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

Application to Register Permanent Residence
or Adjust Status

USCIS
Form I-485

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

OMB No. 1615-0023
Expires 03/31/2027

For USCIS Use Only

DRAFT
NOT FOR
PRODUCTION
04/30/2024
Receipt

Preference Category:

Action Block

Country Chargeable:
Priority Date:

Date Form I-693 Received:
Applicant
Interviewed
Date of
Initial Interview:

Interview
Waived

Lawful Permanent
Resident as of:

Section of Law

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

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

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

3.a. Family Name
(Last Name)
3.b. Given Name
(First Name)

Your Current Legal Name (do not provide a
nickname)

3.c. Middle Name

1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)

4.a. Family Name
(Last Name)
4.b. Given Name
(First Name)

1.c. Middle Name

4.c. Middle Name

Other Names You Have Used Since Birth (if
applicable)

Other Information About You

NOTE: Provide all other names you have ever used, including
your family name at birth, other legal names, nicknames,
aliases, and assumed names. If you need extra space to
complete this section, use the space provided in Part 14.
Additional Information.
2.a. Family Name
(Last Name)
2.b. Given Name
(First Name)

5.

Date of Birth (mm/dd/yyyy)
NOTE: In addition to providing your actual date of birth,
include any other dates of birth you have used in
connection with any legal names or non-legal names in
the space provided in Part 14. Additional Information.

6.

Sex

Male

7.

City or Town of Birth

Female

2.c. Middle Name
Form I-485 Edition 08/28/24

Page 1 of 20

A-Number ► A-

Part 1. Information About You (Person applying
for lawful permanent residence) (continued)
8.

Social Security Card
14.

Country of Birth

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9.

Country of Citizenship or Nationality

10.

Alien Registration Number (A-Number) (if any)
► A-

►

16.

Do you want the SSA to issue you a Social Security card?
(You must also answer “Yes” to Item Number 17.
Consent for Disclosure, to receive a card).
Yes
No

17.

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.
Yes
No

U.S. Mailing Address

12.a. In Care Of Name (if any)

Recent Immigration History

Provide the information for Item Numbers 18. - 24. if you last
entered the United States using a passport or travel document.

12.b. Street Number
and Name
12.c.

Apt.

Ste.

Flr.

12.d. City or Town
12.e. State

Provide your U.S. Social Security Number (SSN).
►

NOTE: If you have EVER used other A-Numbers,
include the additional A-Numbers in the space provided
in Part 14. Additional Information.
USCIS Online Account Number (if any)

No

If you answered “Yes,” provide the information requested
in Item Number 15.

15.

11.

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

18.

Passport Number Used at Last Arrival

19.

Travel Document Number Used at Last Arrival

20.

Expiration Date of this Passport or Travel Document

12.f. ZIP Code

(USPS ZIP Code Lookup)

Alternate and/or Safe Mailing Address
If you are applying based on the Violence Against Women Act
(VAWA) or as a special immigrant juvenile, human trafficking
victim (T nonimmigrant), or victim of a qualifying crime (U
nonimmigrant) and you do not want USCIS to send notices
about this application to your home, you may provide an
alternative and/or safe mailing address.

(mm/dd/yyyy)
21.

Country that Issued this Passport or Travel Document

22.

Nonimmigrant Visa Number from this Passport (if any)

Place of Last Arrival into the United States

13.a. In Care Of Name (if any)

23.a. City or Town
13.b. Street Number
and Name
13.c.

Apt.

Ste.

Flr.

24.

13.d. City or Town
13.e. State

23.b. State
Date of Last Arrival (mm/dd/yyyy)

13.f. ZIP Code

Form I-485 Edition 08/28/24

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Part 1. Information About You (Person applying
for lawful permanent residence) (continued)
When I last arrived in the United States, I:
25.a.

25.b.

Part 2. Application Type or Filing Category
NOTE: Attach a copy of the Form I-797 receipt or approval
notice for the underlying petition or application, as appropriate.
I am applying to register lawful permanent residence or adjust
status to that of a lawful permanent resident based on the
following immigrant category (select only one box). (See the
Form I-485 Instructions for more information, including any
Additional Instructions that relate to the immigrant category
you select.):

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Was inspected at a port of entry and admitted as (for
example, exchange visitor; visitor, waived through;
temporary worker; student):

Was inspected at a port of entry and paroled as (for
example, humanitarian parole, Cuban parole):

1.a. Family-based

Immediate relative of a U.S. citizen, Form I-130

25.c.
25.d.

