| 
			Pages 1-2, When
			Should I Use Form
			I-914,
			Supplement B? 
 | 
			[Page
			1] 
 When
			Should I Use Form
			I-914,
			Supplement B? 
 If
			you,
			the certifying Federal, state, local, or tribal law enforcement
			official, believe that this individual is or has been a victim of
			a severe form of trafficking in persons and has cooperated with
			your reasonable requests for assistance in your investigation or
			prosecution, you
			may
			complete this Supplement B. 
			You should
			complete all fields of this form yourself. Supplement B must be
			signed with an original signature.  A photocopy of a signed
			application or a typewritten name in place of a signature is not
			acceptable.  The applicant
			will
			submit Supplement B, to USCIS with his or her application for T
			nonimmigrant status. 
 … 
 To
			be eligible for
			T
			nonimmigrant
			status, the applicant must demonstrate to USCIS that he or she: 
 1.
			 
			Is or was a
			victim of a severe form of trafficking
			in persons (see
			Supplement B, Part
			3.
			Statement of Claim,
			for a
			definition); 
 2.
			 
			Is present in
			the United States as a result of being a victim of a severe form
			of trafficking
			in persons
			(including physical presence based on having been allowed entry
			into the United States to participate in investigative or judicial
			processes associated with an act or perpetrator of trafficking); 
 3.
			 
			Has complied
			with any reasonable requests from Federal, state, local,
			or tribal law enforcement in the investigation
			or prosecution of the trafficking
			crime of which
			he or she was a victim; unless 
 
 
 [Page
			2] 
 A.
			
			The applicant is
			under 18 years of age; or 
 B.
			
			He or she is
			unable to cooperate due to physical or psychological trauma; and 
 
 
 
 
 4.
			 
			Would
			suffer
			extreme hardship involving unusual and severe harm upon removal
			from the United States. 
 USCIS
			(not the certifying Federal, state, or local, and tribal law
			enforcement official)
			determines
			whether the evidence is sufficient
			and whether the
			applicant meets each eligibility requirement.  A
			signed declaration provides valuable evidence of the victim’s
			cooperation. However,
			the applicant may establish eligibility without submitting the
			Supplement B, as it is not a required form of evidence. 
 | 
			[Page
			1] 
 When
			Should I Use Form
			I-914,
			Supplement B? 
 If
			you,
			the certifying Federal, State,
			Tribal, or local law
			enforcement official, believe
			the applicant is
			or has been a victim of a severe form of trafficking in persons
			and has cooperated with any
			reasonable requests for assistance in your investigation or
			prosecution (if
			opened or initiated),
			you may
			complete this Supplement B. 
			You should
			complete all fields of this form yourself. Supplement B must be
			signed with an original signature.  A photocopy of a signed
			application or a typewritten name in place of a signature is not
			acceptable.  The applicant
			will submit
			Supplement B, to USCIS with
			their Form I-914. 
 … 
 To
			be eligible for
			T
			nonimmigrant
			status, the applicant must demonstrate to USCIS that
			they: 
 1.
			 
			Are
			or were a victim
			of a severe form of trafficking
			in persons (see
			Supplement B, Part
			3.
			Statement of Claim,
			for a
			definition); 
 2.
			 
			Are
			present in the United States on
			account of being
			a victim of a severe form of trafficking
			in persons
			(including physical presence based on having been allowed entry
			into the United States to participate in investigative or judicial
			processes associated with an act or perpetrator of trafficking); 
 3.
			 
			Have complied
			with any reasonable requests from Federal, State,
			Tribal, or local
			law enforcement
			in the investigation or
			prosecution of the trafficking
			crime of which
			they
			were a victim;
			unless 
 
 
 
 
 A.
			
			The applicant is
			under 18 years of age; or 
 B.
			
			They
			are unable to
			cooperate due to physical or psychological trauma; and 
 
 
 [Page
			2] 
 4.
			 
			Would
			suffer
			extreme hardship involving unusual and severe harm upon removal
			from the United States. 
 USCIS
			(not the certifying Federal, State,
			Tribal, or local law
			enforcement official)
			determines
			whether the evidence is sufficient
			and whether the
			applicant meets each eligibility requirement.  A
			signed Supplement
			B provides
			valuable evidence of the victim’s cooperation. However,
			the applicant may establish eligibility without submitting the
			Supplement B, as it is not a required form of evidence. | 
	
		| 
			New 
 And
			
			 
 Pages
			2-3, General Instructions 
			 | 
			[Page
			2] 
 
 
 [Page
			1, General Instructions] 
 This
			form is divided into Parts
			1. - 6.
			 The following information will help you fill
			out the form: 
 Part
			1.
			Victim
			Information 
 1.
			 
