Form I-485 Edition 04/01/24 Page 1 of 20

1.b. 

1.c.

1.a. Family Name 

(Last Name)

Given Name 

(First Name)

Middle Name

Your Current Legal Name (do not provide a 

nickname)

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

Priority Date:

Country Chargeable:

INA 209(a) INA 249

Section of Law

INA 245(a)

INA 245(i)

INA 245(m)

Sec. 13, Act of 9/11/57

Cuban Adjustment Act

Lawful Permanent Other 

Resident as of:

Date of 

Initial Interview:

Receipt Action Block

Interview 

Waived

Applicant 

Interviewed

Date Form I-693 Received:

Attorney State Bar Number 

(if applicable)

Select this box if 

Form G-28 is 

attached.

Volag Number 

(if any) 

Attorney or Accredited Representative 

USCIS Online Account Number (if any)

To be completed by an attorney or accredited representative (if any).

For USCIS Use Only 

► START HERE - Type or print in black ink.

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)

A-Number ► ANOTE: 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.

Other Names You Have Used Since Birth (if 

applicable)

2.b. 

2.c.

2.a. Family Name 

(Last Name)

Given Name 

(First Name)

Middle Name

3.b. 

3.c.

3.a. Family Name 

(Last Name)

Given Name 

(First Name)

Middle 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 Female

INA 209(b)

4.b. 

4.c.

4.a. Family Name 

(Last Name)

Given Name 

(First Name)

Middle Name

Preference Category:

Other Information About You

7. City or Town of Birth
Form I-485 Edition 04/01/24 Page 2 of 20

A-Number► A8. Country of Birth

9. Country of Citizenship or Nationality

Part 1. Information About You (Person applying 

for lawful permanent residence) (continued)

► A10. Alien Registration Number (A-Number) (if any)

NOTE: If you have EVER used other A-Numbers, 

include the additional A-Numbers in the space provided 

in Part 14. Additional Information.

►

11. USCIS Online Account Number (if any)

U.S. Mailing Address 

12.d. City or Town

12.e. State 12.f. ZIP Code

Street Number 

and Name

12.b.

12.c. Apt. Ste. Flr.

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

13.d. City or Town

13.e. State 13.f. ZIP Code

Street Number 

and Name

13.b.

13.c. Apt. Ste. Flr.

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

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.

(USPS ZIP Code Lookup)

Social Security Card

14. Has the Social Security Administration (SSA) ever 

officially issued a Social Security card to you?

Yes No

If you answered “Yes,” provide the information requested 

in Item Number 15.

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

►

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).

16.

Yes No

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.

17.

Yes No

18. Passport Number Used at Last Arrival

19. Travel Document Number Used at Last Arrival

Recent Immigration History

20. Expiration Date of this Passport or Travel Document

(mm/dd/yyyy)

21. Country that Issued this Passport or Travel Document

22. Nonimmigrant Visa Number from this Passport (if any)

23.a.

Place of Last Arrival into the United States

City or Town

23.b. State

Provide the information for Item Numbers 18. - 24. if you last 

entered the United States using a passport or travel document.

24. Date of Last Arrival (mm/dd/yyyy)
Form I-485 Edition 04/01/24 Page 3 of 20

A-Number► APart 1. Information About You (Person applying 

for lawful permanent residence) (continued)

When I last arrived in the United States, I:

Was inspected at a port of entry and admitted as (for 

example, exchange visitor; visitor, waived through; 

temporary worker; student):

25.a. 

Was inspected at a port of entry and paroled as (for 

example, humanitarian parole, Cuban parole): 

25.b.

Came into the United States without admission or 

parole.

25.c.

25.d. Other:

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

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)

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

►

Provide your name exactly as it appears on your Form I-94 (if 

any)

28.b. 

28.c.

28.a. Family Name 

(Last Name)

Given Name 

(First Name)

Middle Name

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.):

1.a. Family-based

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

Other relative of a U.S. citizen or relative of a lawful 

permanent resident under the family-based preference 

categories, Form I-130

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)

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

VAWA self-petitioner, Form I-360

Alien worker, Form I-140

Alien entrepreneur, Form I-526

1.b. Employment-based 

Special Immigrant 

Special immigrant juvenile, Form I-360

Certain Afghan or Iraqi National, Form I-360 or 

Form DS-157

Religious worker, Form I-360

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.c.

What is your current immigration status (if it has changed 

since your arrival)?

