Fillable Form I-485: Application to Register Permanent Residence (USCIS)

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Form I-485: Application to Register Permanent Residence (USCIS)

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U.S. Citizenship and Immigration Services (USCIS) is an office of the U.S. Branch of Homeland Security (DHS) that oversees the nation's naturalization and migration framework. It is a successor to the Immigration and Naturalization Service (INS), which was disintegrated by the Homeland Security Act of 2002 and supplanted by three segments inside the DHS: USCIS, Immigration and Customs Enforcement (ICE), and Customs and Border Protection (CBP).

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Form I-485 Edition 10/15/19 Page 1 of 20
1.b.
1.c.
1.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Your Current Legal Name (do not provide a
nickname)
Application to Register Permanent Residence
or Adjust Status
Department of Homeland Security
U.S. Citizenship and Immigration Services
USCIS
Form I-485
OMB No. 1615-0023
Expires 10/31/2020
Priority Date:
Country Chargeable:
INA 209(a)
INA 249
Section of Law
INA 245(a)
INA 245(i)
INA 245(m)
Sec. 13, Act of 9/11/57
Cuban Adjustment Act
Other
Lawful Permanent
Resident as of:
Date of
Initial Interview:
Action BlockReceipt
Interview
Waived
Applicant
Interviewed
Date Form I-693 Received:
Attorney State Bar Number
(if applicable)
Select this box if
Form G-28 is
attached.
Volag Number
(if any)
Attorney or Accredited Representative
USCIS Online Account Number (if any)
To be completed by an attorney or accredited representative (if any).
For USCIS Use Only
START HERE - Type or print in black ink.►
NOTE TO ALL APPLICANTS: If you do not completely fill out this application or fail to submit required documents listed in the
Instructions, U.S. Citizenship and Immigration Services (USCIS) may deny your application.
Part 1. Information About You (individual
applying for lawful permanent residence)
►
A-
A-Number
NOTE: Provide all other names you have ever used, including
your family name at birth, other legal names, nicknames,
aliases, and assumed names. If you need extra space to
complete this section, use the space provided in Part 14.
Additional Information.
Other Names You Have Used Since Birth (if
applicable)
2.b.
2.c.
2.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
3.b.
3.c.
3.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
5. Date of Birth (mm/dd/yyyy)
NOTE: In addition to providing your actual date of birth,
include any other dates of birth you have used in
connection with any legal names or non-legal names in
the space provided in Part 14. Additional Information.
FemaleMaleGender6.
INA 209(b)
4.b.
4.c.
4.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Preference Category:
Other Information About You
City or Town of Birth7.
Form I-485 Edition 10/15/19 Page 2 of 20
►
A-
A-Number
Country of Birth8.
Country of Citizenship or Nationality9.
Part 1. Information About You (Person applying
for lawful permanent residence) (continued)
►
A-
Alien Registration Number (A-Number) (if any)10.
NOTE: If you have EVER used other A-Numbers,
include the additional A-Numbers in the space provided
in Part 14. Additional Information.
►
11. USCIS Online Account Number (if any)
U.S. Mailing Address
City or Town13.d.
ZIP Code
13.f.
State
13.e.
Street Number
and Name
13.b.
13.c. Apt.
Flr.Ste.
13.a. In Care Of Name (if any)
Passport Number Used at Last Arrival15.
Travel Document Number Used at Last Arrival16.
Recent Immigration History
17. Expiration Date of this Passport or Travel Document
(mm/dd/yyyy)
Country that Issued this Passport or Travel Document18.
Nonimmigrant Visa Number from this Passport (if any)19.
20.a.
Place of Last Arrival into the United States
City or Town
20.b.
State
Date of Last Arrival (mm/dd/yyyy)
21.
Provide the information for Item Numbers 15. - 19. if you last
entered the United States using a passport or travel document.
City or Town14.d.
ZIP Code
14.f.
State
14.e.
Street Number
and Name
14.b.
14.c. Apt.
Flr.Ste.
14.a. In Care Of Name (if any)
Alternate and/or Safe Mailing Address
If you are applying based on the Violence Against Women Act
(VAWA) or as a special immigrant juvenile, human trafficking
victim (T nonimmigrant), or victim of qualifying criminal
activity (U nonimmigrant) and you do not want USCIS to send
notices about this application to your home, you may provide an
alternative and/or safe mailing address.
When I last arrived in the United States, I:
Was inspected at a port of entry and admitted as (for
example, exchange visitor; visitor, waived through;
temporary worker; student):
22.a.
U.S. Social Security Number (if any)
►
12.
Was inspected at a port of entry and paroled as (for
example, humanitarian parole, Cuban parole):
22.b.
Came into the United States without admission or
parole.
22.c.
Other:
22.d.
If you were issued a Form I-94 Arrival-Departure Record Number:
Expiration Date of Authorized Stay Shown on Form I-9423.b.
(mm/dd/yyyy)
23.c. Status on Form I-94 (for example, class of admission, or
paroled, if paroled)
Form I-94 Arrival-Departure Record Number 23.a.
►
(USPS ZIP Code Lookup)
Form I-485 Edition 10/15/19 Page 3 of 20
►
A-
A-Number
Part 1. Information About You (Person applying
for lawful permanent residence) (continued)
Provide your name exactly as it appears on your Form I-94 (if
any)
25.b.
25.c.
25.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Part 2. Application Type or Filing Category
What is your current immigration status (if it has changed
since your arrival)?
24.
NOTE: Attach a copy of the Form I-797 receipt or approval
notice for the underlying petition or application, as appropriate.
I am applying as a principal or derivative applicant to register
lawful permanent residence or adjust status to that of a lawful
permanent resident based on the following immigrant category
(select only one category).
(See the Form I-485 Instructions for
more information, including any Additional Instructions that
relate to the immigrant category you select.):
2.a. Immediate relative spouse of a U.S. citizen, parent of
a U.S. citizen if the U.S. citizen is 21 years of age or
older, and unmarried child under 21 years of age of a
U.S. citizen, Form I-130
Other relative of a U.S. citizen or relative of a lawful
permanent resident under the family-based preference
categories, Form I-130
Individual admitted to the United States as a fiancé(e)
or child of a fiancé(e) of a U.S. citizen, Form I-129F
(K-1/K-2 Nonimmigrant)
Widow or widower of a U.S. citizen, Form I-360
VAWA self-petitioner, Form I-360
1. I am filing this Form I-485 as a (select only one box):
Principal applicant
Derivative applicant
2.b.
