Selective Service Registration.
Ciba:
Pl advse on this..
this part 4 is different..according to our lawyer CSC some times may ask this part 4 ...
my lawyer asking me to sign and wants to keep this in their files, in case INS asks, they wants to submit....pl advise......
Part 4. Sognature. ( Read the information on penalities in the instructions before completing this scection. You must file this application while in the United States)
I certify, under penality of prejury under the laws of the United States of America, that this application and the evidence submitted with it is all true and correct. I authorize to release of any information from my recoeds which the INS need to determine eligibility for the benefit I am seeking.
Selective Service Registration.The following applies to you if you are a man atleast 18 years old, but not yet 26 years old, who is required to register with the Selective Service System: I understand that my filing this adjust of status application with the INS authorizes the INS to provide certain registration information to the Selective Service System in accordance with the Military Selective Service Act. Upon INS acceptance of my application, I authorize the INS to transmit to the Selective Service System my name, current address, SS#, date of birth and the date I filed the application for the purpose of recording my Selective Service Registration as of the filing date. If, however, INS doesn\'t accept my application, I further understand that, if so required, I am responsible for registring with the selective service by other names, provided I have not yet reached age 26.
Signature Print your name Date Daytime Phone #
Please Note: If you do not completely fill out this form or fail to submit required documents listed in the instructions, you may not be found eligible for the requested benefit and this application and this application may be denied
Part 5, Signature of Person Preparing Form, if other than above (sign below)
I declare that I prepared this application at the request of the above person and it is based on all information of which I have knowledge.
Signature Print your name Date Daytime Phone #
Firm and Address:
