This form contains 716 fields organized into 55 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name	Type	Description
Additional Information
Row 3 – Page Number	Text	Enter the page number of the main Form I-485 where the question you are providing extra information for appears. Max length: 2 characters
Row 3 – Part Number	Text	Enter the part number (section) of Form I-485 that contains the question you are elaborating on. Max length: 6 characters
Row 3 – Item Number	Text	Enter the specific item number on Form I-485 that you are giving additional details about. Max length: 6 characters
Row 3 – Additional Information	Text	Provide your detailed explanation or any extra facts related to the Page/Part/Item numbers listed for Row 3.
Row 4 – Page Number	Text	Indicate the page number of Form I-485 connected to the information you are clarifying in Row 4. Max length: 2 characters
Row 4 – Part Number	Text	Specify the part (section) number of Form I-485 that the additional information in Row 4 refers to. Max length: 6 characters
Row 4 – Item Number	Text	Give the exact item number from Form I-485 that needs further explanation in Row 4. Max length: 6 characters
Row 4 – Additional Information	Text	Write your supplemental explanation or details for the question identified in Row 4.
Row 5 – Page Number	Text	Enter the page number in Form I-485 for the question you are expanding upon in Row 5. Max length: 2 characters
Row 5 – Part Number	Text	Enter the part number (section) of Form I-485 relevant to the Row 5 explanation. Max length: 6 characters
Row 5 – Item Number	Text	Indicate the specific item number on Form I-485 that your Row 5 additional information addresses. Max length: 6 characters
Row 5 – Additional Information	Text	Provide any extra facts or context answering the question referenced in Row 5.
Row 6 – Page Number	Text	State the page number of Form I-485 that correlates with the additional information in Row 6. Max length: 2 characters
Row 6 – Part Number	Text	Give the part number (section) of the form for the Row 6 clarification. Max length: 6 characters
Row 6 – Item Number	Text	Identify the item number needing clarification on Form I-485 in Row 6. Max length: 6 characters
Row 6 – Additional Information	Text	Detail your explanation or any extra data for the question listed in Row 6.
Row 7 – Page Number	Text	Enter the corresponding page number from Form I-485 for the Row 7 supplemental information. Max length: 2 characters
Row 7 – Part Number	Text	Provide the part number (section) that the Row 7 explanation refers to. Max length: 6 characters
Row 7 – Item Number	Text	Specify the exact item number on Form I-485 that you are addressing in Row 7. Max length: 6 characters
Row 7 – Additional Information	Text	Enter your detailed explanation or extra facts for the question cited in Row 7.
Additional Information About You
No	CheckBox	Check this box if you have never applied for an immigrant visa to obtain permanent resident status at a U.S. Embassy or U.S. Consulate abroad.
Have you ever applied for an immigrant visa to obtain permanent resident status at a U.S. Embassy or U.S. Consulate abroad? – Yes	CheckBox	Check this box if you have previously applied for an immigrant visa to obtain U.S. permanent resident status at a U.S. Embassy or Consulate abroad.
City of U.S. Embassy or Consulate	Text	If you previously applied for an immigrant visa abroad, enter the city where the U.S. Embassy or Consulate was located. Max length: 20 characters
Country of U.S. Embassy or Consulate	Text	Indicate the country in which the listed Embassy or Consulate is situated.
Date of Decision on Prior Immigrant Visa Application	Text	Provide the date the decision listed above was made, using MM/DD/YYYY format.
Decision on Prior Immigrant Visa Application	Text	State the outcome of the prior immigrant visa application, such as “approved,” “refused,” “denied,” or “withdrawn.”
Address History
Physical Address 1 – Street Number and Name	Text	Enter the street number and full street name of your current physical (residential) address. Max length: 25 characters
Flr.	CheckBox	Check this box if your current address includes a floor designation and you will provide the floor number in the adjacent field.
Apt.	CheckBox	Check this box if your current physical address is in an apartment and then enter the apartment number in the adjoining field.
Physical Address 1 – Apartment/Suite/Floor Number	Text	If your current address includes an apartment, suite, or floor, enter that number or designation here; otherwise leave this field blank. Max length: 6 characters
Ste.	CheckBox	Select this box if your current physical address is identified by a suite number rather than an apartment or floor.
Physical Address 1 – City or Town	Text	Provide the city or town for your current physical address. Max length: 20 characters
Physical Address 1 – Province	Text	If your current address is outside the United States, enter the province, region, or equivalent here. Leave blank for U.S. addresses. Max length: 20 characters
Physical Address 1 – Postal Code	Text	If the address is outside the United States, enter the foreign postal code. Leave blank for U.S. addresses. Max length: 9 characters
Physical Address 1 – ZIP Code	Text	Enter the five-digit (or ZIP+4) postal ZIP code for your current U.S. address. Max length: 5 characters
Physical Address 1 – State	ComboBox	Enter the two-letter U.S. state abbreviation for your current address. If the address is outside the United States, leave this blank. CO GA GU IN FM CA AR NC NH VT ME MT MH MD AK VI AS VA WA WI AA MP WY NM TX PA AL MO TN HI IA OK MI PW DE FL LA KY WV NE SC PR IL NY AE SD MS ND NJ KS OR ID MN UT DC OH NV RI MA CT AZ AP
Physical Address 1 – Country	Text	Write the full name of the country where your current address is located.
Dates of Residence at Physical Address 1 – From	Text	Enter the date (mm/dd/yyyy) you began residing at your current address.
Dates of Residence at Physical Address 1 – To	Text	If you still live at this address, write “Present.” Otherwise, enter the date (mm/dd/yyyy) you stopped living there.
Physical Address 2 – Street Number and Name	Text	Enter the street number and name of the residence you lived at immediately before your current address (within the last five years). Max length: 25 characters
Flr.	CheckBox	Check this box when the secondary address line refers to a floor number (rather than an apartment or suite).
Apt.	CheckBox	Check this box if your secondary physical address is an apartment and enter the apartment number in the adjacent field.
Part 3. Additional Information About You. Address History. Physical Address Two. 7. B. Enter Apartment, Suite or Floor Number	Text	Enter the apartment, suite, or floor number of your physical address. Maximum length is 6 characters. Max length: 6 characters
Ste.	CheckBox	Check this box when the applicant’s physical address includes a suite designation (Ste.).
Physical Address 2 – City or Town	Text	Provide the city or town for Physical Address 2. Max length: 20 characters
Physical Address 2 – Province	Text	If Physical Address 2 is outside the United States, enter the province or region here. Max length: 20 characters
Physical Address 2 – Postal Code	Text	Provide the foreign postal code for Physical Address 2, if applicable. Max length: 9 characters
Physical Address 2 – ZIP Code	Text	Enter the ZIP code for Physical Address 2 if it is in the United States. Max length: 5 characters
Physical Address 2 – State	ComboBox	Enter the two-letter state abbreviation for Physical Address 2 if it is in the United States; leave blank if foreign. CO GA GU IN FM CA AR NC NH VT ME MT MH MD AK VI AS VA WA WI AA MP WY NM TX PA AL MO TN HI IA OK MI PW DE FL LA KY WV NE SC PR IL NY AE SD MS ND NJ KS OR ID MN UT DC OH NV RI MA CT AZ AP
Physical Address 2 – Country	Text	Write the country where Physical Address 2 is located.
Dates of Residence at Physical Address 2 – From	Text	Enter the date (mm/dd/yyyy) you started living at Physical Address 2.
Dates of Residence at Physical Address 2 – To	Text	Enter the date (mm/dd/yyyy) you moved out of Physical Address 2.
Foreign Address (lived over 1 year) – Street Number and Name	Text	Provide the street number and name of the most recent address outside the United States where you lived for more than one year. Max length: 25 characters
Flr.	CheckBox	Check this box when you are providing the floor number for your most recent address outside the United States where you lived for more than one year.
Apt.	CheckBox	Check this box if the most recent address you are providing outside the United States includes an apartment unit number.
Foreign Address – Apartment/Suite/Floor Number	Text	If the foreign address includes an apartment, suite, or floor, enter that identifier here. Max length: 6 characters
Ste. (Suite)	CheckBox	Check this box when your most recent address outside the United States includes a suite number.
Foreign Address – City or Town	Text	Enter the city or town of the foreign address where you lived for more than one year. Max length: 20 characters
Foreign Address – Province	Text	Provide the province or similar subdivision for the foreign address. Max length: 20 characters
Foreign Address – Postal Code	Text	Enter the foreign postal code for this address. Max length: 9 characters
Foreign Address – ZIP Code	Text	If the foreign address uses a ZIP-style code, enter it here; otherwise leave blank. Max length: 5 characters
Foreign Address – State/Region	ComboBox	If applicable, enter the state, region, or equivalent for the foreign address. CO GA GU IN FM CA AR NC NH VT ME MT MH MD AK VI AS VA WA WI AA MP WY NM TX PA AL MO TN HI IA OK MI PW DE FL LA KY WV NE SC PR IL NY AE SD MS ND NJ KS OR ID MN UT DC OH NV RI MA CT AZ AP
Foreign Address – Country	Text	Write the full name of the country for the foreign address where you lived for more than one year.
Dates of Residence at Foreign Address – From	Text	Enter the date (mm/dd/yyyy) you began living at the foreign address.