2.c.
2.d.
2.e.
Spouse, child, or parent of a deceased U.S. active
duty service member in the armed forces under the
National Defense Authorization Act (NDAA), Form
I-130 or Form I-360
2.f.
Family-based
Alien worker, Form I-140 (if you select this box, you
must answer Item Number 9.a.)
Alien entrepreneur, Form I-526
3.a.
Employment-based
3.b.
Special immigrant juvenile, Form I-360
Certain Afghan or Iraqi national, Form I-360
Religious worker, Form I-360
Certain international broadcaster, Form I-360
Certain G-4 international organization or family
member or NATO-6 employee or family member,
Form I-360
4.a.
Special Immigrant
4.b.
4.d.
4.e.
4.f.
4.g.
4.h.
4.i.
4.c.
Certain U.S. armed forces members (also known as
the Six and Six program), Form I-360
Panama Canal Zone employees, Form I-360
Certain Physicians, Form I-360
Certain employee or former employee of the U.S.
Government abroad, Form I-360
Asylum status (INA section 208), Form I-589 or
Form I-730
Refugee status (INA section 207), Form I-590 or
Form I-730
5.a.
Victim of Qualifying Criminal Activity (U
Nonimmigrant), Form I-918, derivative family
member, Form I-918A, or qualifying family member,
Form I-929
Human trafficking victim (T Nonimmigrant), Form
I-914 or derivative family member, Form I-914A
Asylee or Refugee
5.b.
6.a.
Human Trafficking Victim or Victim of Qualifying
Criminal Activity
6.b.
Form I-485 Edition 10/15/19 Page 4 of 20
►
A-
A-Number
Applicant adjusting based on dependent status under
the Haitian Refugee Immigrant Fairness Act for
battered spouses and children
Diplomats or high ranking officials unable to return
home (Section 13 of the Act of September 11, 1957)
Lautenberg Parolees
Applicant adjusting based on dependent status under
the Haitian Refugee Immigrant Fairness Act
Applicant adjusting under the Indochinese Parole
Adjustment Act of 2000
Applicant adjusting under the Cuban Adjustment Act
for battered spouses and children
Applicant adjusting under the Cuban Adjustment Act
Special Programs Based on Certain Public Laws
7.a.
7.b.
7.c.
7.d.
7.e.
7.f.
7.g.
7.h. Applicant adjusting under the Amerasian Act
(October 22, 1982), Form I-360
Part 2. Application Type or Filing Category
(continued)
Diversity Visa program
Individual born in the United States under diplomatic
status
Continuous residence in the United States since
before January 1, 1972 ("Registry")
8.a.
Additional Options
8.b.
8.c.
8.d.
8.e.
S nonimmigrants and qualifying family members
(only law enforcement agencies can file Form I-485
for someone in this category.)
Did a relative file the associated Form I-140 for you or
does a relative have a significant ownership interest (five
percent or more) in the business that filed Form I-140 for
you? (The relative must be your husband, wife, father,
mother, child, adult son, adult daughter, brother, or sister.)
Yes No
9.a.
Additional Alien Worker Information
Answer Item Number 9.a. only if you selected Item Number
3.a. “Alien worker, Form I-140.”
If you answered "Yes" to Item Number 9.a., answer
Item Numbers 9.b. - 9.c. If you answered "No," skip to
Item Number 10.
How is your relative related to you?9.b.
This relative is a:
Regardless of the immigrant category you are adjusting
under, do you hold:
9.c.
10.
Are you applying for adjustment based on the
Immigration and Nationality Act (INA) section 245(i)?
Yes No
11.
NOTE: If you answered "Yes" to Item Number 11., you
must have selected a family-based, employment-based,
special immigrant, or Diversity Visa immigrant category
listed above in Item Numbers 2.a. - 8.e. as the basis for
your application for adjustment of status. Fill out the rest
of this application AND Supplement A to Form I-485,
Adjustment of Status Under Section 245(i) (Supplement
A). For detailed filing instructions, read the Form I-485
Instructions (including any Additional Instructions that
relate to the immigrant category that you selected in Item
Numbers 2.a. - 8.e.) and Supplement A Instructions.
Information About Your Immigrant Category
If you are the principal applicant, provide the following
information.
Receipt Number of Underlying Petition (if any)12.
Priority Date from Underlying Petition (if any)
(mm/dd/yyyy)
13.
INA Section 245(i)
Brother or sister
Husband, wife, father, mother, child, adult son, or
adult daughter
U.S. citizen
U.S. national
Lawful permanent resident
None of the above
VAWA self-petitioner status
No
Human trafficking victim (T nonimmigrant) status
Yes No
Yes
Victim of Qualifying Criminal Activity (U nonimmigrant)
status
Yes No
Other eligibility (see the Form I-485 Instructions,
Who May Form I-485, Item Number 3. Other
Immigrant Categories for examples)
Form I-485 Edition 10/15/19 Page 5 of 20
►
A-
A-Number
Principal Applicant's Date of Birth (mm/dd/yyyy)16.
Receipt Number of Principal's Underlying Petition (if any)17.
Priority Date of Principal Applicant's Underlying Petition
(if any) (mm/dd/yyyy)
18.
►
►
A-
Principal Applicant's A-Number (if any)15.
Part 2. Application Type or Filing Category
(continued)
Part 3. Additional Information About You
1. Have you ever applied for an immigrant visa to obtain
permanent resident status at a U.S. Embassy or U.S.
Consulate abroad?
NoYes
If you answered "Yes" to Item Number 1., complete
Item Numbers 2.a. - 4. below. If you need extra space to
complete this section, use the space provided in Part 14.
Additional Information.
Location of U.S. Embassy or U.S. Consulate
2.a.
City
Country
2.b.
4. Date of Decision (mm/dd/yyyy)
Decision (for example, approved, refused, denied,
withdrawn)
3.
Address History
Provide physical addresses for everywhere you have lived
during the last five years, whether inside or outside the United
States. Provide your current address first. If you need extra
space to complete this section, use the space provided in
Part 14. Additional Information.
City or Town5.c.
5.f.
5.h.
Province
Country
5.g.
