Form I-485 Application to Register Permanent Residence or Adjust St

Application to Register Permanent Residence or Adjust Status

I485-034-FRM-REV-OMBReview-07022024

Application to Register Permanent Residence or Adjust Status

OMB: 1615-0023

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1615-0023 can be found here:

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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 02/28/2026

For USCIS Use Only
Receipt

Preference Category:

Action Block

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Country Chargeable:
Priority Date:

Date Form I-693 Signed By Civil Surgeon:
Applicant
Interviewed
Date of
Initial Interview:

Section of Law

Interview
Waived

Lawful Permanent
Resident as of:

INA 245(m)

INA 209(a)
INA 209(b)
INA 245(a)
INA 245(i)

INA 249
Sec. 13, Act of 9/11/57
Cuban Adjustment Act

INA 245(j)

Other

To be completed by an Attorney or Accredited Representative (if any).

Select this box if
Form G-28 is
attached.

Volag Number
(if any)

Attorney State Bar Number
(if applicable)

► START HERE - Type or print in black ink.

Attorney or Accredited Representative
USCIS Online Account Number (if any)

A-Number ► A-

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 reject or deny your application.
For all sections of this application, if you need to provide any additional information or are instructed to provide an explanation, use
the space provided in Part 14. Additional Information.

Part 1. Information About You (Person applying for lawful permanent residence)
1.

Your Current Legal Name (Do not provide a nickname)
Family Name (Last Name)

Given Name (First Name)

Middle Name (if applicable)

Other Names You Have Used Since Birth (if applicable)
Provide all other names you have ever used, including your family name at birth, other legal names, nicknames, aliases, and
assumed names.
Family Name (Last Name)

Given Name (First Name)

Middle Name (if applicable)

Date of Birth (mm/dd/yyyy)
Have you ever used any other date of birth?

Yes

If you answered "Yes," provide all
other dates of birth (mm/dd/yyyy).

Form I-485 Edition 04/01/24

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A-Number ► A-

Part 1. Information About You (Person applying for lawful permanent residence) (continued)
4.

Do you have an Alien Registration Number (A-Number)?

Yes

If you answered "Yes," provide your A-Number.
A-Number (if any) ► A5.

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Have you ever used, or been assigned, any other A-Number?

Yes

If you answered "Yes," provide the A-Numbers.

Gender

Place of Birth

Male

Female

Another Gender Identity

City or Town of Birth

Country of Citizenship or Nationality

USCIS Online Account Number (if any)
►

Country of Birth

If one has been assigned, you can find it on a notice that USCIS may have sent to you.
10.

Recent Immigration History

If you last entered the United States using a passport or travel document, provide the following information.
Passport or Travel Document Number Used at Last Arrival

Expiration Date of this Passport or Travel Document (mm/dd/yyyy)
Country that Issued this Passport or Travel Document

Nonimmigrant Visa Number Used During Most Recent Arrival (if any)
Date Nonimmigrant Visa Was Issued (mm/dd/yyyy)
Place and Date of Last Arrival into the United States
City or Town

11.

State

Date of Last Arrival (mm/dd/yyyy)

When I last arrived in the United States:
I was inspected at a Port of Entry and admitted as (for example, exchange visitor, visitor, temporary worker, student):

I was inspected at a Port of Entry and paroled as (for example, humanitarian parole, Cuban parole):

I came into the United States without admission or parole.
Other:

Form I-485 Edition 04/01/24

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A-Number ► A-

Part 1. Information About You (Person applying for lawful permanent residence) (continued)
12.

If you were issued a Form I-94 Arrival/Departure Record, provide the information from your most recent Form I-94 below:
Family Name (Last Name)

Given Name (First Name)

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Form I-94 Arrival/Departure Record Number

►

Expiration Date of Authorized Stay Shown on Form I-94 (mm/dd/yyyy)
or Type or Print "D/S" for Duration of Status
Immigration Status on Form I-94 (for example, class of admission,
or paroled, if paroled)
13.

Was your last arrival the first time you were physically present in the United States?

14.

What is your current immigration status (if it has changed since your last arrival)?

15.

Expiration Date of Current Immigration Status (mm/dd/yyyy) or Type or
Print "D/S" for Duration of Status

16.

Yes

Have you ever been issued an "alien crewman" visa?

Yes

17.

Did you last arrive in the United States to join a vessel as a seaman or crewman, or while serving in any
capacity aboard a vessel or aircraft?

Yes

18.

Addresses

Current U.S. Physical Address
In Care Of Name (if any)

Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

ZIP Code

Date You First Resided at This Address (mm/dd/yyyy)
Is this your current mailing address?

Yes

If you answered "No," provide your current mailing address.
Current Mailing Address (Safe or Alternate Mailing Address, if applicable)
In Care Of Name (if any)

Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

Form I-485 Edition 04/01/24

ZIP Code

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A-Number ► A-

Part 1. Information About You (Person applying for lawful permanent residence) (continued)
Have you resided at your current address for at least 5 years?

Yes

If you answered "No," provide your prior address(es) for the last 5 years. Use the space provided in Part 14. Additional
Information, if necessary.

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Prior Address

In Care Of Name (if any)

Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

Province

Postal Code

ZIP Code

Country

Dates of Residence

From (mm/dd/yyyy)

To (mm/dd/yyyy)

Most Recent Address Outside the United States

Provide your most recent physical address outside the United States where you lived for more than one year (if not already
listed above).
Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

Province

Postal Code

ZIP Code

Country

Dates of Residence
From (mm/dd/yyyy)
19.