Dates of Residence at Foreign Address – To	Text	Enter the date (mm/dd/yyyy) you stopped living at the foreign address, or write “Present” if you still live there.
Alternate Mailing Address
Street Number and Name (Alternate/Safe Mailing Address)	Text	Provide the street number and street name of the alternate or safe address where USCIS should send notices. Max length: 25 characters
Flr. (Floor) checkbox	CheckBox	Select this box when the additional unit in your mailing address is a floor number rather than an apartment or suite.
Apt.	CheckBox	Check this box when your alternative or safe mailing address includes an apartment number, then enter that number in the space provided.
Applicant Information
Applicant’s A-Number	Text	Provide your nine-digit USCIS Alien Registration Number (A-Number) exactly as it appears on your immigration documents. If you do not have an A-Number, leave this field blank. Max length: 9 characters
Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1	Text	This field displays the Alien Registration Number (A. Number) and is read-only. It is pre-populated from page 1. Max length: 9 characters
Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1	Text	This is a read-only field that displays the Alien Registration Number (A. Number) of the applicant. It is pre-populated from page 1 of the form. Max length: 9 characters
Applicant's Contact Information
Applicant’s Daytime Telephone Number	Text	Provide a phone number where USCIS can reach you during normal business hours. Max length: 15 characters
Applicant’s Mobile Telephone Number	Text	Enter your personal mobile (cell) phone number, if you have one. Max length: 15 characters
Applicant’s Email Address	Text	Provide your primary email address for USCIS correspondence and status updates. Max length: 38 characters
Applicant's Declaration
Date of Applicant’s Signature	Text	Enter the date (mm/dd/yyyy) on which the applicant actually signed this form. This must match the day the signature was provided.
Part 10. Applicant's Statement, Contact Information, Declaration, Certification, and Signature. Applicant's Signature. 6. A. Applicant's Signature. This signature field can not be signed with a digital signature and the signee's name can not be typewritten into this space. This is a protected field. Print and sign in ink	Text	Sign your name in ink. Digital signatures and typewritten names are not allowed.
Applicant's Statement
The interpreter named in Part 11 read to me every question and instruction on this application and my answer to every question in [language], a language in which I am fluent, and I understood everything.	CheckBox	Check this box if an interpreter has read every question, instruction, and your answers to you in a language you are fluent in and you understood all of it.
Interpreter Language	Text	Specify the language in which the interpreter read the questions and instructions to you and in which you confirmed you 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.	CheckBox	Check this box if you, the applicant, personally read and fully understand English and have reviewed every question, instruction, and your answers on the form.
At my request, the preparer named in Part 12 prepared this application for me based only upon information I provided or authorized	CheckBox	Check this box if you asked the person named as your preparer to fill out the form on your behalf using only the information you gave or approved.
Preparer’s Name	Text	Enter the full name of the person identified in Part 12 who prepared the application at your request.
Application Type or Filing Category
Immediate relative of a U.S. citizen, Form I-130	CheckBox	Check this box when you are applying to adjust status based on being an immediate relative of a U.S. citizen for whom a Form I-130 petition has been filed or approved.
Other relative of a U.S. citizen or relative of a lawful permanent resident under the family-based preference categories, Form I-130	CheckBox	Check this box when you are applying to register for permanent residence or adjust status based on an approved family-based preference petition as an other relative of a U.S. citizen or lawful permanent resident.
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)	CheckBox	Check this box if you are filing to adjust your status based on your admission as a K-1 fiancé(e) or K-2 child of a U.S. citizen.
Widow or widower of a U.S. citizen, Form I-360	CheckBox	Check this box if you are applying to adjust status as the widow or widower of a U.S. citizen based on an approved Form I-360 petition.
VAWA self-petitioner, Form I-360	CheckBox	Check this box when you are applying for adjustment of status to lawful permanent residence based on a self-petition filed under the Violence Against Women Act using Form I-360.
Alien entrepreneur, Form I-526	CheckBox	Select this box when you are filing for adjustment of status based on an approved immigrant petition as an alien entrepreneur on Form I-526.
Alien worker, Form I-140	CheckBox	Select this box when you are applying to adjust status to lawful permanent residence based on an employment-based petition filed on Form I-140.
Religious worker, Form I-360	CheckBox	Check this box if you are applying to adjust your status based on classification as a special immigrant religious worker under a Form I-360 petition.
Certain Afghan or Iraqi National, Form I-360 or Form DS-157	CheckBox	Check this box when you are applying for adjustment of status as a special immigrant Afghan or Iraqi national based on an approved Form I-360 or Form DS-157 petition.
Special immigrant juvenile, Form I-360	CheckBox	Select this box when you are applying to adjust your status to lawful permanent resident based on your classification as a special immigrant juvenile under Form I-360.
Certain G-4 international organization or family member or NATO-6 employee or family member, Form I-360	CheckBox	Check this box when you are applying to adjust status as a special immigrant under a Form I-360 petition for a G-4 international organization employee or family member or a NATO-6 employee or family member.
Certain international broadcaster, Form I-360	CheckBox	Check this box if you are applying to adjust status to lawful permanent residence as a special immigrant classified as an international broadcaster under a Form I-360 petition.
Refugee status (INA section 207), Form I-590 or Form I-730	CheckBox	Check this box when you are applying to adjust your status on the basis of having been admitted as a refugee under INA section 207 and are providing the corresponding Form I-590 or I-730 evidence.
Asylum status (INA section 208), Form I-589 or Form I-730	CheckBox	Check this box when applying to adjust your status to lawful permanent residence based on being granted asylum under INA section 208 with an underlying Form I-589 or Form I-730.
Human trafficking victim (T Nonimmigrant), Form I-914 or derivative family member, Form I-914A	CheckBox	Check this box if you are applying for lawful permanent residence based on having T nonimmigrant status as a human trafficking victim or as an approved derivative family member under Form I-914 or Form I-914A.
Crime victim (U Nonimmigrant), Form I-918, derivative family member, Form I-918A, or qualifying family member, Form I-929	CheckBox	Check this box when you are applying to adjust your status based on having U nonimmigrant classification as a crime victim or as a derivative or qualifying family member of a U nonimmigrant.
Dependent status under the Haitian Refugee Immigrant Fairness Act	CheckBox	Check this box if you are applying to adjust your status as a dependent beneficiary under the Haitian Refugee Immigrant Fairness Act.
Lautenberg Parolees	CheckBox	Check this box if you are seeking adjustment of status based on having been admitted or paroled into the United States under the Lautenberg parolee refugee program.
Diplomats or high ranking officials unable to return home (Section 13 of the Act of September 11, 1957)	CheckBox	Check this box if you are a diplomat or other high-ranking official who cannot return to your home country and are applying under the special program for individuals in this category.
Dependent status under the Haitian Refugee Immigrant Fairness Act for battered spouses and children	CheckBox	Check this box when you are applying for adjustment of status as the spouse or unmarried child of a principal applicant under the Haitian Refugee Immigrant Fairness Act’s battered spouses and children program.
Indochinese Parole Adjustment Act of 2000	CheckBox	Check this box if you are applying to adjust your immigration status under the Indochinese Parole Adjustment Act of 2000 special program.
The Cuban Adjustment Act	CheckBox	Check this box if you are applying for adjustment of status under the Cuban Adjustment Act special program.
The Cuban Adjustment Act for battered spouses and children	CheckBox	Check this box if you are filing under the Cuban Adjustment Act as a spouse or child who has experienced battery or extreme cruelty by a Cuban national.
Continuous residence in the United States since before January 1, 1972 ("Registry")	CheckBox	Check this box if you have continuously resided in the United States since before January 1, 1972 and are applying for permanent residence under the registry provision.
Individual born in the United States under diplomatic status	CheckBox	Check this box if the applicant was born in the United States while under diplomatic status as a dependent of accredited foreign diplomatic personnel.
Diversity Visa program	CheckBox	Check this box if you are applying to adjust status based on selection in the Diversity Visa lottery program.
Other eligibility	CheckBox	Check this box if you are seeking adjustment of status under an eligibility category not covered by any of the specified public-law programs or listed additional options and will provide the specific basis in the space provided.
Other eligibility basis	Text	If your adjustment of status category does not fit any of the listed options, briefly describe the statutory section or special provision that makes you eligible. Enter a short text such as “VAWA self-petitioner,” “Liberian Refugee Immigration Fairness,” etc.
Yes (applying for adjustment based on INA section 245(i))	CheckBox	Check this box if you are filing to adjust your status under the Immigration and Nationality Act’s section 245(i) eligibility provisions.
No	CheckBox	Check this box if you are not seeking adjustment of status under the special provision that allows certain applicants to adjust despite previous immigration violations.
Asset Information
Total household assets $0–18,400	CheckBox	Check this box if the combined value of all your household assets is between $0 and $18,400.
$18,401-136,000	CheckBox	Check this box if, for the public charge review, the total value of your household assets falls between $18,401 and $136,000.
Household assets of $136,001 to $321,400	CheckBox	Check this box if the total value of your household assets falls between $136,001 and $321,400.
Value of household assets $321,401–707,100	CheckBox	Check this box if the combined value of all household assets you hold falls between $321,401 and $707,100 when completing the public charge assessment.