Postal Code
ZIP Code
5.e.
State
5.d.
Street Number
and Name
5.a.
5.b. Apt.
Flr.Ste.
Physical Address 1 (current address)
Dates of Residence
From (mm/dd/yyyy)
To (mm/dd/yyyy)
6.a.
6.b.
City or Town7.c.
7.f.
7.h.
Province
Country
7.g.
Postal Code
ZIP Code
7.e.
State
7.d.
Street Number
and Name
7.a.
7.b. Apt.
Flr.Ste.
Physical Address 2
If you are a derivative applicant (the spouse or unmarried
child under 21 years of age of a principal applicant), provide the
following information for the principal applicant.
Principal Applicant's Name
14.b.
14.c.
14.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Form I-485 Edition 10/15/19 Page 6 of 20
►
A-
A-Number
Part 3. Additional Information About You
(continued)
Dates of Residence
From (mm/dd/yyyy)
To (mm/dd/yyyy)
8.a.
8.b.
Provide your most recent address outside the United States
where you lived for more than one year (if not already listed
above).
City or Town9.c.
9.f.
9.h.
Province
Country
9.g.
Postal Code
ZIP Code
9.e.
State
9.d.
Street Number
and Name
9.a.
9.b. Apt.
Flr.Ste.
Dates of Residence
From (mm/dd/yyyy)
To (mm/dd/yyyy)
10.a.
10.b.
Provide your employment history for the last five years,
whether inside or outside the United States. Provide the most
recent employment first. If you need extra space to complete
this section, use the space provided in Part 14. Additional
Information.
Name of Employer or Company
Employer 1 (current or most recent)
Employment History
11.
City or Town12.c.
12.f.
12.h.
Province
Country
12.g.
Postal Code
ZIP Code
12.e.
State
12.d.
Street Number
and Name
12.a.
12.b. Apt.
Flr.Ste.
Address of Employer or Company
Your Occupation
13.
Dates of Employment
From (mm/dd/yyyy)
To (mm/dd/yyyy)
14.a.
14.b.
Name of Employer or Company15.
Employer 2
City or Town16.c.
16.f.
16.h.
Province
Country
16.g.
Postal Code
ZIP Code
16.e.
State
16.d.
Street Number
and Name
16.a.
16.b. Apt.
Flr.Ste.
Address of Employer or Company
Your Occupation
17.
Dates of Employment
From (mm/dd/yyyy)
To (mm/dd/yyyy)
18.a.
18.b.
Form I-485 Edition 10/15/19 Page 7 of 20
►
A-
A-Number
Part 3. Additional Information About You
(continued)
Provide your most recent employment outside of the United
States (if not already listed above).
Name of Employer or Company19.
City or Town20.c.
20.f.
20.h.
Province
Country
20.g.
Postal Code
ZIP Code
20.e.
State
20.d.
Street Number
and Name
20.a.
20.b. Apt.
Flr.Ste.
Address of Employer or Company
Your Occupation
21.
Dates of Employment
From (mm/dd/yyyy)
To (mm/dd/yyyy)
22.a.
22.b.
Part 4. Information About Your Parents
Parent 1's Legal Name
Information About Your Parent 1
1.b.
1.c.
1.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Parent 1's Name at Birth (if different than above)
2.b.
2.c.
2.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Date of Birth (mm/dd/yyyy)3.
FemaleMaleGender4.
City or Town of Birth
5.
Country of Birth6.
Current Country of Residence (if living)8.
Current City or Town of Residence (if living)7.
Information About Your Parent 2
Parent 2's Legal Name
9.b.
9.c.
9.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
City or Town of Birth
Date of Birth (mm/dd/yyyy)11.
13.
Parent 2's Name at Birth (if different than above)
10.b.
10.c.
10.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Current Country of Residence (if living)16.
Current City or Town of Residence (if living)15.
Country of Birth14.
FemaleMaleGender12.
Form I-485 Edition 10/15/19 Page 8 of 20
►
A-
A-Number
Part 5. Information About Your Marital History
What is your current marital status?1.
DivorcedSingle, Never Married
Widowed
Married
Marriage Annulled
Legally Separated
If you are married, is your spouse a current member of the
U.S. armed forces or U.S. Coast Guard?
2.
NoYesN/A
How many times have you been married (including
annulled marriages and marriages to the same individual)?
3.
If you are currently married, provide the following information
about your current spouse.
Information About Your Current Marriage
(including if you are legally separated)
4.b.
4.c.
4.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Current Spouse's Legal Name
Current Spouse's Date of Birth (mm/dd/yyyy)6.
Date of Marriage to Current Spouse (mm/dd/yyyy)7.
A-Number (if any)
►
A-
5.
Current Spouse's Place of Birth
Country8.c.
State or Province8.b.
City or Town8.a.
Place of Marriage to Current Spouse
Country9.c.
State or Province9.b.
City or Town9.a.
10. Is your current spouse applying with you?
NoYes
Prior Spouse's Legal Name (provide family name before
marriage)
11.b.
11.c.
11.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
If you have been married before, whether in the United States or
in any other country, provide the following information about
your prior spouse. If you have had more than one previous
marriage, use the space provided in Part 14. Additional
Information to provide the information below.
Information About Prior Marriages (if any)
Prior Spouse's Date of Birth (mm/dd/yyyy)12.
Date of Marriage to Prior Spouse (mm/dd/yyyy)13.
Place of Marriage to Prior Spouse
Country14.c.
State or Province14.b.
City or Town14.a.
Date Marriage with Prior Spouse Legally Ended 15.
(mm/dd/yyyy)
Form I-485 Edition 10/15/19 Page 9 of 20
►
A-
A-Number
Part 5. Information About Your Marital History
(continued)
Place Where Marriage with Prior Spouse Legally Ended
City or Town
16.a.
State or Province16.b.
Country16.c.
Indicate the total number of ALL living children
(including adult sons and daughters) that you have.
1.
Part 6. Information About Your Children
NOTE: The term “children” includes all biological or
legally adopted children, as well as current stepchildren,
of any age, whether born in the United States or other
countries, married or unmarried, living with you or
elsewhere and includes any missing children and those
born to you outside of marriage.
Provide the following information for each of your children.
If you have more than three children, use the space provided in
Part 14. Additional Information.
Child 1
Current Legal Name
2.b.