To (mm/dd/yyyy)

Social Security Card
Has the Social Security Administration (SSA) ever officially issued a Social Security card to you?

Yes

If you answered "Yes," provide your U.S. Social Security Number (SSN). ►
Do you want the SSA to issue you a Social Security card?
If you answered "Yes," you must also answer "Yes" to the Consent for Disclosure below.
Consent for Disclosure: I authorize disclosure of information from this application to the SSA as
required for the purpose of assigning me an SSN and issuing me a Social Security Card.

Form I-485 Edition 04/01/24

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A-Number ► A-

Part 2. Application Type or Filing Category
1.

Are you filing for adjustment of status with the Executive Office for Immigration Review (EOIR) while
in removal, exclusion, rescission, or deportation proceedings?

Receipt Number of Underlying Petition (if any)

Yes

Priority Date from Underlying Petition (if any)

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(mm/dd/yyyy)

I am filing this Form I-485 as a (select only one box):
Principal Applicant

Derivative Applicant (Provide the following information about the principal applicant.)

Principal Applicant's Name
Family Name (Last Name)

Given Name (First Name)

Principal Applicant's A-Number (if any)

Principal Applicant's Date of Birth

► A-

(mm/dd/yyyy)

Middle Name (if applicable)

I am applying based on the following category (You must select ONLY ONE category. If you are filing as a derivative
applicant, select the appropriate box based on the category under which the principal applicant is applying or has applied. See
the Form I-485 Instructions for more information, including any Additional Instructions that relate to the immigrant category
you select.):
3.a. Family-based

Immediate relative of a U.S. citizen, Form I-130, I-129F, or I-360 (select your specific category below):
Spouse of a U.S. Citizen.

Unmarried child under 21 years of age of a U.S. citizen.

Parent of a U.S. citizen (if the citizen is at least 21 years of age).

Person admitted to the United States as a fiancé(e) or child of a fiancé(e) of a U.S. citizen (K-1/K-2 Nonimmigrant).
Widow or widower of a U.S. citizen.
Spouse, child, or parent of a deceased U.S. active-duty service member in the armed forces under the National Defense
Authorization Act (NDAA).

Other relative of a U.S. citizen under the family-based preference categories, Form I-130 (select your specific category below):
Unmarried son or daughter of a U.S. citizen and I am 21 years of age or older.
Married son or daughter of a U.S. citizen.
Brother or sister of a U.S. citizen (if the citizen is at least 21 years of age).
Relative of a lawful permanent resident under the family-based preference categories, Form I-130 (select your specific category
below):
Spouse of a lawful permanent resident.
Unmarried child under 21 years of age of a lawful permanent resident.
Unmarried son or daughter of a lawful permanent resident and I am 21 years of age or older.
VAWA self-petitioner (victim of battery or extreme cruelty), Form I-360 (select your specific category below):
VAWA self-petitioning spouse of a U.S. citizen or lawful permanent resident.
VAWA self-petitioning child of a U.S. citizen or lawful permanent resident.
VAWA self-petitioning parent of a U.S. citizen (if the citizen is at least 21 years of age).
Form I-485 Edition 04/01/24

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A-Number ► A-

Part 2. Application Type or Filing Category (continued)
3.b. Employment-based
Alien Investor, Form I-526 or Form I-526E
Alien Workers, Form I-140 (select your category below and answer the following questions below, as applicable):

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Alien of Extraordinary Ability

Outstanding Professor or Researcher
Multinational Executive or Manager

Member of the Professions Holding an Advanced Degree or Alien of Exceptional Ability (who is NOT seeking a National
Interest Waiver)
A Professional (at a minimum, requiring a bachelor's degree or a foreign degree equivalent to a U.S. bachelor's degree)
A Skilled Worker (requiring at least 2 years of specialized training or experience)
Any Other Worker (requiring less than 2 years of training or experience)

An Alien Applying For a National Interest Waiver (who IS a member of the professions holding an advanced degree or an
alien of exceptional ability)

Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a
relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the
principal applicant, if you are a derivative applicant)?
N/A (I am adjusting on the basis of a Form I-140 self-petition)
No

Yes

If you answered "Yes," is this relative your (select only one box):
Father

Mother

Child

Adult Son

Adult Daughter

Brother

Sister

None of These

Is the relative above a:
U.S. Citizen

U.S. National

Lawful Permanent Resident

None of These

3.c. Special Immigrant
Special Immigrant Juvenile, Form I-360
Certain Afghan or Iraqi National, Form I-360 or Form DS-157
Certain International Broadcaster, Form I-360
Certain G-4 International Organization or Family Member or NATO-6 Employee or Family Member, Form I-360
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, DS-1884
Religious Worker, Form I-360 (select your specific category below):
Minister of Religion
Other Religious Worker

Form I-485 Edition 04/01/24

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A-Number ► A-

Part 2. Application Type or Filing Category (continued)
3.d. Asylee or Refugee
Asylum Status (Immigration and Nationality Act (INA) section 208), Form I-589 or Form I-730
If you selected asylum, date you were granted asylum (mm/dd/yyyy).