Came into the United States without admission or
parole.
Other:

Other relative of a U.S. citizen or relative of a lawful
permanent resident under the family-based preference
categories, Form I-130

If you were issued a Form I-94 Arrival-Departure Record Number:

Person admitted to the United States as a fiancé(e) or
child of a fiancé(e) of a U.S. citizen, Form I-129F
(K-1/K-2 Nonimmigrant)

26.a. Form I-94 Arrival-Departure Record Number

Widow or widower of a U.S. citizen, Form I-360

►

26.b. Expiration Date of Authorized Stay Shown on Form I-94
(mm/dd/yyyy)

26.c. Status on Form I-94 (for example, class of admission, or
paroled, if paroled)

VAWA self-petitioner, Form I-360

1.b. Employment-based

Alien worker, Form I-140

Alien entrepreneur, Form I-526

1.c. Special Immigrant

Religious worker, Form I-360

27.

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

Special immigrant juvenile, Form I-360

Certain Afghan or Iraqi National, Form I-360 or
Form DS-157
Provide your name exactly as it appears on your Form I-94 (if
any)
28.a. Family Name
(Last Name)
28.b. Given Name
(First Name)
28.c. Middle Name

Certain international broadcaster, Form I-360
Certain G-4 international organization or family
member or NATO-6 employee or family member,
Form I-360
1.d. Asylee or Refugee
Asylum status (INA section 208), Form I-589 or
Form I-730
Refugee status (INA section 207), Form I-590 or
Form I-730
1.e. Human Trafficking Victim or Crime Victim
Human trafficking victim (T Nonimmigrant), Form
I-914 or derivative family member, Form I-914A
Crime victim (U Nonimmigrant), Form I-918,
derivative family member, Form I-918A, or
qualifying family member, Form I-929

Form I-485 Edition 08/28/24

Page 3 of 20

A-Number ► A-

Information About Your Immigrant Category

Part 2. Application Type or Filing Category
(continued)
1.f.

If you are the principal applicant, provide the following
information.

Special Programs Based on Certain Public Laws

3.

Receipt Number of Underlying Petition (if any)

4.

Priority Date from Underlying Petition (if any)

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The Cuban Adjustment Act

The Cuban Adjustment Act for battered spouses and
children

(mm/dd/yyyy)

Dependent status under the Haitian Refugee
Immigrant Fairness Act

If you are a derivative applicant (the spouse or unmarried
child under 21 years of age of a principal applicant), provide the
following information for the principal applicant.

Dependent status under the Haitian Refugee
Immigrant Fairness Act for battered spouses and
children

Principal Applicant's Name

Lautenberg Parolees

Diplomats or high ranking officials unable to return
home (Section 13 of the Act of September 11, 1957)
Indochinese Parole Adjustment Act of 2000

5.a. Family Name
(Last Name)
5.b. Given Name
(First Name)

5.c. Middle Name

1.g. Additional Options

6.

Diversity Visa program

Principal Applicant's A-Number (if any)
► A-

Continuous residence in the United States since
before January 1, 1972 ("Registry")

7.

Individual born in the United States under diplomatic
status

Principal Applicant's Date of Birth
(mm/dd/yyyy)

8.

Receipt Number of Principal's Underlying Petition (if any)
►

Other eligibility

9.

2.

Are you applying for adjustment based on the
Immigration and Nationality Act (INA) section 245(i)?
Yes

No

NOTE: If you answered "Yes" to Item Number 2., you
must have selected a family-based, employment-based,
special immigrant, or Diversity Visa immigrant category
listed above in Item Numbers 1.a. - 1.g. as the basis for
your application for adjustment of status. Fill out the rest
of this application and Supplement A to Form I-485,
Adjustment of Status Under Section 245(i) (Supplement
A). For detailed filing instructions, read the Form I-485
Instructions (including any Additional Instructions that
relate to the immigrant category that you selected in Item
Numbers 1.a. - 1.g.) and Supplement A Instructions.

Priority Date of Principal Applicant's Underlying Petition
(if any) (mm/dd/yyyy)

Part 3. 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
No
If you answered "Yes" to Item Number 1., complete
Item Numbers 2.a. - 4. below. If you need extra space to
complete this section, use the space provided in Part 14.
Additional Information.

Location of U.S. Embassy or U.S. Consulate
2.a. City
2.b. Country

Form I-485 Edition 08/28/24

3.

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

4.

Date of Decision (mm/dd/yyyy)
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A-Number ► A-

Part 3. Additional Information About You
(continued)

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

Address History

9.a. Street Number
and Name

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Provide physical addresses for everywhere you have lived
during the last five years, whether inside or outside the United
States. Provide your current address first. If you need extra
space to complete this section, use the space provided in
Part 14. Additional Information.

9.b.

Apt.

Ste.

Flr.

9.c. City or Town
9.d. State

9.e. ZIP Code

Physical Address 1 (current address)

9.f.

5.a. Street Number
and Name
5.b.

Apt.

Province

9.g. Postal Code

Ste.

Flr.

9.h. Country

5.c. City or Town
5.d. State
5.f.

