Form I-751, Petition to Remove Conditions on Residence Instructions

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This form contains 330 fields organized into 80 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
A-Number
A-Number Text
Provide your A-Number, if applicable.
Max length: 9 characters
Acknowledgement of Appointment at USCIS Application Support Center
Acknowledging Person's Name Text
Enter the full name of the person acknowledging the USCIS Application Support Center appointment details.
Additional Information
Item 21 No Checkbox
Check this box if your current marriage is not different from the one through which you gained conditional resident status.
Item 21 Yes Checkbox
Check this box if your current marriage is different from the one through which you gained conditional resident status.
Item 22 No Checkbox
Check this box if you have not resided at any other address since you became a permanent resident.
Item 22 Yes Checkbox
Check this box if you have resided at any other address since you became a permanent resident.
Item 23 Yes Checkbox
Check this box if your spouse or parent's spouse is currently serving with or employed by the U.S. Government and serving outside the United States.
Item 23 No Checkbox
Check this box if your spouse or parent's spouse is not currently serving with or employed by the U.S. Government and serving outside the United States.
Arrest History Status
Arrest History Status Yes Checkbox
Check this box if you have ever been arrested, detained, charged, indicted, fined, or imprisoned for breaking or violating any law or ordinance (excluding traffic regulations), or committed any crime which you were not arrested in the United States or abroad.
Arrest History Status No Checkbox
Check this box if you have never been arrested, detained, charged, indicted, fined, or imprisoned for breaking or violating any law or ordinance (excluding traffic regulations), or committed any crime which you were not arrested in the United States or abroad.
Attorney/Accredited Representative Information
PDF417BarCode1 Text
Form G-28 Attached Checkbox
Check this box if Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative, is attached to this petition.
Attorney State Bar Number Text
Provide the attorney's state bar number, if applicable.
Max length: 15 characters
Attorney/Accredited Representative USCIS Online Account Number Text
Provide the attorney or accredited representative's USCIS online account number, if any.
Max length: 12 characters
Blind or Low Vision Accommodation Request
4.b. I am blind or have low vision Checkbox
Check this box if you are blind or have low vision and are requesting an accommodation.
Blind or Low Vision Accommodation Request Text
Please describe the accommodation you are requesting due to blindness or low vision.
Child 1 Applying With You
Child 1 Applying With You - Yes Checkbox
Check this box if the first child listed is applying with you.
Child 1 Applying With You - No Checkbox
Check this box if the first child listed is not applying with you.
Child 1 Living With You
Child 1 Living With You No Checkbox
Check this box if Child 1 is not currently living with you.
Child 1 Living With You Yes Checkbox
Check this box if Child 1 is currently living with you.
Child 1 Personal Information
Child 1 Given Name Text
Enter the first child's given name or first name.
Child 1 Family Name Text
Enter the first child's family name or last name.
Child 1 Middle Name Text
Enter the first child's middle name.
Child 1 Date of Birth Date
Enter the first child's date of birth.
Child 1 A-Number Text
Enter the first child's Alien Registration Number (A-Number) if applicable.
Max length: 9 characters
Child 2 Application Status
Child 2 Applying: No Checkbox
Check this box if Child 2 is not applying with you.
Child 2 Applying: Yes Checkbox
Check this box if Child 2 is applying with you.
Child 2 Living Arrangement
Child 2 Is Living With You (Yes) Checkbox
Check this box if Child 2 is currently living with you.
Child 2 Is Not Living With You (No) Checkbox
Check this box if Child 2 is not currently living with you.
Child 2 Personal Information
Child 2 Given Name (First Name) Text
Enter the first name of Child 2.
Child 2 Family Name (Last Name) Text
Enter the last name of Child 2.
Child 2 Middle Name Text
Enter the middle name of Child 2.
Child 2 Date of Birth Date
Enter the date of birth for Child 2.
Child 2 A-Number Text
Enter the Alien Registration Number (A-Number) for Child 2, if applicable.
Max length: 9 characters
Child 2 Physical Address
Child 4 Street Number and Name Text
Enter the street number and name for Child 4's physical address.
Max length: 34 characters
Child 4 Apartment, Suite, or Floor Number Text
Enter the apartment, suite, or floor number for Child 4's physical address, if applicable.
Max length: 6 characters
Child 4 City or Town Text
Enter the city or town for Child 4's physical address.
Max length: 20 characters
Child 2 Apt. Checkbox
Check this box if the physical address for Child 2 includes an apartment number.
Child 2 Ste. Checkbox
Check this box if the physical address for Child 2 includes a suite number.
Child 2 Flr. Checkbox
Check this box if the physical address for Child 2 includes a floor number.
Child 4 ZIP Code Text
Enter the ZIP code for Child 4's physical address.
Max length: 5 characters
Child 4 State Combobox
Enter the state for Child 4's physical address.
