Application for Waiver of Grounds of Inadmissibility

OMB No. 1615-0029; Expires 06/06/2012

Instructions for I-601, Application for Waiver
of Grounds of Inadmissibility

Department of Homeland Security
U.S. Citizenship and Immigration Services

Instructions

DRAFT - Not
For Production

Read these instructions carefully to properly complete this form. If you need more space to complete an answer, use a
separate sheet of paper. Write your name and Alien Registration Number (A-Number), if any, at the top of each sheet of paper
and indicate the section and number of the item to which the answer refers.

What Is the Purpose of This Form?

E. Smugglers (INA section 212(a)(6)(E)) and Being
Subject of Civil Penalty (INA section 212(a)(6)(F));

An alien who is ineligible to be admitted to the United States
as an immigrant or to adjust status in the United States, and
certain nonimmigrant applicants who are inadmissible, must
file this form to seek a waiver of certain grounds of
inadmissibility.

F. The 3-year or 10-year bar (INA section 212(a)(9)(B));

Who May File This Form?
1. An applicant who is outside the United States who has had
a visa interview with a consular officer and was found
inadmissible;
2. Any applicant for adjustment of status;
3. K-1 or K-2 nonimmigrant visa applicant (see
Specific Instructions);
4. K-3, K-4, or V nonimmigrant visa applicant;
5. Temporary Protected Status (TPS) applicant;
6. Nicaraguan Adjustment and Central American Relief Act
(NACARA) applicant;
7. Haitian Refugee Immigrant Fairness Act (HRIFA)
applicant;
8. Violence Against Women Act (VAWA)
self-petitioner; or
9. T nonimmigrant visa status holder filing for adjustment of
status who is inadmissible by reason of a ground that has
not already been waived in connection with the T
nonimmigrant status;
and who seeks a waiver of the following grounds of
inadmissibility:
A. Health-related grounds (Immigration and Nationality
Act (INA) section 212(a)(1));
B. Certain criminal grounds (INA section 212(a)(2));
C. Immigrant Membership in Totalitarian Party (INA
section 212(a)(3)(D));
D. Immigration fraud or misrepresentation (INA section
212(a)(6)(C)) except that a waiver under INA section
212(i) is not available, if you are inadmissible based on
a false claim to be a U.S. citizen (INA section 212(a)(6)
(C)(ii)), and if you made your false claim on or after
September 30, 1996;

G. Certain grounds of inadmissibility, if filed by an
applicant for TPS;
H. INA section 212(a)(9)(A) (Aliens Previously
Removed) and (9)(C) (Unlawfully Present After
Previous Immigration Violations), if filed by a
NACARA or HRIFA adjustment applicant;
I. INA section 212(a)(9)(C) (Unlawfully Present After
Previous Immigration Violations) for a VAWA selfpetitioner;
J. T nonimmigrant visa status holders applying for
adjustment of status may receive a waiver of INA
section 212(a)(1) (Public Health) and INA section 212
(a)(4) (Public Charge), and any other ground of
inadmissibility, with the following exclusions. Grounds
that cannot be waived are INA section 212(a)(3)
(Security Related Grounds), INA section 212(a)(10)(C)
(International Child Abductors), or INA section 212(a)
(10)(E) (Former Citizens who Renounced Citizenship
to Avoid Taxation).

NOTE: Except as provided in Title 8, Code of Federal
Regulations (CFR), part 204.313(g)(1)(ii) for convention
adoption cases, if you seek a waiver of grounds of
inadmissibility in connection with your application for an
immigrant visa or adjustment of status and the waiver is
granted, the waiver is valid indefinitely even if you do not
obtain your immigrant visa, immigrant admission, or
adjustment of status, or if you otherwise lose your legal
permanent resident status. If you obtained the waiver in
connection with an application for lawful permanent residence
on a conditional basis under section 216 of the INA, the
validity of the waiver automatically ceases with the
termination of such residence; no separate notification of
termination of the waiver is needed, and the termination of the
waiver cannot be appealed. However, if the immigration judge
determines that you are not removable based on the
termination of your conditional resident status, the waiver will
become effective again. Also, a waiver granted in relation to a
TPS application is only valid for the TPS application.

Form I-601 Instructions (11/14/11) Y

General Instructions

Specific Instructions

DRAFT - Not
For Production

Step 1. Fill Out Form I-601

1. When filling out the form, type or print legibly in black
ink. Make sure the entire form, including the agency copy,
is properly completed.
2. If extra space is needed to complete any item, attach a
continuation sheet, indicate the item number, and date and
sign each sheet.
3. Answer all questions fully and accurately. If the answer is
not applicable write "N/A." If the answer is none, write
"None."
4. Applicant's Signature. Under 8 CFR 103.2(a)(2), you
must sign this application personally, unless one of the
following exceptions apply.
If you are under 14 years of age, your parent or legal
guardian may sign the application for you.
If you are not competent to sign the application, but you
are over 14 years of age, a duly appointed legal guardian
may sign the application for you.