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Refugee Status (INA section 207), Form I-590 or Form I-730

If you selected refugee, date of initial admission as refugee (mm/dd/yyyy).
3.e. Human Trafficking Victim or Crime Victim

Human Trafficking Victim (T Nonimmigrant), Form I-914 or Derivative Family Member, Form I-914A

Victim of Qualifying Criminal Activity (U Nonimmigrant), Form I-918, Derivative Family Member, Form I-918A, or
Qualifying Family Member, Form I-929

3.f.

Special Programs Based on Certain Public Laws
The Cuban Adjustment Act

A Victim of Battery or Extreme Cruelty as a Spouse or Child Under the Cuban Adjustment Act

Applicant Adjusting Based on Dependent Status Under the Haitian Refugee Immigrant Fairness Act

A Victim of Battery or Extreme Cruelty as a Spouse or Child Applying Based on Dependent Status Under the Haitian
Refugee Immigrant Fairness Act
Lautenberg Parolees

Diplomats or High-Ranking Officials Unable to Return Home (Section 13 of the Act of September 11, 1957)

Nationals of Vietnam, Cambodia, and Laos Applying for Adjustment of Status Under section 586 of Public Law 106-429
Applicant Adjusting Under the Amerasian Act (October 22, 1982), Form I-360

3.g. Additional Options

Diversity Visa program

If you selected Diversity Visa program, provide your Diversity Visa Rank Number:
Continuous Residence in the United States Since Before January 1, 1972 ("Registry")
Individual Born in the United States Under Diplomatic Status
S Nonimmigrants and Qualifying Family Members (can only adjust in this category with an approved Form I-854B filed by
a law enforcement officer)
Other Eligibility

If you selected a family-based, employment-based, special immigrant, or Diversity Visa immigrant
category listed above in Item Numbers 3.a. - 3.g. as the basis for your application for adjustment of
status, are you applying for adjustment based on INA section 245(i)?

Yes

Are you 21 years of age or older and applying for adjustment based on classification as a child, under the
provisions of the Child Status Protection Act (CSPA)?

Yes

NOTE: For more information to determine if you are eligible under CSPA, see the Who May File Form I-485 section of these
Instructions.

Form I-485 Edition 04/01/24

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A-Number ► A-

Part 3. Request for Exemption for Intending Immigrant's Affidavit of Support Under Section 213A of
the INA
I am requesting an exemption from submitting an Affidavit of Support Under Section 213A of the INA (Form I-864 or Form I-864EZ)
because (select only one):
1.a.

1.b.
1.c.
1.d.
1.e.
1.f.

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 meanstested public benefit.)

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I am under 18 years of age, unmarried, the child of a U.S. citizen, am not likely to become a public charge, and will
automatically become a U.S. citizen under INA section 320, upon my admission as a lawful permanent resident.
I am applying under the widow or widower of a U.S. citizen (Form I-360) immigrant category.
I am applying as a VAWA self-petitioner.

None of these exemptions apply to me and I am not required by statute to submit an Affidavit of Support Under Section
213A of the INA, nor am I required to request an exemption.
None of these exemptions apply to me and I am not requesting an exemption as I am required to submit an Affidavit of
Support Under Section 213A of the INA.

Part 4. 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?

Yes

If you answered "Yes," complete Item Numbers 2. - 4. below.
2.

Location of U.S. Embassy or U.S. Consulate
City or Town

Country

Decision (for example, approved, refused, denied, withdrawn)

Date of Decision (mm/dd/yyyy)

Have you previously applied for permanent residence while in the United States?

Yes

Have you EVER held lawful permanent resident status which was later rescinded under INA section 246?

Yes

Employment and Educational History
7.

Provide ALL of your employment and educational history for the last 5 years as indicated in the Instructions. Provide your
current employment or school attended first. Include periods of self-employment, unemployment, or retirement. For each period
of unemployment or retirement, list source of financial support. If you have additional employment or educational history, use
the space provided in Part 14. Additional Information.
Employer or School (current or most recent)

Name of Employer, Company, or School

Your Occupation (if unemployed or retired, so state)

Form I-485 Edition 04/01/24

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Part 4. Additional Information About You (continued)
Address of Employer, Company, or School
Street Number and Name

Apt. Ste. Flr. Number

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City or Town

Province

State

Postal Code

ZIP Code

Country

Dates of Employment, Unemployment, Retirement, or School Attendance
From (mm/dd/yyyy)

To (mm/dd/yyyy)

If unemployed or retired, source of financial support:

Provide your most recent employer or school outside of the United States (if not already listed above).
Name of Employer, Company, or School

Your Occupation (if unemployed or retired, so state)

Address of Employer, Company, or School
Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

Province

Postal Code

ZIP Code

Country

Dates of Employment, Unemployment, Retirement, or School Attendance
From (mm/dd/yyyy)

To (mm/dd/yyyy)

If unemployed or retired, source of financial support:

Part 5. Information About Your Parents
Information About Your Parent 1
1.

Parent 1's Legal Name
Family Name (Last Name)

Middle Name (if applicable)

Parent 1's Name at Birth (if different than above)
Family Name (Last Name)

Given Name (First Name)

Middle Name (if applicable)

Date of Birth (mm/dd/yyyy)

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A-Number ► A-

Part 5. Information About Your Parents (continued)
4.

Country of Birth

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Information About Your Parent 2
5.

Parent 2's Legal Name

Family Name (Last Name)

Given Name (First Name)

Middle Name (if applicable)

Parent 2's Name at Birth (if different than above)
Family Name (Last Name)

Date of Birth (mm/dd/yyyy)

Country of Birth

Given Name (First Name)

Middle Name (if applicable)

Part 6. Information About Your Marital History
1.