27.

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.d.

Human Trafficking Victim or Crime Victim

Crime victim (U Nonimmigrant), Form I-918, 

derivative family member, Form I-918A, or 

qualifying family member, Form I-929

Human trafficking victim (T Nonimmigrant), Form 

I-914 or derivative family member, Form I-914A

1.e.
Form I-485 Edition 04/01/24 Page 4 of 20

A-Number► ADependent status under the Haitian Refugee 

Immigrant Fairness Act for battered spouses and 

children

Diplomats or high ranking officials unable to return 

home (Section 13 of the Act of September 11, 1957)

Lautenberg Parolees

Dependent status under the Haitian Refugee 

Immigrant Fairness Act

Indochinese Parole Adjustment Act of 2000

The Cuban Adjustment Act for battered spouses and 

children

The Cuban Adjustment Act 

1.f. Special Programs Based on Certain Public Laws

Additional Options 

Diversity Visa program

Individual born in the United States under diplomatic 

status

Continuous residence in the United States since 

before January 1, 1972 ("Registry")

Other eligibility

1.g.

Are you applying for adjustment based on the 

Immigration and Nationality Act (INA) section 245(i)?

Yes No

2.

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.

Information About Your Immigrant Category

If you are the principal applicant, provide the following 

information.

3. Receipt Number of Underlying Petition (if any)

4. Priority Date from Underlying Petition (if any)

(mm/dd/yyyy)

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.

Principal Applicant's Name

5.b. 

5.c.

5.a. Family Name 

(Last Name)

Given Name 

(First Name)

Middle Name

► A6. Principal Applicant's A-Number (if any)

7. Principal Applicant's Date of Birth

(mm/dd/yyyy)

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

9. Priority Date of Principal Applicant's Underlying Petition 

►

(if any) (mm/dd/yyyy)

Part 2. Application Type or Filing Category 

(continued)

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

Decision (for example, approved, refused, denied, 

withdrawn)

4. Date of Decision (mm/dd/yyyy)

3.
Form I-485 Edition 04/01/24 Page 5 of 20

A-Number► AAddress History

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.

5.c. City or Town

5.f.

5.h.

Province

Country 

5.g. Postal Code 

5.d. State 5.e. ZIP Code

Street Number 

and Name

5.a.

5.b. Apt. Ste. Flr.

Physical Address 1 (current address)

Dates of Residence 

From (mm/dd/yyyy)

To (mm/dd/yyyy)

6.a.

6.b.

7.c. City or Town

7.f.

7.h.

Province

Country 

7.g. Postal Code 

7.d. State 7.e. ZIP Code

Street Number 

and Name

7.a.

7.b. Apt. Ste. Flr.

Physical Address 2

Part 3. Additional Information About You 

(continued)

Dates of Residence 

From (mm/dd/yyyy)

To (mm/dd/yyyy)

8.a.

8.b.

Provide your most recent address outside the United States 

where you lived for more than one year (if not already listed 

above).

9.c. City or Town

9.f.

9.h.

Province

Country 

9.g. Postal Code 

9.d. State 9.e. ZIP Code

Street Number 

and Name

9.a.

9.b. Apt. Ste. Flr.

Dates of Residence 

From (mm/dd/yyyy)

To (mm/dd/yyyy)

10.a.

10.b.

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.

Name of Employer or Company

Employer 1 (current or most recent)

Employment History

11.

Address of Employer or Company

12.c. City or Town

12.f.

12.h.

Province

Country 

12.g. Postal Code 

12.d. State 12.e. ZIP Code

Street Number 

and Name

12.a.

12.b. Apt. Ste. Flr.

13. Your Occupation
Form I-485 Edition 04/01/24 Page 6 of 20

A-Number► APart 3. Additional Information About You 

(continued)

Dates of Employment 

From (mm/dd/yyyy)

To (mm/dd/yyyy)

14.a.

14.b.

15. Name of Employer or Company

Employer 2 

16.c. City or Town

16.f.

16.h.

Province

Country 

16.g. Postal Code 

16.d. State 16.e. ZIP Code

Street Number 

and Name

16.a.

16.b. Apt. Ste. Flr.

Address of Employer or Company

17. Your Occupation

Dates of Employment 

From (mm/dd/yyyy)

To (mm/dd/yyyy)

18.a.

18.b.

Provide your most recent employment outside of the United 

States (if not already listed above).