2.c.
2.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
A-Number (if any)3.
Date of Birth (mm/dd/yyyy)4.
Country of Birth5.
Is this child applying with you?6. Yes No
Child 2
Current Legal Name
7.b.
7.c.
7.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
A-Number (if any)8.
Date of Birth (mm/dd/yyyy)9.
Country of Birth10.
Is this child applying with you?11. Yes No
Child 3
Current Legal Name
12.b.
12.c.
12.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
A-Number (if any)13.
Date of Birth (mm/dd/yyyy)14.
Country of Birth15.
Is this child applying with you?16. Yes No
1.
Ethnicity (Select only one box)
Part 7. Biographic Information
2.
Race (Select all applicable boxes)
Hispanic or Latino
Not Hispanic or Latino
Asian
White
Black or African American
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
►
A-
►
A-
►
A-
Form I-485 Edition 10/15/19 Page 10 of 20
►
A-
A-Number
Part 7. Biographic Information (continued)
Height
4. Weight
Feet Inches3.
Pounds
5.
Eye Color (Select only one box)
Hair Color (Select only one box) 6.
Part 8. General Eligibility and Inadmissibility
Grounds
1. Have you EVER been a member of, involved in, or in
any way associated with any organization, association,
fund, foundation, party, club, society, or similar group in
the United States or in any other location in the world
including any military service?
NoYes
If you answered "Yes" to Item Number 1., complete Item
Numbers 2. - 13.b. below. If you need extra space to complete
this section, use the space provided in Part 14. Additional
Information. If you answered "No," but are unsure of your
answer, provide an explanation of the events and circumstances
in the space provided in Part 14. Additional Information.
Organization 1
Name of Organization2.
Country3.c.
State or Province3.b.
City or Town3.a.
Nature of Group4.
Blue
Black
Brown
Gray
Green
Hazel
Maroon
Pink Unknown/Other
Bald (No hair)
Black Blond
Brown
Gray
Red
Sandy
White Unknown/Other
Dates of Membership or Dates of Involvement
From (mm/dd/yyyy)
To (mm/dd/yyyy)
5.a.
5.b.
Organization 2
Name of Organization6.
Country7.c.
State or Province7.b.
City or Town7.a.
Nature of Group8.
Dates of Membership or Dates of Involvement
From (mm/dd/yyyy)
To (mm/dd/yyyy)
Organization 3
Name of Organization10.
City or Town11.a.
9.a.
9.b.
Country11.c.
Nature of Group12.
State or Province11.b.
Dates of Membership or Dates of Involvement
From (mm/dd/yyyy)
To (mm/dd/yyyy)
13.a.
13.b.
Form I-485 Edition 10/15/19 Page 11 of 20
►
A-
A-Number
Part 8. General Eligibility and Inadmissibility
Grounds (continued)
Answer Item Numbers 14. - 80.b. Choose the answer that you
think is correct. If you answer “Yes” to any questions (or if
you answer "No," but are unsure of your answer), provide
an explanation of the events and circumstances in the space
provided in Part 14. Additional Information.
15.
Have you EVER worked in the United States without
authorization?
16.
Have you EVER been denied a visa to the United States?
Have you EVER been denied admission to the United
States?
14.
Have you EVER violated the terms or conditions of your
nonimmigrant status?
17.
NoYes
Yes No
NoYes
NoYes
18. Are you presently or have you EVER been in removal,
exclusion, rescission, or deportation proceedings?
Yes No
20.
Have you EVER held lawful permanent resident status
which was later rescinded?
21.
Have you EVER had a prior final order of exclusion,
deportation, or removal reinstated?
Yes No
NoYes
22. Have you EVER been granted voluntary departure by an
immigration officer or an immigration judge but failed to
depart within the allotted time?
Yes No
NoYes
Have you EVER applied for any kind of relief or
protection from removal, exclusion, or deportation?
23.
24.a. Have you EVER been a J nonimmigrant exchange visitor
who was subject to the two-year foreign residence
requirement?
Yes No
If you answered "Yes" to Item Number 24.a., complete Item
Numbers 24.b. - 24.c. If you answered "No" to Item Number
24.a., skip to Item Number 25.
Have you complied with the foreign residence
requirement?
NoYes
24.b.
Have you EVER been issued a final order of exclusion,
deportation, or removal?
19.
NoYes
For Item Numbers 25. - 45., you must answer "Yes" to any
question that applies to you, even if your records were sealed or
otherwise cleared, or even if anyone, including a judge, law
enforcement officer, or attorney, told you that you no longer
have a record. You must also answer "Yes" to the following
questions whether the action or offense occurred here in the
United States or anywhere else in the world. If you answer
"Yes" to Item Numbers 25. - 45., use the space provided in
Part 14. Additional Information to provide an explanation
that includes why you were arrested, cited, detained, or charged;
where you were arrested, cited, detained, or charged; when
(date) the event occurred; and the outcome or disposition (for
example, no charges filed, charges dismissed, jail, probation,
community service).
Criminal Acts and Violations
25.
NoYes
Have you EVER committed a crime of any kind (even if
you were not arrested, cited, charged with, or tried for that
crime)?
26.
Have you EVER been arrested, cited, charged, or
detained for any reason by any law enforcement official
(including but not limited to any U.S. immigration
official or any official of the U.S. armed forces or U.S.
Coast Guard)?
Yes No
27. Have you EVER pled guilty to or been convicted of a
crime or offense (even if the violation was subsequently
expunged or sealed by a court, or if you were granted a
pardon, amnesty, a rehabilitation decree, or other act of
clemency)?
Yes No
NOTE: If you were the beneficiary of a pardon, amnesty,
a rehabilitation decree, or other act of clemency, provide
documentation of that post-conviction action.
Have you EVER been ordered punished by a judge or had
conditions imposed on you that restrained your liberty
(such as a prison sentence, suspended sentence, house
arrest, parole, alternative sentencing, drug or alcohol
treatment, rehabilitative programs or classes, probation, or
community service)?
28.
NoYes
29. Have you EVER been a defendant or the accused in a
criminal proceeding (including pre-trial diversion,
deferred prosecution, deferred adjudication, or any
withheld adjudication)?
Yes No
Yes
Have you been granted a waiver or has Department of
State issued a favorable waiver recommendation letter
for you?