What is your current marital status?
Single, Never Married

Married

Divorced

Widowed

Marriage Annulled

Legally Separated
N/A

Yes

If you are married, is your spouse a current member of the U.S. armed forces or U.S. Coast Guard?

How many times have you been married (including your current marriage, marriages abroad, annulled marriages, and marriages
to the same person)?

Information About Your Current Marriage (including if you are legally separated)
4.

Current Spouse's Legal Name
Family Name (Last Name)

Given Name (First Name)

Current Spouse's A-Number (if any)
► A-

Current Spouse's Country of Birth

Current Spouse's Current Physical Address

Middle Name (if applicable)

Current Spouse's Date of Birth
(mm/dd/yyyy)

Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

Province

Form I-485 Edition 04/01/24

Postal Code

ZIP Code

Country

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A-Number ► A-

Part 6. Information About Your Marital History (continued)
9.

Place of Marriage to Current Spouse
City or Town

State or Province

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Country

Date of Marriage to Current Spouse (mm/dd/yyyy)
10.

Is your current spouse applying with you?

Yes

Information About Prior Marriages (if any)
11.

Prior Spouse's Legal Name (provide family name before marriage)
Family Name (Last Name)

Given Name (First Name)

12.

Prior Spouse's Date of Birth (mm/dd/yyyy)

13.

Prior Spouse's Country of Birth

15.

Date of Marriage to Prior Spouse's (mm/dd/yyyy)

16.

Place of Marriage to Prior Spouse

14.

City or Town

Middle Name (if applicable)

Prior Spouse's Country of Citizenship or Nationality

State or Province

Country

17.

Place Where Marriage with Prior Spouse Legally Ended
City or Town

State or Province

Country

Date of Marriage with Prior Spouse Legally Ended (mm/dd/yyyy)
18.

How Marriage Ended with Prior Spouse (select one):
Annulled

Divorced

Form I-485 Edition 04/01/24

Spouse Deceased

Other (Explain):

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A-Number ► A-

Part 7. Information About Your Children
1.

Indicate the total number of ALL living children anywhere in the world (including adult sons and daughters) that you have.
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.

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Provide the following information for each of your children. If you have more than two children, use the space provided in
Part 14. Additional Information.
2.

Child 1

Current Legal Name

Family Name (Last Name)

Given Name (First Name)

A-Number (if any) ► A-

Middle Name (if applicable)

Date of Birth (mm/dd/yyyy)

Country of Birth

What is your child's relationship to you? (for example, biological child, stepchild, legally adopted child)

Is this child also applying now on a separate Form I-485?
3.

Yes

Child 2

Current Legal Name

Family Name (Last Name)

Given Name (First Name)

A-Number (if any) ► A-

Middle Name (if applicable)

Date of Birth (mm/dd/yyyy)

Country of Birth

What is your child's relationship to you? (for example, biological child, stepchild, legally adopted child)

Is this child also applying now on a separate Form I-485?

Form I-485 Edition 04/01/24

Yes

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A-Number ► A-

Part 8. Biographic Information
1.

Ethnicity (Select only one box)
Hispanic or Latino

Not Hispanic or Latino

Race (Select all applicable boxes)

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American Indian or Alaska Native

Asian

Native Hawaiian or Other Pacific Islander
3.

Height Feet

Eye Color (Select only one box)
Black

Inches

Blue

Black or African American

White

Weight Pounds

Brown

Gray

Green

Hazel

Maroon

Pink

Unknown/Other

Blond

Brown

Gray

Red

Sandy

White

Unknown/Other

Hair Color (Select only one box)
Bald (No hair)

Black

Part 9. General Eligibility and Inadmissibility Grounds

Choose the answer that you think is correct in Part 9. 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.
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?

Yes

If you answered "Yes" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two
organizations, use the space provided in Part 14. Additional Information.
Organization 1
2.

Name of Organization

City or Town

State or Province

Country

Nature of Organization, including its purposes and activities, whether illicit or legitimate.

Nature of involvement in organization, including role or positions(s) held, whether illicit or legitimate.

Dates of Membership or Dates of Involvement
From (mm/dd/yyyy)

To (mm/dd/yyyy)

Organization 2
6.

Name of Organization

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Part 9. General Eligibility and Inadmissibility Grounds (continued)
7.

City or Town

State or Province

Country

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Nature of Organization, including its purposes and activities, whether illicit or legitimate.

Nature of involvement in organization, including role or positions(s) held, whether illicit or legitimate.

Dates of Membership or Dates of Involvement
From (mm/dd/yyyy)

To (mm/dd/yyyy)

10.

Have you EVER been denied admission to the United States?

Yes

11.

Have you EVER been denied a visa to the United States?

Yes

12.

Have you EVER worked in the United States without authorization?

Yes

13.

Have you EVER violated the terms or conditions of your nonimmigrant status?

Yes

14.

Are you presently or have you EVER been in removal, exclusion, rescission, or deportation proceedings,
including expedited removal proceedings?

Yes

15.

Have you EVER been issued a final order of exclusion, deportation, or removal?

Yes

16.

Have you EVER had a prior final order of exclusion, deportation, or removal reinstated?

Yes

17.

Have you EVER been granted voluntary departure by an immigration officer or an immigration judge but
failed to depart within the allotted time?

Yes

18.

Have you EVER applied for any kind of relief or protection from removal, exclusion, or deportation?

