO) was Form I-130 adjudicated

Part 1. Information About You

Select this box if Volag Number Attorney State Bar Number Attorney of Accredited Representative
Form G-28 is (if any) (if applicable) USCIS Online Account Number (if any)
attached.

Electronic
► START HERE - Type or Print in Black Ink
If you need extra space to complete any section of this petition, use the space provided in Part 9. Additional Information.
Complete and submit as many copies of Part 9., as necessary, with your petition.

Part 1. Relationship (You are the Petitioner. Your Part 2. Information About You (Petitioner)
relative is the Beneficiary) 1. Alien Registration Number (A-Number) (if any)
1. I am filing this petition for my (Select only one box): ► A- 055228978
Spouse Parent Brother/Sister Child 2. USCIS Online Account Number (if any)
2.

Form
If you are filing this petition for your child or parent,
select the box that describes your relationship (Select only
one box):
Child was born to parents who were married to each
other at the time of the child's birth

Stepchild/Stepparent

Child was born to parents who were not married to

3.

Your Full Name

4.a.
►
U.S. Social Security Number (if any)

► 651-34-4228

Family Name PRIETO GARZON

(Last Name)

Only
each other at the time of the child's birth 4.b. Given Name SANDRA
Child was adopted (not an Orphan or Hague (First Name)
Convention adoptee) 4.c. Middle Name BIBIANA
3. If the beneficiary is your brother/sister, are you related by
adoption?
Yes No
4. Did you gain lawful permanent resident status or
citizenship through adoption?
Yes No

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 Part 2. Information About You (Petitioner) Address History
(continued) Provide your physical addresses for the last five years, whether
inside or outside the United States. Provide your current
address first if it is different from your mailing address in Item
Other Names Used (if any)
Numbers 10.a. - 10.i.
Provide all other names you have ever used, including aliases,
maiden name, and nicknames. Physical Address 1
5.a. Family Name 12.a. Street Number 2510 Oakrill Rd
(Last Name) and Name
5.b. Given Name 12.b. Apt. Ste. Flr.
(First Name)
12.c. City or Town Marietta
5.c. Middle Name
12.d. State GA 12.e. Zip Code 30062
Other Information
12.f. Province
6. City/Town/Village of Birth
12.g. Postal Code
Bogota
12.h. Country
7. Country of Birth
United States
Colombia
13.a. Date From (mm/dd/yyyy)
8. Date of Birth (mm/dd/yyyy) 12/25/1971
13.b. Date To (mm/dd/yyyy)
9. Sex Male Female

Mailing Address Physical Address 2

10.a. In Care of Name 14.a. Street Number 2510 Oakrill Rd
and Name

Electronic
14.b. Apt. Ste. Flr.
10.b. Street Number 2510 Oakrill Rd
and Name 14.c. City or Town Marietta
10.c. Apt. Ste. Flr. 14.d. State GA 14.e. Zip Code 30062
10.d. City or Town Marietta
14.f. Province
10.e. State GA 10.f. Zip Code 30062
14.g. Postal Code
10.g. Province 14.h. Country

Form
10.h. Postal Code United States
10.i. Country 15.a. Date From (mm/dd/yyyy) 06/28/2011
United States 15.b. Date To (mm/dd/yyyy) 12/29/2023
11. Is your current mailing address the same as your physical
address? Your Marital Information
Yes No
16. How many times have you been married? ►2
If you answered "No" to Item Number 11., provide
information on your physical address in Item Numbers 12.a. -
17. Current Marital Status

Only
13.b.
Single, Never Married Married Divorced
Widowed Separated Annulled

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 Part 2. Information About You (Petitioner) 27. Country Of Birth
(continued) Colombia
18. Date of Current Marriage (if currently married) 28. City/Town/Village of Residence
(mm/dd/yyyy)
07/18/2015 ENCISO SANTANDER
29. Country of Residence
Place of Your Current Marriage (if married)
19.a. City or Town HOLLYWOOD United States