If you are filing this application to waive inadmissibility
for a communicable disease of public health significance
(under INA section 212(g)), and you are not competent to
sign the application, a qualified family member listed in
"Specific Instructions, Applicants Seeking A Waiver of
Health-Related Grounds of Inadmissibilty Under INA
Section 212(a)(1), 1. Applicants With Communicable
Diseases" may file and sign the waiver application on your
behalf. This qualifying relative may sign the application
for you even if that person is not your legal guardian.
5. Preparer's Signature. If an individual, other than the
applicant prepared this application, that individual must
sign and date the application and provide the information
requested.
6. Any documentation submitted to U.S. Citizenship and
Immigration Services (USCIS) that is in a foreign
language or which contains foreign language must be
accompanied by a full and complete English translation.
The translator must certify that he or she is fluent in
English and the language contained in the document, and
that he or she is competent to translate from the foreign
language into English. The translator must furthermore
certify that the translation is complete and accurate.
7. The application must be signed by the applicant and
submitted with the required fee. If the application is not
properly signed and submitted with the required fee, the
application will be returned as incomplete. Please see
"Specific Instructions" for additional reasons why the
application may be rejected.

NOTE: If this form is approved, the waiver that is granted
will apply ONLY for those grounds of inadmissibility and
those crimes, incidents, events, or conditions that you have
included in your application. For this reason, it is important
that you disclose all grounds of inadmissibility for which you
seek a waiver.

Special Note to K-1 and K-2 Nonimmigrant Visa
Applicants
Since you do not have the requisite relationship to a citizen or
lawful permanent resident of the United States to qualify for a
waiver, you must enter one of the following in Block B,
Information About Relative Through Whom Applicant
Claims Eligibility, on the form:
1. If you are a fiancé(e) of a U.S. citizen:
A. Complete items B.1, B.2, B.3, and B.5 with
information regarding the U.S. citizen who filed a
fiancé(e) petition on your behalf; and
B. Indicate "Prospective Spouse" in item B.5
(Relationship to Applicant).
2. If you are the child of a fiancé(e) of a U.S. citizen and
will be less than 18 years of age when your parent
marries such person:
A. Complete items B.1, B.2, B.3, and B.5 with
information regarding the U.S. citizen who filed a
fiancé(e) petition on your parent's behalf; and
B. Indicate "Prospective Step-child" in item B.5
(Relationship to Applicant).
3. If you are the child of a fiancé(e) of a U.S. citizen, and
will be at least 18 years of age but less than 21 years of
age when your parent marries such person:
A. Complete items B.1, B.2, and B.3 with information
regarding your parent who will marry the U.S. citizen
who filed a fiancé(e) petition on your parent's behalf;
and
B. Indicate "Child" in item B.5 (Relationship to
Applicant); and
C. Indicate "Prospective LPR" in item B.6 (Immigration
Status).
If, upon review of your application, USCIS determines that
you will be eligible for an immigrant waiver from
inadmissibility once you have (or your parent has)
celebrated a bona fide marriage to the U.S. citizen who
filed the K visa petition, USCIS will conditionally approve
the waiver application. The condition imposed on the
approval is that is that you (or your parent) and the U.S.
Form I-601 Instructions (11/14/11) Y Page 2

citizen who filed the K visa petition celebrate a bona fide
marriage within the statutory time frame of 3 months from
the day of your (or your parent's) admission. Despite the
conditional approval, USCIS may ultimately deny Form
I-601 if you (or your parent) do not marry the U.S. citizen
who filed the K visa petition and if you (or your parent) do
not seek and receive permanent residence on the basis of
that marriage.

2. Applicants With Class A Tuberculosis Condition as Per
HHS Regulations
If you have been diagnosed with a Class A Tuberculosis
condition as per HHS regulations, Page 6 of this form
must be completed. If Page 6 of the application is not
completed, the application will be returned to you without
further action.

DRAFT - Not
For Production

Applicants Seeking a Waiver of Health-Related
Grounds of Inadmissibility Under INA
Section 212(a)(1)

1. Applicants With Communicable Diseases
If you have a communicable disease that has been
determined to be of public health significance, you must
complete the application and provide the information as
requested in the form.

Communicable diseases of public health significance are
defined in 42 CFR 34.2(b) and include but are not limited
to:

3. Applicants With Physical or Mental Disorder and
Associated Harmful Behavior
If you have a physical or mental disorder and behavior
associated with the disorder that poses, may pose, or has
posed a threat to the property, safety, or welfare of you or
others, you must file this form, and a waiver may be
granted under INA section 212(g)(3). You must also
submit this form if you have a history of such a physical or
mental disorder and a history of behavior associated with
the disorder that has posed a threat to your property, safety,
or welfare or the property, safety, or welfare of others, and
if the behavior is likely to recur or to lead to other harmful
behavior.