Over $707,100	CheckBox	Check this box if the combined total value of your household assets exceeds $707,100 when reporting your assets for the public charge evaluation.
Attorney Information
A-Number – Digit Box	Text	Enter a single numeric digit that is part of your nine-digit Alien Registration Number (A-Number). Fill the digits in order from left to right, one digit per box, with no dashes or spaces. Max length: 9 characters
Select this box if Form G-28 is attached	CheckBox	Check this box when you have attached Form G-28 to indicate that an attorney or accredited representative is completing this application on your behalf.
Volag Number (if any)	Text	Enter the Voluntary Agency (VOLAG) number if you are being represented by a refugee resettlement or other qualifying voluntary agency. If you do not have a VOLAG number, leave this field blank. Max length: 10 characters
A-Number – Digit Box	Text	Enter the next numeric digit of your nine-digit Alien Registration Number (A-Number). Provide only one digit in this box, continuing the sequence from left to right. Max length: 12 characters
Biographic Information
Hispanic or Latino	CheckBox	Check this box if the applicant’s ethnicity is Hispanic or Latino.
Not Hispanic or Latino	CheckBox	Check this box if the applicant does not identify as Hispanic or Latino in their biographic information.
Asian	CheckBox	Check this box to indicate that you identify your race as Asian when completing the biographic information.
White	CheckBox	Check this box if you identify your race as White when providing biographic information on your application to register for permanent residence or adjust your immigration status.
Black or African American	CheckBox	Check this box if you identify your race as Black or African American on your biographic information for the adjustment of status application.
American Indian or Alaska Native	CheckBox	Check this box if, in providing your biographic information on the application, you identify your race as American Indian or Alaska Native.
Native Hawaiian or Other Pacific Islander	CheckBox	Select this box if you identify your race as Native Hawaiian or Other Pacific Islander when providing your biographic information for permanent residence or adjustment of status.
Applicant Height – Feet	ComboBox	Write the feet portion of your height (whole number only). Example: 5 if you are 5 feet 7 inches tall. 7 8 5 6 2 3 4
Applicant Height – Inches	ComboBox	Write the remaining inches of your height (0–11). Example: 07 if you are 5 feet 7 inches tall. 11 7 8 5 9 1 2 3 6 10 4 0
Applicant Weight – Pounds (Box 1)	Text	Enter the first (hundreds) digit of your weight in pounds. Use leading zero if necessary. Max length: 1 characters
Applicant Weight – Pounds (Box 2)	Text	Enter the second (tens) digit of your weight in pounds. Max length: 1 characters
Applicant Weight – Pounds (Box 3)	Text	Enter the third (ones) digit of your weight in pounds. Max length: 1 characters
Eye Color (Blue)	CheckBox	Check this box if the applicant’s natural eye color is blue.
Eye Color: Black	CheckBox	Check this box if the applicant’s eye color is black.
Eye Color – Brown	CheckBox	Select this box if the applicant’s eye color is brown.
Eye Color: Gray	CheckBox	Check this box if the applicant’s eye color is gray.
Eye Color – Green	CheckBox	Select this box if your natural eye color is green when providing your biographic information on the application.
Eye Color – Hazel	CheckBox	Check this box if the applicant’s eye color is hazel when providing biographic information.
Eye Color: Maroon	CheckBox	Check this box if the applicant’s eye color is maroon.
Eye Color: Pink	CheckBox	Check this box if the applicant’s eye color is pink.
Eye Color: Unknown/Other	CheckBox	Select this box if your eye color is not listed among the provided options (Black, Blue, Brown, Gray, Green, Hazel, Maroon, or Pink).
Bald (No hair)	CheckBox	Check this box if the applicant has no hair on their head (is bald), as their declared hair color.
Hair Color: Black	CheckBox	Check this box if the applicant’s natural hair color is black.
Hair Color – Blond	CheckBox	Select this box if your hair color is blond.
Hair Color: Brown	CheckBox	Select this box if your hair color is brown.
Hair Color – Gray	CheckBox	Check this box to indicate that the applicant’s hair color is gray.
Hair Color: Red	CheckBox	Check this box to indicate that the applicant’s hair color is red on their biographic information form.
Sandy	CheckBox	Check this box if your natural hair color is sandy.
Hair Color – White	CheckBox	Check this box if the applicant’s hair color is white.
Hair Color – Unknown/Other	CheckBox	Check this box if your hair color is not one of the listed categories or if you are unsure of your hair color.
Children Information
Total Number of Living Children	Text	Enter the total number of all living children you have (biological, step, adopted, living anywhere, of any age). Numeric value only. Max length: 5 characters
Child 1 – Family Name (Last Name)	Text	Enter the last (family) name of your first listed child.
Child 1 – Given Name (First Name)	Text	Enter the first (given) name of your first listed child.
Child 1 – Middle Name	Text	Enter the middle name of your first listed child. If none, leave blank.
Child 1 – Date of Birth	Text	Provide the date of birth of your first listed child in MM/DD/YYYY format.
Child 1 – Country of Birth	Text	Enter the country where your first listed child was born.
Child 1 – Is this child applying with you? Yes	CheckBox	Select this box when your first listed child is applying for adjustment of status together with you on this form.
Child 1 – No (Is this child applying with you?)	CheckBox	Check this box when your first child is not applying with you for adjustment of status.
Part 6. Information About Your Children. Child One. 3. Enter Alien Registration Number (A. Number), if any	Text	Enter the Alien Registration Number (A. Number) for Child One, if they have one. This number is typically 9 digits long. Max length: 9 characters
Child 2 – Family Name (Last Name)	Text	Enter the last (family) name of your second listed child.
Child 2 – Given Name (First Name)	Text	Enter the first (given) name of your second listed child.
Child 2 – Middle Name	Text	Enter the middle name of your second listed child. If none, leave blank.
Child 2 – Date of Birth	Text	Provide the date of birth of your second listed child in MM/DD/YYYY format.
Child 2 – Country of Birth	Text	Enter the country where your second listed child was born.
Is this child applying with you? Yes	CheckBox	Check this box when the child whose details are entered in this section is also filing the I-485 application together with you.
Is this child applying with you? – No (Child 2)	CheckBox	Check this box when the second child listed on the form will not be filing an adjustment of status application with you.
Child 2 – A-Number (if any)	Text	If your second listed child already has a USCIS Alien Registration Number, enter the 9-digit A-Number here; otherwise leave blank. Max length: 9 characters
Children's Information
Child 3 – Family Name (Last Name)	Text	Type the child’s legal last (family) name exactly as it appears on the child’s passport or birth certificate.
Child 3 – Given Name (First Name)	Text	Type the child’s legal first (given) name as shown on official documents.
Child 3 – Middle Name	Text	Enter the child’s complete middle name, if any. If the child has no middle name, leave this field blank.
Child 3 – Date of Birth	Text	Provide the child’s full date of birth in MM/DD/YYYY format.
Child 3 – Country of Birth	Text	Enter the full, current name of the country where the child was born.
Is this child applying with you? – Yes	CheckBox	Check this box when the child named is applying for adjustment of status together with the primary applicant on the same Form I-485.
No (Is this child applying with you?)	CheckBox	Select this box when the child you have listed is not filing their own adjustment of status application alongside you.
Criminal History
Ever been arrested, cited, charged, or detained – Yes	CheckBox	Check this box if you have ever been arrested, cited, charged, or detained for any reason by any law enforcement official, including U.S. immigration authorities or the U.S. armed forces.
Have you EVER been arrested, cited, charged, or detained for any reason by any law enforcement official? – No	CheckBox	Check this box if you have never been arrested, cited, charged, or detained by any law enforcement official for any reason anywhere in the world.
No – Have you EVER committed a crime of any kind (even if you were not arrested, cited, charged with, or tried for that crime)?	CheckBox	Select this box when you have never committed any crime of any kind, regardless of whether you were ever arrested, cited, charged, or tried.
Yes – Have you EVER committed a crime of any kind	CheckBox	Select this box if you have ever committed any crime, even if you were not arrested, cited, charged, or tried for it.
Current Marriage Information
Current Spouse – Family Name (Last Name)	Text	Enter your current spouse’s legal last name (surname) exactly as it appears on their passport or other legal documents.
Current Spouse – Given Name (First Name)	Text	Provide your current spouse’s legal first (given) name.
Current Spouse – Middle Name	Text	Enter your current spouse’s middle name, if any. If they do not have one, write “N/A.”
Current Spouse – Date of Birth	Text	Supply your current spouse’s date of birth in MM/DD/YYYY format.
Date of Marriage to Current Spouse	Text	State the exact date you were legally married to your current spouse, using MM/DD/YYYY format.
Current Spouse's Application Status
Is your current spouse applying with you? – No	CheckBox	Check this box if your current spouse is not applying with you on this Form I-485 application.
Yes (Current spouse applying with you)	CheckBox	Check this box if your current spouse is applying for adjustment of status together with your I-485 application.
Current Spouse's Information
Current Spouse – A-Number (if any)	Text	If your current spouse has a USCIS Alien Registration Number, enter the nine-digit A-Number here. If they do not have one, leave the field blank. Max length: 9 characters
Current Spouse's Place of Birth
Current Spouse – Country of Birth	Text	Enter the country where your current spouse was born, written in full (no abbreviations).
