Form G-28I Notice of Entry of Appearance as Attorney In matters Out

Notice of Entry of Appearance as Attorney In Matters
Outside the Geographical Confines of the United States
Department of Homeland Security

DHS
Form G-28I

OMB No. 1615-0105
Expires 05/31/2021

Part 1. Information About Attorney

Part 2. Eligibility Information for Attorney

1.

Select all applicable items.

USCIS Online Account Number (if any)
►

1.a.

Name of Attorney
2.a. Family Name
(Last Name)
2.b. Given Name
(First Name)

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.
Licensing Authority

2.c. Middle Name
1.b. License Number (if applicable)

Address of Attorney
3.a. Street Number
and Name
3.b.

Apt.

Ste.

Flr.

3.c. City or Town
3.d. Province

1.c. I (select only one box)
am not
am
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.
1.d. Name of Law Firm or Organization (if applicable)

3.e. Postal Code
3.f.

Country

2.

,
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 Attorney
4.

Daytime Telephone Number

5.

Mobile Telephone Number (if any)

6.

Email Address (if any)

7.

Fax Number (if any)

I am associated with

Part 3. Notice of Appearance as Attorney
Admitted to Practice Outside the United States
If you need extra space to complete this section, use the space
provided in Part 6. Additional Information.
This appearance relates to immigration matters before
(select only one box):
1.a.

U.S. Citizenship and Immigration Services (USCIS)

1.b. List the form numbers or specific matter in which
appearance is entered.
2.a.

U.S. Immigration and Customs Enforcement (ICE)

2.b. List the specific matter in which appearance is entered.

Form G-28I 05/23/18

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Part 3. Notice of Appearance as Attorney
Admitted to Practice Outside the United States
(continued)
3.a.

U.S. Customs and Border Protection (CBP)

3.b. List the specific matter in which appearance is entered.
4.

Receipt Number (if any)
►

5.

I enter my appearance as an attorney at the request of the
(select only one box):
Applicant
Petitioner
Beneficiary/Derivative
Respondent (ICE, CBP)

6.a. Family Name
(Last Name)
6.b. Given Name
(First Name)

13.a. Street Number
and Name
13.b.

Apt.

Ste.

Flr.

13.d. Province
13.e. Postal Code
13.f. Country

Part 4. Client's Consent to Representation and
Signature
Consent to Representation and Release of
Information

6.c. Middle Name
7.a. Name of Entity (if applicable)
7.b. Title of Authorized Signatory for Entity (if applicable)

9.

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.c. City or Town

Information About Client (Applicant, Petitioner,
Beneficiary or Derivative, Respondent, or
Authorized Signatory for an Entity)

8.

Mailing Address of Client

Client's USCIS Online Account Number (if any)
►
Client's Alien Registration Number (A-Number) (if any)
► A-

Client's Contact Information
10.

Daytime Telephone Number

11.

Mobile Telephone Number (if any)

12.

Email Address (if any)

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.

Options Regarding Receipt of USCIS Notices
USCIS 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.
1.

I request that USCIS send original notices on an
application or petition to the business address of my
attorney as listed in this form.

Signature of Client or Authorized Signatory for an
Entity
2.a. Signature of Client or Authorized Signatory for an Entity

2.b. Date of Signature (mm/dd/yyyy)

Form G-28I 05/23/18

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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)

Form G-28I 05/23/18

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4.a. Page Number

Part 6. Additional Information
If 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.

4.b. Part Number

4.c. Item Number

5.b. Part Number

5.c. Item Number

6.b. Part Number

6.c. Item Number

4.d.

1.a

Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
2.a. Page Number

2.b. Part Number

2.c. Item Number

2.d.
5.a. Page Number
5.d.

3.a. Page Number

3.b. Part Number

3.c. Item Number
6.a. Page Number

3.d.
6.d.

Form G-28I 05/23/18

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