A. Class A Tuberculosis condition, as per U.S.
Department of Health and Human Services (HHS)
regulations;

In addition to this form, you must submit a complete
medical history and a report that addresses the following:

B. Chancroid;
C. Gonorrhea;

A. Your physical or mental disorder, and the behavior
associated with the disorder that poses, has posed, or
may pose in the future a threat to the property, safety,
or welfare of you or other individuals. The report
should also provide details of any hospitalization,
institutional care, or any other treatment you may have
received in relation to this physical or mental disorder;

D. Granuloma inguinale;
E. Lymphogranuloma venerum;
F. Syphilis, infectious stage;
G. Leprosy, infectious;
H. Any other communicable disease as determined by the
U.S. Secretary of Health and Human Services and as
defined at 42 CFR 34.2(b).
The application may be approved if:
A. You are the spouse, parent, the unmarried son or
daughter, or the minor unmarried lawfully adopted
child of a U.S. citizen, or of an alien lawfully admitted
for permanent residence, or of an alien who has been
issued an immigrant visa, or if you are the fiancé(e)'s of
a U.S. citizen or the fiancé(e)'s child; or
B. You are a VAWA self-petitioner.
For specific information pertaining to applicants with a
Class A Tuberculosis condition as per HHS regulations,
please see item number 2.

B. Findings regarding your current physical condition,
including, if applicable, reports of chest X-rays and a
serologic test, if you are 15 years of age or older, and
other pertinent diagnostic tests; and
C. Findings regarding the current mental or physical
condition, including a detailed prognosis that should
specify, based on a reasonable degree of medical
certainty, the possibility that the harmful behavior is
likely to recur or that other harmful behavior associated
with the disorder is likely to occur; and
D. A recommendation concerning treatment that is
reasonably available in the United States and that can
reasonably be expected to significantly reduce the
likelihood that the physical or mental disorder will
result in harmful behavior in the future.
The medical report will be referred to the U.S. Public
Health Service for review and, if found acceptable, you
will be required to submit such additional assurances as the
U.S. Public Health Service may decide is necessary in your
particular case.

Form I-601 Instructions (11/14/11) Y Page 3

4. Applicants Seeking to Waive the Vaccination
Requirement

C. Your qualifying U.S. citizen or legal permanent
resident relative (spouse, son, daughter,
parent), or K visa petitioner would experience
extreme hardship if you were denied admission; OR

DRAFT - Not
For Production

If you seek an exemption from the vaccination requirement
because being vaccinated is against your religious beliefs
or moral convictions, you must file this form. You must
establish with evidence that:
A. You are opposed to vaccinations in any form;

B. The objection is based on religious beliefs or moral
convictions; and
C. The belief or conviction is sincere.

Applicants Seeking a Waiver of Certain
Criminal Grounds of Inadmissibility and
Immigration Fraud or Misrepresentation Under
INA Sections 212(h) and (i)
1. Criminal Grounds

If you are found to be inadmissible based on criminal
grounds, you may seek a waiver of inadmissibility for the
following:
A. A crime involving moral turpitude (other than a purely
political offense);
B. A controlled substance violation according to the laws
and regulations of any country related to a single
offense of simple possession of 30 grams or less of
marijuana;
C. Two or more convictions, other than purely political
ones, for which the aggregate sentences to confinement
were 5 years or more;
D. Prostitution;
E. Unlawful commercialized vice whether or not related
to prostitution; and
F. Certain aliens involved in serious criminal activity who
have asserted immunity from prosecution.
With the application, you will have to establish that:
A. You are inadmissible only because of your
participation in prostitution, including having procured
others for prostitution or having received the proceeds
of prostitution, but that you have been rehabilitated
and your admission to the United States will not be
contrary to the national welfare, safety, or security of
the United States; OR
B. At least 15 years have passed since the activity or
event that makes you inadmissible, that you have
been rehabilitated, and that your admission to the
United States or the issuance of the immigrant visa
will not be contrary to the national welfare, safety, or
security of the United States; OR

D. You are an approved VAWA self-petitioner.

For information about how you can establish extreme
hardship, please see "What Evidence Should Be
Submitted With the Application?" (Page 7).
NOTE: If you are convicted of a violent or dangerous
crime, the waiver may not be approved unless there is an
extraordinary circumstance, such as one involving national
security or foreign policy consideration, or if the denial of
your admission would result in exceptional and extremely
unusual hardship. Even if that standard is met, your waiver
may still be denied. See 8 CFR 212.7(d).

2. Immigration Fraud or Misrepresentation
If you are inadmissible because you have sought to procure
an immigration benefit by fraud or misrepresenting a
material fact (INA section 212(a)(6)(C)(i)), you may seek a
waiver by filing this form. This waiver may be approved if
you can establish that:
A. Your qualifying U.S. citizen or legal permanent
resident relative (spouse, parent) or the K visa
petitioner would experience extreme hardship if
you were denied admission; or
B. You are a VAWA self-petitioner, and that you or your
U.S. citizen, lawful permanent resident, or qualified
parent or child may experience extreme hardship if you
were denied admission.
For information about how you can establish extreme
hardship, please see "What Evidence Should Be
Submitted With the Application?" (Page 7).