19.b. State FL Parent 2's Information

Full Name of Parent 2
19.c. Province
30.a. Family Name GARZON CASTRO
19.d. Country (Last Name)
United States 30.b. Given Name NOHEMI
(First Name)
Name of All Your Spouses (if any) 30.c. Middle Name
Provide information on your current spouse (if currently married) 31. Date of Birth (mm/dd/yyyy) 10/06/1943
first and then list all your prior spouses (if any).
32. Sex Male Female
Spouse 1
33. Country Of Birth
20.a. Family Name LUGO GIL
(Last Name) Colombia
20.b. Given Name OSCAR 34. City/Town/Village of Residence
(First Name)
20.c. Middle Name HUMBERTO BOGOTA
35. Country of Residence
21. Date Marriage Ended (mm/dd/yyyy) 11/19/2013

Electronic
Colombia

Spouse 2 Additional Information About You (Petitioner)

20.a. Family Name CALLISON 36. I am a (Select only one box):
(Last Name)
U.S. Citizen Lawful Permanent Resident
20.b. Given Name Stephen
(First Name) If you are a U.S. citizen, complete Item Number 37.
20.c. Middle Name LEE 37. My citizenship was acquired through (Select only one
box):

Form
21. Date Marriage Ended (mm/dd/yyyy) 11/19/2013
Birth in the United States
Information About Your Parents Naturalization
Parent 1's Information Parents
Full Name of Parent 1 38. Have you obtained a Certificate of Naturalization or a
Certificate of Citizenship?
24.a. Family Name PRIETO RINCON Yes No
(Last Name)
If you answered "Yes" to Item Number 38., complete the
24.b. Given Name JAIME following:

Only
(First Name)
39.a. Certificate Number
24.c. Middle Name
25 Date of Birth (mm/dd/yyyy) 32098496
09/23/1943 39.b. Place Of Issuance
26. Sex Male Female
Oakland Park Florida
39.c Date of Issuance (mm/dd/yyyy) 03/18/2009

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 Part 2. Information About You (Petitioner) Employer 2
(continued) 46. Name of Employer/Company
If you are a lawful permanent resident, complete Item New Story Inc.
Numbers 40.a. - 41.
47.a. Street Number 199 Armour Dr NE
40.a. Class of Admission and Name
47.b. Apt. Ste. Flr. Suite A
40.b. Date of Admission (mm/dd/yyyy) 47.c. City or Town Atlanta
Place Of Admission 47.d. State GA 47.e. Zip Code 30324
40.c. City or Town
47.f. Province
47.g. Postal Code
40.d. State
47.h. Country
41. Did you gain lawful permanent resident status through
marriage to a U.S. citizen or lawful permanent resident? United States
Yes No 48. Your Occupation

Employment History Managing Director Impact

Provide your employment history for the last five years, whether 49.a. Date From (mm/dd/yyyy) 07/19/2021
inside or outside the United States. Provide your current
49.b. Date To (mm/dd/yyyy) 11/22/2023
employment first. If you are currently unemployed, type or print
"Unemployed" in Item Number 42.
Employer 1
Part 3. Biographic Information
NOTE: Provide the biographic information about you, the
42. Name of Employer/Company petitioner.
Self-employed 1. Ethnicity (Select only one box)

43.b.
and Name
Apt.
Electronic
43.a. Street Number 2510 Oakrill Rd

Ste.
43.c. City or Town Marietta
43.d. State

43.f Province
GA
Flr.

43.e. Zip Code 30062

2.
Hispanic or Latino
Not Hispanic or Latino
Race (Select all applicable boxes)

White
Asian
Black or African American

Form
43.g. Postal Code American Indian or Alaska Native
43.h. Country Native Hawaiian or Other Pacific Islander
United States 3. Height Feet 5 Inches 4
44. Your Occupation 4. Weight Pounds 135

Consultant Non - Profit Management 5. Eye Color (Select only one box)
45.a. Date From (mm/dd/yyyy) 11/23/2023 Black Blue Brown
45.b. Date To (mm/dd/yyyy) Gray Green Hazel