Dates of Residence

5.e. ZIP Code

10.a. From (mm/dd/yyyy)

Province

10.b. To (mm/dd/yyyy)

5.g. Postal Code
5.h. Country

Employment History

Provide your employment history for the last five years,
whether inside or outside the United States. Provide the most
recent employment first. If you need extra space to complete
this section, use the space provided in Part 14. Additional
Information.

Dates of Residence

6.a. From (mm/dd/yyyy)
6.b. To (mm/dd/yyyy)

Present

Employer 1 (current or most recent)

Physical Address 2

11.

7.a. Street Number
and Name
7.b.

Apt.

Address of Employer or Company
Ste.

Flr.

7.c. City or Town

12.a. Street Number
and Name
12.b.

7.d. State

Name of Employer or Company

Apt.

Ste.

Flr.

7.e. ZIP Code
12.c. City or Town

7.f.

Province
12.d. State

12.e. ZIP Code

7.g. Postal Code
12.f. Province
7.h. Country
12.g. Postal Code
Dates of Residence

12.h. Country

8.a. From (mm/dd/yyyy)
13.

Your Occupation

8.b. To (mm/dd/yyyy)

Form I-485 Edition 08/28/24

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A-Number ► A-

Part 3. Additional Information About You
(continued)

Address of Employer or Company

Dates of Employment

20.b.

Apt.

Ste.

Flr.

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14.a. From (mm/dd/yyyy)

20.c. City or Town

14.b. To (mm/dd/yyyy)

20.d. State

Employer 2
15.

20.a. Street Number
and Name

20.e. ZIP Code

20.f. Province

Name of Employer or Company

20.g. Postal Code

Address of Employer or Company
16.a. Street Number
and Name
16.b.

Apt.

21.

Ste.

16.d. State

Your Occupation

Flr.

Dates of Employment

16.c. City or Town

16.e. ZIP Code

16.f. Province

16.g. Postal Code
16.h. Country

17.

20.h. Country

Your Occupation

Dates of Employment
18.a. From (mm/dd/yyyy)

22.a. From (mm/dd/yyyy)
22.b. To (mm/dd/yyyy)

Part 4. Information About Your Parents

Information About Your Parent 1

Parent 1's Legal Name
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)

1.c. Middle Name

18.b. To (mm/dd/yyyy)

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

Provide your most recent employment outside of the United
States (if not already listed above).

2.a. Family Name
(Last Name)
2.b. Given Name
(First Name)

19.

Name of Employer or Company

2.c. Middle Name

Form I-485 Edition 08/28/24

3.

Date of Birth (mm/dd/yyyy)

4.

Sex

5.

City or Town of Birth

6.

Country of Birth

Male

Female

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A-Number ► A-

Part 4. Information About Your Parents
(continued)
7.

8.

3.

How many times have you been married (including
annulled marriages and marriages to the same person)?

Current City or Town of Residence (if living)

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

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Current Country of Residence (if living)

If you are currently married, provide the following information
about your current spouse.
Current Spouse's Legal Name

Information About Your Parent 2

4.a. Family Name
(Last Name)
4.b. Given Name
(First Name)

Parent 2's Legal Name
9.a. Family Name
(Last Name)
9.b. Given Name
(First Name)

4.c. Middle Name
5.

9.c. Middle Name

A-Number (if any)

► A-

Parent 2's Name at Birth (if different than above)
10.a. Family Name
(Last Name)
10.b. Given Name
(First Name)

6.

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

7.

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

10.c. Middle Name

Current Spouse's Place of Birth

11.

Date of Birth (mm/dd/yyyy)

12.

Sex

13.

City or Town of Birth

8.b. State or Province

14.

Country of Birth

8.c. Country

15.

Current City or Town of Residence (if living)

Place of Marriage to Current Spouse

Male

8.a. City or Town

Female

9.a. City or Town
16.

Current Country of Residence (if living)
9.b. State or Province

Part 5. Information About Your Marital History
1.

9.c. Country

What is your current marital status?
Single, Never Married
Widowed

Married

Divorced

Marriage Annulled

10.

Is your current spouse applying with you?
Yes

No

Legally Separated
2.

If you are married, is your spouse a current member of the
U.S. armed forces or U.S. Coast Guard?
N/A
Yes
No

Form I-485 Edition 08/28/24

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A-Number ► A-

Part 5. Information About Your Marital History
(continued)

Part 6. Information About Your Children
1.

Information About Prior Marriages (if any)

Indicate the total number of ALL living children
(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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If you have been married before, whether in the United States or
in any other country, provide the following information about
your prior spouse. If you have had more than one previous
marriage, use the space provided in Part 14. Additional
Information to provide the information below.
Prior Spouse's Legal Name (provide family name before
marriage)
11.a. Family Name
(Last Name)
11.b. Given Name
(First Name)

11.c. Middle Name

Provide the following information for each of your children.
If you have more than three children, use the space provided in
Part 14. Additional Information.
Child 1

Current Legal Name

12.