Current Spouse – State or Province of Birth	Text	If applicable, provide the state, province, or region where your current spouse was born. If not applicable, write “N/A.”
Current Spouse – City or Town of Birth	Text	Indicate the city, town, or village where your current spouse was born.
Disability Accommodations
I am deaf or hard of hearing and request the following accommodation	CheckBox	Check this box if you are deaf or hard of hearing and need an accommodation (for example, a sign‐language interpreter) when completing the application.
Part 9. Accommodations for Individuals With Disabilities and/or Impairments. 2. A. Enter Language	Text	Enter the language for the sign-language interpreter if you are deaf or hard of hearing and requesting this accommodation.
No (are you requesting an accommodation because of your disabilities and/or impairments?)	CheckBox	Check this box if you are not requesting any accommodation for disabilities or impairments.
Are you requesting an accommodation because of your disabilities and/or impairments? – Yes	CheckBox	Check this box if you need an accommodation due to a disability or impairment when completing the application.
I am blind or have low vision and request the following accommodation	CheckBox	Check this box if you are blind or have low vision and need a specific accommodation to complete the application.
Accommodation for Blind or Low Vision	Text	Describe the specific accommodation you need because you are blind or have low vision (e.g., large-print notices, Braille materials, electronic correspondence).
I have another type of disability and/or impairment	CheckBox	Check this box if you require an accommodation for a disability or impairment that is not covered by the predefined categories and you wish to describe its nature and the accommodation needed.
Other Disability/Impairment Accommodation	Text	If you have a disability or impairment not listed, explain its nature and the accommodation you are requesting so USCIS can provide appropriate assistance.
Education
High school diploma, GED, or alternative credential	CheckBox	Check this box if your highest level of education completed is a high school diploma, GED, or other alternative credential.
1 or more years of college credit, no degree	CheckBox	Check this box when the highest level of education you have completed is one or more years of college credit but you have not earned a degree.
Associate's degree	CheckBox	Check this box if the highest level of education you have completed is an Associate’s degree.
Bachelor's degree	CheckBox	Check this box if the highest level of education you have completed is a bachelor’s degree.
Master’s degree	CheckBox	Check this box if the highest level of education you have completed is a Master’s degree.
Professional degree (JD, MD, DMD, etc.)	CheckBox	Check this box if your highest level of education completed is a professional degree, such as a JD, MD, DMD, or equivalent.
Doctorate degree	CheckBox	Select this checkbox if the highest level of schooling you have completed is a doctorate degree.
Educational Background
Grades 1 through 11	CheckBox	Check this box if the highest level of school you have completed is grades 1 through 11 without having earned a diploma, GED, or other credential.
12th grade – no diploma	CheckBox	Check this box if the highest level of education you have completed is the 12th grade but you did not receive a diploma.
Eligibility and Inadmissibility
Have you been granted a waiver or has Department of State issued a favorable waiver recommendation letter for you? – Yes	CheckBox	Check this box if you have been granted a waiver or received a favorable waiver recommendation letter from the Department of State regarding the foreign residence requirement
No	CheckBox	Check this box if you have not been granted a waiver and the Department of State has not issued you a favorable waiver recommendation letter.
Have you EVER pled guilty to or been convicted of a crime or offense? – Yes	CheckBox	Check this box if you have ever pled guilty to or been convicted of any crime or offense, even if the record was later expunged, sealed, or you received a pardon, amnesty, or similar act of clemency.
Have you EVER pled guilty to or been convicted of a crime or offense? – No	CheckBox	Check this box if you have never pled guilty to or been convicted of any crime or offense, even if the violation was later sealed, expunged, or forgiven by a pardon, amnesty, or other act of clemency.
No, never been ordered punished or had liberty-restraining conditions imposed	CheckBox	Check this box if you have never been sentenced or subjected by a judge to any punishment or conditions that restricted your freedom, such as prison, probation, house arrest, or similar measures.
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)?	CheckBox	Check this box if you have ever been sentenced or otherwise punished by a court or subjected to any form of liberty-restraining condition such as imprisonment, house arrest, parole, probation, alternative sentencing, or required treatment programs.
Have you EVER been a defendant or the accused in a criminal proceeding? – Yes	CheckBox	Check this box if you have at any time been named as a defendant or accused person in any criminal proceeding, including pre-trial diversion, deferred prosecution, deferred adjudication, or any situation where adjudication was withheld.
Have you EVER been a defendant or the accused in a criminal proceeding? No	CheckBox	Select this box if you have never been a defendant or accused in any criminal proceeding (including pre-trial diversion, deferred prosecution, deferred adjudication, or withheld adjudication).
Have you EVER violated any controlled substance law or regulation of a state, the United States, or a foreign country? – No	CheckBox	Check this box if the applicant has never violated, attempted, or conspired to violate any controlled substance law or regulation in any jurisdiction.
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	CheckBox	Check this box if you have at any time violated, attempted, or conspired to violate any controlled substance law or regulation of a state, the United States, or a foreign country.
Have you EVER illicitly (illegally) trafficked or benefited from the trafficking of any controlled substances, such as chemicals, illegal drugs, or narcotics? – Yes	CheckBox	Check this box if you have ever illegally trafficked or benefited from the trafficking of any controlled substances such as chemicals, illegal drugs, or narcotics.
No – illicit trafficking or benefit from trafficking controlled substances	CheckBox	Check this box if you have never illegally trafficked or benefited from the trafficking of any controlled substances such as chemicals, illegal drugs, or narcotics.
Have you EVER knowingly aided, abetted, assisted, conspired, or colluded in the illicit trafficking of any illegal narcotic or other controlled substances? – No	CheckBox	Check this box if you have never knowingly aided, abetted, assisted, conspired, or colluded in the illicit trafficking of any illegal narcotic or other controlled substances during your lifetime.
Yes to knowingly aiding illicit trafficking of controlled substances	CheckBox	Check this box if you have ever knowingly aided, abetted, assisted, conspired, or colluded in the illicit trafficking of any illegal narcotic or other controlled substances.
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? – No	CheckBox	Check this box if you have never been convicted of two or more offenses (other than purely political offenses) where the total sentences to confinement added up to five years or more.
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	CheckBox	Check this box if you have ever been convicted of two or more non-political offenses whose combined sentences to confinement totaled five years or more.
No for spouse, son, or daughter of a foreign national trafficker	CheckBox	Check this box if you did not receive any financial or other benefit in the last five years from the illicit trafficking of controlled substances by your spouse or parent.
Yes – spouse, son, or daughter of a foreign national who trafficked controlled substances and received benefits	CheckBox	Check this box if, within the last five years, you obtained any financial or other benefit from the illicit trafficking of controlled substances by your spouse or parent, and you knew or reasonably should have known the benefit resulted from their illegal activity.
No (Have you EVER engaged in prostitution or are you coming to the United States to engage in prostitution?)	CheckBox	Check this box if you have never engaged in prostitution and are not coming to the United States to engage in prostitution.
Have you EVER engaged in prostitution or are you coming to the United States to engage in prostitution? – Yes	CheckBox	Check this box if the applicant has ever engaged in prostitution or is coming to the United States to engage in prostitution.
Have you EVER directly or indirectly procured (or attempted to procure) or imported prostitutes or persons for the purpose of prostitution? – Yes	CheckBox	Check this box if you have ever procured, attempted to procure, or imported any person for the purpose of prostitution.
No, I have never directly or indirectly procured or imported persons for prostitution	CheckBox	Check this box if you have never directly or indirectly procured (or attempted to procure) or imported prostitutes or persons for the purpose of prostitution.
Have you EVER received any proceeds or money from prostitution? – No	CheckBox	Select this box if you have never received any proceeds or money from prostitution when applying for adjustment of status.
Have you EVER received any proceeds or money from prostitution? Yes	CheckBox	Check this box if you have at any time received financial proceeds or money from prostitution.
Yes – intend to engage in illegal gambling or any other form of commercialized vice in the United States	CheckBox	Check this box if you plan to engage in illegal gambling or any form of commercialized vice, such as prostitution, bootlegging, or the sale of child pornography, while in the United States.
Intent to engage in illegal gambling or other commercialized vice – No	CheckBox	Check this box if you do not 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.
Have you EVER exercised immunity (diplomatic or otherwise) to avoid being prosecuted for a criminal offense in the United States? – No	CheckBox	Select this box if you have never invoked diplomatic or other immunity to evade criminal prosecution in the United States when applying to adjust your immigration status.
Have you EVER exercised immunity to avoid being prosecuted for a criminal offense in the United States? – Yes	CheckBox	Select this box if you have ever claimed diplomatic or any other form of immunity to avoid prosecution for a criminal offense in the United States.
Have you EVER, while serving as a foreign government official, been responsible for or directly carried out violations of religious freedoms? – Yes	CheckBox	Check this box if you have ever served as a foreign government official and were responsible for or directly carried out violations of religious freedoms.
No, I have not been responsible for or directly carried out violations of religious freedoms while serving as a foreign government official	CheckBox	Check this box if you have never been responsible for or directly carried out violations of religious freedoms during your service as a foreign government official.