No
24.c.
NoYes
30. Have you EVER violated (or attempted or conspired to
violate) any controlled substance law or regulation of a
state, the United States, or a foreign country?
Form I-485 Edition 10/15/19 Page 12 of 20
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Part 8. General Eligibility and Inadmissibility
Grounds (continued)
Yes No
32. Have you EVER illicitly (illegally) trafficked or benefited
from the trafficking of any controlled substances, such as
chemicals, illegal drugs, or narcotics?
33.
NoYes
Have you EVER knowingly aided, abetted, assisted,
conspired, or colluded in the illicit trafficking of any
illegal narcotic or other controlled substances?
34.
No
Are you the spouse, son, or daughter of a foreign national
who illicitly trafficked or aided (or otherwise abetted,
assisted, conspired, or colluded) in the illicit trafficking of
a controlled substance, such as chemicals, illegal drugs, or
narcotics and you obtained, within the last five years, any
financial or other benefit from the illegal activity of your
spouse or parent, although you knew or reasonably should
have known that the financial or other benefit resulted
from the illicit activity of your spouse or parent?
Yes
NoYes
35. Have you EVER engaged in prostitution or are you
coming to the United States to engage in prostitution?
36. Have you EVER directly or indirectly procured (or
attempted to procure) or imported prostitutes or persons
for the purpose of prostitution?
Yes No
37.
No
Have you EVER received any proceeds or money from
prostitution?
Yes
38. Do you intend to engage in illegal gambling or any other
form of commercialized vice, such as prostitution,
bootlegging, or the sale of child pornography, while in the
United States?
Yes No
No
Have you EVER exercised immunity (diplomatic or
otherwise) to avoid being prosecuted for a criminal
offense in the United States?
Yes
39.
42.
43.
No
Yes No
Yes
Have you EVER trafficked a person into involuntary
servitude, peonage, debt bondage, or slavery? Trafficking
includes recruiting, harboring, transporting, providing, or
obtaining a person for labor or services through the use of
force, fraud, or coercion.
Have you EVER knowingly aided, abetted, assisted,
conspired, or colluded with others in trafficking persons
for commercial sex acts or involuntary servitude,
peonage, debt bondage, or slavery?
44.
NoYes
Are you the spouse, son or daughter of a foreign national
who engaged in the trafficking of persons and have
received or obtained, within the last five years, any
financial or other benefits from the illicit activity of your
spouse or your parent, although you knew or reasonably
should have known that this benefit resulted from the illicit
activity of your spouse or parent?
45.
Yes No
Have you EVER engaged in money laundering or have
you EVER knowingly aided, assisted, conspired, or
colluded with others in money laundering or do you seek
to enter the United States to engage in such activity?
Security and Related
Do you intend to:
Yes No
46.a.
Engage in any activity that violates or evades any law
relating to espionage (including spying) or sabotage in the
United States?
46.b. Engage in any activity in the United States that violates or
evades any law prohibiting the export from the United
States of goods, technology, or sensitive information?
NoYes
46.c. Engage in any activity whose purpose includes opposing,
controlling, or overthrowing the U.S. Government by
force, violence, or other unlawful means while in the
United States?
NoYes
46.d. Engage in any activity that could endanger the welfare,
safety, or security of the United States?
NoYes
40.
Yes No
Have you EVER, while serving as a foreign government
official, been responsible for or directly carried out
violations of religious freedoms?
46.e.
Yes NoEngage in any other unlawful activity?
31.
No
Have you EVER been convicted of two or more offenses
(other than purely political offenses) for which the
combined sentences to confinement were five years or
more?
Yes
NoYes
41.
Have you EVER induced by force, fraud, or coercion (or
otherwise been involved in) the trafficking of persons for
commercial sex acts?
47. Are you engaged in or, upon your entry into the United
States, do you intend to engage in any activity that could
have potentially serious adverse foreign policy
consequences for the United States?
NoYes
Form I-485 Edition 10/15/19 Page 13 of 20
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Part 8. General Eligibility and Inadmissibility
Grounds (continued)
48.a. Committed, threatened to commit, attempted to commit,
conspired to commit, incited, endorsed, advocated,
planned, or prepared any of the following: hijacking,
sabotage, kidnapping, political assassination, or use of a
weapon or explosive to harm another individual or cause
substantial damage to property?
NoYes
Have you EVER:
Yes No
Participated in, or been a member of, a group or
organization that did any of the activities described in
Item Number 48.a.?
48.b.
49. Have you EVER received any type of military,
paramilitary, or weapons training?
NoYes
Yes No
Recruited members or asked for money or things of value
for a group or organization that did any of the activities
described in Item Number 48.a.?
48.c.
48.d. Provided money, a thing of value, services or labor, or
any other assistance or support for any of the activities
described in Item Number 48.a.?
NoYes
50. Do you intend to engage in any of the activities listed in
any part of Item Numbers 48.a. - 49.?
Yes No
48.e. Provided money, a thing of value, services or labor, or
any other assistance or support for an individual, group,
or organization who did any of the activities described in
Item Number 48.a.?
NoYes
NOTE: If you answered “Yes” to any part of Item Numbers
46.a. - 50., explain what you did, including the dates and
location of the circumstances, or what you intend to do in the
space provided in Part 14. Additional Information.
NoYes
Committed, threatened to commit, attempted to commit,
conspired to commit, incited, endorsed, advocated,
planned, or prepared any of the following: hijacking,
sabotage, kidnapping, political assassination, or use of a
weapon or explosive to harm another individual or cause
substantial damage to property?
51.a.
Are you the spouse or child of an individual who EVER:
NoYes
Provided money, a thing of value, services or labor, or
any other assistance or support for any of the activities
described in Item Number 51.a.?
51.d.
NoYes
Provided money, a thing of value, services or labor, or
any other assistance or support to an individual, group, or
organization who did any of the activities described in
Item Number 51.a.?
51.e.
NoYes
Received any type of military, paramilitary, or weapons
training from a group or organization that did any of the
activities described in Item Number 51.a.?
51.f.
NOTE: If you answered “Yes” to any part of Item Number
51., explain the relationship and what occurred, including the
dates and location of the circumstances, in the space provided
in Part 14. Additional Information.
NoYes
Have you EVER worked, volunteered, or otherwise
served in any prison, jail, prison camp, detention facility,
labor camp, or any other situation that involved detaining
persons?
