REQUEST FOR HUMANITARIAN PAROLE / SIGNIFICANT PUBLIC BENEFIT PAROLE

Form I-131, Application for Travel Documents, Parole Documents, and Arrival/Departure Records

[DATE]

[REQUESTOR/ATTORNEY NAME]
[ADDRESS]
[CITY, STATE ZIP]
[TELEPHONE]
[EMAIL]

U.S. Citizenship and Immigration Services
[APPROPRIATE USCIS ADDRESS]
[CITY, STATE ZIP]

RE: Request for Parole into the United States
Beneficiary/Applicant: [FULL LEGAL NAME]
Date of Birth: [DOB]
Country of Citizenship: [COUNTRY]
Current Location: [CITY, COUNTRY]
Type of Parole Requested: ☐ Humanitarian Parole ☐ Significant Public Benefit Parole

Dear USCIS Officer:

This letter is submitted in support of an application for parole into the United States pursuant to INA § 212(d)(5) and 8 CFR § 212.5. [BENEFICIARY NAME] requests parole based on [URGENT HUMANITARIAN REASONS / SIGNIFICANT PUBLIC BENEFIT] as detailed below.

I. TYPE OF PAROLE REQUESTED

A. Basis for Parole

☐ Humanitarian Parole - Based on urgent humanitarian reasons
☐ Significant Public Benefit Parole - Based on significant public benefit

B. Specific Category (If Applicable)

☐ Medical emergency
☐ Organ/tissue donation
☐ Family emergency (serious illness/death)
☐ Witness in legal proceeding
☐ Prosecution/investigation assistance
☐ Military/veteran family member
☐ Other urgent humanitarian reason: [SPECIFY]
☐ Significant public benefit: [SPECIFY]

II. BENEFICIARY INFORMATION

III. U.S. PETITIONER/SPONSOR INFORMATION

IV. URGENT HUMANITARIAN REASONS

[SELECT AND COMPLETE APPLICABLE SECTION]

A. MEDICAL EMERGENCY

☐ The beneficiary requires urgent medical treatment available in the United States

Medical Condition:

Urgency:

[EXPLAIN WHY THIS IS AN EMERGENCY AND CANNOT WAIT:]
- Current condition severity:
- Risk if treatment delayed:
- Timeline for treatment:

Supporting Evidence:
☐ Medical records from abroad
☐ Physician's letter explaining condition
☐ Letter from U.S. medical facility confirming treatment
☐ Treatment plan
☐ Evidence that treatment unavailable in home country

B. ORGAN/TISSUE DONOR

☐ The beneficiary will donate an organ/tissue to a U.S. citizen or LPR

Supporting Evidence:
☐ Letter from transplant center
☐ Medical evaluation confirming donor compatibility
☐ Recipient's medical records
☐ Proof of recipient's U.S. status

C. FAMILY MEDICAL EMERGENCY

☐ A close family member in the U.S. is seriously ill or near death

Supporting Evidence:
☐ Medical records showing serious illness
☐ Physician's letter on prognosis
☐ Proof of family relationship

D. DEATH IN FAMILY

☐ A close family member in the U.S. has died or is near death

Supporting Evidence:
☐ Death certificate (if already deceased)
☐ Physician's letter (if imminent)
☐ Funeral arrangements
☐ Proof of family relationship

E. PROTECTION FROM HARM

☐ The beneficiary faces danger in their home country

Type of Danger:
☐ Political persecution
☐ Religious persecution
☐ Violence/threats
☐ Natural disaster
☐ War/civil unrest
☐ Other: [DESCRIBE]

[DESCRIBE THE DANGER IN DETAIL:]

Supporting Evidence:
☐ Country conditions documentation
☐ Personal threat documentation
☐ News articles
☐ Expert declarations

F. OTHER URGENT HUMANITARIAN REASON

☐ Other humanitarian reason: [SPECIFY]

[PROVIDE DETAILED EXPLANATION:]

V. SIGNIFICANT PUBLIC BENEFIT

[IF SEEKING PUBLIC BENEFIT PAROLE]

The beneficiary's presence in the United States would provide significant public benefit because:

☐ Witness in Legal Proceedings
- Case name/number:
- Court:
- Date of proceeding:
- Nature of testimony:

☐ Assistance to Law Enforcement
- Agency:
- Type of assistance:
- Contact at agency:

☐ Other Public Benefit
[DESCRIBE:]

Supporting Evidence:
☐ Letter from court/agency
☐ Subpoena
☐ Law enforcement letter
☐ Other documentation

VI. IMMIGRATION HISTORY

A. Prior U.S. Immigration History

☐ Beneficiary has never been to the United States
☐ Beneficiary has prior U.S. immigration history:

B. Prior Visa Applications

☐ Beneficiary has never applied for a U.S. visa
☐ Beneficiary has applied for U.S. visa:

C. Immigration Violations

☐ No prior immigration violations
☐ Prior violations: [EXPLAIN]

D. Criminal History

☐ No criminal history
☐ Criminal history: [EXPLAIN]

VII. DURATION OF PAROLE REQUESTED

VIII. FINANCIAL SUPPORT

A. Financial Sponsor

B. Financial Ability

☐ Form I-134, Declaration of Financial Support, is enclosed
☐ The sponsor has the financial ability to support the beneficiary

Evidence of Financial Support:
☐ Sponsor's employment letter
☐ Sponsor's tax returns
☐ Sponsor's bank statements
☐ Sponsor's pay stubs
☐ Evidence beneficiary will not become public charge

C. Medical Coverage

☐ Sponsor will provide medical coverage
☐ Beneficiary has travel/medical insurance
☐ Treatment facility will provide care regardless of payment
☐ Other arrangement: [EXPLAIN]

IX. ACCOMMODATION AND CARE

A. Where Beneficiary Will Stay

B. Medical Care (If Applicable)

X. INTENT TO DEPART

The beneficiary intends to depart the United States upon completion of the purpose for which parole is sought because:

1. ☐ Beneficiary has strong ties to home country:
   - Family remaining: [DESCRIBE]
   - Property: [DESCRIBE]
   - Employment: [DESCRIBE]
   - Other ties: [DESCRIBE]

2. ☐ Beneficiary understands parole is temporary and confers no immigration status

3. ☐ Beneficiary agrees to depart by [DATE]

XI. WHY PAROLE IS NECESSARY

Parole is the only available option because:

☐ Beneficiary is inadmissible to the United States under INA § 212(a) due to: [SPECIFY]

☐ There is insufficient time to obtain a visa through normal channels because: [EXPLAIN URGENCY]

☐ Beneficiary does not qualify for a visa because: [EXPLAIN]

☐ Other: [EXPLAIN]

XII. SUPPORTING DOCUMENTS

The following documents are submitted in support of this parole request:

A. Required Documents

☐ Form I-131, Application for Travel Documents
☐ Form I-134, Declaration of Financial Support
☐ Photographs (2 passport-style)
☐ Copy of beneficiary's passport (biographical page)
☐ Copy of beneficiary's birth certificate
☐ Proof of petitioner's U.S. status
☐ Proof of relationship (if applicable)

B. Evidence of Humanitarian Reason

☐ Medical records/letters
☐ Death certificate/funeral arrangements
☐ Country conditions documentation
☐ Letters from medical facilities
☐ [OTHER RELEVANT EVIDENCE]

C. Financial Documents

☐ Sponsor's tax returns
☐ Sponsor's pay stubs
☐ Sponsor's bank statements
☐ Employment verification letter
☐ Evidence of medical insurance/coverage

D. Evidence of Ties to Home Country

☐ Employment letter from abroad
☐ Property ownership documents
☐ Family information
☐ [OTHER EVIDENCE]

XIII. REQUEST FOR EXPEDITED PROCESSING

☐ Expedited processing is requested due to:

[EXPLAIN URGENT CIRCUMSTANCES REQUIRING EXPEDITED REVIEW:]

XIV. CONTACT INFORMATION

For Questions Regarding This Application:

XV. CONCLUSION

For the foregoing reasons, [BENEFICIARY NAME] respectfully requests that USCIS grant parole into the United States based on [URGENT HUMANITARIAN REASONS / SIGNIFICANT PUBLIC BENEFIT].

The beneficiary's situation involves [BRIEFLY SUMMARIZE URGENT CIRCUMSTANCES] and parole is the only means to address this emergency.

Respectfully submitted,

_______________________________
[SIGNATURE]

[PRINTED NAME]
[RELATIONSHIP TO BENEFICIARY / ATTORNEY]
[DATE]

FILING INFORMATION

Filing Address: Verify current filing address at www.uscis.gov/i-131

Filing Fee: Check current fee at USCIS website
- Fee waiver may be requested based on inability to pay

Processing Time: Varies; expedited processing may be requested for emergencies

IMPORTANT NOTES

1. Parole is Discretionary: USCIS has sole discretion to grant or deny parole

2. Parole is Temporary: Parole does not confer lawful immigration status

3. No Guarantee of Extension: Extensions are not guaranteed

4. Work Authorization: Parolees may apply for work authorization in certain circumstances

5. Deportation Possible: Parolees may be placed in removal proceedings

6. Advance Parole Different: This template is for humanitarian/public benefit parole for persons OUTSIDE the U.S., not advance parole for persons inside the U.S. with pending applications

This template is provided for informational purposes only and does not constitute legal advice. Parole applications involve complex considerations. Applicants are strongly encouraged to consult with a qualified immigration attorney.