AS LA NH IN GU IA AL CO MP WY OR OK FL VA AR AZ TN AP VI DC MA KS OH IL DE ND AA NM NV WV PA PR CA CT MD WI UT SC KY MI NC MO ME HI WA FM GA AK MN AE SD TX NY MT NJ RI ID PW MS NE VT MH
Child 4 Postal Code Text
Enter the postal code for Child 4's physical address.
Max length: 9 characters
Child 4 Country Text
Enter the country for Child 4's physical address.
Child 4 Province Text
Enter the province for Child 4's physical address.
Max length: 20 characters
Child 3 Application Status
Child 3 Applying: No Checkbox
Check this box if Child 3 is not applying with you.
Child 3 Applying: Yes Checkbox
Check this box if Child 3 is applying with you.
Child 3 Living Arrangement
Child 3 Living Arrangement Yes Checkbox
Check this box if Child 3 is currently living with you.
Child 3 Living Arrangement No Checkbox
Check this box if Child 3 is not currently living with you.
Child 3 Personal Information
Child 3 Given Name Text
Enter the child's given name (first name).
Child 3 Family Name Text
Enter the child's family name (last name).
Child 3 Middle Name Text
Enter the child's middle name.
Child 3 Date of Birth Date
Enter the child's date of birth.
Child 3 A-Number Text
Enter the child's A-Number, if applicable.
Max length: 9 characters
Child 3 Physical Address
Child 3 Street Number and Name Text
Enter the street number and name for Child 3's physical address.
Max length: 34 characters
Child 3 Apartment/Suite/Floor Number Text
Enter the apartment, suite, or floor number for Child 3's physical address, if applicable.
Max length: 6 characters
Child 3 City or Town Text
Enter the city or town for Child 3's physical address.
Max length: 20 characters
Child 3 Apt. Checkbox
Check this box if the child's physical address includes an apartment number.
Child 3 Ste. Checkbox
Check this box if the child's physical address includes a suite number.
Child 3 Flr. Checkbox
Check this box if the child's physical address includes a floor number.
Child 3 ZIP Code Text
Enter the ZIP code for Child 3's physical address.
Max length: 5 characters
Child 3 State Combobox
Enter the state for Child 3's physical address.
AS LA NH IN GU IA AL CO MP WY OR OK FL VA AR AZ TN AP VI DC MA KS OH IL DE ND AA NM NV WV PA PR CA CT MD WI UT SC KY MI NC MO ME HI WA FM GA AK MN AE SD TX NY MT NJ RI ID PW MS NE VT MH
Child 3 Postal Code Text
Enter the postal code for Child 3's physical address.
Max length: 9 characters
Child 3 Country Text
Enter the country for Child 3's physical address.
Child 3 Province Text
Enter the province for Child 3's physical address.
Max length: 20 characters
Child 4 Application Status
Child 4 Applying With You: No Checkbox
Check this box if Child 4 is not applying with you.
Child 4 Applying With You: Yes Checkbox
Check this box if Child 4 is applying with you.
Child 4 Living Arrangement
Child 4 Is Living With You - Yes Checkbox
Check this box if Child 4 is currently living with you.
Child 4 Is Living With You - No Checkbox
Check this box if Child 4 is not currently living with you.
Child 4 Personal Information
Child 4 Given Name Text
Enter the first name of Child 4.
Child 4 Family Name Text
Enter the last name of Child 4.
Child 4 Middle Name Text
Enter the middle name of Child 4.
Child 4 Date of Birth Date
Enter the date of birth for Child 4.
Child 4 A-Number Text
Enter the A-Number for Child 4, if applicable.
Max length: 9 characters
Child 5 Information
Child 5 Given Name Text
Provide the given name (first name) of the fifth child.
Child 5 Family Name Text
Provide the family name (last name) of the fifth child.
Child 5 Middle Name Text
Provide the middle name of the fifth child.
Child 5 Date of Birth Date
Provide the date of birth for the fifth child.
Child 5 A-Number Text
Provide the A-Number for the fifth child, if any.
Max length: 9 characters
Child 5 Living with You - Yes Checkbox
Check this box if Child 5 is currently living with you.
Child 5 Applying with You - No Checkbox
Check this box if Child 5 is not applying with you.
Child 5 Applying with You - Yes Checkbox
Check this box if Child 5 is applying with you.
Child 5 Living with You - No Checkbox
Check this box if Child 5 is not currently living with you.
Child 5 Physical Address
Child 5 Street Number and Name Text
Enter the street number and name of Child 5's physical address.
Max length: 34 characters
Child 5 Apartment, Suite, or Floor Text
Enter the apartment, suite, or floor number for Child 5's physical address.
Max length: 6 characters
Child 5 City or Town Text
Enter the city or town of Child 5's physical address.
Max length: 20 characters
Child 5 Physical Address Apartment Checkbox
Check this box if Child 5's physical address includes an apartment number.
Child 5 Physical Address Suite Checkbox
Check this box if Child 5's physical address includes a suite number.
Child 5 Physical Address Floor Checkbox
Check this box if Child 5's physical address includes a floor number.
Child 5 ZIP Code Text
Enter the ZIP code for Child 5's physical address.