53.
52. Have you EVER assisted or participated in selling,
providing, or transporting weapons to any person who,
to your knowledge, used them against another person?
Yes No
54. Have you EVER been a member of, assisted, or
participated in any group, unit, or organization of any
kind in which you or other persons used any type of
weapon against any person or threatened to do so?
Yes No
NoYes
Have you EVER served in, been a member of, assisted,
or participated in any military unit, paramilitary unit,
police unit, self-defense unit, vigilante unit, rebel group,
guerilla group, militia, insurgent organization, or any
other armed group?
55.
NoYes
Have you EVER been a member of, or in any way
affiliated with, the Communist Party or any other
totalitarian party (in the United States or abroad)?
56.
NoYes
Participated in, or been a member or a representative of a
group or organization that did any of the activities
described in Item Number 51.a.?
51.b.
NoYes
Recruited members, or asked for money or things of value,
for a group or organization that did any of the activities
described in Item Number 51.a.?
51.c.
57. During the period from March 23, 1933 to May 8, 1945,
did you ever order, incite, assist, or otherwise participate
in the persecution of any person because of race, religion,
national origin, or political opinion, in association with
either the Nazi government of Germany or any
organization or government associated or allied with the
Nazi government of Germany?
Yes No
Form I-485 Edition 10/15/19 Page 14 of 20
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Part 8. General Eligibility and Inadmissibility
Grounds (continued)
Have you EVER ordered, incited, called for, committed, assisted,
helped with, or otherwise participated in any of the following:
Acts involving torture or genocide?58.a.
NoYes
Killing any person?58.b.
Yes No
Intentionally and severely injuring any person?58.c.
NoYes
NoYes
Engaging in any kind of sexual contact or relations with
any person who did not consent or was unable to consent,
or was being forced or threatened?
58.d.
58.e. Limiting or denying any person's ability to exercise
religious beliefs?
Yes No
59. Have you EVER recruited, enlisted, conscripted, or used
any person under 15 years of age to serve in or help an
armed force or group?
Yes No
NoYes
60. Have you EVER used any person under 15 years of age
to take part in hostilities, or to help or provide services to
people in combat?
Public Charge
NoYes
Are you exempt from the public charge ground of
inadmissibility?
61.
Affidavit of Support Under Section 213A of the
INA (Form I-864)
You may need to file Form I-864. For more information, read
the Form I-485 Instructions, What Evidence Must You
Submit, Item Number 9. Public Charge: Declaration of Self-
Sufficiency (Form I-944) and Affidavit of Support Under
INA section 213A (Form I-864).
I am EXEMPT from filing Form I-864 because:
I have earned or can receive credit for 40 qualifying
quarters (credits) of work in the United States (as
defined by the Social Security Act (SSA). (Attach
your SSA earnings statements. Do not count any
quarters during which you received a means-tested
public benefit).
62.a.
I am under 18 years of age, unmarried, immigrating
as the child of a U.S. citizen, and will automatically
become a U.S. citizen under the Child Citizenship
Act of 2000 upon my admission to the United States.
62.b.
I am applying under the widow or widower of a U.S.
citizen (Form I-360) immigrant category.
62.c.
I am applying under an alien worker (Form I-140)
employment-based preference immigrant category
and both of the following apply:
62.d.
I am not a relative of the Form I-140 petitioner;
and
I do not have a relative with a significant
ownership interest (at least five percent) in the
business that filed Form I-140.
62.e.
I am applying under the alien entrepreneur (Form
I-526) immigrant category.
62.f.
I am applying under the human trafficking victim
(T nonimmigrant) immigrant category (INA section
245(l)).
62.g.
(1)
(2)
I am applying under the victim of qualifying criminal
activity (U nonimmigrant) immigrant category (INA
section 245(m)).
62.h.
Declaration of Self-Sufficiency (Form I-944)
To determine if you are exempt from the public charge ground
of inadmissibility, and therefore exempt from filing Form I-944,
read the Form I-485 Instructions, What Evidence Must You
Submit, Item Number 9. Public Charge: Declaration of Self-
Sufficiency (Form I-944) and Affidavit of Support Under
Section 213A of the INA (Form I-864). If you answered
“Yes” to Item Number 61., proceed to Item Number 63.a. If
you answered “No,” complete Form I-944 and include it with
your Form I-485 filing, and proceed to Item Number 62.a.
NOTE: If, when USCIS adjudicates your adjustment
application, your Form I-914 is no longer pending a decision or
you are no longer in valid T nonimmigrant status, you may have
to submit a Form I-944 and Form I-864.
I am applying under a category other than the human
trafficking victim (T nonimmigrant) category (INA
section 245(l)), or as an alien worker under the
employment-based preference categories where a
relative filed Form I-140 for me or has a five percent
or more ownership interest in the business that filed
Form I-140, and I either have a pending application
for T nonimmigrant status or I am an individual who
is in valid T nonimmigrant status.
NOTE: If you answered “Yes” to any part of Item Numbers
52. - 60., explain what occurred, including the dates and
location of the circumstances, in the space provided in Part 14.
Additional Information.
Those who are subject to the public charge ground of
inadmissibility under INA section 212(a)(4) must complete
Form I-944, Declaration of Self-Sufficiency, and may also have
to submit Form I-864, Affidavit of Support Under Section 213A
of the INA. Answer the questions below to determine whether
you need to submit these forms together with this Form I-485.
Form I-485 Edition 10/15/19 Page 15 of 20
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Part 8. General Eligibility and Inadmissibility
Grounds (continued)
62.j.
I am applying under the diplomat or high ranking
official unable to return home (Section 13 of the Act
of September 11, 1957) immigrant category.
Illegal Entries and Other Immigration Violations
NoYes
Have you EVER failed or refused to attend or to remain
in attendance at any removal proceeding filed against you
on or after April 1, 1997?
63.a.
68. Have you EVER knowingly encouraged, induced,
assisted, abetted, or aided any foreign national to enter or
to try to enter the United States illegally (alien
smuggling)?
Yes No
NoYes
Are you under a final order of civil penalty for violating
INA section 274C for use of fraudulent documents?
69.
72.a. For more than 180 days but less than a year, and then
departed the United States?