Have you ever induced by force, fraud, or coercion in trafficking persons for commercial sex acts? – No	CheckBox	Check this box if you have not used force, fraud, coercion, or otherwise been involved in trafficking persons for commercial sex acts.
Have you EVER induced by force, fraud, or coercion (or otherwise been involved in) the trafficking of persons for commercial sex acts? – Yes	CheckBox	Check this box if you have at any time forced, defrauded, coerced, or otherwise participated in trafficking people for commercial sex acts.
Have you EVER trafficked a person into involuntary servitude, peonage, debt bondage, or slavery? – No	CheckBox	Check this box if you have never recruited, harbored, transported, provided, or obtained any person for labor or services through 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? – Yes	CheckBox	Check this box if the applicant has ever knowingly aided, abetted, assisted, conspired, or colluded with others in the trafficking of persons for commercial sex acts or involuntary servitude, peonage, debt bondage, or slavery.
Answered “No” to involvement in trafficking persons for commercial sex acts or involuntary servitude	CheckBox	Check this box if you have never knowingly aided, abetted, assisted, conspired, or colluded with others in trafficking persons for commercial sex acts or involuntary servitude, including peonage, debt bondage, or slavery.
Have you EVER trafficked a person into involuntary servitude, peonage, debt bondage, or slavery? – Yes	CheckBox	Check this box if you have ever recruited, harbored, transported, provided, or obtained a person for labor or services through force, fraud, or coercion, constituting involuntary servitude, peonage, debt bondage, or slavery.
No – benefited from spouse’s or parent’s trafficking	CheckBox	Check this box if you have not received any financial or other benefits in the past five years from the illicit trafficking activity of your spouse or parent.
Yes – spouse, son, or daughter of a trafficker has received benefits	CheckBox	Check this box if you are the spouse, son, or daughter of a foreign national who engaged in human trafficking and you have received or obtained any financial or other benefits from that illicit activity within the last five years, knowing or reasonably expecting that those benefits resulted from trafficking.
Engaged in money laundering or aided others in money laundering (Yes)	CheckBox	Select this box if you have ever engaged in money laundering, knowingly aided or conspired with others in money laundering, or are seeking to enter the United States to engage in such activity.
No, I have never engaged in or aided money laundering or sought to enter the United States to do so	CheckBox	Check this box if you have never engaged in money laundering, assisted or conspired with others in money laundering, nor intend to enter the United States to engage in such activity.
Intend to engage in any activity that violates or evades any law relating to espionage (including spying) or sabotage in the United States – Yes	CheckBox	Select this box if you plan to carry out any espionage or sabotage activities that violate U.S. law.
Do you intend to engage in any activity that violates or evades any law relating to espionage (including spying) or sabotage in the United States? — No	CheckBox	Check this box if you do not intend to participate in any acts of espionage or sabotage under U.S. law.
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? – No	CheckBox	Check this box if you do not intend to violate U.S. export control laws by exporting goods, technology, or sensitive information when applying to adjust your immigration status.
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)	CheckBox	Check this box if you intend to engage in any activity in the United States that violates or evades U.S. export control laws on goods, technology, or sensitive information.
Do not intend to 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	CheckBox	Check this box if you do not intend to engage in any activity aimed at opposing, controlling, or overthrowing the U.S. Government by force, violence, or other unlawful means while in the United States.
Engage in any activity whose purpose includes opposing, controlling, or overthrowing the U.S. Government by force, violence, or other unlawful means – Yes	CheckBox	Check this box if you do intend to engage in any activity in the United States aimed at opposing, controlling, or overthrowing the U.S. Government by force, violence, or other unlawful means.
Engage in any activity that could endanger the welfare, safety, or security of the United States? No	CheckBox	Check this box if you do not intend to engage in any activity that could endanger the welfare, safety, or security of the United States.
Engage in any activity that could endanger the welfare, safety, or security of the United States (Yes)	CheckBox	Select this box if you intend to engage in any activity that could endanger the welfare, safety, or security of the United States.
Intend to engage in any other unlawful activity – Yes	CheckBox	Select this box if you plan to engage in any unlawful activity in the United States that isn’t already covered by the other security-and-related questions.
Engage in any other unlawful activity? No	CheckBox	Select this box if you have not engaged in any unlawful activity beyond those already listed.
No – not engaged in or intending to engage in any activity that could have potentially serious adverse foreign policy consequences for the United States	CheckBox	Check this box if you are not currently engaged in and do not plan to engage upon entry into the United States in any activity that could have potentially serious adverse foreign policy consequences for the country.
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	CheckBox	Check this box if you are engaged in or plan, upon your entry into the United States, to engage in any activity that could have potentially serious adverse foreign policy consequences for the United States.
No (response to having ever committed any of the listed violent or sabotage activities)	CheckBox	Select this box if you have never committed, threatened, attempted, or conspired to commit hijacking, sabotage, kidnapping, political assassination, or the use of a weapon or explosive to harm another person or property.
Ever committed or planned hijacking, sabotage, kidnapping, political assassination, or use of a weapon or explosive to harm or damage property – Yes	CheckBox	Check this box if you have ever committed, threatened, attempted, conspired, incited, endorsed, advocated, planned, or prepared any act of hijacking, sabotage, kidnapping, political assassination, or use of a weapon or explosive to harm another individual or cause substantial property damage.
Participated in, or been a member of, a group or organization that did any of the activities described in Item Number 48.a. – Yes	CheckBox	Select this box if you have ever been a member of an organization that engaged in hijacking, sabotage, kidnapping, political assassination, or the use of a weapon or explosive to harm individuals or cause substantial damage to property.
Have you ever participated in or been a member of a group or organization that did any of the activities described in Item Number 48.a? – No	CheckBox	Check this box to indicate that you have not participated in or been a member of any group that committed hijacking, sabotage, kidnapping, political assassination, or used a weapon or explosive to harm another individual or cause substantial damage to property.
Have you EVER received any type of military, paramilitary, or weapons training? – No	CheckBox	Check this box if you have never received any military, paramilitary, or weapons training when answering the security and related inadmissibility questions.
Yes – Have you EVER received any type of military, paramilitary, or weapons training?	CheckBox	Select this box if you have at any time received military, paramilitary, or weapons training.
Recruited members or asked for money or things of value for a group or organization that did any of the activities described in Item Number 48.a. – Yes	CheckBox	Check this box if you have ever recruited individuals or solicited money or other valuables for any group or organization that carried out hijacking, sabotage, kidnapping, political assassination, or use of a weapon or explosive to harm others or damage property.
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. – No	CheckBox	Check this box if you have never recruited members or solicited money or other things of value for any organization that committed or planned hijacking, sabotage, kidnapping, political assassination, or use of a weapon or explosive to harm people or property.
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. – No	CheckBox	Check this box if you have never provided financial support, services, labor, or any other assistance or support for the violent or terrorist activities listed earlier.
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.?	CheckBox	Check this box if you have ever given money, goods, services, labor, or other support to facilitate violent or destructive acts such as hijacking, sabotage, kidnapping, political assassination, or use of weapons or explosives against individuals or property.
Do you intend to engage in any of the activities listed in any part of Item Numbers 48.a. – 49.? Yes	CheckBox	Check this box if you plan to engage in any of the support or training activities described in the prior questions about providing assistance to certain groups or receiving military or weapons training.
Do you intend to engage in any of the activities listed in any part of Item Numbers 48.a–49.? – No	CheckBox	Check this box if you do not intend to engage in any of the security-related activities (espionage, export violations, material support, or weapons training) asked about earlier.
No – I have not provided money, services, labor, or other assistance to any individual, group, or organization who engaged in the activities described in the previous question	CheckBox	Select this box when you have never given financial support, services, labor, or any form of assistance to anyone who carried out the previously specified prohibited activities.
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.	CheckBox	Check this box if you have ever given money, goods, services, labor, or any other form of assistance or support to anyone engaged in the activities described in the previous question.
Not the spouse or child of someone who ever committed hijacking, sabotage, kidnapping, political assassination, or use of a weapon or explosive	CheckBox	Check this box if you are not the spouse or child of any individual who has ever committed, threatened, attempted, conspired to commit, incited, endorsed, advocated, planned, or prepared hijacking, sabotage, kidnapping, political assassination, or use of a weapon or explosive to harm another individual or cause substantial damage to property.
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?	CheckBox	Check this box if you are the spouse or child of an individual who has ever engaged in any of the listed violent or destructive acts.
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. – No	CheckBox	Check this box if you are not the spouse or child of anyone who has ever participated in or been a member or representative of a group or organization that committed hijacking, sabotage, kidnapping, political assassination, or use of a weapon or explosive.
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.	CheckBox	Check this box if you are the spouse or child of an individual who has ever participated in or represented a group or organization that carried out hijacking, sabotage, kidnapping, political assassination, or used a weapon or explosive to harm others.
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.?	CheckBox	Check this box if you have never recruited members or solicited money or other support for any organization that engaged in hijacking, sabotage, kidnapping, political assassination, or use of weapons or explosives to harm individuals or property.
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.	CheckBox	Check this box if you are the spouse or child of an individual who ever recruited members or solicited funds or things of value for a group that carried out hijacking, sabotage, kidnapping, political assassination, or used weapons or explosives.