Only Maroon Pink Unknown/Other

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 Part 3. Biographic Information (continued) Beneficiary's Physical Address
6. Hair Color (Select only one box) If the beneficiary lives outside the United States in a home
without a street number or name, leave Item Numbers 11.a.
Bald (No hair) Black Blonde and 11.b. blank.
Brown Gray Red 11.a. Street Number 2510 Oakrill Rd
and Name
Sandy White Unknown/Other
11.b. Apt. Ste. Flr.
Part 4. Information About Beneficiary 11.c. City or Town Marietta
1. Alien Registration Number (A-Number) (if any) 11.d. State GA 11.e. Zip Code 30062
► A-
11.f. Province
2. USCIS Online Account Number (if any)
11.g. Postal Code
►
11.h. Country
3. U.S. Social Security Number (if any)
United States
►
Other Address and Contact Information
Beneficiary's Full Name Provide the address in the United States where the beneficiary
4.a. Family Name PRIETO RINCON intends to live, if different from Item Numbers 11.a. - 11.b. If
(Last Name) the address is the same, type or print "SAME" in Item Number
4.b. Given Name JAIME 12.a.
(First Name)
12.a. Street Number 2510 Oakrill Rd
4.c. Middle Name and Name
12.b. Apt. Ste. Flr. EUU
Other Names used (if any) 12.c. City or Town MARIETTA

Electronic
Provide all other names the beneficiary has ever used, including
aliases, maiden name, and nicknames. 12.d. State GA 12.e. Zip Code 30062
5.a. Family Name Provide the beneficiary's address outside the United States, if
(Last Name) different from Item Numbers 11.a. - 11.h. If the address is the
5.b. Given Name same, type or print "SAME" in Item Number 13.a.
(First Name)
13.a. Street Number
5.c. Middle Name and Name
13.b. Apt. Ste. Flr.
Other Information About Beneficiary

Form
13.c. City or Town
6. City/Town/Village of Birth
13.d. Province
ENCISO SANTANDER 13.e. Postal Code
7. Country of Birth
13.f. Country
Colombia
8. Date of Birth (mm/dd/yyyy) 09/23/1943 14. Daytime Telephone Number (if any)
9. Sex Male Female

Only
10. Has anyone else ever filed a petition for the beneficiary? 17542040413

Yes No Unknown

NOTE: Select "Unknown" only if you do not know,and

the beneficiary also does not know, if anyone else has
ever filed a petition for the beneficiary.

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 Part 4. Information About Beneficiary 24. Date Marriage Ended (mm/dd/yyyy)
(continued)
15. Mobile Telephone Number (if any)
Information About Beneficiary's Family
Provide information about the beneficiary's spouse and
children.
16. Email Address (if any) Person 1

2023jaimeprietorincon@gmail.com 25.a. Family Name

(Last Name)
Beneficiary's Marital Information 25.b. Given Name
(First Name)
17. How many times has the beneficiary been married?
25.c. Middle Name
►1
26. Relationship
18. Current Marital Status
27. Date of Birth (mm/dd/yyyy)
Single, Never Married Married Divorced
28. Country of Birth
Widowed Separated Annulled
19. Date of Current Marriage (if currently married)
(mm/dd/yyyy)
Person 2

Place of Beneficiary's Current Marriage 29.a. Family Name

(Last Name)
(if married)
29.b. Given Name
20.a. City or Town (First Name)
20.b. State 29.c. Middle Name
30. Relationship

Electronic
20.c. Province
31. Date of Birth (mm/dd/yyyy)
20.d. Country
32. Country of Birth

Names of Beneficiary's Spouses (if any)

Provide information on the beneficiary's current spouse (if Person 3
currently married) first and then list all the beneficiary's prior
33.a. Family Name
spouses (if any).
(Last Name)
Spouse 1

(First Name)
21.c. Middle Name
22.
Form
21.a. Family Name Garzon Castro
(Last Name)
21.b. Given Name Nohemi

Date Marriage Ended (mm/dd/yyyy) 06/11/2023

33.b. Given Name

35.
36.
(First Name)
33.c. Middle Name
34. Relationship
Date of Birth (mm/dd/yyyy)
Country of Birth