Yes

19.

Have you EVER been a J nonimmigrant exchange visitor who was subject to the two-year foreign
residence requirement?

Yes

20.

If you answered "Yes" to Item Number 19., have you complied with the foreign residence requirement?

Yes

21.

If you answered "Yes" to Item Number 19. and "No" to Item Number 20., have you been granted a
waiver or has Department of State issued a favorable waiver recommendation letter for you?

Yes

Criminal Acts and Violations
For Item Numbers 22. - 41., 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 22. - 41., use the space provided in Part 14. Additional Information to provide an
explanation for each offense, if applicable, that includes a description of the criminal offense; where the criminal offense occurred;
when the criminal offense occurred; whether you were arrested, cited, charged, or detained for the criminal offense you committed;
and the outcome or disposition of that criminal offense (for example, convicted, placement in a diversion program, no charges filed,
charges dismissed, jail, prison, detention, probation, or community service). Your explanation must include the duration of any
sentence to confinement (even if suspended).
22.

Have you EVER been arrested, cited, charged, or permitted to participate in a diversion program (including
pre-trial diversion, deferred prosecution, deferred adjudication, or any withheld adjudication), or detained
for any reason by any law enforcement official in any country including but not limited to any U.S.
immigration official or any official of the U.S. armed forces or U.S. Coast Guard or by a similar official of
a country other than the United States?

Form I-485 Edition 04/01/24

Yes

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Part 9. General Eligibility and Inadmissibility Grounds (continued)
23.

Have you EVER committed a crime of any kind (even if you were not arrested, cited, charged with, or
tried for that crime, or convicted)?

Yes

24.

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

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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.
25.

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)?

Yes

26.

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?

Yes

27.

Have you EVER trafficked in or benefited from, or knowingly aided, abetted, assisted, conspired or
colluded in the illegal trafficking of any controlled substances, such as chemicals, illegal drugs, or
narcotics?

Yes

28.

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 5 years, any financial or other benefit
from this activity of your spouse or parent?

Yes

29.

If your answer to Item Number 28. is "Yes," did you know or should you have reasonably known that the
financial or other benefit you obtained resulted from this activity of your spouse or parent?

Yes

30.

Have you EVER engaged in prostitution or are you coming to the United States to engage in prostitution?

Yes

31.

Have you EVER directly or indirectly procured or attempted to procure, or imported prostitutes or persons
for the purpose of prostitution?

Yes

32.

Have you EVER received any proceeds or money from prostitution?

Yes

33.

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

34.

Have you EVER exercised immunity (diplomatic or otherwise) to avoid being prosecuted for a criminal
offense in the United States?

Yes

35.a. Have you EVER served as a foreign government official?

Yes

35.b. If your answer to Item Number 35.a. is "Yes," have you EVER been responsible for, enforced, or directly
carried out violations of religious freedoms?

Yes

36.

Yes

Have you EVER induced by force, fraud, or coercion (or otherwise been involved in) the trafficking of
another person for commercial sex acts (sex trafficking)?

NOTE: Sex trafficking involves inducing or causing an adult to engage in a commercial sex act (any sex act performed for
anything of value) through fraud, force, or coercion, or inducing or causing any person under 18 years of age to engage in a
commercial sex act (even without force, fraud, or coercion). Sex trafficking may include recruiting, enticing, harboring,
transporting, providing, obtaining, advertising, maintaining, patronizing, or soliciting by any means a person to engage in the
commercial sex act knowing (or, in the case of advertising, with reckless disregard of the fact) that the person is under 18 years
of age or that force, fraud, or coercion was used to induce or cause the person to engage in the commercial sex act. Sex
trafficking may also include knowingly benefiting financially or by receiving anything of value, from participation in a venture
involving sex trafficking.
37.

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.

Form I-485 Edition 04/01/24

Yes

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Part 9. General Eligibility and Inadmissibility Grounds (continued)
38.

Have you EVER knowingly aided, abetted, assisted, conspired, or colluded with others in trafficking in
persons for commercial sex acts or involuntary servitude, peonage, debt bondage, or slavery?

Yes

39.

Are you the spouse, son, or daughter of a foreign national who engaged in the trafficking in persons and
have received or obtained, within the last 5 years, any financial or other benefits from this activity of your
spouse or your parent?

Yes

40.

If your answer is "Yes" to Item Number 39., did you know or reasonably should have known that this
benefit resulted from this activity of your spouse or parent?

Yes

41.

Have you EVER engaged in money laundering or have you EVER knowingly aided, assisted, abetted,
conspired, or colluded with others in money laundering or do you seek to enter the United States to engage
in such activity?

Yes

42.a. Engage in any activity that violates or evades any law relating to espionage (including spying) or sabotage
in the United States?

Yes

42.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?

Yes

42.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?

Yes

42.d. Engage in any other unlawful activity?

Yes

43.a. Received any weapons training, paramilitary training, or other military-type training?

Yes

43.b. Committed kidnapping, assassination, or hijacking or sabotage of a conveyance (including an aircraft,
vessel, vehicle, or train)?

Yes

43.c. Used a weapon or explosive or any dangerous device with the intent to endanger the safety of another
person or people or cause damage to property?

Yes

43.d. Threatened, attempted, conspired, prepared, or planned to do any of the things described in Item Numbers
43.b. - 43.c.?

Yes

43.e. Incited, under circumstances indicating an intention to cause death or serious bodily harm/injury, any of the
activities described in Item Numbers 43.b. - 43.c.?

