Form I-687 Worksheet 03/30/15 Y Page 2
Part 1. Information About You (Continued)
Part 2. General Information
A. I entered the United States before January 1, 1982, on a nonimmigrant visa and then resided in
continuous unlawful status, except for brief absences, from before 1982 until the date I (or my parent or
spouse) was turned away by INS when I (or my parent or spouse) tried to apply for legalization in 1987
- 1988.
NoYes
B. I was continuously physically present in the United States, except for brief, casual, and innocent
departures from November 6, 1986, until the date I (or my parent or spouse) was turned away by INS
when I (or my parent or spouse) tried to apply for legalization.
NoYes
C. I have not been convicted in the United States of one felony or three or more misdemeanors, nor have I
ever been convicted of crimes or committed acts which make me inadmissible pursuant to any
provision of the Immigration and Nationality Act (INA), including but not limited to:
NoYes
IMPORTANT: USCIS will accept your I-687 application and Class Member Worksheet for filing so long as the following
requirements are met: (Check all that apply to you)
If your application and Worksheet does not meet the above requirements, USCIS may reject it and return it to you within 30 days
of receipt. If the application is rejected and returned to you as incomplete, you must correct the deficiency and re-file your
application, and do so BEFORE the IAP/NWIRP class member filing period ends. Rejected applications re-submitted after the close of
the filing period will not be accepted. It is very important that you properly submit a complete application within the filing
deadline.
The boxes checked on Parts 2, 3, and 4 of this Worksheet establish that I am a class member, as explained in the instructions.
I have signed my Class Membership Worksheet.
I have attached evidence available to me about my entry prior to January 1, 1982, with a nonimmigrant visa as described in
the instructions to this Worksheet.
I have signed my Form I-687.
I have included a money order or personal check for the current Form I-687 filing fee.
I have included a money order or personal check for the current biometrics fee.
c. 212(a)(2)(C) - Controlled substance traffickers.
a. 212(a)(A)(i)(I) - Crime involving moral turpitude.
b. 212(a)(2)(B) - Multiple criminal convictions.
d. 212(a)(2)(A)(i)(II) - Controlled substances (Other than less than 30 grams of marijuana).
e. 212(a)(3) - Security and related grounds.
NOTE: If you answered "Yes" to Questions A, B, and C in Part 2, go to Part 3. If you answered "No" to any of these questions,
STOP. You are not eligible for NWIRP class membership.
A. I violated my nonimmigrant status prior to January 1, 1982, and the violation of status is evident based
on a review of government files.
Part 3. NWIRP Class Requirements
NoYes
This category includes individuals who worked without authorization before January 1, 1982, and who have social security
records, tax records, or other government records to show income relating to such unauthorized work in their name. It also
includes individuals who failed to file annual and quarterly address reports as required under Section 265 of the INA before
January 1, 1982.