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. – No	CheckBox	Check this box if you are not the spouse or child of an individual who ever provided financial support, goods, services, labor, or any assistance for violent or terrorist activities such as hijacking, sabotage, kidnapping, political assassination, or use of a weapon or explosive.
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.	CheckBox	Check this box if you have ever given money, goods, services, or any other assistance to support your spouse’s or child’s involvement in violent or sabotage activities such as hijacking, kidnapping, political assassination, or use of a weapon or explosive.
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. – No	CheckBox	Select this box if you have not given any financial, material, or other support to any person or organization that engaged in violent or terrorist acts such as hijacking, sabotage, kidnapping, or political assassination.
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.?	CheckBox	Check this box if you are the spouse or child of someone who has ever provided money, services, labor, or other assistance or support to an individual, group, or organization that engaged in hijacking, sabotage, kidnapping, political assassination, or use of a weapon or explosive to harm another or damage property.
Received any type of military, paramilitary, or weapons training from a prohibited group – No	CheckBox	Check this box when the applicant has not received any military, paramilitary, or weapons training from an organization that engaged in hijacking, sabotage, kidnapping, political assassination, or use of a weapon or explosive to harm others.
Received any type of military, paramilitary, or weapons training from a group or organization that did any of the activities described in Item Number 51.a. – Yes	CheckBox	Check this box if you are the spouse or child of someone who ever received military, paramilitary, or weapons training from an organization that committed hijacking, sabotage, kidnapping, political assassination, or similar violent acts.
No to serving in any military or other armed group	CheckBox	Check this box if you have never served in, been a member of, assisted, or participated in any military unit, paramilitary unit, police unit, self-defense unit, vigilante unit, rebel group, guerrilla group, militia, insurgent organization, or any other armed group.
Have you EVER served in or participated in any military or other armed group? – Yes	CheckBox	Check this box if you have at any time served in, been a member of, assisted, or participated in any military, paramilitary, police, self-defense, vigilante, rebel, guerrilla, militia, insurgent organization, or similar armed group.
No for membership in or affiliation with the Communist Party or any other totalitarian party	CheckBox	Check this box if you have never been a member of, or in any way affiliated with, the Communist Party or any other totalitarian party.
Member of or affiliated with the Communist Party or any other totalitarian party – Yes	CheckBox	Check this box if you have 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.
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)	CheckBox	Check this box if you participated in ordering, inciting, assisting, or otherwise taking part in the persecution of any person for race, religion, national origin, or political opinion in association with the Nazi regime or its allies during that period.
No – I did not participate in persecution in association with the Nazi government	CheckBox	Check this box if you did not order, incite, assist, or otherwise participate in the persecution of any person because of race, religion, national origin, or political opinion in association with the Nazi government of Germany or its allied organizations during the period from March 23, 1933 to May 8, 1945.
No	CheckBox	Check this box if you have never used any person under 15 years of age to take part in hostilities or to help or provide services to people in combat.
Have you ever used any person under 15 years of age in hostilities – Yes	CheckBox	Check this box if you have ever used any person under 15 years of age to take part in hostilities or to help or provide services to people in combat.
Limiting or denying any person’s ability to exercise religious beliefs	CheckBox	Check this box if you have ever ordered, assisted with, or otherwise participated in preventing someone from practicing their religion.
Limiting or denying any person’s ability to exercise religious beliefs? – No	CheckBox	Select this box if you have never ordered, incited, assisted, or otherwise participated in any act that limits or denies someone’s ability to exercise their religious beliefs.
Acts involving torture or genocide? – No	CheckBox	Check this box if you have never ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any acts involving torture or genocide.
Acts involving torture or genocide? Yes	CheckBox	Check this box if you have ever ordered, incited, called for, committed, assisted with, helped with, or otherwise participated in acts involving torture or genocide.
Killing any person?	CheckBox	Select this box if you have ever ordered, incited, called for, committed, assisted, helped with, or otherwise participated in killing any person.
Killing any person? – No	CheckBox	Check this box if you have never ordered, incited, assisted with, or otherwise participated in killing any person.
Intentionally and severely injuring any person? – No	CheckBox	Check this box to indicate that you have never ordered, incited, or participated in intentionally and severely injuring any person.
Intentionally and severely injuring any person	CheckBox	Select this box if you have ever ordered, incited, assisted with, or otherwise participated in intentionally and severely injuring any person in connection with any group or action.
No, engaging in any kind of sexual contact or relations with a person who did not consent or was unable to consent or was forced or threatened	CheckBox	Check this box to indicate that you have never engaged in any sexual contact or relations with someone who did not consent or was unable to consent or was forced or threatened.
Engaging in any kind of sexual contact or relations with any person who did not consent or was unable to consent, or was being forced or threatened – Yes	CheckBox	Check this box if you have ever been involved in any non-consensual or forced sexual contact or relations with another person.
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	CheckBox	Check this box if you have at any time recruited, enlisted, conscripted, or used any person under the age of 15 to serve in or help an armed force or armed group.
No (for recruiting any person under 15 years of age to serve in or help an armed force or group)	CheckBox	Select this box if you have never recruited, enlisted, conscripted, or used any person under 15 years of age to serve in or help an armed force or group.
Have you ever received Supplemental Security Income (SSI), TANF, or other cash benefit programs – Yes	CheckBox	Check this box if you have ever received SSI, Temporary Assistance for Needy Families, or state, tribal, territorial, or local cash assistance programs for income maintenance.
No – never received SSI, TANF, or similar cash benefit programs	CheckBox	Check this box if you have never received Supplemental Security Income, Temporary Assistance for Needy Families, or any state, tribal, territorial, or local cash benefit program for income maintenance.
Benefit Dollar Amount – Row 3	Text	State the total amount of money received for the benefit in Row 3 during the stated period.
Benefit Dollar Amount – Row 4	Text	State the total amount of money received for the benefit in Row 4 during the stated period.
Benefit Received – Row 4	Text	Provide the name of the fourth public cash benefit that you have received.
Benefit Start Date – Row 1	Text	Enter the date (MM/DD/YYYY) on which you first began receiving the benefit listed in Row 1.
Benefit Start Date – Row 2	Text	Enter the date you began receiving the benefit listed in Row 2.
Benefit Start Date – Row 3	Text	Enter the date you began receiving the benefit listed in Row 3.
Benefit Start Date – Row 4	Text	Enter the date you began receiving the benefit listed in Row 4.
Benefit End Date – Row 1	Text	Enter the date (MM/DD/YYYY) on which receipt of the benefit in Row 1 ended. If you are still receiving it, write “Present.”
Benefit End Date – Row 2	Text	Enter the date the benefit in Row 2 stopped, or write “Present” if it is ongoing.
Benefit End Date – Row 3	Text	Enter the date the benefit in Row 3 stopped, or write “Present” if it is ongoing.
Benefit End Date – Row 4	Text	Enter the date the benefit in Row 4 stopped, or write “Present” if it is ongoing.
Certifications, Licenses, or Skills	Text	List any professional certifications, occupational licenses, vocational skills, or educational certificates you hold. Include the full title, issuing authority, and date obtained.
No, I was not unlawfully present for more than 180 days but less than a year and then departed the United States	CheckBox	Check this box if you have not been unlawfully present in the U.S. for over 180 days but under one year and then departed since April 1, 1997.
Unlawful presence for more than 180 days but less than a year and then departed – Yes	CheckBox	Check this box if, since April 1, 1997, you were unlawfully present in the United States for more than 180 days but less than one year and then departed the country.
Have you been unlawfully present for one year or more and then departed the United States? Yes	CheckBox	Check this box if, since April 1, 1997, you were unlawfully present in the United States for one year or more and then departed the United States.
For one year or more and then departed the United States? No	CheckBox	Check this box if you were not unlawfully present in the United States for one year or more and then departed.
No – I have never been excluded, deported, or removed from the United States or voluntarily departed after an order	CheckBox	Select this box if you have never been excluded, deported, removed, or voluntarily departed following a removal order when applying to adjust your immigration status.
Have you ever been excluded, deported, or removed from the United States or departed on your own after such an order? – Yes	CheckBox	Check this box if you have at any time been formally excluded, deported, or removed from the United States or left voluntarily following an official removal order.
No – having been unlawfully present in the United States for more than one year in the aggregate	CheckBox	Select this box if you have not reentered or attempted to reenter the United States without inspection after accruing over one year of unlawful presence.
Having been unlawfully present in the United States for more than one year in the aggregate – Yes	CheckBox	Check this box if you have ever reentered or attempted to reenter the United States without inspection after accumulating over one year of unlawful presence in total.
Having been deported, excluded, or removed from the United States – No	CheckBox	Check this box if you have never been deported, excluded, or removed from the United States when answering the question about reentering without inspection since April 1, 1997.
Having been deported, excluded, or removed from the United States	CheckBox	Check this box if since April 1, 1997 you have reentered or attempted to reenter the United States without inspection after having been deported, excluded, or removed.
Do you plan to practice polygamy in the United States? – Yes	CheckBox	Check this box if you intend to enter into or maintain more than one marital relationship at the same time while in the United States.