Yes

43.f. Participated in, or been a member of, a group or organization that did any of the activities described in
Item Numbers 43.b. - 43.e.?

Yes

43.g. Recruited members or asked for money or things of value for a group or organization that did any of the
activities described in Item Numbers 43.b. - 43.e.?

Yes

43.h. Provided money, a thing of value, services or labor, or any other assistance or support for any of the
activities described in Item Numbers 43.b. - 43.e.?

Yes

43.i. 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 Numbers 43.b. - 43.e.?

Yes

44.

Do you intend to engage in any of the activities listed in any part of Item Numbers 43.b. - 43.e.?

Yes

45.

Do you intend to engage in any activity that could endanger the welfare, safety, or security of the United
States?

Yes

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Security and Related
Do you intend to:

Have you EVER:

NOTE: If you answered "Yes" to any part of Item Numbers 42.a. - 45., 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.

Form I-485 Edition 04/01/24

Page 16 of 24

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Part 9. General Eligibility and Inadmissibility Grounds (continued)
46.

Are you the spouse or child of an individual who EVER engaged in any of the activities listed in Item
Numbers 43.b. - 43.i.?

Yes

NOTE: If you answered "Yes" to any part of Item Number 46., explain what your parent or spouse did, including the dates and
location of the circumstances in Part 14. Additional Information.

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47.

Have you EVER sold, provided, or transported weapons, or assisted any person in selling, providing, or
transporting weapons, which you knew or believed would be used against another person?

Yes

48.

Have you EVER worked, volunteered, or otherwise served in any prison, jail, prison camp, detention
facility, labor camp, or any other place where people were detained, or have you EVER directed or
participated in any other activity that involved detaining people?

Yes

49.

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

50.

Have you EVER served in, been a member of, assisted (helped), or participated in any military or police
unit?

Yes

51.

Have you EVER served in, been a member of, assisted (helped), or participated in any armed group (a
group that carries weapons), for example: paramilitary unit (a group of people who act like a military
group, but are not part of the official military), self-defense unit, vigilante unit, rebel group, or guerrilla
group?

Yes

If you answered "Yes" to Item Number 50. or 51., include the name of the country, the name of the military unit or armed
group, your rank or position, and your dates of involvement in your explanation in Part 14. Additional Information.
52.

Have you EVER been a member of, or in any way affiliated with, the Communist Party or any totalitarian
party (in the United States or abroad)?

Yes

Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following:
53.a. Torture?

Yes

53.b. Genocide?

Yes

53.c. Killing, or trying to kill, any person?

Yes

53.d. Intentionally and severely injuring or trying to injure any person?

Yes

54.

Have you EVER recruited, enlisted, conscripted, or used any person under 15 years of age to take part in
hostilities or to serve in or help an armed force or group, or attempted or worked with others to do so?

Yes

55.

Have you EVER used any person under 15 years of age to take part in hostilities, for instance, participating
in combat or providing services related to combat (such as sabotage or serving as a courier) or providing
support services (such as transporting supplies), or attempted or worked with others to do so?

Yes

NOTE: If you answered "Yes" to any part of Item Numbers 47. - 55., explain what occurred, including the dates and location
of the circumstances, in the space provided in Part 14. Additional Information.

Form I-485 Edition 04/01/24

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A-Number ► A-

Part 9. General Eligibility and Inadmissibility Grounds (continued)
Public Charge
Each noncitizen who is subject to the public charge ground of inadmissibility in INA section 212(a)(4) must complete Item Numbers
57. - 66. A noncitizen is subject to the public charge ground of inadmissibility if the noncitizen does not fall under one of the
categories exempt from the public charge ground of inadmissibility listed below. If you fall under one of the exempt categories listed
below, please select the exempt category, and skip Item Numbers 57. - 66. If you do not fall under one of the exempt categories listed
below, select "I do not fall under any of the exempt categories listed above and will complete Item Numbers 57. - 66."

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NOTE: For more information, see Part 9. General Eligibility and Inadmissibility Grounds, Public Charge section of these
Instructions.
56.

I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box):
VAWA Self-Petitioner (Form I-360)

Special Immigrant Juvenile (Form I-360)

Certain Afghan or Iraqi National (Form I-360 or Form DS-157)
Asylee (Form I-589 or Form I-730)

Refugee (Form I-590 or Form I-730)

Victim of Qualifying Criminal Activity (U Nonimmigrant) under INA section 245(m) (Form I-918, Form I-918A, or Form
I-929)
Any category other than INA section 245(m), but you are in valid U nonimmigrant status at the time you file your
application for adjustment of status. (This exemption only applies if, at the time of the adjudication of Form I-485, you are
still in valid U nonimmigrant status. If, at the time of adjudication of Form I-485, you are no longer in valid U
nonimmigrant status, you will be subject to the public charge ground of inadmissibility.)
Human Trafficking Victim (T nonimmigrant) under INA section 245(l) (Form I-914 or Form I-914A)