Spouse 2
23.a. Family Name
(Last Name)
23.b. Given Name
(First Name)
23.c. Middle Name
Only
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 Part 4. Information About Beneficiary 48. Travel Document Number
(continued)
49. Country of Issuance for Passport or Travel Document
Person 4
37.a. Family Name COL
(Last Name) 50. Expiration Date for Passport or Travel Document
(mm/dd/yyyy)
37.b. Given Name 10/14/2025
(First Name)
37.c. Middle Name Beneficiary's Employment Information
38. Relationship Provide the beneficiary's current employment information (if
applicable), even if they are employed outside of the United
39. Date of Birth (mm/dd/yyyy)
States. If the beneficiary is currently unemployed, type or print
40. Country of Birth "Unemployed" in Item Number 51.a.
51.a. Name of Current Employer (if applicable)

RETIRED
Person 5 51.b. Street Number Carrera 16 N 7D-16
and Name
41.a. Family Name
(Last Name) 51.c. Apt. Ste. Flr. Centro Comercial C
41.b. Given Name 51.d. City or Town Zipaquira
(First Name)
51.e. State 51.f. Zip Code
41.c. Middle Name
42. Relationship 51.g. Province Cundinamarca
43. Date of Birth (mm/dd/yyyy) 51.h. Postal Code

Electronic
44. Country of Birth 51.i Country

Colombia
52. Date Employment Began (mm/dd/yyyy)
Beneficiary's Entry Information
45. Was the beneficiary EVER in the United States? 01/01/2014

Yes No Additional Information About Beneficiary

If the beneficiary is currently in the United States, complete 53. Was the beneficiary EVER in immigration proceedings?
Items Numbers 46.a. - 46.d.

Form
Yes No
46.a. He or she arrived as a (Class of Admission):
54. If you answered "Yes," select the type of proceedings and
B2 provide the location and date of the proceedings.
46.b. Form I-94 Arrival-Departure Record Number Removal Exclusion/Deportation
► 664122315A3 Rescission Other Judicial Proceedings
46.c. Date of Arrival (mm/dd/yyyy) 12/06/2023 55.a. City or Town
46.d. Date Authorized stay expired, or will expire, as shown on
Form I-94 or Form I-95 (mm/dd/yyyy) or type or print

Only
55.b. State
"D/S" for Duration of Status
06/05/2024 56. Date (mm/dd/yyyy)
47. Passport Number

AR691277

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 Part 4. Information About Beneficiary The beneficiary will not apply for adjustment of status in
the United States, but he or she will apply for an immigrant
(continued) visa abroad at the U.S. Embassy or U.S. Consulate in:
If the beneficiary's native written language does not use
Roman letters, type or print his or her name and foreign 62.a. City or Town
address in their native written language. 62.b. Province
57.a. Family Name 62.c. Country
(Last Name)
57.b. Given Name Unknown
(First Name)
NOTE: Choosing a U.S. Embassy or U.S. Consulate outside
57.c. Middle Name the country of the beneficiary's last residence does not
58.a. Street Number guarantee that it will accept the beneficiary's case for
and Name processing. In these situations, the designated U.S. Embassy or
U.S. Consulate has discretion over whether or not to accept the
58.b. Apt. Ste. Flr. beneficiary's case.
58.c. City or Town
58.d. Province Part 5. Other Information
58.e. Postal Code 1. Have you EVER previously filed a petition for this
beneficiary or any other alien?
58.f. Country Yes No
If you answered "Yes," provide the name, place, date of filing,
and result.
2.a. Family Name
If filing for your spouse, provide the last address at which (Last Name)
you physically lived together. If you never lived together,
2.b. Given Name
type or print, "Never lived together" in Item Number 59.a.
(First Name)

Electronic
59.a. Street Number 2.c. Middle Name
and Name
3.a. City or Town
59.b. Apt. Ste. Flr.
3.b. State
59.c. City or Town
4. Date Filed (mm/dd/yyyy)
59.d. State 59.e. Zip Code
5. Result (for example, approved, denied, withdrawn)
59.f. Province
59.g. Postal Code