No
Since April 1, 1997, have you been unlawfully present in the
United States:
Yes
Yes No
For one year or more and then departed the United States? 72.b.
Removal, Unlawful Presence, or Illegal Reentry
After Previous Immigration Violations
No
71. Have you EVER entered the United States without being
inspected and admitted or paroled?
Yes No
Yes
Have you EVER been excluded, deported, or removed
from the United States or have you ever departed the
United States on your own after having been ordered
excluded, deported, or removed from the United States?
70.
NOTE: You were unlawfully present in the United States if
you entered the United States without being inspected and
admitted or inspected and paroled, or if you legally entered the
United States but you stayed longer than permitted.
62.k.
I am a law enforcement officer filing this Form I-485
for an S nonimmigrant immigrant (or a qualifying
family member).
62.l.
I am applying under the Diversity Visa program
immigrant category.
62.m.
I am applying under one of the following special
immigrant categories (select one):
NoYes
Have you EVER been a stowaway on a vessel or aircraft
arriving in the United States?
67.
Armed forces (also known as the Six and Six
program)
Panama Canal Zone
Certain broadcasters
G-4 or NATO-6 employees and their family
members
International employees of the U.S. Government
abroad
Religious workers
Certain physicians
Employed by or on behalf of the U.S.
Government
66. Have you EVER falsely claimed to be a U.S. citizen (in
writing or any other way)?
Yes No
NoYes
Have you EVER lied about, concealed, or misrepresented
any information on an application or petition to obtain a
visa, other documentation required for entry into the
United States, admission to the United States, or any other
kind of immigration benefit?
65.
62.i. I am applying under a category other than the victim
of qualifying criminal activity (U nonimmigrant)
category under INA section 245(m) or as an alien
worker under the employment-based preference
categories where a relative filed Form I-140 for me or
has a five percent or more ownership interest in the
business that filed Form I-140, but I either have a
pending petition for U nonimmigrant status or I am
an individual who is granted U nonimmigrant status.
NOTE: If, at the time of the adjudication of the Form I-485,
your Form I-918 is no longer pending a decision or you are no
longer in valid U nonimmigrant status, you may be required to
submit Form I-944 and Form I-864.
64. Have you EVER submitted fraudulent or counterfeit
documentation to any U.S. Government official to obtain
or attempt to obtain any immigration benefit, including a
visa or entry into the United States?
Yes No
Yes No
63.b. If your answer to Item Number 63.a. is "Yes," do you
believe you had reasonable cause?
If your answer to Item Number 63.b. is "Yes," attach a
written statement explaining why you had reasonable
cause.
63.c.
62.n.
I am applying under the Amerasian Act (October 22,
1982)
Form I-485 Edition 10/15/19 Page 16 of 20
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Part 8. General Eligibility and Inadmissibility
Grounds (continued)
Part 9. Accommodations for Individuals With
Disabilities and/or Impairments
NOTE: Read the information in the Form I-485 Instructions
before completing this part.
Are you requesting an accommodation because of your
disabilities and/or impairments?
No
Yes
1.
If you answered "Yes" to Item Number 1., select any
applicable box in Item Numbers 2.a. - 2.c. and provide
an answer.
2.a.
I am deaf or hard of hearing and request the
following accommodation. (If you are requesting a
sign-language interpreter, indicate for which
language (for example, American Sign Language).):
I have another type of disability and/or impairment.
(Describe the nature of your disability and/or
impairment and the accommodation you are
requesting.)
2.c.
I am blind or have low vision and request the
following accommodation:
2.b.
Are you accompanying another foreign national who
requires your protection or guardianship but who is
inadmissible after being certified by a medical officer as
being helpless from sickness, physical or mental
disability, or infancy, as described in INA section 232(c)?
NoYes
75.
76. Have you EVER assisted in detaining, retaining, or
withholding custody of a U.S. citizen child outside the
United States from a U.S. citizen who has been granted
custody of the child?
Yes No
NoYes
Have you EVER voted in violation of any Federal, state,
or local constitutional provision, statute, ordinance, or
regulation in the United States?
77.
78. Have you EVER renounced U.S. citizenship to avoid
being taxed by the United States?
Yes No
Have you EVER:
79.a. Applied for exemption or discharge from training or
service in the U.S. armed forces or in the U.S. National
Security Training Corps on the ground that you are a
foreign national?
NoYes
79.b. Been relieved or discharged from such training or service
on the ground that you are a foreign national?
NoYes
79.c. Been convicted of desertion from the U.S. armed forces?
NoYes
Part 10. Applicant's Statement, Contact
Information, Certification, and Signature
NOTE: Read the Penalties section of the Form I-485
Instructions before completing this part. You must file Form
I-485 while in the United States.
Having been deported, excluded, or removed from the
United States?
73.b.
NoYes
Miscellaneous Conduct
74. Do you plan to practice polygamy in the United States?
Yes No
If your answer to Item Number 80.a. is “Yes,” what was
your nationality or immigration status immediately before
you left (for example, U.S. citizen or national, lawful
permanent resident, nonimmigrant, parolee, present
without admission or parole, or any other status)?
80.b.
80.a. Have you EVER left or remained outside the United
States to avoid or evade training or service in the U.S.
armed forces in time of war or a period declared by the
President to be a national emergency?
NoYes
Since April 1, 1997, have you EVER reentered or attempted to
reenter the United States without being inspected and admitted
or paroled after:
Having been unlawfully present in the United States for
more than one year in the aggregate?
73.a.
NoYes
Form I-485 Edition 10/15/19 Page 17 of 20
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Part 10. Applicant's Statement, Contact
Information, Certification, and Signature
(continued)
2. At my request, the preparer named in Part 12.,
prepared this application for me based only upon
information I provided or authorized.
,
The interpreter named in Part 11. read to me every
question and instruction on this application and my
answer to every question in
1.b.
a language in which I am fluent, and I understood
everything.
,
Applicant's Daytime Telephone Number3.
Applicant's Contact Information
Applicant's Mobile Telephone Number (if any)4.
I understand that USCIS may require me to appear for an
appointment to take my biometrics (fingerprints, photograph,
and/or signature) and, at that time, if I am required to provide
biometrics, I will be required to sign an oath reaffirming that:
1)
I reviewed and understood all of the information
contained in, and submitted with, my application;
and
2)
All of this information was complete, true, and
correct at the time of filing.