			Full
			Legal Name.
			 Provide the legal name
			of the victim, as shown on his or her birth certificate, passport
			or other legal
			name change document.  If the victim has two last names, include
			both and use a hyphen (-) between the names, if appropriate.  Type
			or print the
			victim’s
			last, first
			and middle names
			in each appropriate field. 
 2.
			 
			Other
			Names
			Used.  You should
			provide all the names
			the victim has used, including maiden name, nicknames, aliases,
			etc. 
 3.
			 
			Date of
			Birth.
			Use eight
			numbers to show the victim’s
			date of birth (example:  May 1, 1979, should be written
			05/01/1979). 
 4.
			 
			Gender
			or Sex.
			Select the
			appropriate box. 
 5.
			 
			A-Number.
			Provide the
			USCIS (former INS) file
			number if there
			is one, and if it is known to you. 
 6.
			 
			Social
			Security
			Number.
			Provide the
			Social Security Number if there is one, and if it is known to you. 
 Part
			2.
			Agency
			Information 
 1.
			 
			Name of
			Certifying
			Agency.
			 The certifying agency
			must be a Federal,
			state, local, or tribal law enforcement agency, prosecutor,
			judge, labor agency, children's protective services agency,
			or other authority that has the responsibility and authority for
			the detection, investigation, and/or prosecution of
			severe forms of trafficking in persons.  8 CFR 214.11. 
			 
 
 
 2.
			 
			Name,
			Title, and Division/Office of Certifying Official.
			Give your name,
			title, and division or office. 
 3.
			 
			Agency
			Mailing Address.
			 Give the agency’s
			mailing address. 
 4.
			 
			Daytime
			Telephone
			Number
			and Fax
			Number.
			Give your phone
			number and fax number with area code. 
 5.
			 
			Agency
			Type.
			Select the
			appropriate box. 
 6.
			 
			Case
			Information. 
			Provide the case status
			information and case identification
			number,
			if applicable. 
 
 
 
 
 
 
 Part
			3. 
			Statement of Claim 
 1.
			 
			In order to
			qualify for
			T
			nonimmigrant
			status,
			the applicant
			must be or have been a victim of a severe form of trafficking
			in persons. 
			Select the box that describes the applicant’s victimization. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 [Page
			3, General Instructions] 
 A.
			 Sex trafficking where
			the commercial sex act was induced through the use of force, fraud
			or coercion.  Sex trafficking is the recruitment,
			harboring, transportation, provision, obtaining, patronizing, or
			soliciting of a person for the purpose of inducing a commercial
			sex act.   
			 
 B.
			
			Sex trafficking
			where the victim
			is under 18 years of age.  Inducing an individual under 18 years
			of age to perform a commercial sex act is considered sex
			trafficking, regardless of the use of force, fraud, or coercion. 
 C.
			 Labor trafficking:
			 the recruitment,
			harboring, transportation, provision, or obtaining of a person for
			labor or services through the use of force, fraud, or coercion for
			the purpose of subjection to involuntary servitude, peonage, debt
			bondage, or slavery. 
 D.
			
			Other.
			Attach
			additional sheets to explain. 
 
 
 2.
			 Describe the
			victimization the applicant’s
			claim is based on and identify the relationship of the
			victimization to the crime investigated or prosecuted by attaching
			additional sheets.
			 Attach the
			results of any name or database inquiry and any relevant reports
			or findings.
			 Attach
			additional sheets if necessary. 
 3.
			 Explain if the
			individual has expressed any fear of retaliation or revenge if
			they are removed from the United States. 
 
 
 
 4.
			Provide the
			dates on which the acts of trafficking
			occurred. 
 5.
			List the
			statutory citations that are or were being investigated or
			prosecuted. 
 6.
			Provide the date
			on which the investigation or prosecution was initiated. 
 7.
			Provide the date
			on which the investigation or prosecution was completed, if any. 
 Part
			4. 
			Cooperation of
			Victim 
 In
			order to qualify for
			T
			nonimmigrant
			status, the individual must show that he or she has complied with
			any reasonable requests from Federal, state, local, or tribal law
			enforcement in the investigation or prosecution of the acts of
			trafficking
			of which he or
			she was a victim (unless he or she is under 18 years of age or he
			or she is unable to cooperate with the request due to physical or
			psychological trauma). It is not necessary for you to demonstrate
			that the cooperation of the victim led to a formal investigation,
			arrest, or prosecution. If
			the applicant is unable to cooperate with law enforcement’s
			reasonable request due to physical or psychological trauma or age,
			the applicant must provide evidence to this effect. 
 