19. Name of Employer or Company

20.c. City or Town

20.f.

20.h.

Province

Country 

20.g. Postal Code 

20.d. State 20.e. ZIP Code

Street Number 

and Name

20.a.

20.b. Apt. Ste. Flr.

Address of Employer or Company

21. Your Occupation

Dates of Employment 

From (mm/dd/yyyy)

To (mm/dd/yyyy)

22.a.

22.b.

Part 4. Information About Your Parents

Parent 1's Legal Name

Information About Your Parent 1 

1.b. 

1.c.

1.a. Family Name 

(Last Name)

Given Name 

(First Name)

Middle Name

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

2.b. 

2.c.

2.a. Family Name 

(Last Name)

Given Name 

(First Name)

Middle Name

3. Date of Birth (mm/dd/yyyy)

4. Sex Male Female

5. City or Town of Birth 

6. Country of Birth
Form I-485 Edition 04/01/24 Page 7 of 20

A-Number ► A8. Current Country of Residence (if living)

7. Current City or Town of Residence (if living)

Information About Your Parent 2 

Parent 2's Legal Name

9.b. 

9.c.

9.a. Family Name 

(Last Name)

Given Name 

(First Name)

Middle Name

City or Town of Birth 

11. Date of Birth (mm/dd/yyyy)

13.

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

10.b. 

10.c.

10.a. Family Name 

(Last Name)

Given Name 

(First Name)

Middle Name

16. Current Country of Residence (if living)

15. Current City or Town of Residence (if living)

14. Country of Birth

12. Sex Male Female

Part 4. Information About Your Parents 

(continued)

Part 5. Information About Your Marital History

1. What is your current marital status?

Single, Never Married Divorced

Widowed

Married

Marriage Annulled 

Legally Separated

If you are married, is your spouse a current member of the 

U.S. armed forces or U.S. Coast Guard?

2.

N/A Yes No

How many times have you been married (including 

annulled marriages and marriages to the same person)?

3.

If you are currently married, provide the following information 

about your current spouse.

Information About Your Current Marriage 

(including if you are legally separated)

4.b. 

4.c.

4.a. Family Name 

(Last Name)

Given Name 

(First Name)

Middle Name

Current Spouse's Legal Name

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

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

A-Number (if any)

► A5.

Current Spouse's Place of Birth

8.c. Country

8.b. State or Province

8.a. City or Town

Place of Marriage to Current Spouse

9.c. Country

9.b. State or Province

9.a. City or Town

10. Is your current spouse applying with you?

Yes No
Form I-485 Edition 04/01/24 Page 8 of 20

A-Number ► APrior Spouse's Legal Name (provide family name before 

marriage)

11.b. 

11.c.

11.a. Family Name 

(Last Name)

Given Name 

(First Name)

Middle Name

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.

Information About Prior Marriages (if any)

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

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

Place of Marriage to Prior Spouse

14.c. Country

14.b. State or Province

14.a. City or Town

15. Date Marriage with Prior Spouse Legally Ended 

(mm/dd/yyyy)

Part 5. Information About Your Marital History

(continued)

Place Where Marriage with Prior Spouse Legally Ended

16.a. City or Town

16.b. State or Province

16.c. Country

Indicate the total number of ALL living children 

(including adult sons and daughters) that you have. 

1.

Part 6. Information About Your Children

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.

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

2.b. 

2.c.

2.a. Family Name 

(Last Name)

Given Name 

(First Name)

Middle Name

3. A-Number (if any)

4. Date of Birth (mm/dd/yyyy)

5. Country of Birth

6. Is this child applying with you? Yes No

► AChild 2

Current Legal Name

7.b. 

7.c.

7.a. Family Name 

(Last Name)

Given Name 

(First Name)

Middle Name

8. A-Number (if any)

9. Date of Birth (mm/dd/yyyy)

10. Country of Birth

11. Is this child applying with you? Yes No

► A-
Form I-485 Edition 04/01/24 Page 9 of 20

A-Number ► AChild 3

Current Legal Name

12.b. 

12.c.