Any category other than INA section 245(l), but you either have a pending application for T nonimmigrant status (Form
I-914) that sets forth a prima facie case for eligibility or are in valid T nonimmigrant status at the time you file your
application for adjustment of status. (This exemption only applies if your Form I-914 is still pending and deemed to be
prima facie eligible or you are in valid T nonimmigrant status when we adjudicate your adjustment of status application.)
Cuban Adjustment Act
Cuban Adjustment Act for Battered Spouses and Children
Dependent Status under the Haitian Refugee Immigrant Fairness Act
Dependent Status under the Haitian Refugee Immigrant Fairness Act for Battered Spouses and Children
Cuban and Haitian Entrants Applying for Adjustment of Status under section 202 of the Immigration Reform and Control
Act of 1986
A Lautenberg Parolee
National of Vietnam, Cambodia, or Laos Applying under the Foreign Operations, Export Financing, and Related Programs
Continuous Residence in the United States Since Before January 1, 1972 (“Registry”)
Amerasian Homecoming Act
Polish or Hungarian Parolee
Nicaraguans and Other Central Americans under section 203 of the Nicaraguan Adjustment and Central American Relief
Act (NACARA)
American Indian Born in Canada (INA section 289) or the Texas Band of Kickapoo Indians of the Kickapoo Tribe of
Oklahoma, Public Law 97-429 (Jan. 8, 1983)
Section 7611 of the National Defense Authorization Act for Fiscal Year 2020 (Liberian Refugee Immigration Fairness)

Form I-485 Edition 04/01/24

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Part 9. General Eligibility and Inadmissibility Grounds (continued)
Syrian National Adjusting Status under Public Law 106-378
Spouse, Child, or Parent of a U.S. Active-Duty Service Member in the Armed Forces under the National Defense
Authorization Act (NDAA) (Form I-130 or Form I-360)

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I do not fall under any of the exempt categories listed above and will complete Item Numbers 57. - 66.

If you selected "I do not fall under any of the exempt categories listed above and will complete Item Numbers 57. - 66." in Item
Number 56., complete Item Numbers 57. - 66. below. If you selected an exempt category in Item Number 56., go to Item Number
67. If you need extra space to complete this section, use the space provided in Part 14. Additional Information.
57.

What is the size of your household?

58.

Indicate your annual household income.
$0-27,000

59.

$85,001-141,000

Over $141,000

$18,401-136,000

$136,001-321,400

$321,401-707,100

Over $707,100

Identify the total value of your household liabilities (including both secured and unsecured liabilities).
$0

61.

$52,001-85,000

Identify the total value of your household assets.
$0-18,400

60.

$27,001-52,000

$1-10,100

$10,101-57,700

$57,701-186,800

Over $186,800

What is the highest degree or grade of school you have completed?

Less than a high school diploma. If you select this option, indicate the highest grade of school you have completed.

High school diploma, GED, or alternative credential
Associate's degree

Bachelor's degree

1 or more years of college credit, no degree

Master's degree

Professional degree (JD, MD, DMD, etc.)

Doctorate degree

62.

List your certifications, licenses, skills obtained through work experience, and educational certificates.
List of Certifications

63.

Have you ever received Supplemental Security Income (SSI), Temporary Assistance for Needy Families
(TANF), or state, Tribal, territorial, or local cash benefit programs for income maintenance (often called
“General Assistance” in the state context, but which also exist under other names)?

Yes

64.

Have you ever received long-term institutionalization at government expense?

Yes

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A-Number ► A-

Part 9. General Eligibility and Inadmissibility Grounds (continued)
65.

If your answer to Item Number 63. is "Yes," list the specific benefit(s) you received, the start and end dates of each period of
receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration
category exempt from the public charge ground of inadmissibility.
Benefit Received

66.

Start Date

End Date

Dollar Amount

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Yes

Yes

If your answer to Item Number 64. is "Yes," list the name, city, and state for each institution, the start and end dates of each
period of institutionalization, the reason you were institutionalized, and whether you were institutionalized while you were in an
immigration category exempt from the public charge ground of inadmissibility.
Institution Name/City/State

Date From

Date To

Reason

Yes

Illegal Entries and Other Immigration Violations
67.

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?

Yes

NOTE: If your answer to Item Number 67. is "Yes," attach a written statement explaining why you failed or refused to attend
or remain in attendance at the removal proceeding, including any explanation of a reasonable cause for that failure or refusal.
68.

Have you EVER submitted altered, 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

69.

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?

Yes

70.

Have you EVER falsely claimed to be a U.S. citizen (in writing or any other way)?

Yes

71.

Have you EVER been a stowaway on a vessel or aircraft arriving in the United States?

Yes

72.

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

73.

Are you under a final order of civil penalty for violating INA section 274C for use of fraudulent
documents?

Yes

Removal, Unlawful Presence, or Illegal Reentry After Previous Immigration Violations
74.

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?

Yes

75.

Have you EVER entered the United States without being inspected and admitted or paroled?

Yes

Form I-485 Edition 04/01/24

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A-Number ► A-

Part 9. General Eligibility and Inadmissibility Grounds (continued)
76.

Since April 1, 1997, have you been unlawfully present in the United States? You were unlawfully present
in the United States if you were present in the United States after the expiration of the period of stay
authorized by the Department of Homeland Security (DHS) Secretary or were present in the United States
without being admitted or paroled.

Yes

NOTE: If you answered "Yes" to Item Number 76., give the dates of unlawful presence in the space provided in Part 14.
Additional Information.
77.

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If you answered "Yes" to Item Number 76., was a severe form of trafficking in persons at least one
central reason for your unlawful presence in the United States?