 Select
			the box that describes the individual’s
			cooperation with you and explain, attaching additional sheets if
			necessary. 
 
 
 
 Part
			5.  Family Members Implicated in
			Trafficking 
 List
			whether any of the victim’s
			family members are believed to have been involved in the
			trafficking
			in persons. 
 A
			principal applicant is prohibited from filing
			for derivative
			T
			nonimmigrant
			status on behalf of a family member who participated in the
			trafficking
			that established
			the principal applicant’s eligibility.
			Therefore, USCIS
			will not grant an immigration benefit
			to a family
			member who committed trafficking. 
 
 
 
 
 Part
			6.
			Attestation 
 The
			law enforcement officer
			filling
			out this form
			(identified
			in
			Part
			2.
			of Supplement
			B), and their supervisor,
			must sign and date the form in this section. 
 
 
 
 Supplement
			B must have an original signature.
			A
			photocopy of a
			signed declaration or a typewritten name in place of a signature
			is not acceptable. 
 [new] 
 
 
 
 
 | 
			[Page
			2] 
 Specific
			Instructions 
 
 
 This
			form is divided into Parts
			1. - 7.
			 The following
			information will help you fill
			out the form: 
 Part
			1.
			Victim
			Information 
 1.
			 
			Full
			Legal Name.
			 Provide the legal name
			of the victim, as shown on their
			birth certificate, passport,
			or other legal
			document.  If
			the victim has two last names, include both and use a hyphen (-)
			between the names, if appropriate.  Type
			or print the
			victim’s
			last, first,
			and middle names
			in each appropriate field. 
 
 2.
			 
			Other
			Names
			Used.  You should
			provide all the names
			the victim has used, including maiden name, nicknames, aliases,
			etc. 
 3.
			 
			Date of
			Birth.
			Use eight
			numbers to show the victim’s
			date of birth (example:  May 1, 1979, should be written
			05/01/1979). 
 4.
			  Gender.
			 Indicate
			how the victim identifies. 
 5.
			  A-Number. Provide
			the USCIS (former INS) file number if there is one, and if it is
			known to you. 
 6.
			  Social Security Number.
			Provide the Social
			Security Number if there is one, and if it is known to you. 
 Part
			2.
			Agency
			Information 
 1.
			 
			Name of
			Certifying
			Agency.
			 The certifying agency
			must be a Federal,
			State,
			Tribal, or local, law
			enforcement agency, prosecutor, judge, labor agency, children's
			protective services agency, adult
			protective services agency,
			or other authority that has the responsibility and authority for
			the detection, investigation, and/or prosecution of
			severe forms of trafficking in persons under
			any administrative, civil, criminal, or Tribal laws.  8
			CFR 214.201.
			
			 
 2.
			– 4. 
			
			Name,
			Title, and Division/Office of Certifying Official.
			Give your name,
			title, and division or office. 
 5.
			 
			Agency
			Mailing Address.
			 Give the agency’s
			mailing address. 
 6.
			-7.  
			Daytime
			Telephone
			Number
			and Fax
			Number.
			Give your phone
			number and fax number with area code. 
 8.
			 
			Agency
			Type.
			Select the
			appropriate box. 
 9.
			- 12. 
			Case
			Information. 
			Provide the case status
			information and,
			if applicable, the case
			identification
			number,
			FBI Universal Control Number (UCN), or State Identification Number
			(SID). 
 
 
 [Page
			3] 
 Part
			3. 
			Statement of Claim 
 1.
			 
			In order to
			qualify for
			T
			nonimmigrant
			status,
			the applicant
			must be or have been a victim of a severe form of trafficking
			in persons. 
			Select all
			applicable boxes that describe
			the applicant’s victimization.
			 It is not necessary for the victim to actually perform the labor
			or commercial sex act(s) to be eligible for T nonimmigrant status.
			