12.a. Family Name 

(Last Name)

Given Name 

(First Name)

Middle Name

13. A-Number (if any)

14. Date of Birth (mm/dd/yyyy)

15. Country of Birth

16. Is this child applying with you? Yes No

1. Ethnicity (Select only one box)

Part 7. Biographic Information

2. Race (Select all applicable boxes)

Hispanic or Latino

Not Hispanic or Latino

Asian

White

Black or African American

American Indian or Alaska Native

Native Hawaiian or Other Pacific Islander

► APart 6. Information About Your Children

(continued)

Height

4. Weight 

3. Feet Inches

Pounds

5. Eye Color (Select only one box) 

6. Hair Color (Select only one box) 

Black Blue Brown

Gray Green Hazel

Maroon Pink Unknown/Other

Bald (No hair) Black Blond

Brown Gray Red

Sandy White Unknown/Other

Part 8. General Eligibility and Inadmissibility 

Grounds

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 

including any military service? Yes No

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.

Organization 1

2. Name of Organization

3.c. Country

3.b. State or Province

3.a. City or Town

4. Nature of Group

Dates of Membership or Dates of Involvement 

From (mm/dd/yyyy)

To (mm/dd/yyyy)

5.a.

5.b.

Organization 2

6. Name of Organization

7.c. Country

7.b. State or Province

7.a. City or Town

8. Nature of Group
Form I-485 Edition 04/01/24 Page 10 of 20

A-Number ► ADates of Membership or Dates of Involvement

From (mm/dd/yyyy)

To (mm/dd/yyyy)

Organization 3

10. Name of Organization

11.a. City or Town

9.a.

9.b.

11.c. Country

12. Nature of Group

11.b. State or Province

Dates of Membership or Dates of Involvement 

From (mm/dd/yyyy)

To (mm/dd/yyyy)

13.a.

13.b.

Part 8. General Eligibility and Inadmissibility 

Grounds (continued)

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. 

15.

Have you EVER worked in the United States without 

authorization?

16.

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

Have you EVER been denied admission to the United 

States?

14.

Have you EVER violated the terms or conditions of your 

nonimmigrant status?

17.

Yes No

Yes No

Yes No

Yes No

18. Are you presently or have you EVER been in removal, 

exclusion, rescission, or deportation proceedings?

Yes No

20.

Have you EVER held lawful permanent resident status 

which was later rescinded? 

21.

Have you EVER had a prior final order of exclusion, 

deportation, or removal reinstated? Yes No

Yes No

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

Yes No

Have you EVER applied for any kind of relief or 

protection from removal, exclusion, or deportation? 

23.

24.a. Have you EVER been a J nonimmigrant exchange visitor 

who was subject to the two-year foreign residence 

requirement? Yes No

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. 

Have you complied with the foreign residence 

requirement? Yes No

24.b.

Have you EVER been issued a final order of exclusion, 

deportation, or removal?

19.

Yes No

Yes

Have you been granted a waiver or has Department of 

State issued a favorable waiver recommendation letter 

for you? No

24.c.

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).

Criminal Acts and Violations

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

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

26.
Form I-485 Edition 04/01/24 Page 11 of 20

Part 8. General Eligibility and Inadmissibility 

Grounds (continued) 

A-Number ► A27. 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

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 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)?

28.

Yes No

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

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

32. Have you EVER illicitly (illegally) trafficked or benefited 

from the trafficking of any controlled substances, such as 

chemicals, illegal drugs, or narcotics?

33.

Yes No

Have you EVER knowingly aided, abetted, assisted, 

conspired, or colluded in the illicit trafficking of any 

illegal narcotic or other controlled substances?

31.

No

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

34.

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

Yes No

35. Have you EVER engaged in prostitution or are you 

coming to the United States to engage in prostitution?

36. Have you EVER directly or indirectly procured (or 

attempted to procure) or imported prostitutes or persons 

for the purpose of prostitution? Yes No

37.

No

Have you EVER received any proceeds or money from 

prostitution? Yes

38. 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

No

Have you EVER exercised immunity (diplomatic or 

otherwise) to avoid being prosecuted for a criminal 

offense in the United States? Yes

39.

40.

Yes No

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?

42.

43.

No

Yes No

Yes

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.

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?

44.

Yes No

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? 

45.

Yes No

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?
Form I-485 Edition 04/01/24 Page 12 of 20

Part 8. General Eligibility and Inadmissibility 

Grounds (continued)

A-Number ► ASecurity and Related

Do you intend to:

Yes No

46.a. Engage in any activity that violates or evades any law 

relating to espionage (including spying) or sabotage in the 

United States?

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? 

