If in U.S., give address/immigration status
Part 3. Additional Information About You
Other Names Used (including maiden name):
Date of Marriage (mm/dd/yyyy)
Are you in removal, deportation, or rescission proceedings?
Was a fee paid to anyone other than an attorney in connection with this petition?
Have you ever been arrested, detained, charged, indicted, fined, or imprisoned for breaking or violating any
law or ordianance (excluding traffic regulations), or committed any crime which you were not arrested in
the United States or abroad?
If you are married, is this a different marriage than the one through which conditional residence status was
obtained?
Have you resided at any other address since you became a permanent resident? (If yes, attach a list of all
addresses and dates.)
Is your spouse currently serving with or employed by the U.S. government and serving outside the United States?
Part 4. Information About the Spouse or Parent Through Whom You Gained Your Conditional Residence
Date of Birth (mm/dd/yyyy)
Social Security # (if any)
Part 5. Information About Your Children-List all your children (Attach other sheet(s) if necessary)
Read the information on penalties in the instructions before completing this section. If you checked block
"a" in Part 2, your spouse must also sign below.
I certify, under penalty of perjury of the laws of the United States of America, that this petition and the evidence submitted with it is all true and
correct. If conditional residence was based on a marriage, I further certify that the marriage was entered in accordance with the laws of the place
where the marriage took place and was not for the purpose of procuring an immigration benefit. I also authorize the release of any information from
my records that the U.S. Citizenship and Immigration Services needs to determine eligibility for the benefit sought.
NOTE: If you do not completely fill out this form or fail to submit any required documents listed in the instructions, you may not be found eligible
for the requested benefit and this petition may be denied.
Part 7. Signature of Person Preparing Form, If Other than Above
I declare that I prepared this petition at the request of the above person and it is based on all information of which I have knowledge.
Daytime Phone Number
(Area/Country codes)
If your spouse is deceased, give the date of death (mm/dd/yyyy)
Form I-751 (Rev.08/25/08) N Page 2
Date of Birth (mm/dd/yyyy)
If you answered "Yes" to any of the above, provide a detailed explanation on a separate sheet(s) of paper and refer to "What Initial Evidence Is Required?" to determine
what criminal history documentation to include with your petition. Place your name and Alien Registration Number (A#) at the top of each sheet and give the number of
the item that refers to your response.