Applicants Seeking a Waiver for Immigrant
Membership in a Totalitarian Party Under INA
Section 212(a)(3)(D)(i)
If you are inadmissible for having been a member of or
affiliated with the Communist or any other totalitarian party
(or subdivision or affiliate thereof) whether domestic or
foreign, you may apply for a waiver pursuant to INA section
212(a)(3)(D)(iv), if you are the parent, spouse, son, daughter,
brother, or sister of a U.S. citizen or a spouse, son, or daughter
of an alien lawfully admitted for permanent residence, or if
you are the fiancé(e) of a U.S. citizen. The waiver may be
granted for humanitarian purposes to assure family unity, or
when it is otherwise in the public interest, if you are not a
threat to the security of the United States.

Form I-601 Instructions (11/14/11 ) Y Page 4

Applicants Seeking a Waiver for Smuggling under
INA section 212(a)(6)(E) and Being Subject of Civil
Penalty Under INA Section 212(a)(6)(F)

If you are inadmissible because you have been unlawfully
present in the United States in excess of either 180 days (3year bar) or 1 year (10-year bar), you may seek a waiver by
filing this form.

DRAFT - Not
For Production

If you are inadmissible for having engaged in alien smuggling
(INA section 212(a)(6)(E)(i)), you may apply for a waiver
under INA section 212(d)(11) that may be granted for
humanitarian purposes, to assure family unity, or when it is
otherwise in the public interest, if you have encouraged,
induced, assisted, abetted, or aided only an individual who at
the time of such action was your spouse, parent, son, or
daughter (and no other individual) to enter the United States in
violation of the law, and;
1. If you are an alien lawfully admitted for permanent
residence who temporarily proceeded abroad voluntarily
and not under an order of deportation or removal and who
is otherwise admissible to the United States as a returning
resident under INA section 211(b); or

2. If you are seeking admission or adjustment of status as an
immediate relative under INA section 201(b)(2)(A), as an
immigrant under INA section 203(a)(Preference allocation
for family-sponsored immigrants based on the first,
second, or third preference, but not the fourth preference)
or as the fiancé(e) (or his or her child(ren) of a U.S. citizen.
If you are inadmissible because you have been the subject of a
final order for violation of INA section 274C, you may apply
for a waiver under INA section 212(d)(12). A waiver may be
granted for humanitarian purposes or to assure family unity, if
no previous civil money penalty was imposed against you
under INA section 274C, and the offense was committed
solely to assist, aid, or support your spouse or child (and not
another individual); and
1. If you are an alien lawfully admitted for permanent
residence who temporarily proceeded abroad voluntarily
and not under an order of removal and who is otherwise
admissible to the United States as a returning resident
under INA section 211(b); or
2. If you are seeking admission or adjustment of status as an
immediate relative, as an immigrant under INA section
203(a)(preference allocation for family-sponsored
immigrants) or as the fiancé(e) (or his or her child(ren)) of
a U.S. citizen.

Applicants Seeking a Waiver of Inadmissibility
Based on the 3-Year or 10-Year Bar Under INA
Section 212(a)(9)(B)(v)
T nonimmigrant visa status holders seeking exemption from
only INA section 212(a)(9)(B) do not need to file this form.

The waiver may be granted if your qualifying U.S. citizen or
legal permanent resident relative (spouse, parent), or the K
visa petitioner would experience extreme hardship if you
were denied admission.
For TPS applicants and VAWA self-petitioners, see special
instructions below.
For information about how you can establish extreme
hardship, please see "What Evidence Should Be Submitted
With the Application?" (Page 7).

TPS Applicants Seeking a Waiver of Grounds of
Inadmissibility Under INA Section 244
If you are a TPS applicant applying for a waiver of any
grounds of inadmissibility listed in INA section 212, your
waiver may be granted for humanitarian purposes to assure
family unity or when it is otherwise in the public interest.
No waiver of inadmissibility is available to TPS applicants for
the following grounds of inadmissibility:
1. INA Section 212(a)(2)(A), (B) or (C) (except for a single
offense of simple possession of 30 grams or less of
marijuana); or
2. INA Section 212(a)(3)(A), (B), (C), or (E).
NOTE: A waiver that is granted in relation to an application
for TPS is valid only for purposes of your application for
TPS. If you seek an immigrant visa or adjustment of status,
you may need to apply for an additional waiver at that time.

NACARA and HRIFA Applicants Seeking a Waiver
From Inadmissibility Based on Prior Removal Under
INA Section 212(a)(9)(A) or Unlawful Presence After
Previous Immigration Violations Under INA
Section 212(a)(9)(C)
If you are a NACARA or HRIFA applicant for adjustment of
status under section 202 of NACARA or section 902 of
HRIFA, who is inadmissible under INA section 212(a)(9)(A)
or INA section 212(a)(9)(C), you may apply for a waiver of
these grounds of inadmissibility while present in the United
States. You may seek this waiver by filing Form I-601, rather
than Form I-212 that is used to obtain "Consent to Reapply"
under INA section 212(a)(9)(A)(iii) or (C)(ii).