Yes No

46.e. Engage in any other unlawful activity? Yes No

47. 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

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

Have you EVER:

Yes No

Participated in, or been a member of, a group or 

organization that did any of the activities described in 

Item Number 48.a.? 

48.b.

49. Have you EVER received any type of military, 

paramilitary, or weapons training? Yes No

Yes No

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.? 

48.c.

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. Do you intend to engage in any of the activities listed in 

any part of Item Numbers 48.a. - 49.? Yes No

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

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. 

Yes No

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? 

51.a.

Are you the spouse or child of an individual who EVER: 

Yes No

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.? 

51.b.

Yes No

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.? 

51.c.

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.d.

Yes No

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.? 

51.e.

Yes No

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.? 

51.f.

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 No
Form I-485 Edition 04/01/24 Page 13 of 20

Part 8. General Eligibility and Inadmissibility 

Grounds (continued)

A-Number ► AYes No

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?

53.

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?

Yes No

Yes No

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?

55.

Yes No

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)?

56.

57. 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

Yes No

60. 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?

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.

58.e. Limiting or denying any person's ability to exercise 

religious beliefs? 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

58.c. Intentionally and severely injuring any person?

Yes No

Yes No

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?

58.d.

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

Public Charge

62. What is the size of your household? 

61. Are you subject to the public charge ground of 

inadmissibility under INA section 212(a)(4)?

Yes No

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.

63. Indicate your annual household income.

$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

$321,401-707,100

Over $707,100
Form I-485 Edition 04/01/24 Page 14 of 20

A-Number ► APart 8. General Eligibility and Inadmissibility Grounds (continued)

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

66.

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

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

$0 $1-10,100 $10,101-57,700 $57,701-186,800 Over $186,800

Grades 1 through 11 12th grade - no diploma High school diploma, GED, or alternative credential

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

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

Bachelor's degree

Master's degree Professional degree (JD, MD, DMD, etc.) Doctorate degree

68.b. Have you ever received long-term institutionalization at government expense? Yes No

68.c.

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 Date From Date To Reason

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
Form I-485 Edition 04/01/24 Page 15 of 20

A-Number ► A78.a. For more than 180 days but less than a year, and then 

departed the United States? No

Since April 1, 1997, have you been unlawfully present in the 

United States:

Yes

Yes No

78.b. For one year or more and then departed the United States? 

Removal, Unlawful Presence, or Illegal Reentry 

After Previous Immigration Violations

Yes No

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?

76.

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.

Having been unlawfully present in the United States for 

more than one year in the aggregate? 

79.a.

Yes No

Having been deported, excluded, or removed from the 

United States?

79.b.

Yes No

Since April 1, 1997, have you EVER reentered or attempted to 

reenter the United States without being inspected and admitted 

or paroled after:

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)?

Miscellaneous Conduct

80. Do you plan to practice polygamy in the United States?

Yes No

Yes No

81.

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

Yes No

Have you EVER voted in violation of any Federal, state, 

or local constitutional provision, statute, ordinance, or 

regulation in the United States?

83.

84. Have you EVER renounced U.S. citizenship to avoid 

being taxed by the United States?

Yes No

Yes No

Are you under a final order of civil penalty for violating 

INA section 274C for use of fraudulent documents?

75.

Have you EVER falsely claimed to be a U.S. citizen (in 

writing or any other way)?

Yes No

Have you EVER been a stowaway on a vessel or aircraft 

arriving in the United States?

73.

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

72.

Yes No

Illegal Entries and Other Immigration Violations

No

Yes No

Yes

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?

69.a.

69.b. If your answer to Item Number 69.a. is "Yes," do you 

believe you had reasonable cause?

If your answer to Item Number 69.b. is "Yes," attach a 

written statement explaining why you had reasonable 

cause.

69.c.

70. 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

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?

71.

77. Have you EVER entered the United States without being 

inspected and admitted or paroled? Yes No

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

Have you EVER:

Part 8. General Eligibility and Inadmissibility 

Grounds (continued)
Form I-485 Edition 04/01/24 Page 16 of 20

Part 8. General Eligibility and Inadmissibility 

Grounds (continued)

A-Number ► A85.b. Been relieved or discharged from such training or service 

on the ground that you are a foreign national?

Yes No

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

Yes No

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)?

86.b.

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

Part 9. Accommodations for Individuals With 

Disabilities and/or Impairments

2.a. 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).):

NOTE: Read the information in the Form I-485 Instructions 

before completing this part.