I certify, under penalty of perjury, that all of the information in
my application and any document submitted with it were
provided or authorized by me, that I reviewed and understand
all of the information contained in, and submitted with, my
application and that all of this information is complete, true,
and correct.
Applicant's Signature
Date of Signature (mm/dd/yyyy)6.b.
Applicant's Signature (sign in ink)6.a.
NOTE TO ALL APPLICANTS: If you do not completely fill
out this application or fail to submit required documents listed
in the Instructions, USCIS may deny your application.
Applicant's Email Address (if any)5.
Applicant's Certification
Copies of any documents I have submitted are exact photocopies
of unaltered, original documents, and I understand that USCIS
may require that I submit original documents to USCIS at a later
date. Furthermore, I authorize the release of any information
from any and all of my records that USCIS may need to
determine my eligibility for the immigration benefit that I seek.
I understand that if I am a male who is 18 to 26 years of age,
submitting this application will automatically register me with
the Selective Service System as required by the Military
Selective Service Act.
Interpreter's Business or Organization Name (if any)
2.
Interpreter's Given Name (First Name)1.b.
Interpreter's Family Name (Last Name)1.a.
Interpreter's Full Name
Part 11. Interpreter's Contact Information,
Certification, and Signature
Provide the following information about the interpreter.
I furthermore authorize release of information contained in this
application, in supporting documents, and in my USCIS
records, to other entities and persons where necessary for the
administration and enforcement of U.S. immigration law.
I can read and understand English, and I have read
and understand every question and instruction on this
application and my answer to every question.
1.a.
NOTE: Select the box for either Item Number 1.a. or 1.b. If
applicable, select the box for Item Number 2.
Applicant's Statement
Form I-485 Edition 10/15/19 Page 18 of 20
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Interpreter's Mailing Address
3.c. City or Town
3.d. State 3.e. ZIP Code
3.f.
Postal Code
Street Number
and Name
3.a.
3.b. Apt.
Flr.Ste.
3.g.
3.h. Country
Province
Interpreter's Contact Information
Interpreter's Daytime Telephone Number4.
Interpreter's Email Address (if any)6.
Interpreter's Mobile Telephone Number (if any)
5.
Preparer's Given Name (First Name)1.b.
2. Preparer's Business or Organization Name (if any)
Preparer's Full Name
Provide the following information about the preparer.
1.a. Preparer's Family Name (Last Name)
Part 12. Contact Information, Declaration, and
Signature of the Person Preparing this
Application, if Other Than the Applicant
Preparer's Mailing Address
3.c. City or Town
3.d. State 3.e. ZIP Code
3.f.
Postal Code
Street Number
and Name
3.a.
3.b. Apt.
Flr.Ste.
3.g.
3.h. Country
Province
Part 11. Interpreter's Contact Information,
Certification, and Signature (continued)
Interpreter's Certification
I am fluent in English and
which is the same language specified in Part 10., Item
Number 1.b., and I have read to this applicant in the identified
language every question and instruction on this application and
his or her answer to every question. The applicant informed me
that he or she understands every instruction, question, and
answer on the application, including the Applicant's
Certification, and has verified the accuracy of every answer.
I certify, under penalty of perjury, that:
,
Interpreter's Signature
Date of Signature (mm/dd/yyyy)7.b.
Interpreter's Signature (sign in ink)
7.a.
Preparer's Contact Information
Preparer's Mobile Telephone Number (if any)5.
Preparer's Daytime Telephone Number4.
Preparer's Email Address (if any)6.
Form I-485 Edition 10/15/19 Page 19 of 20
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Preparer's Certification
By my signature, I certify, under penalty of perjury, that I
prepared this application at the request of the applicant. The
applicant then reviewed this completed application and
informed me that he or she understands all of the information
contained in, and submitted with, his or her application,
including the Applicant's Certification, and that all of this
information is complete, true, and correct. I completed this
application based only on information that the applicant
provided to me or authorized me to obtain or use.
Preparer's Signature
8.a.
Preparer's Signature (sign in ink)
8.b. Date of Signature (mm/dd/yyyy)
Part 12. Contact Information, Declaration, and
Signature of the Person Preparing this
Application, if Other Than the Applicant
(continued)
Part 13. Signature at Interview
I swear (affirm) and certify under penalty of perjury under the
laws of the United States of America that I know that the
contents of this Form I-485, Application to Register Permanent
Residence or Adjust Status, subscribed by me, including the
Subscribed to and sworn to (affirmed) before me
USCIS Officer's Printed Name or Stamp
Applicant's Signature (sign in ink)
Date of Signature (mm/dd/yyyy)
USCIS Officer's Signature (sign in ink)
additional pages submitted by me with this Form I-485, on
corrections made to this application, numbered
through , are complete, true, and correct. All
true, and correct. All documents submitted at this interview
were provided by me and are complete, true, and correct.
numbered pages through are complete,
NOTE: Do not complete Part 13. until the USCIS Officer
instructs you to do so at the interview.
Preparer's Statement
I am not an attorney or accredited representative but
have prepared this application on behalf of the
applicant and with the applicant's consent.
NOTE: If you are an attorney or accredited
representative, you may be obliged to submit a
completed Form G-28, Notice of Entry of
Appearance as Attorney or Accredited
Representative, with this application.
I am an attorney or accredited representative and my
representation of the applicant in this case
extends does not extend beyond the
7.a.
7.b.
preparation of this application.
Form I-485 Edition 10/15/19 Page 20 of 20
Part 14. Additional Information
If you need extra space to provide any additional information
within this application, use the space below. If you need more
space than what is provided, you may make copies of this page
to complete and file with this application or attach a separate
sheet of paper. Type or print your 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.
A-Number (if any) ►
A-
3.a.
2.
Page Number 3.b. Part Number 3.c. Item Number
3.d.
Page Number Part Number Item Number
Page Number Part Number Item Number5.a.
Page Number
5.b.
Part Number
5.c.
Item Number
5.d.
Part NumberPage Number Item Number
1.b.
1.c.
1.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
4.c.4.b.
4.d.
4.a.
6.d.
6.c.6.b.6.a.
7.c.7.b.7.a.
7.d.
►
A-
A-Number
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Form I-485: Application to Register Permanent Residence (USCIS)

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Completed 25 August 2020

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