Form
If you are also submitting separate petitions for other relatives,
59.h. Country provide the names of and your relationship to each relative.
Relative 1
60.a. Date From (mm/dd/yyyy) 6.a. Family Name
(Last Name)
60.b. Date To (mm/dd/yyyy)
6.b. Given Name
(First Name)
The beneficiary is in the United States and will apply for
adjustment of status to that of a lawful permanent resident 6.c. Middle Name

Only
at the U.S. Citizenship and Immigration Services (USCIS) 7. Relationship
office in:
61.a. City or Town atlanta
61.b. State GA

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 Part 5. Other Information (continued) Petitioner's Contact Information
Relative 2 3. Petitioner's Daytime Telephone Number
8.a. Family Name 17542040413
(Last Name)
4. Petitioner's Mobile Telephone Number (if any)
8.b. Given Name
(First Name)
8.c. Middle Name 5. Petitioner's Email Address (if any)
9. Relationship 2023jaimeprietorincon@gmail.com

WARNING: USCIS investigates the claimed relationships and Petitioner's Declaration and Certification
verifies the validity of documents you submit. If you falsify a
Copies of any documents I have submitted are exact
family relationship to obtain a visa, USCIS may seek to have
photocopies of unaltered, original documents, and I understand
you criminally prosecuted.
that USCIS may require that I submit original documents to
USCIS at a later date. Furthermore, I authorize the release of
PENALTIES: By law, you may be imprisoned for up to 5 any information from any of my records that USCIS may need
years or fined $250,000, or both, for entering into a marriage to determine my eligibility for the immigration benefit I seek.
contract in order to evade any U.S. immigration law. In
addition, you may be fined up to $10,000 and imprisoned for I further authorize release of information contained in this
up to 5 years, or both, for knowingly and willfully falsifying petition, in supporting documents, and in my USCIS records to
or concealing a material fact or using any false document in other entities and persons where necessary for the administration
submitting this petition. and enforcement of U.S. immigration laws.

Part 6. Petitioner's Statement, Contact I understand that USCIS may require me to appear for an
appointment to take my biometrics (fingerprints, photograph,
Information, Declaration, and Signature and/or signature) and, at that time, if I am required to provide
NOTE: Read the Penalties section of the form I-130 biometrics, I will be required to sign an oath reaffirming that:
Instructions before completing this part.

Electronic
1) I provided or authorized all of the information
Petitioner's Statement contained in, and submitted with, my petition;
NOTE: Select the box for either Item Number 1.a. or 1.b. If
2) I reviewed and understood all of the information in,
applicable, select the box for Item Number 2.
and submitted with, my petition; and
1.a. I can read and understand English, and I have read
and understand every question and instruction on this 3) All of this information was complete, true, and correct
petition and my answer to every question. at the time of filing.
1.b. The interpreter named in Part 7. read to me every

Form
I certify, under penalty of perjury, that all of the information in
question and instruction on this petition and my
my petition and any document submitted with it were provided
answer to every question in
or authorized by me, that I reviewed and understand all of the
information contained in, and submitted with, my petition, and
a language in which I am fluent. I understood all of that all of this information is complete, true, and correct.
this information as interpreted.
2. At my request, the preparer named in Part 8.,
Petitioner's Signature
6.a. Petitioner's Signature

prepared this petition for me based only upon

➡

Only
information I provided or authorized. 6.b. Date of Signature (mm/dd/yyyy)

NOTE TO ALL PETITIONERS: If you do not completely

fill out this petition or fail to submit required documents listed
in the Instructions, USCIS may deny your petition.

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 Part 7. Interpreter's Contact Information, Interpreter's Certification
Certification, and Signature I certify, under penalty of perjury, that:
I am fluent in English and
Provide the following information about the interpreter if you
used one.
which is the same language provided in Part 6., Item Number
1.b., and I have read to this petitioner in the identified language
Interpreter's Full Name every question and instruction on this petition and his or her
1.a. Interpreter's Family Name (Last Name) answer to every question. The petitioner informed me that he or
she understands every instruction, question, and answer on the
petition, including the Petitioner's Declaration and
1.b. Interpreter's Given Name (First Name) Certification, and has verified the accuracy of every answer.

