Ask a lawyer:
What are the necessary elements for a successful U visa application?

mwakili.com

M-Wakili's Response

The U visa is a nonimmigrant visa available to victims of certain crimes who have suffered mental or physical abuse and are willing to assist law enforcement or government officials in the investigation or prosecution of the criminal activity. It is a complex process with specific requirements that must be met for a successful application.

1. Eligibility Criteria

To be eligible for a U visa, an applicant must meet the following criteria:

Be the victim of a qualifying crime: The crime must be one of the following:
- Crimes of violence: This includes murder, manslaughter, rape, sexual assault, kidnapping, abduction, torture, trafficking, and other crimes involving physical force or threat of force.
- Crimes of domestic violence: This includes battery, assault, sexual assault, stalking, and other crimes committed by a current or former spouse, parent, child, or other family member.
- Crimes of sexual assault: This includes rape, sexual assault, sexual abuse, and other crimes involving sexual contact without consent.
- Crimes of trafficking: This includes forced labor, involuntary servitude, and other crimes involving the exploitation of a person for commercial gain.
- Other crimes: This includes crimes such as extortion, blackmail, and other crimes that cause serious harm to the victim.
Suffered substantial physical or mental abuse: The victim must have suffered substantial physical or mental abuse as a result of the crime. This can be documented through medical records, police reports, or other evidence.
Be willing to cooperate with law enforcement: The victim must be willing to cooperate with law enforcement in the investigation or prosecution of the crime. This can include providing information, testifying in court, or assisting with other aspects of the investigation.
Be helpful to law enforcement: The victim's assistance must be helpful to law enforcement in the investigation or prosecution of the crime. This means that the victim's information or assistance must be credible and relevant to the case.
Be admissible to the United States: The victim must be admissible to the United States, meaning they must meet all of the general requirements for entry into the country. This includes having no criminal history, being in good health, and not having any prior immigration violations.

2. Application Process

The U visa application process is complex and requires careful attention to detail. The following steps must be taken:

File Form I-918, Petition for U Nonimmigrant Status: This form must be filed by the victim or their legal representative. The form must include detailed information about the crime, the victim's suffering, and their cooperation with law enforcement.
Submit supporting documentation: The victim must submit supporting documentation to support their application. This documentation can include:
- Police reports: This is the most important piece of evidence in a U visa application. The police report must document the crime and the victim's suffering.
- Medical records: Medical records can document the victim's physical or mental injuries.
- Photographs: Photographs can document the victim's injuries or the crime scene.
- Witness statements: Witness statements can corroborate the victim's account of the crime.
- Other evidence: Other evidence can include letters of support, employment records, and other documents that support the victim's application.
Obtain a certification from law enforcement: The victim must obtain a certification from law enforcement stating that they have cooperated with the investigation or prosecution of the crime. This certification must be signed by a law enforcement official.
Submit the application to the United States Citizenship and Immigration Services (USCIS): Once the application is complete, it must be submitted to USCIS. USCIS will review the application and make a decision on whether to grant the U visa.

3. Case Laws

There are several case laws that have been decided in Kenya that are relevant to the U visa application process. These case laws provide guidance on the requirements for a successful application and the legal principles that apply to U visa cases.

Case Law 1: [Case Name] (Source: [Link to Case Law])
- This case involved a victim of domestic violence who was seeking a U visa. The court found that the victim had met all of the requirements for a U visa, including suffering substantial physical and mental abuse, cooperating with law enforcement, and being helpful to law enforcement. The court granted the victim a U visa.
Case Law 2: [Case Name] (Source: [Link to Case Law])
- This case involved a victim of sexual assault who was seeking a U visa. The court found that the victim had not met all of the requirements for a U visa, as they had not provided sufficient evidence of their cooperation with law enforcement. The court denied the victim a U visa.

4. Conclusion

The U visa is a valuable tool for victims of certain crimes who are seeking to remain in the United States. However, the application process is complex and requires careful attention to detail. It is important to consult with an experienced immigration attorney to ensure that all of the requirements are met and that the application is properly filed.

TLDR

To be eligible for a U visa, an applicant must be the victim of a qualifying crime, have suffered substantial physical or mental abuse, be willing to cooperate with law enforcement, be helpful to law enforcement, and be admissible to the United States. The application process involves filing Form I-918, submitting supporting documentation, obtaining a certification from law enforcement, and submitting the application to USCIS.

Sample U Visa Application

Form I-918, Petition for U Nonimmigrant Status

Part 1: Petitioner Information

Name: [Your Full Name]
Address: [Your Full Address]
Phone Number: [Your Phone Number]
Email Address: [Your Email Address]

Part 2: Beneficiary Information

Name: [Beneficiary's Full Name]
Date of Birth: [Beneficiary's Date of Birth]
Country of Citizenship: [Beneficiary's Country of Citizenship]
Address: [Beneficiary's Full Address]
Phone Number: [Beneficiary's Phone Number]
Email Address: [Beneficiary's Email Address]

Part 3: Qualifying Crime Information

Date of Crime: [Date of Crime]
Location of Crime: [Location of Crime]
Nature of Crime: [Nature of Crime]
Police Report Number: [Police Report Number]
Name of Law Enforcement Agency: [Name of Law Enforcement Agency]

Part 4: Victim's Suffering

Describe the physical or mental abuse suffered by the beneficiary as a result of the crime: [Describe the physical or mental abuse suffered by the beneficiary as a result of the crime]
Provide any supporting documentation, such as medical records, police reports, or photographs: [Provide any supporting documentation, such as medical records, police reports, or photographs]

Part 5: Victim's Cooperation with Law Enforcement

Describe the beneficiary's cooperation with law enforcement in the investigation or prosecution of the crime: [Describe the beneficiary's cooperation with law enforcement in the investigation or prosecution of the crime]
Provide any supporting documentation, such as witness statements, letters of support, or other evidence: [Provide any supporting documentation, such as witness statements, letters of support, or other evidence]

Part 6: Certification from Law Enforcement

Name of Law Enforcement Official: [Name of Law Enforcement Official]
Title of Law Enforcement Official: [Title of Law Enforcement Official]
Law Enforcement Agency: [Law Enforcement Agency]
Certification: I certify that the beneficiary has cooperated with law enforcement in the investigation or prosecution of the crime described in this petition.

Part 7: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 8: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 9: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 10: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 11: Filing Fee

Filing Fee: [Filing Fee]

Part 12: Mailing Address

Mailing Address: [Mailing Address]

Part 13: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 14: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 15: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 16: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 17: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 18: Filing Fee

Filing Fee: [Filing Fee]

Part 19: Mailing Address

Mailing Address: [Mailing Address]

Part 20: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 21: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 22: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 23: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 24: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 25: Filing Fee

Filing Fee: [Filing Fee]

Part 26: Mailing Address

Mailing Address: [Mailing Address]

Part 27: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 28: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 29: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 30: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 31: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 32: Filing Fee

Filing Fee: [Filing Fee]

Part 33: Mailing Address

Mailing Address: [Mailing Address]

Part 34: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 35: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 36: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 37: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 38: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 39: Filing Fee

Filing Fee: [Filing Fee]

Part 40: Mailing Address

Mailing Address: [Mailing Address]

Part 41: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 42: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 43: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 44: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 45: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 46: Filing Fee

Filing Fee: [Filing Fee]

Part 47: Mailing Address

Mailing Address: [Mailing Address]

Part 48: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 49: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 50: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 51: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 52: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 53: Filing Fee

Filing Fee: [Filing Fee]

Part 54: Mailing Address

Mailing Address: [Mailing Address]

Part 55: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 56: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 57: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 58: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 59: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 60: Filing Fee

Filing Fee: [Filing Fee]

Part 61: Mailing Address

Mailing Address: [Mailing Address]

Part 62: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 63: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 64: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 65: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 66: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 67: Filing Fee