Max length: 5 characters
Child 5 State Combobox
Enter the state for Child 5's physical address.
AS LA NH IN GU IA AL CO MP WY OR OK FL VA AR AZ TN AP VI DC MA KS OH IL DE ND AA NM NV WV PA PR CA CT MD WI UT SC KY MI NC MO ME HI WA FM GA AK MN AE SD TX NY MT NJ RI ID PW MS NE VT MH
Child 5 Postal Code Text
Enter the postal code for Child 5's physical address.
Max length: 9 characters
Child 5 Country Text
Enter the country for Child 5's physical address.
Child 5 Province Text
Enter the province for Child 5's physical address.
Max length: 20 characters
Child's Physical Address (continued)
Child's Street Number and Name Text
Provide the child's street number and full street name for their physical address.
Max length: 34 characters
Child's Apt/Ste/Flr Number Text
Provide the child's apartment, suite, or floor number for their physical address.
Max length: 6 characters
Child's City or Town Text
Provide the child's city or town for their physical address.
Max length: 20 characters
Part 5. Information About Your Children. Child 4. Physical Address. 24. B. Select Apartment CheckBox
Part 5. Information About Your Children. Child 4. Physical Address. 24. B. Select Suite CheckBox
Part 5. Information About Your Children. Child 4. Physical Address. 24. B. Select Floor CheckBox
Child's ZIP Code Text
Provide the child's ZIP Code for their physical address.
Max length: 5 characters
Child's State Combobox
Provide the child's state for their physical address.
AS LA NH IN GU IA AL CO MP WY OR OK FL VA AR AZ TN AP VI DC MA KS OH IL DE ND AA NM NV WV PA PR CA CT MD WI UT SC KY MI NC MO ME HI WA FM GA AK MN AE SD TX NY MT NJ RI ID PW MS NE VT MH
Child's Postal Code Text
Provide the child's postal code for their physical address.
Max length: 9 characters
Child's Country Text
Provide the child's country for their physical address.
Child's Province Text
Provide the child's province for their physical address.
Max length: 20 characters
Children's Disability Accommodation Request
Children's Disability Request No Checkbox
Check this box if you are not requesting an accommodation because of your included children's disabilities and/or impairments.
Children's Disability Request Yes Checkbox
Check this box if you are requesting an accommodation because of your included children's disabilities and/or impairments.
Conditional Residence Expiration Date
Conditional Residence Expiration Date Date
Enter the date on which your conditional residence expires.
Conditional Resident's Full Name
Conditional Resident's 1.a. Family Name Text
Enter the conditional resident's family name (last name).
Conditional Resident's 1.b. Given Name Text
Enter the conditional resident's given name (first name).
Conditional Resident's 1.c. Middle Name Text
Enter the conditional resident's middle name.
Country of Birth
Country of Birth Text
Enter the country where the conditional resident was born.
Country of Citizenship or Nationality
Country of Citizenship or Nationality Text
Enter the country of your citizenship or nationality.
Date of Birth
Date of Birth Date
Provide the applicant's date of birth.
Deaf or Hard of Hearing Accommodation Request
Sign Language Interpreter Language Text
Specify the language for the sign-language interpreter requested for the deaf or hard of hearing accommodation.
4.a. Deaf or Hard of Hearing Accommodation Checkbox
Check this box if you are deaf or hard of hearing and are requesting an accommodation.
Ethnicity
Not Hispanic or Latino Ethnicity Checkbox
Check this box if you do not identify as Hispanic or Latino.
Hispanic or Latino Ethnicity Checkbox
Check this box if you identify as Hispanic or Latino.
Eye Color
Blue Checkbox
Check this box if your eye color is Blue.
Green Checkbox
Check this box if your eye color is Green.
Hazel Checkbox
Check this box if your eye color is Hazel.
Pink Checkbox
Check this box if your eye color is Pink.
Maroon Checkbox
Check this box if your eye color is Maroon.
Brown Checkbox
Check this box if your eye color is Brown.
Black Checkbox
Check this box if your eye color is Black.
Unknown/Other Checkbox
Check this box if your eye color is Unknown or falls into another category not listed.
Gray Checkbox
Check this box if your eye color is Gray.
Fifth Additional Information Entry
Fifth Additional Information Page Number Text
Enter the page number to which this fifth additional information refers.
Max length: 2 characters
Fifth Additional Information Part Number Text
Enter the part number to which this fifth additional information refers.
Max length: 4 characters
Fifth Additional Information Item Number Text
Enter the item number to which this fifth additional information refers.
Max length: 9 characters
Fifth Additional Information Details Text
Provide the detailed additional information for this fifth entry, ensuring to reference the relevant page, part, and item numbers.
First Additional Information Entry
First Additional Information Text Text
Provide the additional information you wish to include, ensuring it is referenced by the corresponding Page Number, Part Number, and Item Number.
First Additional Information Page Number Text
Enter the page number of the form to which this additional information refers.
Max length: 2 characters
First Additional Information Part Number Text
Enter the part number of the form to which this additional information refers.
