eoir42apg7

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Page 7



APPLICATION NOT TO BE SIGNED BELOW UNTIL APPLICANT APPEARS BEFORE AN IMMIGRATION JUDGE

I do swear or affirm that the contents ofthe above application, including the documents attached hereto, are true to the best ofmy knowledge and that this application is now signed by me with my full, true name.



(Complete and tnte signature of applicant or parent or guardian)



Subscribed and..sworn to before me by the above-named applicant at



Immigration Judge Date: (Month. Day. Year)



CERTIFICATE OF SERVICE

I hereby certify that a copy of the foregoing was:



0to



delivered in person,



0



- mailed first class, postage prepaid



on



(Month, Day, Year)



(INS Disfricr Corrnsel and Address)



Signature of Applicant (or attorney or representative)



I

(Internet Version)



Please use a separate sheet for additional entries. (7)



Form EOIR-42A



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