Form I-601 Instructions (11/14/11) Y Page 5

When adjudicating your waiver application, USCIS will
consider the same factors that would be considered if you
were seeking "Consent to Reapply." Factors that may be
considered include but are not limited to:

If you are inadmissible under INA section 212(a)(9)(C)(i):
USCIS has discretion to waive this ground of inadmissibility
under INA section 212(a)(9)(C)(iii) for an approved VAWA
self-petitioner and his or her child(ren), if the VAWA selfpetitioner can establish a "connection" between the battery or
extreme cruelty that is the basis for the VAWA claim, the
unlawful presence and departure, or the removal, or his or her
subsequent unlawful entry or attempted reentry into the United
States. If you seek such a waiver, complete Form I-601 and
attach evidence that shows the connection between the battery
or extreme cruelty and your removal or departure from the
United States, or your reentry or reentries into the United
States, or attempted reentry into the United States.

DRAFT - Not
For Production

1. The length of time you have lived in the United States,
whether lawfully or unlawfully;
2. Whether you have any criminal records;

3. Your immigration history in the United States;

4. Your family ties to U.S. citizens or to aliens living
lawfully in the United States;

5. Whether the denial of your application will impose
hardship on you or on these relatives, and the degree of
that hardship;
6. Whether granting your waiver application is likely to
result in your ability to immigrate lawfully;
7. Your employment history in the United States and the
continued need for your services;
8. Whether you are a person of good moral character;

9. Any other factor that you believe USCIS should consider
in deciding your case.
In addition to this form, you should submit a brief statement
indicating why USCIS should grant your waiver application
and any documentary evidence that may be available to
support your factual claims. Although hardship to a relative
who is a U.S. citizen or an alien who is living lawfully in the
United States is not specifically required by statute, this factor
can play a significant role in establishing why USCIS should
grant your application.
For information about how you can establish hardship, please
see "What Evidence Should Be Submitted With the
Application?" (Page 7).

Approved I-360 VAWA Self-Petitioner and His or
Her Child(ren) Seeking a Waiver of Inadmissibility
Under Section 212(a)(9)(C)(iii)
The INA provides special forms of relief for an approved
VAWA self-petitioner and his or her child(ren) who are
applying for adjustment of status or an immigrant visa but
who are inadmissible under certain provisions of INA section
212(a)(6)(A)(i), section 212(a)(9)(B)(i), or section
212(a)(9)(C)(i). You should only file this Form I-601 to seek
a waiver of inadmissibility pursuant to INA section
212(a)(9)(C)(i); you do not need to file this form if you are
inadmissible under INA sections 212(a)(6)(A)(i) or
212(a)(9)(B)(i), as explained in the "NOTES" that follow.

NOTE: You do not need to file Form I-601 if you are an
approved VAWA self-petitioner (and his or her child(ren))
seeking adjustment of status, and if you are inadmissible
under INA section 212(a)(6)(A)(i) (presence in the United
States without admission or parole, or arrival in the
United States, other than at an open port of entry).
According to USCIS policy, you are eligible for adjustment of
status under INA section 245(a) regardless of your unlawful
entry. Because INA section 212(a)(6)(A)(i) inadmissibility
ends when you depart the United States, you also do not have
to submit any special documentation with an immigrant visa
application.
NOTE: You do not need to file Form I-601 if you are an
approved VAWA self-petitioner (and his or her child(ren))
and inadmissible under INA section 212(a)(9)(B)(i)(3-year
or 10-year bar to admission). You may be exempt from this
inadmissibility if you, the approved VAWA self-petitioner, or
his or her child(ren) can establish a "substantial connection"
between the battery or extreme cruelty that is the basis for
your VAWA claim and the violation of your prior
nonimmigrant admission. You must submit evidence of the
"substantial connection" with your Form I-485, Application to
Register Permanent Residence or Adjust Status, or your
immigrant visa application.

Applicants for Adjustment of Status Based on T
Nonimmigrant Status
If you are a T nonimmigrant status holder admitted to the
United States and applying for adjustment of status, you may
obtain a waiver of almost any ground listed in INA section
212(a). If you are inadmissible based on public health grounds
(INA section 212(a)(1)) or public charge (INA section 212(a)
(4)), the waiver may be approved if granting the waiver is in
the national interest.
If you are inadmissible based on any other ground of
inadmissibility, the waiver may be approved if the activities
making you inadmissible were caused by or were incident to
your trafficking victimization, and granting the waiver is in
the national interest.

Form I-601 Instructions (11/14/11) Y Page 6

No waiver of inadmissibility is available to adjustment-ofstatus applicants based on T nonimmigrant status, for the
following grounds of inadmissibility:

7. If you are applying for a waiver because you are the
spouse, parent, son, or daughter of a U.S. citizen or an
alien lawfully admitted for permanent residence, or the
fiancé(e) of a U.S. citizen, you must attach evidence that
demonstrates your denial of admission would result in
extreme hardship to the U.S. citizen or legal permanent
resident spouse, son, daughter or parent, or your U.S.
citizen fiancé(e). Such evidence can include but is not
limited to:

DRAFT - Not
For Production

1. INA section 212(a)(3) (Security Related Grounds);
2. INA section 212(a)(10)(C) (International Child
Abductors);

3. INA section 212(a)(10)(E) (Former Citizens who
Renounced Citizenship to Avoid Taxation).

NOTE: You do not need to file Form I-601 if you are
inadmissible because you have been unlawfully present in
the United States and then departed under INA section
212(a)(9)(B). You may be exempt from the 3-year or 10-year
bar if you can establish that your victimization was at least one
central reason for your unlawful presence in the United States.
You should submit evidence with your Form I-485,
Application to Register Permanent Residence or Adjust Status,
to demonstrate that the victimization you suffered was a
central reason for the unlawful presence in the United States.