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

2.a. Family Name
(Last Name)
2.b. Given Name
(First Name)

13.

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

2.c. Middle Name
3.

A-Number (if any)

► A-

Place of Marriage to Prior Spouse
14.a. City or Town

14.b. State or Province

14.c. Country

4.

Date of Birth (mm/dd/yyyy)

5.

Country of Birth

6.

Is this child applying with you?

Yes

No

Yes

No

Child 2
15.

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

Place Where Marriage with Prior Spouse Legally Ended
16.a. City or Town

Current Legal Name
7.a. Family Name
(Last Name)
7.b. Given Name
(First Name)
7.c. Middle Name

16.b. State or Province

8.

A-Number (if any)
► A-

16.c. Country

Form I-485 Edition 08/28/24

9.

Date of Birth (mm/dd/yyyy)

10.

Country of Birth

11.

Is this child applying with you?

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Part 6. Information About Your Children
(continued)

Part 8. General Eligibility and Inadmissibility
Grounds

Child 3

1.

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Current Legal Name
12.a. Family Name
(Last Name)
12.b. Given Name
(First Name)

If you answered "Yes" to Item Number 1., complete Item
Numbers 2. - 13.b. below. If you need extra space to complete
this section, use the space provided in Part 14. Additional
Information. If you answered "No," but are unsure of your
answer, provide an explanation of the events and circumstances
in the space provided in Part 14. Additional Information.

12.c. Middle Name
13.

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
including any military service?
Yes
No

A-Number (if any)

► A-

14.

Date of Birth (mm/dd/yyyy)

Organization 1

15.

Country of Birth

2.

16.

Is this child applying with you?

Yes

No

3.a. City or Town

3.b. State or Province

Part 7. Biographic Information
1.

Name of Organization

Ethnicity (Select only one box)

3.c. Country

Hispanic or Latino

Not Hispanic or Latino
2.

4.

Race (Select all applicable boxes)

Nature of Group

White
Asian

Dates of Membership or Dates of Involvement

Black or African American
American Indian or Alaska Native

5.a. From (mm/dd/yyyy)
5.b. To (mm/dd/yyyy)

Native Hawaiian or Other Pacific Islander
3.

Height

Feet

4.

Weight

5.

Eye Color (Select only one box)

Inches

Organization 2
6.

6.

Name of Organization

Pounds
7.a. City or Town

Black

Blue

Brown

Gray

Green

Hazel

Maroon

Pink

Unknown/Other

Hair Color (Select only one box)

7.c. Country

Bald (No hair)

Black

Blond

Brown

Gray

Red

Sandy

White

Unknown/Other

Form I-485 Edition 08/28/24

7.b. State or Province

8.

Nature of Group

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Part 8. General Eligibility and Inadmissibility
Grounds (continued)
Dates of Membership or Dates of Involvement

20.

Have you EVER had a prior final order of exclusion,
deportation, or removal reinstated?
Yes
No

21.

Have you EVER held lawful permanent resident status
which was later rescinded?
Yes
No

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9.a. From (mm/dd/yyyy)

22.

Have you EVER been granted voluntary departure by an
immigration officer or an immigration judge but failed to
depart within the allotted time?
Yes
No

23.

Have you EVER applied for any kind of relief or
protection from removal, exclusion, or deportation?
Yes
No

9.b. To (mm/dd/yyyy)
Organization 3
10.

Name of Organization

24.a. Have you EVER been a J nonimmigrant exchange visitor
who was subject to the two-year foreign residence
requirement?
Yes
No

11.a. City or Town

11.b. State or Province

11.c. Country

If you answered "Yes" to Item Number 24.a., complete Item
Numbers 24.b. - 24.c. If you answered "No" to Item Number
24.a., skip to Item Number 25.

12.

24.b. Have you complied with the foreign residence
requirement?
Yes

Nature of Group

No

24.c. Have you been granted a waiver or has Department of
State issued a favorable waiver recommendation letter
for you?
Yes
No

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

Criminal Acts and Violations

13.b. To (mm/dd/yyyy)

Answer Item Numbers 14. - 86.b. Choose the answer that you
think is correct. 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.
14.

Have you EVER been denied admission to the United
States?
Yes
No

15.

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

No

16.

Have you EVER worked in the United States without
authorization?
Yes
No

17.

Have you EVER violated the terms or conditions of your
nonimmigrant status?
Yes
No

18.

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

19.

No

Have you EVER been issued a final order of exclusion,
deportation, or removal?
Yes
No

Form I-485 Edition 08/28/24

For Item Numbers 25. - 45., 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 25. - 45., use the space provided in
Part 14. Additional Information to provide an explanation
that includes why you were arrested, cited, detained, or charged;
where you were arrested, cited, detained, or charged; when
(date) the event occurred; and the outcome or disposition (for
example, no charges filed, charges dismissed, jail, probation,
community service).
25.