Do you plan to practice polygamy in the United States? – No	CheckBox	Check this box to indicate that the applicant does not plan to practice polygamy in the United States.
No	CheckBox	Select this box if you are not accompanying another foreign national who requires your protection or guardianship because they have been certified as helpless from sickness, physical or mental disability, or infancy.
Have you EVER failed or refused to attend or to remain in attendance at any removal proceeding filed against you on or after April 1, 1997? – Yes	CheckBox	Select this box if you have ever failed or refused to attend or remain in attendance at any removal proceeding filed against you on or after April 1, 1997.
Have you EVER submitted fraudulent or counterfeit documentation to any U.S. Government official to obtain or attempt to obtain any immigration benefit? – Yes	CheckBox	Check this box if you have at any time submitted fraudulent or counterfeit documentation to a U.S. Government official to obtain or attempt to obtain any immigration benefit, including a visa or entry into the United States.
Have you EVER submitted fraudulent or counterfeit documentation to any U.S. Government official to obtain or attempt to obtain any immigration benefit? – No	CheckBox	Select this box if you have never submitted any fraudulent or counterfeit documentation to a U.S. government official in order to obtain or attempt to obtain an immigration benefit, including a visa or entry into the United States.
No – Have you EVER lied about, concealed, or misrepresented any information on an application or petition to obtain an immigration benefit?	CheckBox	Check this box if you have never lied about, concealed, or misrepresented any information on any application or petition for a visa, entry, admission, or other immigration benefit.
Have you EVER lied about, concealed, or misrepresented any information on an application or petition to obtain a visa, other documentation required for entry into the United States, admission to the United States, or any other kind of immigration benefit? – Yes	CheckBox	Check this box if you have at any time lied about, concealed, or misrepresented information on any application or petition to obtain an immigration benefit, visa, or entry into the United States.
Have you EVER entered the United States without being inspected and admitted or paroled? – Yes	CheckBox	Check this box if you have at any time entered the United States without having been inspected and admitted or paroled.
Have you EVER entered the United States without being inspected and admitted or paroled? – No	CheckBox	Select this box if you have never entered the United States without being inspected and admitted or paroled.
No – 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	CheckBox	Check this box if you have never applied for an exemption or discharge from U.S. military service or the National Security Training Corps on the basis of your foreign-national status.
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	CheckBox	Check this box if you have ever applied for an exemption or discharge from U.S. military or National Security Training Corps service on the basis of being a foreign national.
No, relieved or discharged from such training or service on the ground that you are a foreign national	CheckBox	Check this box if you have not been relieved or discharged from any training or service on the basis of being a foreign national.
Been relieved or discharged from such training or service on the ground that you are a foreign national? – Yes	CheckBox	Check this box if you were relieved or discharged from training or service because you were a foreign national.
No, not convicted of desertion from the U.S. armed forces	CheckBox	Check this box if you have never been convicted of desertion from the U.S. armed forces.
Been convicted of desertion from the U.S. armed forces?	CheckBox	Select this box if you have ever been legally convicted of desertion from the U.S. armed forces.
Previous Nationality or Immigration Status	Text	If you answered “Yes” to question 86.a (leaving or remaining outside the U.S. to avoid military service), enter the nationality or U.S. immigration status you held immediately before you left (for example, U.S. citizen, lawful permanent resident, nonimmigrant, parolee, etc.).
No – never left or remained outside the United States to avoid or evade U.S. armed forces service	CheckBox	Check this box if you have not ever left or remained outside the United States to avoid or evade training or service in the U.S. armed forces during a time of war or a period declared by the President to be a national emergency.
Yes, I have ever left or remained outside the United States to avoid or evade training or service in the U.S. armed forces during a time of war or national emergency	CheckBox	Select this box if you have ever left or remained outside the United States to avoid or evade U.S. armed forces training or service during a time of war or a period declared by the President to be a national emergency.
Employment History
Employer 1 – Name of Employer or Company	Text	Provide the full legal name of your current or most recent employer or company. Max length: 34 characters
Employer 1 – Street Number and Name	Text	Enter the street number and name of the employer’s address. Max length: 25 characters
Flr. checkbox	CheckBox	Check this box if the address of your current or most recent employer includes a floor designation as part of the street address.
Apt.	CheckBox	Check this box to indicate that the employer or company’s address for your current or most recent employment is located in an apartment unit.
Employer 1 – Apartment/Suite/Floor	Text	If the employer’s address includes a suite, floor, or unit, enter that designation here. Max length: 6 characters
Ste.	CheckBox	Check this box if the employer or company address includes a suite number.
Employer 1 – City or Town	Text	Enter the city or town where your employer’s office is located. Max length: 20 characters
Employer 1 – Province	Text	If the employer is outside the United States, enter the province, region, or equivalent here. Max length: 20 characters
Employer 1 – Postal Code	Text	Provide the foreign postal code for the employer’s address, if applicable. Max length: 9 characters
Employer 1 – ZIP Code	Text	Enter the ZIP code for the employer’s U.S. address. Leave blank for foreign employers. Max length: 5 characters
Employer 1 – State	ComboBox	Enter the two-letter state abbreviation for the employer’s address if in the United States. Leave blank if outside the U.S. CO GA GU IN FM CA AR NC NH VT ME MT MH MD AK VI AS VA WA WI AA MP WY NM TX PA AL MO TN HI IA OK MI PW DE FL LA KY WV NE SC PR IL NY AE SD MS ND NJ KS OR ID MN UT DC OH NV RI MA CT AZ AP
Employer 1 – Country	Text	Enter the name of the country where your employer is located.
Employer 1 – Your Occupation	Text	State your job title or occupation for this period of employment (e.g., ‘Software Engineer’, ‘Sales Associate’). Max length: 34 characters
Employment From Date (Job Listed in Item 14)	Text	Provide the first day you started this job in MM/DD/YYYY format.
Employment To Date (Job Listed in Item 14)	Text	Provide the last day you worked at this job in MM/DD/YYYY format. If you are still employed, write “Present.”
Employer/Company Name (Job Listed in Item 15)	Text	Enter the full legal name of the employer or company for this period of employment. Max length: 34 characters
Employer Street Number and Name (Item 16.a)	Text	Write the street address of the employer’s location, including any building number and street name. Max length: 25 characters
Flr.	CheckBox	Check this box when the employer or company address includes a floor designation so you may enter the floor number in the adjacent field.
Apt.	CheckBox	Check this box when the address of the listed employer or company includes an apartment unit.
Employer Apt./Suite/Floor (Item 16.b)	Text	If applicable, enter the apartment, suite, or floor number for the employer’s address; otherwise leave blank. Max length: 6 characters
Ste.	CheckBox	Check this box when the employer’s address includes a suite number to indicate a suite designation in the street address field.
Employer City or Town (Item 16.c)	Text	Enter the city or town where this employer is located. Max length: 20 characters
Employer Province (Item 16.f)	Text	If the employer is outside the United States, enter the province or region; otherwise leave blank. Max length: 20 characters
Employer Postal Code (Item 16.g)	Text	If the employer is outside the United States, enter the postal code for the address. Max length: 9 characters
Employer ZIP Code (Item 16.e)	Text	Enter the five-digit ZIP Code for the employer’s address. Max length: 5 characters
Employer State (Item 16.d)	ComboBox	Provide the two-letter U.S. state or territory abbreviation for the employer’s address. CO GA GU IN FM CA AR NC NH VT ME MT MH MD AK VI AS VA WA WI AA MP WY NM TX PA AL MO TN HI IA OK MI PW DE FL LA KY WV NE SC PR IL NY AE SD MS ND NJ KS OR ID MN UT DC OH NV RI MA CT AZ AP
Employer Country (Item 16.h)	Text	Enter the country where this employer is located.
Your Occupation/Job Title (Item 17)	Text	Specify the position or job title you held with this employer. Max length: 34 characters
Employment From Date (Job Listed in Item 18)	Text	Enter the date you began this second period of employment in MM/DD/YYYY format.
Employment To Date (Job Listed in Item 18)	Text	Enter the date you ended this employment in MM/DD/YYYY format, or write “Present” if you are still employed.
Most Recent Non-U.S. Employer/Company Name (Item 19)	Text	Provide the full name of your most recent employer located outside the United States, if not already listed. Max length: 34 characters
Foreign Employer Street Number and Name (Item 20.a)	Text	Enter the street address of the non-U.S. employer, including building number and street name. Max length: 25 characters
Ste.	CheckBox	Check this box when the employer’s address includes a suite number as the secondary address indicator.
Apt.	CheckBox	Select this box if the employer’s address includes an apartment number.
Foreign Employer Apt./Suite/Floor (Item 20.b)	Text	If applicable, enter an apartment, suite, or floor number for this employer’s address. Max length: 6 characters
Suite	CheckBox	Check this box when entering your employer’s address if it includes a suite number.