A. Evidence establishing the family relationship (birth
certificate, marriage certificate, etc.);
B. Presence of legal permanent resident or U.S. citizen
family ties to the United States;
C. Qualifying relative's family ties outside the United
States;
D. Country conditions in the country you would have to
relocate to and the qualifying relative's family ties to
that country;
E. Financial impact of departure from the United States;

What Evidence Should Be Submitted With the
Application?
Pay close attention to the qualifying family relationship
that you have to establish if you apply for a hardship
waiver. While the relationships appear to be similar, the
various waiver provisions contain different qualifying
family relationships.
Also, pay close attention to the requirements that need to
be established to have a particular ground of
inadmissibility waived, as listed in the "Specific
Instructions."
In support of your application, you should provide evidence
that establishes why you may qualify for a waiver of
inadmissibility. Depending on the type of waiver, this
information and evidence may include but is not limited to:
1. Affidavits from you or other individuals in support of your
application;
2. Police reports from any country you lived in;
3. Complete court records regarding any conviction or charge
from any country;
4. If applicable, evidence of rehabilitation;
5. Any evidence you may wish to submit to establish that
your admission to the United States would not be against
national welfare or national security;

F. Significant health conditions, and if appropriate, what
type of treatment and suitable medical care is available
in that country;
G. The impact of separation;
H. Other conditions that impact the relocation, such as
economic and social conditions impacting quality of
life, technical skills, etc.
8. If you are a VAWA self-petitioner and you seek a waiver
under INA section 212(a)(9)(C)(iii), submit any evidence
that you believe establishes a connection between the
battery or extreme cruelty that is the basis for the VAWA
claim, your unlawful presence and your departure (or your
removal) and your unlawful return or attempted unlawful
return.
9. If you are a T nonimmigrant status holder seeking a waiver
under INA section 212(a)(1) or section 212(a)(4), submit
any evidence that demonstrates it is in the national interest
to waive these grounds. If you are seeking a waiver under
any other INA section 212(a) ground, submit any evidence
that demonstrates it is in the national interest to waive such
ground and that the activities rendering you inadmissible
were caused by or were related to your victimization.
10. If you are a TPS applicant, any information that supports
granting your waiver request on humanitarian, family
unity, or public interest grounds.

6. Medical reports;

Form I-601 Instructions (11/14/11) Y Page 7

NOTE: Your application should be supported by
documentary evidence, or you should have a detailed
explanation why such evidence cannot be obtained. Mere
assertions will not suffice. Medical assertions should be
supported by a professional's statement.

B. Are a T nonimmigrant seeking adjustment of status:
USCIS Vermont Service Center
75 Lower Welden Street
St. Albans, VT 05479-0001

DRAFT - Not
For Production

Where To File?

Updated Filing Address Information

The filing addresses provided on this form reflect the most
current information as of the date this form was last printed. If
you are filing Form I-601 more than 30 days after the latest
edition date shown in the lower right corner, visit our Web site
at www.uscis.gov before you file, and check the "FORMS"
page to confirm the correct filing address and version currently
in use.
Check the edition date located in the lower right corner of the
form. If the edition date on your Form I-601 matches the
edition date listed for Form I-601 on the online "FORMS"
page, your version is current. If the edition date on the online
version is more recent, download a copy and use it.
If you do not have Internet access, call the National Customer
Service Center at 1-800-375-5283 to verify the current filing
address and edition date.
1. If you are outside the United States and were found
inadmissible at your visa interview with a consular officer,
you must file your Form I-601 with the USCIS Phoenix
Lockbox facility at the following address:

3. If you are in the United States and filing Form I-601
together with Form I-485, Application To Register
Permanent Residence or Adjust Status, you must file
Forms I-485 and I-601 at the filing location specified on
Form I-485. See the filing instructions for Form I-485.
4. If you are in the United States and your Form I-485 is
currently pending, you must file Form I-601 with a
USCIS Lockbox facility at the appropriate address listed
below.
If your I-797C "Notice of Action" receipt number for
acceptance of your Form I-485 begins with "MSC" or does not
have a three-letter code at the beginning of the receipt number,
then mail your Form I-601 to the USCIS Chicago Lockbox
facility.
If your I-797C "Notice of Action" receipt number for
acceptance of your Form I-485 begins with "EAC" or "SRC,"
then file your Form I-601 with the USCIS Dallas Lockbox
facility.
If your I-797C "Notice of Action" receipt number for
acceptance of your Form I-485 begins with "LIN" or "WAC,"
then file your Form I-601 with the USCIS Phoenix Lockbox
facility.

