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S) is referred to as a derivative applicant. Form I-914, Supplement A, is to be completed by the principal applicant. For USCIS Use Only Returned Receipt Date Date Resubmitted PART A. Family Member Relationship to You (the principal) The family member that I am filing for is my: (Check one) Husband/Wife Child Parent Unmarried Sibling Under Age 18 PART B. General Information About You (the principal) Family Name (Last Name) Given Name (First Name) Middle Name (if any) Date Date Reloc S.

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