Max length: 6 characters
First Additional Information Item Number Text
Enter the item number of the form to which this additional information refers.
Max length: 6 characters
First Other Name Used
First Other Name Used - Family Name Text
Please provide the family name (last name) for the first other name used.
First Other Name Used - Given Name Text
Please provide the given name (first name) for the first other name used.
First Other Name Used - Middle Name Text
Please provide the middle name for the first other name used.
Fourth Additional Information Entry
Fourth Page Number Text
Enter the page number to which this fourth additional information entry refers.
Max length: 2 characters
Fourth Part Number Text
Enter the part number to which this fourth additional information entry refers.
Max length: 6 characters
Fourth Item Number Text
Enter the item number to which this fourth additional information entry refers.
Max length: 6 characters
Fourth Additional Information Details Text
Provide the detailed additional information for this fourth entry.
General
Page Number Text
Enter the current page number of the form.
Part 2. Biographic Information. 4. Weight. Pounds. Enter first digit of Weight in Pounds Text
Max length: 1 characters
Part 2. Biographic Information. 4. Weight. Pounds. Enter second digit of Weight in Pounds Text
Max length: 1 characters
Part 2. Biographic Information. 4. Weight. Pounds. Enter third digit of Weight in Pounds Text
Max length: 1 characters
Page Identifier Text
Enter the unique identifier for this page of the form.
Page Number Text
Enter the page number or identifier for this form page.
Page Number Text
Enter the page number.
PDF417BarCode1 Text
Petitioner's Signature Text
Enter the petitioner's signature.
PDF417BarCode1 Text
Page Number Text
Enter the current page number.
PDF417BarCode1 Text
Hair Color
Part 2. Biographic Information. 6. Hair Color(Select only one box). Select Bald (No hair) CheckBox
Blond Checkbox
Check this box if the individual has blond hair.
Gray Checkbox
Check this box if the individual has gray hair.
Sandy Checkbox
Check this box if the individual has sandy-colored hair.
Unknown/Other Checkbox
Check this box if the individual's hair color is unknown or is not listed as an option.
White Checkbox
Check this box if the individual has white hair.
Red Checkbox
Check this box if the individual has red hair.
Brown Checkbox
Check this box if the individual has brown hair.
Black Checkbox
Check this box if the individual has black hair.
Height
Height Feet Combobox
Enter the height in feet.
7 3 6 5 2 8 4
Height Inches Combobox
Enter the height in inches.
7 3 9 4 6 10 1 5 2 8 0 11
Identification Numbers
Alien Registration Number Text
Enter the Alien Registration Number (A-Number) if applicable.
Max length: 9 characters
USCIS Online Account Number Text
Enter your USCIS Online Account Number if you have one.
Max length: 12 characters
U.S. Social Security Number Text
Enter your U.S. Social Security Number if you have one.
Max length: 9 characters
Interpreter Language
Interpreter Language Text
Enter the language in which the interpreter is fluent, other than English.
Max length: 18 characters
Interpreter's Contact Information
Interpreter's Email Address Text
Enter the interpreter's email address, if applicable.
Max length: 10 characters
Interpreter's Daytime Telephone Number Text
Enter the interpreter's daytime telephone number.
Max length: 10 characters
Interpreter's Mailing Address
City or Town Text
Provide the city or town for the interpreter's mailing address.
Max length: 20 characters
Street Number and Name Text
Provide the street number and name for the interpreter's mailing address.
Max length: 34 characters
Apt, Ste, or Flr Text
Provide the apartment, suite, or floor number for the interpreter's mailing address, if applicable.
Max length: 6 characters
Province Text
Provide the province for the interpreter's mailing address, if applicable.
Max length: 20 characters
ZIP Code Text
Provide the ZIP code for the interpreter's mailing address.
Max length: 5 characters
State Combobox
Provide the state for the interpreter's mailing address.
AS LA NH IN GU IA AL CO MP WY OR OK FL VA AR AZ TN AP VI DC MA KS OH IL DE ND AA NM NV WV PA PR CA CT MD WI UT SC KY MI NC MO ME HI WA FM GA AK MN AE SD TX NY MT NJ RI ID PW MS NE VT MH
Country Text
Provide the country for the interpreter's mailing address.
Postal Code Text
Provide the postal code for the interpreter's mailing address, if applicable.
Max length: 9 characters
Apt. Checkbox
Check this box if the interpreter's mailing address includes an apartment number.
Ste. Checkbox
Check this box if the interpreter's mailing address includes a suite number.
Flr. Checkbox
Check this box if the interpreter's mailing address includes a floor number.
Interpreter's Name and Organization
Interpreter's Given Name Text
Please enter the interpreter's given name (first name).
Interpreter's Family Name Text
Please enter the interpreter's family name (last name).
Interpreter's Business or Organization Name Text
Please enter the interpreter's business or organization name, if applicable.
Max length: 34 characters
Interpreter's Signature
Date of Interpreter's Signature Date
Provide the date the interpreter signed the form.
Interpreter's Signature Text
Provide the interpreter's signature.
Max length: 1 characters
Joint Filing Basis
1.a. Joint Filing - My spouse Checkbox
Check this box if you are filing this joint petition with your spouse.
1.b. Joint Filing - My parent's spouse Checkbox
Check this box if you are filing this joint petition with your parent's spouse because you are unable to be included in a joint petition filed by your parent and your parent's spouse.
Mailing Address
In Care Of Name Text
Enter the name of the person or entity in whose care the mail should be delivered.
Max length: 34 characters
City or Town Text
Enter the city or town of your mailing address.
Max length: 20 characters
Street Number and Name Text
Enter the street number and name of your mailing address.
Max length: 34 characters
Apt/Ste/Flr Number Text
Enter the apartment, suite, or floor number for your mailing address.
Max length: 6 characters
Part 1. Information About You, the Conditional Resident. Mailing Address. 15. C. Select Apartment CheckBox
ZIP Code Text
Enter the five-digit or nine-digit ZIP Code for your mailing address.
Max length: 5 characters
State Combobox
Enter the state for your mailing address.
AS LA NH IN GU IA AL CO MP WY OR OK FL VA AR AZ TN AP VI DC MA KS OH IL DE ND AA NM NV WV PA PR CA CT MD WI UT SC KY MI NC MO ME HI WA FM GA AK MN AE SD TX NY MT NJ RI ID PW MS NE VT MH
Part 1. Information About You, the Conditional Resident. Mailing Address. 15. C. Select Suite CheckBox
Part 1. Information About You, the Conditional Resident. Mailing Address. 15. C. Select Floor CheckBox
Marital Status
Married Checkbox
Check this box if you are currently married.
Widowed Checkbox
Check this box if you are currently widowed.
Part 1. Information About You, the Conditional Resident. Marital Status. 10. Marital Status. Select Single CheckBox
Divorced Checkbox
Check this box if you are currently divorced.
Marriage End Date
Marriage End Date Date
Enter the date the marriage ended, either due to divorce or the death of a spouse.
Marriage Information
Date of Marriage Date
Enter the date of your marriage.
Place of Marriage Text
Enter the city, state, and country where your marriage took place.
Other Disability Accommodation Request
Other Disability Accommodation Request Text
Provide details about the nature of your disability or impairment and the specific accommodation you are requesting.
Another Type of Disability Checkbox
Check this box if you have a disability or impairment that is not deafness/hard of hearing or blindness/low vision, and you are requesting an accommodation for it.
Other Information
Given Name Text
Provide your given name, also known as your first name.
Family Name Text
Provide your family name, also known as your last name.
Middle Name Text
Provide your middle name.
Date of Birth Date
Enter your date of birth.
U.S. Social Security Number Text
Enter your U.S. Social Security Number if you have one.
Max length: 9 characters
A-Number Text
Enter your A-Number if you have one.
Max length: 9 characters
Page 10
PDF417BarCode1 Text
Part 10. Contact Information, Statement, Certification, and Signature of the Person Preparing this Petition, If Other Than the Petitioner. Preparer's Signature. 8. A. Preparer's Signature. No Entry. Print and Sign completed form Text
Max length: 1 characters
Part 10. Contact Information, Statement, Certification, and Signature of the Person Preparing this Petition, If Other Than the Petitioner. Preparer's Signature. 8. B. Enter Date of Signature. Enter as 2 digit Month, 2 digit Day, and 4 digit Year Text
Personal Disability Accommodation Request
Personal Disability Accommodation Request - No Checkbox
Check this box if you are NOT requesting an accommodation because of your own disabilities and/or impairments.
Personal Disability Accommodation Request - Yes Checkbox
Check this box if you are requesting an accommodation because of your own disabilities and/or impairments.
Petition Fee Payment Status
Petition Fee Paid No Checkbox
Check this box if no fee was paid to anyone other than an attorney in connection with this petition.
Petition Fee Paid Yes Checkbox
Check this box if a fee was paid to anyone other than an attorney in connection with this petition.
Petitioner's Contact Information
Petitioner's Email Address Text
Provide the petitioner's email address, if applicable.
Max length: 38 characters
Petitioner's Daytime Telephone Number Text
Provide the petitioner's daytime telephone number.
Max length: 10 characters
Petitioner's Mobile Telephone Number Text
Provide the petitioner's mobile telephone number, if applicable.
Max length: 10 characters
Petitioner's Signature
6.b. Date of Signature Date
Enter the date the petitioner signed.
6.a. Petitioner's Signature Text
Enter the petitioner's signature.
Petitioner's Statement
1.a. English Proficient Checkbox
Check this box if you can read and understand English, and have reviewed all petition questions, instructions, your answers, and the Acknowledgement of Appointment at USCIS Application Support Center.
1.b. Interpreter Used Checkbox
Check this box if an interpreter named in Part 9 has read and translated all petition questions, instructions, your answers, and the Acknowledgement of Appointment at USCIS Application Support Center to you in a language you are fluent in.
1.b. Interpreter Language Text
Enter the language in which the interpreter read the petition and provided responses.
2. Requested Preparer Services Checkbox
Check this box if you have requested and consented to the services of the person who assisted you in preparing this petition.
2. Preparer's Name Text
Provide the name of the person who assisted in preparing the petition.
2. Preparer Is Attorney or Representative Checkbox
Check this box if the person assisting you with this petition IS an attorney or accredited representative.
2. Preparer Is Not Attorney or Representative Checkbox
Check this box if the person assisting you with this petition IS NOT an attorney or accredited representative.
Physical Address
Part 1. Information About You, the Conditional Resident. Physical Address. 17. A. Enter In Care Of Name Text
Max length: 34 characters
Physical Address City or Town Text
Enter the city or town of your physical address.
Max length: 20 characters
Physical Address Street Number and Name Text
Provide the street number and name of your physical address.
Max length: 34 characters
Physical Address Floor Text
Enter the floor number or designation for your physical address, if applicable.
Max length: 6 characters
Physical Address ZIP Code Text
Enter the ZIP code for your physical address.
Max length: 5 characters
Physical Address State Combobox
Enter the state of your physical address.
AS LA NH IN GU IA AL CO MP WY OR OK FL VA AR AZ TN AP VI DC MA KS OH IL DE ND AA NM NV WV PA PR CA CT MD WI UT SC KY MI NC MO ME HI WA FM GA AK MN AE SD TX NY MT NJ RI ID PW MS NE VT MH
Physical Address Apt. Checkbox
Check this box if the physical address includes an apartment number.
Physical Address Ste. Checkbox
Check this box if the physical address includes a suite number.
Physical Address Flr. Checkbox
Check this box if the physical address includes a floor number.
City or Town Text
Provide the city or town of the physical address.
Max length: 20 characters
Street Number and Name Text
Provide the street number and name of the physical address.
Max length: 34 characters
Apartment, Suite, or Floor Number Text
Provide the apartment, suite, or floor number of the physical address, if applicable.
Max length: 6 characters
ZIP Code Text
Provide the ZIP code of the physical address.
Max length: 5 characters
State Combobox
Provide the state of the physical address.
AS LA NH IN GU IA AL CO MP WY OR OK FL VA AR AZ TN AP VI DC MA KS OH IL DE ND AA NM NV WV PA PR CA CT MD WI UT SC KY MI NC MO ME HI WA FM GA AK MN AE SD TX NY MT NJ RI ID PW MS NE VT MH
Postal Code Text
Provide the postal code of the physical address, if applicable.
Max length: 9 characters
Country Text
Provide the country of the physical address.
Part 4. Information About the U.S. Citizen or Lawful Permanent Resident Spouse. If Filing as a Child Separately, Information About the U.S. Citizen or Lawful Permanent Resident Stepparent Through Whom You Gained Your Conditional Residence. Physical Address. 6. B. Select Apartment CheckBox
Part 4. Information About the U.S. Citizen or Lawful Permanent Resident Spouse. If Filing as a Child Separately, Information About the U.S. Citizen or Lawful Permanent Resident Stepparent Through Whom You Gained Your Conditional Residence. Physical Address. 6. B. Select Suite CheckBox
Part 4. Information About the U.S. Citizen or Lawful Permanent Resident Spouse. If Filing as a Child Separately, Information About the U.S. Citizen or Lawful Permanent Resident Stepparent Through Whom You Gained Your Conditional Residence. Physical Address. 6. B. Select Floor CheckBox
Province Text
Provide the province of the physical address, if applicable.
Max length: 20 characters
Street Number and Name Text
Provide the street number and name of the physical address.
Max length: 34 characters
Apt, Suite, or Floor Text
Enter the apartment, suite, or floor number, if applicable, for the physical address.
Max length: 6 characters
City or Town Text
Provide the city or town of the physical address.
Max length: 20 characters
Part 5. Information About Your Children. Child 1. Physical Address. 6. B. Select Apartment CheckBox
Part 5. Information About Your Children. Child 1. Physical Address. 6. B. Select Suite CheckBox
Part 5. Information About Your Children. Child 1. Physical Address. 6. B. Select Floor CheckBox
ZIP Code Text
Enter the ZIP code of the physical address.
Max length: 5 characters
State Combobox
Provide the state of the physical address.
AS LA NH IN GU IA AL CO MP WY OR OK FL VA AR AZ TN AP VI DC MA KS OH IL DE ND AA NM NV WV PA PR CA CT MD WI UT SC KY MI NC MO ME HI WA FM GA AK MN AE SD TX NY MT NJ RI ID PW MS NE VT MH
Postal Code Text
Enter the postal code of the physical address.
Max length: 9 characters
Country Text
Provide the country of the physical address.
Province Text
Provide the province of the physical address.
Max length: 20 characters
Physical Address Different From Mailing Address
No Checkbox
Check this box if your physical address is the same as your mailing address.
Yes Checkbox
Check this box if your physical address is different from your mailing address.
Preparer Information
Part 8. Spouse's or Individual Listed in Part 4.'s Statement, Contact Information, Acknowledgement of Appointment U S C I S Application Support Center, Certification, and Signature (if applicable). Spouse's or Individual's Statement. Select 2. I have requested the services of and consented to (name of preparer) who is / is not an attorney or accredited representative, preparing this petition for me. This person who assisted me in preparing my petition has reviewed the Acknowledgement of Appointment at U S C I S Application Support Center with me, and I understand the A. S C Acknowledgement CheckBox
Preparer's Name Text
Enter the full name of the individual who assisted in preparing this petition.
Part 8. Spouse's or Individual Listed in Part 4.'s Statement, Contact Information, Acknowledgement of Appointment U S C I S Application Support Center, Certification, and Signature (if applicable). Spouse's or Individual's Statement. Select 2. I have requested the services of and consented to (name of preparer) who is an attorney or accredited representative, preparing this petition for me CheckBox
Part 8. Spouse's or Individual Listed in Part 4.'s Statement, Contact Information, Acknowledgement of Appointment U S C I S Application Support Center, Certification, and Signature (if applicable). Spouse's or Individual's Statement. Select 2. I have requested the services of and consented to (name of preparer) who is not an attorney or accredited representative, preparing this petition for me CheckBox
Preparer's Business or Organization Name
Preparer's Business or Organization Name Text
Enter the name of the preparer's business or organization, if applicable.
Max length: 34 characters
Preparer's Contact Information
Preparer's Email Address Text
Enter the preparer's email address.
Max length: 38 characters
Preparer's Daytime Telephone Number Text
Enter the preparer's daytime telephone number.
Max length: 10 characters
Preparer's Fax Number Text
Enter the preparer's fax number.
Max length: 10 characters
Preparer's Full Name
Preparer's Family Name Text
Enter the preparer's family name (last name).
Preparer's Given Name Text
Enter the preparer's given name (first name).
Preparer's Mailing Address
Preparer's City or Town Text
Enter the preparer's city or town as part of their mailing address.
Max length: 20 characters
Preparer's Street Number and Name Text
Enter the preparer's street number and name as part of their mailing address.
Max length: 34 characters
Preparer's Apt/Ste/Flr Number Text
Enter the preparer's apartment, suite, or floor number, if applicable.
Max length: 6 characters
Preparer's Province Text
Enter the preparer's province, if applicable.
Max length: 20 characters
Preparer's ZIP Code Text
Enter the preparer's ZIP code.
Max length: 5 characters
Preparer's State Combobox
Enter the preparer's state as part of their mailing address.
AS LA NH IN GU IA AL CO MP WY OR OK FL VA AR AZ TN AP VI DC MA KS OH IL DE ND AA NM NV WV PA PR CA CT MD WI UT SC KY MI NC MO ME HI WA FM GA AK MN AE SD TX NY MT NJ RI ID PW MS NE VT MH
Preparer's Country Text
Enter the preparer's country.
Preparer's Postal Code Text
Enter the preparer's postal code, if applicable.
Max length: 9 characters
Part 10. Contact Information, Statement, Certification, and Signature of the Person Preparing this Petition, If Other Than the Petitioner. Preparer's Mailing Address. 3. B. Select Apartment CheckBox
Part 10. Contact Information, Statement, Certification, and Signature of the Person Preparing this Petition, If Other Than the Petitioner. Preparer's Mailing Address. 3. B. Select Suite CheckBox
Part 10. Contact Information, Statement, Certification, and Signature of the Person Preparing this Petition, If Other Than the Petitioner. Preparer's Mailing Address. 3. B. Select Floor CheckBox
Preparer's Statement
Part 10. Contact Information, Statement, Certification, and Signature of the Person Preparing this Petition, If Other Than the Petitioner. Preparer's Statement. Select 7. A. I am not an attorney or accredited representative but have prepared this petition on behalf of the petitioner and with the petitioner's consent CheckBox
Part 10. Contact Information, Statement, Certification, and Signature of the Person Preparing this Petition, If Other Than the Petitioner. Preparer's Statement. Select 7. B. I am an attorney or accredited representative and my representation of the petitioner in this case extends / does not extend beyond the preparation of this petition CheckBox
Part 10. Contact Information, Statement, Certification, and Signature of the Person Preparing this Petition, If Other Than the Petitioner. Preparer's Statement. Select 7. B. I am an attorney or accredited representative and my representation of the petitioner in this case extends beyond the preparation of this petition. NOTE: If you are an attorney or accredited representative whose representation extends beyond preparation of this petition, you must submit a completed Form G - 28, Notice of Entry of Appearance as Attorney or Accredited Representative, with this petition CheckBox
Part 10. Contact Information, Statement, Certification, and Signature of the Person Preparing this Petition, If Other Than the Petitioner. Preparer's Statement. Select 7. B. I am an attorney or accredited representative and my representation of the petitioner in this case does not extend beyond the preparation of this petition CheckBox
Race
Native Hawaiian or Other Pacific Islander Checkbox
Check this box if the applicant identifies as Native Hawaiian or Other Pacific Islander.
American Indian or Alaska Native Checkbox
Check this box if the applicant identifies as American Indian or Alaska Native.
White Checkbox
Check this box if the applicant identifies as White.
Asian Checkbox
Check this box if the applicant identifies as Asian.
Black or African American Checkbox
Check this box if the applicant identifies as Black or African American.
Relationship to U.S. Citizen or Lawful Permanent Resident Spouse
Parent's Spouse or Former Spouse Checkbox
Check this box if the U.S. Citizen or Lawful Permanent Resident is your parent's current or former spouse.
Spouse or Former Spouse Checkbox
Check this box if the U.S. Citizen or Lawful Permanent Resident is your current or former spouse.
Removal Proceedings Status
Removal Proceedings Status Yes Checkbox
Check this box if you are currently in removal, deportation, or rescission proceedings.
Removal Proceedings Status No Checkbox
Check this box if you are not currently in removal, deportation, or rescission proceedings.
Second Additional Information Entry
Second Additional Information Details Text
Provide any additional information or explanations that pertain to the second additional information entry.
Second Page Number Text
Enter the page number where the additional information for the second entry begins.
Max length: 2 characters
Second Part Number Text
Enter the part number to which the additional information for the second entry refers.
Max length: 4 characters
Second Item Number Text
Enter the item number to which the additional information for the second entry refers.
Max length: 9 characters
Second Other Name Used
Second Other Name Used - Family Name Text
Enter the family name (last name) for the second other name you have used.
Second Other Name Used - Given Name Text
Enter the given name (first name) for the second other name you have used.
Second Other Name Used - Middle Name Text
Enter the middle name for the second other name you have used.
Spouse's Disability Accommodation Request
Spouse's Accommodation - Yes Checkbox
Check this box if you are requesting an accommodation because of your spouse's disabilities and/or impairments.
Spouse's Accommodation - No Checkbox
Check this box if you are not requesting an accommodation because of your spouse's disabilities and/or impairments.
Spouse's or Individual's Contact Information
Email Address Text
Enter the email address for the spouse or individual, if applicable.
Max length: 38 characters
Mobile Telephone Number Text
Enter the mobile telephone number for the spouse or individual, if applicable.
Max length: 10 characters
Daytime Telephone Number Text
Enter the daytime telephone number for the spouse or individual.
Max length: 10 characters
Spouse's or Individual's Signature
Date of Signature Date
Enter the date the spouse or individual signed.
Spouse's or Individual's Signature Text
Provide the signature of the spouse or individual.
Spouse's or Individual's Statement
Spouse/Individual Statement 1.a. English Comprehension Checkbox
Check this box if you can read and understand English, and have read and understood every question, instruction, and the petitioner's answer, as well as the Acknowledgement of Appointment.
Spouse/Individual Statement 1.b. Interpreter Assistance Checkbox
Check this box if the interpreter named in Part 9 read every question, instruction, and the petitioner's answer to you in a language you understand.
1b Interpreter Language Text
Provide the language in which the interpreter communicated the petition details and in which the user is fluent.
Third Additional Information Entry
Third Additional Information Page Number Text
Enter the page number to which the additional information refers.
Max length: 2 characters
Third Additional Information Part Number Text
Enter the part number to which the additional information refers.
Max length: 6 characters
Third Additional Information Item Number Text
Enter the item number to which the additional information refers.
Max length: 6 characters
Third Additional Information Details Text
Provide any additional information that requires extra space within this petition.
USCIS Application Support Center Acknowledgement
Acknowledging Individual's Name Text
Enter the full name of the individual who acknowledges their understanding of the USCIS ASC appointment purpose.
Waiver or Individual Filing Request Reasons
1c. My spouse is deceased Checkbox
Check this box if your spouse is deceased, which prevents you from filing a joint petition.
1d. Marriage terminated by divorce or annulment Checkbox
Check this box if your marriage was entered in good faith but was terminated through divorce or annulment, preventing you from filing a joint petition.
1e. Battered or subject to extreme cruelty by spouse Checkbox
Check this box if you entered the marriage in good faith and, during the marriage, you were battered or subjected to extreme cruelty by your U.S. citizen or lawful permanent resident spouse.
1f. Parent battered or subject to extreme cruelty by spouse Checkbox
Check this box if your parent entered the marriage in good faith and, during the marriage, your parent was battered or subjected to extreme cruelty by their U.S. citizen or lawful permanent resident spouse or by your conditional resident parent.
1g. Termination of status would result in extreme hardship Checkbox
Check this box if the termination of your status and removal from the United States would result in an extreme hardship.
Weight
Weight Pounds Number
Enter the person's weight in pounds.
Max length: 3 characters
Your Full Name
Family Name (Last Name) Text
Provide your family name, also known as your last name.
Given Name (First Name) Text
Provide your given name, also known as your first name.
Middle Name Text
Provide your middle name, if you have one.