For U.S. Postal Service:
USCIS
P.O. Box 21600
Phoenix, AZ 85036
For Express mail or Courier deliveries:
USCIS
ATTN: 601/212 Foreign Filers
1820 E. Skyharbor, Circle S, Suite 100
Phoenix, AZ 85034
2. You must always file your Form I-601 at the USCIS
Vermont Service Center (VSC) if you:
A. Have an approved Form I-360 based as a Selfpetitioning spouse or child of an abusive U.S. Citizen
or Lawful Permanent Resident, whether inside or
outside the United States. If you have already filed your
Form I-485, or if your Form I-485 is currently pending,
you must still file your Form I-601 with the VSC; or

If the I-797C "Notice of Then mail your application to:
Action", receipt number
for acceptance of your
I-485 begins with:
MSC or does not have a
3-letter code at the
beginning of the receipt
number

USCIS Chicago Lockbox
For U.S. Postal Service:
USCIS
P.O. Box 805887
Chicago, IL 60680-4120
For Express mail and courier
deliveries:
USCIS
Attn: FBAS
131 S. Dearborn-3rd Floor
Chicago, IL 60603-5520

Form I-601 Instructions (11/14/11) Y Page 8

If the I-797C "Notice of Then mail your application to:
Action", receipt number
for acceptance of your
I-485 begins with:

7. Special Circumstances. USCIS may accept a filing of
Form I-601 at other locations as USCIS may designate in
special situations. USCIS will post the eligible special
circumstance and the alternative filing location on the
Form I-601's entry page at www.uscis.gov/i-601. Please
consult that page if you wish to file Form I-601 at a
location other than one listed above.

DRAFT - Not
For Production

EAC or SRC

USCIS Dallas Lockbox

For U.S. Postal Service:
USCIS
P.O. Box 660867
Dallas, TX 75266

For Express mail and courier
deliveries:

USCIS
2501 S. State Hwy. 121 Business
Suite 400
Lewisville, TX 75067
LIN or WAC

USCIS Phoenix Lockbox
For U.S. Postal Service:
USCIS
P.O. Box 21281
Phoenix, AZ 85036
For Express mail and courier
deliveries:
USCIS
1820 E. Skyharbor Circle S
Suite 100
Phoenix, AZ 85034

5. If you are an applicant for Temporary Protected Status
(TPS) under INA section 244, you must file this form with
Form I-821, Application for Temporary Protected Status.
For the filing location, mail your forms according to the
instructions in the recently published Federal Register
notice for your country's TPS designation.
If you are later notified by USCIS that you are ineligible
for TPS based on a ground of inadmissibility that may be
waived, you must file the Form I-601 in accordance with
the instructions in the notice from USCIS.
6. If you are in removal proceedings, you must file Form
I-601 with the Executive Office for Immigration Review
(EOIR) office with jurisdiction over your case and
according to the instructions that are provided to you in
court. For information about EOIR, visit EOIR's Web site
at www.usdoj.gov/eoir.

If you have any question regarding the filing of this form,
please contact our National Customer Service Center at
1-800-375-5283. If you live outside of the United States
please note that you may have to dial an international code
to access the National Customer Center and that your calls
may not be toll free.

NOTE: In addition to your Form I-601 and supporting
documents, you must include a copy of the I-797C, Notice of
Action, showing that your Form I-485 was accepted.

E-Notification
If you are filing your form I-601 at one of the USCIS Lockbox
facilities, you may elect to receive an e-mail and/or text
message notifying you that your application has been
accepted. You must complete Form G-1145, E-Notification of
Application/Petition Acceptance, and clip it to the first page of
your application. To download a copy of Form G-1145,
including the instructions, refer to www.uscis.gov "FORMS".
The G-1145 is activated and the acceptance message is sent
after your application has been successfully processed at the
Lockbox and your receipt notices has been issued.

What Is the Filing Fee?
All applications must be accompanied by a fee of $585. The
fee cannot be refunded, regardless of the action taken on the
application. Do not mail cash. All fees must be submitted in
the exact amount.
A fee waiver may be requested from a VAWA self-petitioner,
or applicant for a T visa or U visa, battered spouse or child of
a lawful permanent resident or U.S. citizen, an applicant for
Temporary Protected Status, or an applicant who is exempt
from the public charge grounds of inadmissibility under INA
section 212(a)(4). The Form I-912, Request for Fee Waiver,
(or a written request), may be submitted.
NOTE: As stated on Page 2, Specific Instructions, the
approval of a Form I-601 waives only those events and the
resulting grounds of inadmissibility that you have specifically
identified in the application. You should specify on this Form
I-601 every ground of inadmissibility for which you seek a
waiver. You may file just one application, and pay just one
filing fee, if you request more than one type of waiver or a
waiver for more than one event or condition that makes you

Form I-601 Instructions (11/14/11) Y Page 9

inadmissible. If you do not include all applicable events or
grounds of inadmissibility in your application, you may need
to file an additional Form I-601 and pay an additional fee to
request any additional waiver(s).