2. Interpreter's Business or Organization Name (if any)

Interpreter's Signature
7.a. Interpreter's Signature

Interpreter's Mailing Address 7.b. Date of Signature (mm/dd/yyyy)

3.a. Street Number
and Name Part 8. Contact Information, Declaration, and
3.b. Apt. Ste. Flr. Signature of the Person Preparing this Petition, if
3.c. City or Town Other Than the Petitioner
Provide the following information about the preparer.
3.d. State 3.e. Zip Code

3.f. Province
Preparer's Full Name
1.a. Preparer's Family Name (Last Name)
3.g. Postal Code
KING

Electronic
3.h. Country
1.b. Preparer's Given Name (First Name)

MICHAEL
Interpreter's Contact Information 2. Preparer's Business or Organization Name (if any)
4. Interpreter's Daytime Telephone Number

5. Interpreter's Mobile Telephone Number (if any)

Preparer's Mailing Address
3.a. Street Number 573 Davidson Drive

Form
and Name
6. Interpreter's Email Address (if any) 3.b. Apt. Ste. Flr.
3.c. City or Town Norcross
3.d. State GA 3.e. Zip Code 30071

3.f. Province
3.g. Postal Code

Only
3.h. Country

United States

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 Part 8. Contact Information, Declaration, and
Signature of the Person Preparing this Petition, if
Other Than the Petitioner (continued)

Preparer's Contact Information

4. Preparer's Daytime Telephone Number

4046316359
5. Preparer's Mobile Telephone Number (if any)

4046316359
6. Preparer's Email Address (if any)

yadecidi@gmail.com

Preparer's Statement
7.a. I am not an attorney or accredited representative but
have prepared this petition on behalf of the petitioner
and with the petitioner's consent.

7.b. I am an attorney or accredited representative and my

representation of the petitioner in this case
extends does not extend beyond the
preparation of this petition.
NOTE: If you are an attorney or accredited
representative whose representation extends beyond
preparation of this petition, you may be obliged to

Electronic
submit a completed Form G-28, Notice of Entry of
Appearance as Attorney or Accredited
Representative, with this petition.

Preparer's Certification
By my signature, I certify, under penalty of perjury, that I
prepared this petition at the request of the petitioner. The
petitioner then reviewed this completed petition and informed
me that he or she understands all of the information contained
in, and submitted with, his or her petition, including the

Form
Petitioner's Declaration and Certification, and that all of this
information is complete, true and correct. I completed this
petition based only on information that the petitioner provided
to me or authorized me to obtain or use.

Preparer's Signature
8.a. Preparer's Signature

8.b.

Only
Date of Signature (mm/dd/yyyy)

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 Evidence Submitted

File Name Document Category

TRANSLATED SANDRA BIBIANA PRIETO GARZON Birth Certificate(s)
birth certificate.pdf

CERTIFICATE OF NATURALIZATION SANDRA U.S. Citizenship/National/LPR

BIBIANA PRIETO GARZON.pdf

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 Additional Petitioner Employers

Name of Employer/Company

self employment
Street Number 2510 Oakrill Rd
and Name
Apt. Ste. Flr.
City or Town Marietta

State GA Zip Code 30062

Province
Postal Code
Country

United States
Your Occupation

Consultant Non-Profit Management

Date From (mm/dd/yyyy) 11/19/2018
Date To (mm/dd/yyyy) 07/18/2021

Name of Employer/Company

Electronic
Habitat For Humanity
Street Number 285 Peachtree Center Ave NE
and Name
Apt. Ste. Flr.
City or Town Atlanta

State GA Zip Code 30303

Province

Form
Postal Code
Country

United States
Your Occupation

Global Director
Date From (mm/dd/yyyy) 02/06/2012

Only
Date To (mm/dd/yyyy) 11/18/2018

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