Supplement C, HRIFA

OMB No. 1615-0023; Expires 06/30/15
Department of Homeland Security
U.S. Citizenship and Immigration Services

Instructions for I-485, Supplement C, HRIFA
Instructions

These instructions supplement instructions for form I-485 for individuals seeking Adjustment of Status
under section 902 of Public Law 105-277, The Haitian Refugee Immigration Fairness Act (HRIFA).

What Is the Purpose of This Form?
In addition to the other purposes of the form listed in the
instructions, Form I-485, Application to Register Permanent
Residence or Adjust Status, may be used by a national of Haiti
who is seeking lawful permanent resident status under HRIFA
and Title 8 of the Code of Federal Regulations, section 245.15.

1. Section 212(a)(4) - an alien likely to become a public
charge;
2. Section 212(a)(5) - an alien without a labor certification or
proper qualifications for certain occupations;
3. Section 212(a)(6)(A) - an alien present without admission
or parole;
4. Section 212(a)(7)(A) - an alien not in possession of a valid
immigrant visa; and

Who May File This Application?
You may file this application if you:
1. Are a national of Haiti;
2. Qualify as a dependent applicant under HRIFA (see
below);
3. Are admissible to the United States;
4. Have been continuously present in the United States since
December 31, 1995, (except that a spouse or child of a
principal applicant need not meet this requirement); and
5. Are physically present in the United States when the
application is filed.

What is a ''dependent applicant"?
You may qualify as a dependent applicant if you meet the
requirements under Who May File This Application? and are
the spouse, child, or unmarried son or daughter (over 21 years
of age) of a principal applicant. Your relationship to the
principal applicant must have been created prior to the date on
which the principal applicant becomes or became a permanent
resident.

What is meant by "admissible to the United States"?
You are ineligible for adjustment of status under HRIFA if you
are inadmissible to the United States under any of the grounds
of inadmissibility contained in section 212(a) of the
Immigration and Nationality Act (INA), with the exception of
those grounds which do not apply to HRIFA applicants or
from which an individual waiver has been granted. The
following inadmissibility sections of the INA do not apply to
HRIFA adjustment applicants:

5. Section 212(a)(9)(B) - an alien unlawfully present in the
United States.
In addition, you may be eligible for an individual waiver
pertaining to certain medical, criminal, documentary, and
other grounds of inadmissibility.

General Instructions
Step 1. Fill Out Form I-485
1. Type or print legibly in black ink.
2. If extra space is needed to complete any item, attach a
continuation sheet, write your name and Alien Registration
Number (A-Number) (if any), at the top of each sheet of
paper, indicate the Part and Item Number to which your
answer refers, and date and sign each sheet.
3. Answer all questions fully and accurately. If an item is not
applicable or the answer is “none,” leave the space blank.

Important Note
When completing the application for adjustment under
HRIFA, you must indicate in Part 2. of the Form I-485 the
classification you are seeking. Check Block H and write
whichever one of the following is appropriate:
1. HRIFA Dependent - Spouse;
2. HRIFA Dependent - Child under 21 years old; or
3. HRIFA Dependent - Unmarried son or daughter.

Form I-485, Supplement C Instructions 06/20/13 N Page 1

Step 2. General Requirements
Evidence of qualification as a dependent applicant
The evidence needed to qualify as a dependent applicant
depends on which type of dependent applicant you are
claiming.
1. Spouse or child of a principal applicant. If you are the
spouse or unmarried minor (under 21 years of age) child of
a principal applicant, you must submit evidence of your
relationship to the principal applicant. You do not need to
submit any documentation establishing either presence in
the United States on December 31, 1995, or continuity of
presence since that date. You must, however, be present in
the United States at time of filing.
2. Unmarried son or daughter of a principal applicant. If
you are the unmarried son or daughter (over 21 years of
age) of a principal applicant, you must submit evidence of
your relationship to the principal applicant. You must also
submit evidence of your continuity of presence in the
United States since December 31, 1995, along with a
statement regarding all departures and arrivals from the
United States. You do not need to submit evidence of your
presence in the United States on December 31, 1995. You
must, however, be present in the United States at time of
filing.