Are you requesting an accommodation because of your 

disabilities and/or impairments? Yes No

1.

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 blind or have low vision and request the 

following accommodation:

2.b.

I have another type of disability and/or impairment. 

(Describe the nature of your disability and/or 

impairment and the accommodation you are 

requesting.)

2.c.

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.

The interpreter named in Part 11. read to me every 

question and instruction on this application and my 

answer to every question in 

1.b.

a language in which I am fluent, and I understood 

everything. 

,

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.a.

NOTE: Select the box for either Item Number 1.a. or 1.b. If 

applicable, select the box for Item Number 2. 

Applicant's Statement

2. At my request, the preparer named in Part 12.,

prepared this application for me based only upon 

information I provided or authorized.

,

3. Applicant's Daytime Telephone Number

Applicant's Contact Information

4. Applicant's Mobile Telephone Number (if any)

5. Applicant's Email Address (if any)
Form I-485 Edition 04/01/24 Page 17 of 20

A-Number ► AApplicant's Declaration and Certification

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.

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.

Part 10. Applicant's Statement, Contact 

Information, Declaration, Certification, and 

Signature (continued)

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.

Applicant's Signature

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

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

2. Interpreter's Business or Organization Name (if any)

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

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

Interpreter's Full Name

Part 11. Interpreter's Contact Information, 

Certification, and Signature 

Provide the following information about the interpreter.

Interpreter's Mailing Address

3.c. City or Town

3.d. State 3.e. ZIP Code

3.f.

Postal Code

Street Number 

and Name

3.a.

3.b. Apt. Ste. Flr.

3.g.

3.h. Country 

Province

Interpreter's Contact Information

4. Interpreter's Daytime Telephone Number

6. Interpreter's Email Address (if any)

5. Interpreter's Mobile Telephone Number (if any)
Form I-485 Edition 04/01/24 Page 18 of 20

A-Number ► AInterpreter's Certification

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.

I certify, under penalty of perjury, that:

,

Interpreter's Signature

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

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

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

2. Preparer's Business or Organization Name (if any)

Preparer's Full Name

Provide the following information about the preparer.

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

Part 12. Contact Information, Declaration, and 

Signature of the Person Preparing this 

Application, if Other Than the Applicant

Preparer's Mailing Address

3.c. City or Town

3.d. State 3.e. ZIP Code

3.f.

Postal Code

Street Number 

and Name

3.a.

3.b. Apt. Ste. Flr.

3.g.

3.h. Country 

Province

Part 11. Interpreter's Contact Information 

Certification, and Signature (continued)

Preparer's Contact Information

5. Preparer's Mobile Telephone Number (if any)

4. Preparer's Daytime Telephone Number

6. Preparer's Email Address (if any)

Preparer's Statement

I am not an attorney or accredited representative 

but have prepared this application on behalf of 

the applicant and with the applicant's consent.

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. 

I am an attorney or accredited representative and 

my representation of the applicant in this case 

extends does not extend beyond the 

7.a.

7.b.

preparation of this application.
Form I-485 Edition 04/01/24 Page 19 of 20

A-Number ► APart 12. Contact Information, Declaration, and 

Signature of the Person Preparing this 

Application, if Other Than the Applicant 

(continued)

Preparer's Signature

8.a. Preparer'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. 

Preparer's Certification

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.

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 

Subscribed to and sworn to (affirmed) before me

USCIS Officer's Printed Name or Stamp

Applicant's Signature (sign in ink)

Date of Signature (mm/dd/yyyy)

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

corrections made to this application, numbered

through , are complete, true, and correct. All 

true, and correct. All documents submitted at this interview 

were provided by me and are complete, true, and correct.

numbered pages through are complete,
Form I-485 Edition 04/01/24 Page 20 of 20

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.

A-Number (if any) ►A3.a.

2.

Page Number 3.b. Part Number 3.c. Item Number

3.d.

Page Number Part Number Item Number

5.a. Page Number Part Number Item Number

Page Number

5.b.

Part Number

5.c.

Item Number

5.d.

Page Number Part Number Item Number

1.b. 

1.c.

1.a. Family Name 

(Last Name) 

Given Name 

(First Name) 

Middle Name

4.b. 4.c.

4.d.

4.a.

6.d.

6.a. 6.b. 6.c.

7.a. 7.b. 7.c.

7.d.

A-Number ► A-