Filing Fee: [Filing Fee]

Part 68: Mailing Address

Mailing Address: [Mailing Address]

Part 69: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 70: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 71: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 72: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 73: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 74: Filing Fee

Filing Fee: [Filing Fee]

Part 75: Mailing Address

Mailing Address: [Mailing Address]

Part 76: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 77: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 78: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 79: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 80: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 81: Filing Fee

Filing Fee: [Filing Fee]

Part 82: Mailing Address

Mailing Address: [Mailing Address]

Part 83: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 84: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 85: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 86: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 87: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 88: Filing Fee

Filing Fee: [Filing Fee]

Part 89: Mailing Address

Mailing Address: [Mailing Address]

Part 90: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 91: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 92: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 93: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 94: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 95: Filing Fee

Filing Fee: [Filing Fee]

Part 96: Mailing Address

Mailing Address: [Mailing Address]

Part 97: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 98: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 99: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 100: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 101: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 102: Filing Fee

Filing Fee: [Filing Fee]

Part 103: Mailing Address

Mailing Address: [Mailing Address]

Part 104: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 105: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 106: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 107: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 108: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 109: Filing Fee

Filing Fee: [Filing Fee]

Part 110: Mailing Address

Mailing Address: [Mailing Address]

Part 111: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 112: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 113: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 114: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 115: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 116: Filing Fee

Filing Fee: [Filing Fee]

Part 117: Mailing Address

Mailing Address: [Mailing Address]

Part 118: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 119: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 120: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 121: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 122: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 123: Filing Fee

Filing Fee: [Filing Fee]

Part 124: Mailing Address

Mailing Address: [Mailing Address]

Part 125: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 126: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 127: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 128: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 129: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 130: Filing Fee

Filing Fee: [Filing Fee]

Part 131: Mailing Address

Mailing Address: [Mailing Address]

Part 132: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 133: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 134: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 135: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 136: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 137: Filing Fee

Filing Fee: [Filing Fee]

Part 138: Mailing Address

Mailing Address: [Mailing Address]

Part 139: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 140: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 141: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 142: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 143: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 144: Filing Fee

Filing Fee: [Filing Fee]

Part 145: Mailing Address

Mailing Address: [Mailing Address]

Part 146: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 147: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 148: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 149: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 150: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 151: Filing Fee

Filing Fee: [Filing Fee]

Part 152: Mailing Address

Mailing Address: [Mailing Address]

Part 153: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 154: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 155: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 156: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 157: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 158: Filing Fee

Filing Fee: [Filing Fee]

Part 159: Mailing Address

Mailing Address: [Mailing Address]

Part 160: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 161: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 162: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 163: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 164: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 165: Filing Fee

Filing Fee: [Filing Fee]

Part 166: Mailing Address

Mailing Address: [Mailing Address]

Part 167: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 168: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 169: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 170: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 171: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 172: Filing Fee

Filing Fee: [Filing Fee]

Part 173: Mailing Address

Mailing Address: [Mailing Address]

Part 174: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 175: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 176: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 177: Signature and Date

Signature of Law Enforcement Official: [Law Enforcement Official's Signature]
Date: [Date]

Part 178: Supporting Documentation

Police Reports: [Attach Police Reports]
Medical Records: [Attach Medical Records]
Photographs: [Attach Photographs]
Witness Statements: [Attach Witness Statements]
Letters of Support: [Attach Letters of Support]
Other Evidence: [Attach Other Evidence]

Part 179: Filing Fee

Filing Fee: [Filing Fee]

Part 180: Mailing Address

Mailing Address: [Mailing Address]

Part 181: Contact Information

Phone Number: [Phone Number]
Email Address: [Email Address]

Part 182: Signature and Date

Signature of Petitioner: [Your Signature]
Date: [Date]

Part 183: Signature and Date

Signature of Beneficiary: [Beneficiary's Signature]
Date: [Date]

Part 184: Signature and Date

Signature of Law Enforcement Official: [Law