Have you EVER been arrested, cited, charged, or
detained for any reason by any law enforcement official
(including but not limited to any U.S. immigration
official or any official of the U.S. armed forces or U.S.
Coast Guard)?
Yes
No

26.

Have you EVER committed a crime of any kind (even if
you were not arrested, cited, charged with, or tried for that
crime)?
Yes
No

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Part 8. General Eligibility and Inadmissibility
Grounds (continued)
27.

28.

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
No

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

36.

No

Have you EVER directly or indirectly procured (or
attempted to procure) or imported prostitutes or persons
for the purpose of prostitution?
Yes
No

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37.

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.

Have you EVER received any proceeds or money from
prostitution?
Yes
No

38.

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
No

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
No

39.

Have you EVER exercised immunity (diplomatic or
otherwise) to avoid being prosecuted for a criminal
offense in the United States?
Yes
No

40.

Have you EVER, while serving as a foreign government
official, been responsible for or directly carried out
violations of religious freedoms?
Yes
No

41.

Have you EVER induced by force, fraud, or coercion (or
otherwise been involved in) the trafficking of persons for
commercial sex acts?
Yes
No

42.

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.
Yes
No

43.

Have you EVER knowingly aided, abetted, assisted,
conspired, or colluded with others in trafficking persons
for commercial sex acts or involuntary servitude,
peonage, debt bondage, or slavery?
Yes
No

44.

Are you the spouse, son or daughter of a foreign national
who engaged in the trafficking of persons and have
received or obtained, within the last five years, any
financial or other benefits from the illicit activity of your
spouse or your parent, although you knew or reasonably
should have known that this benefit resulted from the illicit
activity of your spouse or parent?
Yes
No

45.

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

29.

Have you EVER been a defendant or the accused in a
criminal proceeding (including pre-trial diversion,
deferred prosecution, deferred adjudication, or any
withheld adjudication)?
Yes
No

30.

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

No

31.

Have you EVER been convicted of two or more offenses
(other than purely political offenses) for which the
combined sentences to confinement were five years or
more?
Yes
No

32.

Have you EVER illicitly (illegally) trafficked or benefited
from the trafficking of any controlled substances, such as
chemicals, illegal drugs, or narcotics?
Yes
No

33.

Have you EVER knowingly aided, abetted, assisted,
conspired, or colluded in the illicit trafficking of any
illegal narcotic or other controlled substances?
Yes

34.

35.

No

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 five years, any
financial or other benefit from the illegal activity of your
spouse or parent, although you knew or reasonably should
have known that the financial or other benefit resulted
from the illicit activity of your spouse or parent?
Yes

Form I-485 Edition 08/28/24

Yes

No

No

Page 11 of 20

A-Number ► A-

Part 8. General Eligibility and Inadmissibility
Grounds (continued)
Security and Related

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49.

Do you intend to:

46.a. Engage in any activity that violates or evades any law
relating to espionage (including spying) or sabotage in the
United States?
Yes
No

46.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

No

46.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
No
46.d. Engage in any activity that could endanger the welfare,
safety, or security of the United States?

46.e. Engage in any other unlawful activity?
47.

48.e. 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 Number 48.a.?
Yes
No

Yes

No

Yes

No

Are you engaged in or, upon your entry into the United
States, do you intend to engage in any activity that could
have potentially serious adverse foreign policy
consequences for the United States?
Yes
No

Have you EVER:
48.a. Committed, threatened to commit, attempted to commit,
conspired to commit, incited, endorsed, advocated,
planned, or prepared any of the following: hijacking,
sabotage, kidnapping, political assassination, or use of a
weapon or explosive to harm another individual or cause
substantial damage to property?
Yes
No
48.b. Participated in, or been a member of, a group or
organization that did any of the activities described in
Item Number 48.a.?
Yes
No
48.c. Recruited members or asked for money or things of value
for a group or organization that did any of the activities
described in Item Number 48.a.?
Yes
No
48.d. Provided money, a thing of value, services or labor, or
any other assistance or support for any of the activities
described in Item Number 48.a.?
Yes
No

50.

Have you EVER received any type of military,
paramilitary, or weapons training?
Yes

Do you intend to engage in any of the activities listed in
any part of Item Numbers 48.a. - 49.?
Yes
No

NOTE: If you answered “Yes” to any part of Item Numbers
46.a. - 50., 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.