Yes

NOTE: Severe trafficking in persons involves sex trafficking (the recruitment, harboring, transportation, provision, or obtaining
of a person to commit a commercial sex act) induced by force, fraud, coercion, or in which the person is induced to perform
such act has not reached 18 years of age, or the recruitment, harboring, transportation, provision, or obtaining of a person for
labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage,
debt bondage, or slavery.
Since April 1, 1997, have you EVER reentered or attempted to reenter the United States without being inspected and admitted or
paroled after:
78.a. Having been unlawfully present in the United States for more than one year in the aggregate on or after
April 1, 1997? You were unlawfully present in the United States for more than one year in the aggregate
if you count all of the days during all of your stays that you were present in the United States after the
expiration of the period of stay authorized by the DHS Secretary or were present in the United States
without being admitted or paroled.

Yes

78.b. Having been deported, excluded, or removed from the United States?

Yes

Miscellaneous Conduct
79.

Do you plan to practice polygamy in the United States?

Yes

80.

Are you accompanying an alien who is inadmissible and who has been certified by a medical officer as
helpless from sickness, mental or physical disability, or infancy, and who requires your protection or
guardianship, as described in INA section 232(c)?

Yes

81.

Have you EVER assisted in detaining, retaining, or withholding custody of a U.S. citizen child outside
the United States from a person who has been granted custody of the child?

Yes

82.

Have you EVER voted in violation of any Federal, state, or local constitutional provision, statute,
ordinance, or regulation in the United States?

Yes

83.

Have you EVER renounced U.S. citizenship to avoid being taxed by the United States?

Yes

84.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?

Yes

84.b. Been relieved or discharged from such training or service on the ground that you are a foreign national?

Yes

84.c. Been convicted of desertion from the U.S. armed forces?

Yes

85.

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?

Yes

86.

If you answered "Yes" to Item Number 85., 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)?

Have you EVER:

Form I-485 Edition 04/01/24

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A-Number ► A-

Part 10. Applicant's Contact Information, Certification, and Signature
Applicant's Contact Information
Provide your daytime telephone number, mobile telephone number (if any), and email address (if any).
1.

Applicant's Daytime Telephone Number

Applicant's Email Address (if any)

Applicant's Mobile Telephone Number (if any)

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Applicant's Certification and Signature

I certify, under penalty of perjury, that I provided or authorized all of the responses and information contained in and submitted with
my application, I read and understand or, if interpreted to me in a language in which I am fluent by the interpreter listed in Part 11.,
understood, all of the responses and information contained in, and submitted with, my application, and that all of the responses and the
information are complete, true, and correct. Furthermore, I authorize the release of any information from any and all of my records
that USCIS may need to determine my eligibility for an immigration request and to other entities and persons where necessary for the
administration and enforcement of U.S. immigration law.
4.

Applicant's Signature

Date of Signature (mm/dd/yyyy)

Part 11. Interpreter's Contact Information, Certification, and Signature
Interpreter's Full Name
1.

Interpreter's Family Name (Last Name)

Interpreter's Business or Organization Name

Interpreter's Given Name (First Name)

Interpreter's Contact Information
3.

Interpreter's Daytime Telephone Number

Interpreter's Email Address (if any)

Interpreter's Mobile Telephone Number (if any)

Interpreter's Certification and Signature
I certify, under penalty of perjury, that I am fluent in English and
,
and I have interpreted every question on the application and Instructions and interpreted the applicant's answers to the questions in that
language, and the applicant informed me that they understood every instruction, question, and answer on the application.
6.

Interpreter's Signature

Date of Signature (mm/dd/yyyy)

Form I-485 Edition 04/01/24

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A-Number ► A-

Part 12. Contact Information, Certification, and Signature of the Person Preparing this Application, if
Other Than the Applicant
Preparer's Full Name
1.

Preparer's Family Name (Last Name)

Preparer's Business or Organization Name

Preparer's Given Name (First Name)

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Preparer's Contact Information
3.

Preparer's Daytime Telephone Number

Preparer's Email Address (if any)

Preparer's Mobile Telephone Number (if any)

Preparer's Certification and Signature

I certify, under penalty of perjury, that I prepared this application for the applicant at their request and with express consent and that
all of the responses and information contained in and submitted with the application are complete, true, and correct and reflects only
information provided by the applicant. The applicant reviewed the responses and information and informed me that they understand
the responses and information in or submitted with the application.
6.

Preparer's Signature

Date of Signature (mm/dd/yyyy)

NOTE: Do not complete Part 13. until the USCIS Officer instructs you to do so at the interview.

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
changes made to this application, numbered

through

, are complete, true, and correct. All

information on additional pages submitted by me with this Form I-485, on numbered pages

through

are complete, true, and correct. All documents submitted at this interview were provided by me and are complete, true, and correct.
Subscribed to and sworn to (affirmed) before me
USCIS Officer's Printed Name or Stamp

Date of Signature (mm/dd/yyyy)

Applicant's Signature (sign in ink)

USCIS Officer's Signature (sign in ink)

Form I-485 Edition 04/01/24

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A-Number ► A-

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.

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Family Name (Last Name)

Page Number

Part Number

Item Number

Page Number

Part Number

Item Number

Page Number

Part Number

Item Number

Page Number

Part Number

Item Number

Form I-485 Edition 04/01/24

Given Name (First Name)

Middle Name (if applicable)

Page 24 of 24

File Type	application/pdf
File Title	Form I-485, Application to Register Permanent Residence  or Adjust Status
Subject	Application to Register Permanent Residence  or Adjust Status
Author	USCIS
File Modified	2024-07-02
File Created	2023-11-01