Processing Information

DRAFT - Not
For Production

Use the following guidelines when you prepare your check or
money order for the Form I-601 fee:
1. The check or money order must be drawn on a bank or
other financial institution located in the United States and
must be payable in U.S. currency; and
2. Make the check or money order payable to U.S.
Department of Homeland Security.

NOTE: Spell out U.S. Department of Homeland Security;
do not use the initials "USDHS" or "DHS."

Any Form I-601 that is not signed or accompanied by the
correct fee will be rejected with a notice that the Form
I-601 is deficient. You may correct the deficiency and
resubmit the Form I-601. An application or petition is not
considered properly filed until accepted by USCIS.

Initial Processing

Once a Form I-601 has been accepted, it will be checked for
completeness, including submission of the required initial
evidence. If you do not completely fill out the form, or file it
without required initial evidence, you will not establish a basis
for eligibility, and we may deny your Form I-601.

Requests for More Information or Interview
Notice to Those Making Payment by Check. If you send us
a check, it will be converted into an electronic funds transfer
(EFT). This means we will copy your check and use the
account information on it to electronically debit your account
for the amount of the check. The debit from your account will
usually take 24 hours and will be shown on your regular
account statement.
You will not receive your original check back. We will
destroy your original check, but we will keep a copy of it. If
the EFT cannot be processed for technical reasons, you
authorize us to process the copy in place of your original
check. If the EFT cannot be completed because of insufficient
funds, we may try to make the transfer up to two times.

How to Check If the Fees Are Correct
The fee on this form is current as of the edition date appearing
in the lower right corner of this page. However, because
USCIS fees change periodically, you can verify if the fees are
correct by following one of the steps below:
1. Visit our Web site at www.uscis.gov, select "FORMS" and
check the appropriate fee; or
2. Telephone our National Customer Service Center at
1-800-375-5283 and ask for the fee information.
NOTE: If you live outside of the United States please note
that you may have to dial an international code to access the
National Customer Center and that your calls may not be toll
free.

We may request more information or evidence, or we may
request that you appear at a USCIS office for an interview.
We may also request that you submit the originals of any
copy. We will return these originals when they are no longer
required.

Decision
The decision on a Form I-601 involves a determination of
whether you have established eligibility for the requested
benefit. You will be notified of the decision in writing.

USCIS Forms and Information
You can get USCIS forms and immigration-related
information on the USCIS Web site at www.uscis.gov. You
may order USCIS forms by calling our toll-free number at
1-800-870-3676. You may also obtain forms and information
by telephoning our USCIS National Customer Service Center
at 1-800-375-5283.
As an alternative to waiting in line for assistance at your local
USCIS office, you can now schedule an appointment through
USCIS Internet-based system, InfoPass. To access the system,
visit USCIS Web site. Use the InfoPass appointment
scheduler and follow the screen prompts to set up your
appointment. InfoPass generates an electronic appointment
notice that appears on the screen.

Penalties
Address Changes
If you have changed your address, you must inform USCIS of
your new address. For information on filing a change of
address got to the USCIS web site at www.uscis.gov/
addresschange or contact the National Customer Service
Center at 1-800-375-5283.

If you knowingly and willfully falsify or conceal a material
fact or submit a false document with this Form I-601, we will
deny the Form I-601 and may deny any other immigration
benefit.
In addition, you will face severe penalties provided by law and
may be subject to criminal prosecution.
Form I-601 Instructions (11/14/11) Y Page 10

USCIS Privacy Act Statement

Paperwork Reduction Act

DRAFT - Not
For Production

AUTHORITIES: The information requested on this form,
and the associated evidence, is collected under the
Immigration and Nationality Act, section 101, et seq.

PURPOSE: The primary purpose for providing the requested
information on this form is to determine if you have
established eligibility for the immigration benefit for which
you are filing. The information you provide will be used to
grant or deny the benefit sought.
DISCLOSURE: The information you provide is voluntary.
However, failure to provide the requested information, and
any requested evidence, may delay a final decision or result in
denial of your form.

ROUTINE USES: The information you provide on this form
may be shared with other Federal, State, local, and foreign
government agencies and authorized organizations following
approved routine uses described in the associated published
system of records notices [DHS-USCIS-007 - Benefits
Information System and DHS-USCIS-001 - Alien File, Index,
and National File Tracking System of Records, which can be
found at www.dhs.gov/privacy]. The information may also be
made available, as appropriate, for law enforcement purposes
or in the interest of national security.

An agency may not conduct or sponsor an information
collection and a person is not required to respond to a
collection of information unless it displays a currently valid
OMB control number. The public reporting burden for this
collection of information is estimated at 90 minutes per
response, including the time for reviewing instructions and
completing and submitting the form. Send comments
regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing
this burden, to: U.S. Citizenship and Immigration Services,
Regulatory Products Division, Office of the Executive
Secretariat, 20 Massachusetts Ave., N.W., Washington, DC
20529-2020, OMB No. 1615-0029. This form expires June 06,
2012. Do not mail your application to this address.

Form I-601 Instructions (11/14/11) Y Page 11