Are you the spouse or child of an individual who EVER:
51.a. Committed, threatened to commit, attempted to commit,
conspired to commit, incited, endorsed, advocated,
planned, or prepared any of the following: hijacking,
sabotage, kidnapping, political assassination, or use of a
weapon or explosive to harm another individual or cause
substantial damage to property?
Yes
No
51.b. Participated in, or been a member or a representative of a
group or organization that did any of the activities
described in Item Number 51.a.?
Yes
No
51.c. Recruited members, or asked for money or things of value,
for a group or organization that did any of the activities
described in Item Number 51.a.?
Yes
No
51.d. Provided money, a thing of value, services or labor, or
any other assistance or support for any of the activities
described in Item Number 51.a.?
Yes
No
51.e. Provided money, a thing of value, services or labor, or
any other assistance or support to an individual, group, or
organization who did any of the activities described in
Item Number 51.a.?
Yes
No
51.f. Received any type of military, paramilitary, or weapons
training from a group or organization that did any of the
activities described in Item Number 51.a.?
Yes
No
NOTE: If you answered “Yes” to any part of Item Number
51., explain the relationship and what occurred, including the
dates and location of the circumstances, in the space provided
in Part 14. Additional Information.
52.

Have you EVER assisted or participated in selling,
providing, or transporting weapons to any person who,
to your knowledge, used them against another person?
Yes

Form I-485 Edition 08/28/24

No

No

Page 12 of 20

A-Number ► A60.

Part 8. General Eligibility and Inadmissibility
Grounds (continued)
53.

Have you EVER worked, volunteered, or otherwise
served in any prison, jail, prison camp, detention facility,
labor camp, or any other situation that involved detaining
persons?
Yes
No

54.

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?

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

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Yes

Public Charge

61.

Have you EVER served in, been a member of, assisted,
or participated in any military unit, paramilitary unit,
police unit, self-defense unit, vigilante unit, rebel group,
guerilla group, militia, insurgent organization, or any
other armed group?
Yes
No

56.

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

Are you subject to the public charge ground of
inadmissibility under INA section 212(a)(4)?

No

55.

57.

Have you EVER used any person under 15 years of age
to take part in hostilities, or to help or provide services to
people in combat?
Yes
No

No

Yes

If you answered “Yes” to Item Number 61., complete Item
Numbers 62. - 68.d. below. If you answered “No” to Item
Number 61., go to Item Number 69.a. If you need extra space
to complete this section, use the space provided in Part 14.
Additional Information.
62.

What is the size of your household?

63.

Indicate your annual household income.

During the period from March 23, 1933 to May 8, 1945,
did you ever order, incite, assist, or otherwise participate
in the persecution of any person because of race, religion,
national origin, or political opinion, in association with
either the Nazi government of Germany or any
organization or government associated or allied with the
Nazi government of Germany?
Yes
No

Have you EVER ordered, incited, called for, committed, assisted,
helped with, or otherwise participated in any of the following:
58.a. Acts involving torture or genocide?

Yes

No

58.b. Killing any person?

Yes

No

No

$0-27,000

$27,001-52,000
$52,001-85,000

$85,001-141,000
Over $141,000

64.

Identify the total value of your household assets.
$0-18,400
$18,401-136,000
$136,001-321,400

58.c. Intentionally and severely injuring any person?
Yes

$321,401-707,100
Over $707,100

No

58.d. Engaging in any kind of sexual contact or relations with
any person who did not consent or was unable to consent,
or was being forced or threatened?
Yes
No
58.e. Limiting or denying any person's ability to exercise
religious beliefs?
Yes
No
59.

Have you EVER recruited, enlisted, conscripted, or used
any person under 15 years of age to serve in or help an
armed force or group?
Yes
No

Form I-485 Edition 08/28/24

Page 13 of 20

A-Number ► A-

Part 8. General Eligibility and Inadmissibility Grounds (continued)
65.

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

66.

$1-10,100

$10,101-57,700

$57,701-186,800

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

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Grades 1 through 11

12th grade - no diploma

1 or more years of college credit, no degree
Master's degree

67.

Over $186,800

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

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

Bachelor's degree
Doctorate degree

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

68.a. 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

No

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

Yes

No

68.c. If your answer to Item Number 68.a. is “Yes,” list the specific benefit(s) you received, the start and end dates of each period of
receipt, and the dollar amount of benefits received.
Benefit Received

Start Date

End Date

Dollar Amount

68.d. If your answer to Item Number 68.b. is “Yes,” list the name, city, and state for each institution, the start and end dates of each
period of institutionalization, and the reason you were institutionalized.
Institution Name/City/State

Form I-485 Edition 08/28/24

Date From

Date To

Reason

Page 14 of 20

A-Number ► A-

Part 8. General Eligibility and Inadmissibility
Grounds (continued)
Illegal Entries and Other Immigration Violations

Since April 1, 1997, have you been unlawfully present in the
United States:
78.a. For more than 180 days but less than a year, and then
departed the United States?
Yes
No

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69.a. 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
No

78.b. For one year or more and then departed the United States?
Yes
No

69.b. If your answer to Item Number 69.a. is "Yes," do you
believe you had reasonable cause?
Yes
No

NOTE: You were unlawfully present in the United States if
you entered the United States without being inspected and
admitted or inspected and paroled, or if you legally entered the
United States but you stayed longer than permitted.

69.c. If your answer to Item Number 69.b. is "Yes," attach a
written statement explaining why you had reasonable
cause.

Since April 1, 1997, have you EVER reentered or attempted to
reenter the United States without being inspected and admitted
or paroled after:

70.

79.a. Having been unlawfully present in the United States for
more than one year in the aggregate?
Yes
No

71.

Have you EVER submitted 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
No

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
No

72.

Have you EVER falsely claimed to be a U.S. citizen (in
writing or any other way)?
Yes
No

73.

Have you EVER been a stowaway on a vessel or aircraft
arriving in the United States?
Yes
No

74.

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
No

75.

No

Removal, Unlawful Presence, or Illegal Reentry
After Previous Immigration Violations
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
77.

Miscellaneous Conduct

80.

Do you plan to practice polygamy in the United States?
Yes
No

81.

Are you accompanying another foreign national who
requires your protection or guardianship but who is
inadmissible after being certified by a medical officer as
being helpless from sickness, physical or mental
disability, or infancy, as described in INA section 232(c)?
Yes

No

Have you EVER entered the United States without being
inspected and admitted or paroled?
Yes
No

Form I-485 Edition 08/28/24

No

82.

Have you EVER assisted in detaining, retaining, or
withholding custody of a U.S. citizen child outside the
United States from a U.S. citizen who has been granted
custody of the child?
Yes
No

83.

Have you EVER voted in violation of any Federal, state,
or local constitutional provision, statute, ordinance, or
regulation in the United States?
Yes
No

84.

Have you EVER renounced U.S. citizenship to avoid
being taxed by the United States?
Yes
No

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

76.

79.b. Having been deported, excluded, or removed from the
United States?
Yes
No

Have you EVER:
85.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
No

Page 15 of 20

A-Number ► A-

Part 8. General Eligibility and Inadmissibility
Grounds (continued)

2.c.

85.b. Been relieved or discharged from such training or service
on the ground that you are a foreign national?
Yes
No

I have another type of disability and/or impairment.
(Describe the nature of your disability and/or
impairment and the accommodation you are
requesting.)

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

No

86.a. 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
No

86.b. If your answer to Item Number 86.a. is “Yes,” 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)?

Part 9. Accommodations for Individuals With
Disabilities and/or Impairments

Part 10. Applicant's Statement, Contact
Information, Declaration, Certification, and
Signature

NOTE: Read the Penalties section of the Form I-485
Instructions before completing this part. You must file Form
I-485 while in the United States.

Applicant's Statement

NOTE: Select the box for either Item Number 1.a. or 1.b. If
applicable, select the box for Item Number 2.
1.a.

I can read and understand English, and I have read
and understand every question and instruction on this
application and my answer to every question.

1.b.

The interpreter named in Part 11. read to me every
question and instruction on this application and my
answer to every question in

NOTE: Read the information in the Form I-485 Instructions
before completing this part.
1.

2.a.

2.b.

a language in which I am fluent, and I understood
everything.

Are you requesting an accommodation because of your
disabilities and/or impairments?
Yes
No
If you answered "Yes" to Item Number 1., select any
applicable box in Item Numbers 2.a. - 2.c. and provide
an answer.
I am deaf or hard of hearing and request the
following accommodation. (If you are requesting a
sign-language interpreter, indicate for which
language (for example, American Sign Language).):

I am blind or have low vision and request the
following accommodation:

Form I-485 Edition 08/28/24

,

2.

At my request, the preparer named in Part 12.,
,
prepared this application for me based only upon
information I provided or authorized.

Applicant's Contact Information
3.

Applicant's Daytime Telephone Number

4.

Applicant's Mobile Telephone Number (if any)

5.

Applicant's Email Address (if any)

Page 16 of 20

A-Number ► A-

Part 10. Applicant's Statement, Contact
Information, Declaration, Certification, and
Signature (continued)

Part 11. Interpreter's Contact Information,
Certification, and Signature
Provide the following information about the interpreter.

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Applicant's Declaration and Certification

Interpreter's Full Name

Copies of any documents I have submitted are exact photocopies
of unaltered, original documents, and I understand that USCIS
may require that I submit original documents to USCIS at a later
date. Furthermore, I authorize the release of any information
from any and all of my records that USCIS may need to
determine my eligibility for the immigration benefit that I seek.

1.a. Interpreter's Family Name (Last Name)

I understand that if I am a male who is 18 to 26 years of age,
submitting this application will automatically register me with
the Selective Service System as required by the Military
Selective Service Act.

I furthermore authorize release of information contained in this
application, in supporting documents, and in my USCIS
records, to other entities and persons where necessary for the
administration and enforcement of U.S. immigration law.
I understand that USCIS may require me to appear for an
appointment to take my biometrics (fingerprints, photograph,
and/or signature) and, at that time, if I am required to provide
biometrics, I will be required to sign an oath reaffirming that:
1)

I reviewed and understood all of the information
contained in, and submitted with, my application; and

2)

All of this information was complete, true, and correct at
the time of filing.

I certify, under penalty of perjury, that all of the information in
my application and any document submitted with it were
provided or authorized by me, that I reviewed and understand
all of the information contained in, and submitted with, my
application and that all of this information is complete, true, and
correct.

Applicant's Signature

1.b. Interpreter's Given Name (First Name)

2.

Interpreter's Business or Organization Name (if any)

Interpreter's Mailing Address

3.a. Street Number
and Name
3.b.

Apt.

Ste.

Flr.

3.c. City or Town
3.d. State
3.f.

3.e. ZIP Code

Province

3.g. Postal Code
3.h. Country

Interpreter's Contact Information
4.

Interpreter's Daytime Telephone Number

5.

Interpreter's Mobile Telephone Number (if any)

6.

Interpreter's Email Address (if any)

6.a. Applicant's Signature (sign in ink)

6.b. Date of Signature (mm/dd/yyyy)
NOTE TO ALL APPLICANTS: If you do not completely fill
out this application or fail to submit required documents listed
in the Instructions, USCIS may deny your application.

Form I-485 Edition 08/28/24

Page 17 of 20

A-Number ► A-

Part 11. Interpreter's Contact Information
Certification, and Signature (continued)

Preparer's Mailing Address
3.a. Street Number
and Name

Interpreter's Certification

3.b.

I certify, under penalty of perjury, that:

3.c. City or Town

Apt.

Ste.

Flr.

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I am fluent in English and
,
which is the same language specified in Part 10., Item Number
1.b., and I have read to this applicant in the identified language
every question and instruction on this application and his or her
answer to every question. The applicant informed me that he or
she understands every instruction, question, and answer on the
application, including the Applicant's Declaration and
Certification, and has verified the accuracy of every answer.

3.d. State
3.f.

3.e. ZIP Code

Province

3.g. Postal Code
3.h. Country

Interpreter's Signature

7.a. Interpreter's Signature (sign in ink)

Preparer's Contact Information

4.

Preparer's Daytime Telephone Number

5.

Preparer's Mobile Telephone Number (if any)

6.

Preparer's Email Address (if any)

7.b. Date of Signature (mm/dd/yyyy)

Part 12. Contact Information, Declaration, and
Signature of the Person Preparing this
Application, if Other Than the Applicant
Provide the following information about the preparer.

Preparer's Full Name

Preparer's Statement

7.a.

I am not an attorney or accredited representative
but have prepared this application on behalf of
the applicant and with the applicant's consent.

7.b.

I am an attorney or accredited representative and
my representation of the applicant in this case
extends
does not extend beyond the
preparation of this application.

1.a. Preparer's Family Name (Last Name)

1.b. Preparer's Given Name (First Name)

2.

Preparer's Business or Organization Name (if any)

Form I-485 Edition 08/28/24

NOTE: If you are an attorney or accredited
representative, you may be obliged to submit a
completed Form G-28, Notice of Entry of
Appearance as Attorney or Accredited
Representative, with this application.

Page 18 of 20

A-Number ► A-

Part 12. Contact Information, Declaration, and
Signature of the Person Preparing this
Application, if Other Than the Applicant
(continued)

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

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Preparer's Certification

corrections made to this application, numbered
through

By my signature, I certify, under penalty of perjury, that I
prepared this application at the request of the applicant. The
applicant then reviewed this completed application and
informed me that he or she understands all of the information
contained in, and submitted with, his or her application,
including the Applicant's Declaration and Certification, and
that all of this information is complete, true, and correct. I
completed this application based only on information that the
applicant provided to me or authorized me to obtain or use.

, are complete, true, and correct. All

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

Preparer's Signature

8.a. Preparer's Signature (sign in ink)

Date of Signature (mm/dd/yyyy)

Applicant's Signature (sign in ink)

8.b. Date of Signature (mm/dd/yyyy)

USCIS Officer's Signature (sign in ink)

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

Form I-485 Edition 08/28/24

Page 19 of 20

A-Number ► A5.a. Page Number

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.

5.b. Part Number

5.c. Item Number

5.d.

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1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)

1.c. Middle Name
2.

6.a. Page Number

6.b. Part Number

6.c. Item Number

7.b. Part Number

7.c. Item Number

A-Number (if any) ► A-

6.d.

3.a. Page Number

3.d.

3.b. Part Number

3.c. Item Number

7.a. Page Number

7.d.
4.a. Page Number

4.b. Part Number

4.c. Item Number

4.d.

Form I-485 Edition 08/28/24

Page 20 of 20