How does an unmarried son or daughter establish
continuity of physical presence since December 31,
1995?
In determining whether you have maintained continuous
physical presence in the United States since December 31,
1995, the law allows absences from the United States totaling
180 days or less. You are required to submit a statement on a
separate piece of paper listing the dates of departure and return
of all absences from the United States since your last arrival
on or prior to December 31, 1995. If you have not been absent
from the United States, write "I have not been outside the U.S.
since my arrival on the date indicated in Part 1 of Form I-485."
You must also support your statement regarding continuity of
physical presence since December 31, 1995, by submitting
documentation from one or more governmental or nongovernmental authorities. This evidentiary requirement is in
addition to the list of departures and returns discussed above.
The document(s) must bear your name (or the name of a
family member with whom you can establish that you were
co-habitating), the date of issuance, and (if the document
normally contains it) the signature, seal, or other
authenticating instrument of the issuing authority.

While you do not need to submit documents covering each and
every day or month since December 31, 1995, there should be
no large, unexplained gaps in the documentation. Examples of
such documents might include but are not limited to rent
receipts, school records, utility bills, other dated receipts,
personal checks, employment records, and credit card
statements.

Other evidence
If you are 14 years of age or older, you must submit a police
clearance from each municipality where you resided for six
months or longer since arriving in the United States. If your
local police authority refuses to provide such clearance, you
may submit written evidence to that effect and request that this
requirement be waived. You are not required to submit either
an employment letter or an affidavit of support.

What if the documentation is already contained in
my immigration file?
If you have received correspondence or had other interaction
with USCIS, and know that your immigration file contains
copies of such correspondence or record of such interaction,
you may simply submit a statement listing the type and dates
of such evidence that is already contained in your immigration
file.

Where To File
Only a dependent spouse and or child of the principal granted
legal status under HRIFA are eligible to apply for benefits
under HRIFA. The filing period for principal HRIFA
applicants has closed. All applications for HRIFA
dependents must be filed at the Nebraska Service Center.
USCIS Nebraska Service Center
PO Box 87245
Lincoln, NE 68501-7245
However, if you are in exclusion, deportation, or removal
proceedings, you should submit the application to the
Immigration Court which has jurisdiction over your case. If
such proceedings have been administratively closed, submit
the application to the Nebraska Service Center.

What Is the Filing Fee?
See Form I-485 instructions for the required filing fee.

Form I-485, Supplement C Instructions 06/20/13 N Page 2

Processing Information
Can an applicant receive employment authorization
while the adjustment application is pending?
You may request authorization to work in the United States
while your application for adjustment of status under HRIFA
is pending by filing Form I-765, Application for Employment
Authorization. You should follow all the directions on that
form pertaining to "Adjustment Applicant - (c)(9)," Except
that you must file the application for employment
authorization in one of the following manners.
1. If you are not in exclusion, deportation, or removal
proceedings and are filing Form I-765 together with Form
I-485, mail your application to:
USCIS Nebraska Service Center
PO Box 87245
Lincoln, NE 68501-7245
2. If you are in exclusion, deportation, or removal proceedings
and are filing Form I-765 after filing Form I-485, mail your
application to:
USCIS Nebraska Service Center
PO Box 87131
Lincoln, NE 68501-7131
3. If you are currently in exclusion, deportation, or removal
proceedings, file Form I-765 with the USCIS office having
jurisdiction over your place of residence in the United
States.

Privacy Act Notice
We ask for the information on this form, and associated
evidence, to determine if you have established eligibility for
the immigration benefit for which you are filing. Our legal
right to ask for this information can be found in the
Immigration and Nationality Act, as amended. We may
provide this information to other government agencies. Failure
to provide this information, and any requested evidence, may
delay a final decision or result in denial of your Form I-485.

Paperwork Reduction Act
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 30 minutes per
response, including the time for reviewing instructions. 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 Coordination Division, Office of Policy
and Strategy, 20 Massachusetts Ave NW, Washington, DC
20529-2140; OMB No. 1615-0023. Do not mail your
completed Form I-485 to this address.

You may receive work authorization if your application has
been pending with USCIS for more than 180 days. However,
work authorization may be issued earlier if your application
for adjustment of status is supported by evidence that is
verified by USCIS from its records.

Penalties
If you knowingly and willfully falsify or conceal a material
fact or submit a false document with Form I-485, we will deny
your application and may deny any other immigration benefit.
In addition, you will face severe penalties provided by law and
may be subject to criminal prosecution.

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