			 
 NOTE:
			 Base your analysis on the practices to which the victim was
			subjected, rather than on the specific violations charged, the
			counts on which convictions were obtained, or whether any
			prosecution resulted in convictions.  The definitions that control
			this analysis are not the elements of criminal offenses, but are
			those in 8 CFR 214.201. 
 
 
 
 
 A.
			 Sex trafficking where
			the commercial sex act was induced through the use of force, fraud
			or coercion.  Sex trafficking is the recruitment,
			harboring, transportation, provision, obtaining, patronizing, or
			soliciting of a person for the purpose of inducing a commercial
			sex act.   
			 
 B.
			
			Sex
			trafficking
			where the
			victim was
			under 18 years of age at
			the time the acts of trafficking occurred.  Inducing
			an individual under 18 years of age to perform a commercial sex
			act is considered sex trafficking, regardless of the use of force,
			fraud, or coercion. 
 C.
			 Labor trafficking:
			 the recruitment,
			harboring, transportation, provision, or obtaining of a person for
			labor or services through the use of force, fraud, or coercion for
			the purpose of subjection to involuntary servitude, peonage, debt
			bondage, or slavery. 
 D.
			
			Other.
			If
			you need extra space to complete this section, use the space
			provided in Part
			7. Additional Information. 
 2.
			 Describe the
			victimization
			on which the applicant’s
			claim is based
			and identify the
			relationship
			between that victimization and the
			crime investigated or prosecuted.
			 If
			you need extra space to complete this section, use the space
			provided in Part
			7. Additional Information.
			
			 
 
 3.
			 Explain if the
			individual has expressed any fear of retaliation or revenge if
			they are removed from the United States.
			 If you need extra space to complete this section, use the space
			provided in Part
			7. Additional Information. 
 4.
			Provide the
			dates on which the acts of trafficking
			occurred. 
 5.
			List the
			statutory citations that are or were being investigated or
			prosecuted. 
 6.
			Provide the date
			on which the investigation or prosecution was initiated. 
 7.
			Provide the date
			on which the investigation or prosecution was completed, if any. 
 Part
			4. 
			Cooperation of
			Victim 
 In
			order to qualify for
			T
			nonimmigrant
			status, the
			applicant must show
			that
			they have complied
			with any reasonable requests from Federal, State,
			Tribal, or local law
			enforcement in the investigation or prosecution of the acts of
			trafficking
			of which
			they were a
			victim (unless
			they were under
			18 years of age at
			the time the acts of trafficking occurred or they are unable
			to cooperate with the request due to physical or psychological
			trauma). It is not necessary for you to demonstrate that the
			cooperation of the victim led to a formal investigation, arrest,
			or prosecution. If the applicant is unable to cooperate with law
			enforcement’s reasonable request due to physical or
			psychological trauma or age, the applicant must provide evidence
			to this effect. 
 Select
			the boxes
			that describe
			the individual’s
			cooperation with
			the investigation or prosecution of the acts of trafficking and
			provide an explanation.  If you need extra space to complete this
			section, use the space provided in Part
			7. Additional Information. 
 Part
			5.  Family Members Implicated in
			Trafficking 
 List
			whether any of the victim’s
			family members are believed to have been involved in the
			trafficking
			in persons. 
 NOTE:
			 A
			victim cannot apply 
			for
			derivative
			T
			nonimmigrant
			status
			for a family
			member who participated in the
			acts of
			trafficking
			that established
			the
			victim’s eligibility
			for
			T nonimmigrant status, and  USCIS
			will not grant an immigration benefit
			to a family
			member who committed trafficking. 
 
 
 [Page
			4] 
 Part
			6.
			Attestation 
 You,
			the certifying Federal, State, Tribal, or local law
			enforcement official
			filling
			out this form
			(identified
			in
			Part
			2.
			of Supplement
			B),
			must sign and
			date the form in this section.  Further,
			your supervisor must provide their name and sign and date this
			supplement. 
 Supplement
			B must have an original signature.
			A
			photocopy of a
			signed declaration or a typewritten name in place of a signature
			is not acceptable. 
 Part
			7.  Additional Information 
 Item
			Numbers 1. - 7. 
			If you need extra space to provide any additional information in
			this form, use the space provided in Part
			7. Additional Information.
			 If you need more space than what is provided in Part
			7.,
			you may make copies of Part
			7. to
			complete and file with your supplement,
			or attach a separate sheet of paper.
			 Type or print the victim’s name and A-Number (if any) 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. 
 |