Foreign Employer City or Town (Item 20.c)	Text	Enter the city or town where the non-U.S. employer is located. Max length: 20 characters
Foreign Employer Province (Item 20.f)	Text	If applicable, enter the province, region, or state for the non-U.S. address. Max length: 20 characters
Foreign Employer Postal Code (Item 20.g)	Text	Provide the postal code for the employer’s address, if not entered above. Max length: 9 characters
Foreign Employer ZIP/Postal Code (Item 20.e)	Text	Write the ZIP or postal code for this employer’s address. Max length: 5 characters
Foreign Employer State/Province Abbrev. (Item 20.d)	ComboBox	If the address includes a state, canton, or province abbreviation, enter it here. CO GA GU IN FM CA AR NC NH VT ME MT MH MD AK VI AS VA WA WI AA MP WY NM TX PA AL MO TN HI IA OK MI PW DE FL LA KY WV NE SC PR IL NY AE SD MS ND NJ KS OR ID MN UT DC OH NV RI MA CT AZ AP
Foreign Employer Country (Item 20.h)	Text	Specify the country where this employer is located.
Your Occupation/Job Title with Foreign Employer (Item 21)	Text	State the position or job title you held with this non-U.S. employer. Max length: 34 characters
Employment From Date (Job Listed in Item 22)	Text	Enter the date you started this job in MM/DD/YYYY format.
Employment To Date (Job Listed in Item 22)	Text	Enter the date you ended this job in MM/DD/YYYY format, or write “Present” if still employed.
Financial Information
$0	CheckBox	Check this box if your total household liabilities, including both secured and unsecured liabilities, amount to zero.
$1-10,100	CheckBox	Check this box if the combined value of all your secured and unsecured household liabilities is between $1 and $10,100.
Total household liabilities $10,101–57,700	CheckBox	Check this box if the combined value of all your secured and unsecured household liabilities falls between $10,101 and $57,700.
$57,701–186,800	CheckBox	Check this box if your total household liabilities, including both secured and unsecured debts, amount to between $57,701 and $186,800.
Over $186,800	CheckBox	Check this box if the combined value of all your household liabilities, both secured and unsecured, exceeds $186,800.
Form Metadata
PDF417BarCode1	Text	This field contains a PDF417 barcode that encodes specific information about the form. It is automatically generated and should not be altered.
PDF417BarCode1	Text	This is a barcode field that contains encoded information about the form.
PDF417BarCode1	Text	This is a barcode field that contains encoded information about the form. No input is required.
PDF417BarCode1	Text	This is a barcode field that contains encoded information about the form.
PDF417BarCode1	Text	This is a barcode field that contains encoded information about the form. No input is required.
Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1	Text	This is a read-only field that displays the Alien Registration Number (A. Number) from page 1. No input is required. Max length: 9 characters
PDF417BarCode1	Text	This is a PDF417 barcode field that contains encoded information about the form. It is read-only and pre-populated.
Applicant A-Number (page header)	Text	Enter your nine-digit U.S. Alien Registration Number (A-Number) exactly as it appears on your immigration documents. Fill one digit per box across the top of every page. Max length: 9 characters
PDF417BarCode1	Text	This is a barcode field that contains encoded information about the form.
PDF417BarCode1	Text	This field contains a PDF417 barcode which encodes specific information about the form. No input is required from the user.
PDF417BarCode1	Text	This field contains a PDF417 barcode that encodes specific information about the form, including the form type and version.
PDF417BarCode1	Text	This is a barcode field that contains encoded information about the form. No input is required.
PDF417BarCode1	Text	This field contains a barcode that encodes specific information about the form and its version.
PDF417BarCode1	Text	This is a barcode field that contains encoded information about the form. It is automatically generated and does not require user input.
PDF417BarCode1	Text	This field contains a barcode for the form I-485.
PDF417BarCode1	Text	This is a barcode field that contains encoded information about the form. No input is required.
PDF417BarCode1	Text	This field contains a PDF417 barcode that encodes specific information about the form. It is a read-only field.
PDF417BarCode1	Text	This field contains a barcode for the Form I-485. No input is required.
General Eligibility and Inadmissibility
Organization 3 – Name of Organization	Text	Provide the complete, official name of the third organization, association, or group in which you have been a member or with which you have been involved.
Organization 3 – City or Town	Text	Enter the city or town where Organization 3 is located or based.
Organization 3 – Country	Text	Specify the country where Organization 3 is located.
Organization 3 – Nature of Group	Text	Describe the type or purpose of Organization 3 (e.g., professional association, political party, charitable group, student club).
Organization 3 – State or Province	Text	Enter the state, province, or similar administrative region for the location of Organization 3.
Organization 4 – Membership Start Date	Text	Enter the month, day, and year (MM/DD/YYYY) you first became involved with Organization 4.
Organization 4 – Membership End Date	Text	Enter the month, day, and year (MM/DD/YYYY) you ended your involvement with Organization 4, or write “Present” if you are still involved.
No—Have you EVER been denied admission to the United States?	CheckBox	Check this box if you have never been denied admission to the United States.
Have you EVER been denied admission to the United States? – Yes	CheckBox	Select this box if you have at any point been denied admission to the United States, even if you were later cleared or admitted.
Have you EVER been denied a visa to the United States? – Yes	CheckBox	Check this box if you have at any time been refused a visa to enter the United States.
Have you EVER been denied a visa to the United States? No	CheckBox	Check this box if the applicant has never been denied a visa to the United States.
No to having ever worked in the United States without authorization	CheckBox	Check this box if you have never worked in the United States without proper authorization.
Have you EVER worked in the United States without authorization? – Yes	CheckBox	Check this box if you have at any time worked in the United States without proper authorization.
Have you ever violated the terms or conditions of your nonimmigrant status? No	CheckBox	Check this box if you have never violated the terms or conditions of your nonimmigrant status.
Have you EVER violated the terms or conditions of your nonimmigrant status? – Yes	CheckBox	Check this box if you have at any time breached the terms or conditions of your nonimmigrant immigration status.
Presently or ever in removal, exclusion, rescission, or deportation proceedings – Yes	CheckBox	Check this box if you are currently or have ever been placed in removal, exclusion, rescission, or deportation proceedings with U.S. immigration authorities.
No, never been in removal, exclusion, rescission, or deportation proceedings	CheckBox	Check this box if the applicant has not ever been and is not currently in removal, exclusion, rescission, or deportation proceedings.
Have you EVER had a prior final order of exclusion, deportation, or removal reinstated? – Yes	CheckBox	Check this box if the applicant has ever had a prior final order of exclusion, deportation, or removal reinstated.
No, I have never had a prior final order of exclusion, deportation, or removal reinstated	CheckBox	Check this box if you have never had any prior final order of exclusion, deportation, or removal reinstated.
No – Have you ever held lawful permanent resident status which was later rescinded?	CheckBox	Check this box if you have never held lawful permanent resident status that was later rescinded.
Have you EVER held lawful permanent resident status which was later rescinded? – Yes	CheckBox	Select this box if you have at any point held lawful permanent resident status that was subsequently rescinded.
General Eligibility and Inadmissibility Grounds
No – never been a member or associated with any organization	CheckBox	Check this box if you have never been a member of, involved in, or associated with any organization, association, fund, foundation, party, club, society, or similar group in the United States or any other location, including military service.
Yes – Have you ever been associated with any organization	CheckBox	Check this box if you have at any time been a member of, involved in, or otherwise associated with any organization, association, fund, foundation, party, club, society, or similar group in the United States or abroad, including military service.
Organization 1 – Name of Organization	Text	Provide the full official name of the first organization, association, fund, party, club, society, or military unit with which you have ever been involved.
Organization 1 – Country	Text	Specify the country where Organization 1 is located or primarily operates.
Organization 1 – State or Province	Text	Enter the state, province, or region for Organization 1, if applicable. If none, leave blank.
Organization 1 – City or Town	Text	Enter the city or town where Organization 1 is based or where you were active.
Organization 1 – Nature of Group	Text	Describe the type or purpose of Organization 1 (e.g., political party, charity, military service, social club).
Organization 1 – Dates of Membership (From)	Text	Enter the month, day, and year you first became involved with Organization 1 (MM/DD/YYYY).
Organization 1 – Dates of Membership (To)	Text	Enter the month, day, and year your involvement with Organization 1 ended. If it is ongoing, write “PRESENT.”
Organization 2 – Name of Organization	Text	Provide the full official name of the second organization with which you have been associated.
Organization 2 – Country	Text	Specify the country where Organization 2 is located or primarily operates.
Organization 2 – State or Province	Text	Enter the state, province, or region for Organization 2, if applicable.
Organization 2 – City or Town	Text	Enter the city or town where Organization 2 is based or where you participated.
Organization 2 – Nature of Group	Text	Describe the type or purpose of Organization 2 (e.g., political, charitable, military, cultural).
Organization 3 – Membership Start Date	Text	Enter the month, day, and year (MM/DD/YYYY) you first became involved with Organization 3. If you are still involved, use today’s date as the start date.
Organization 3 – Membership End Date	Text	Enter the month, day, and year (MM/DD/YYYY) you last participated in or ended your involvement with Organization 3. If you are still involved, write “Present” or leave blank if instructed.
Have you EVER been granted voluntary departure by an immigration officer or an immigration judge but failed to depart within the allotted time? Yes	CheckBox	Select this box if you have ever been granted voluntary departure by an immigration officer or an immigration judge but failed to depart within the allotted time.
No	CheckBox	Select this box if you have never failed to depart within the allotted time after being granted voluntary departure by an immigration officer or an immigration judge.
Have you EVER applied for any kind of relief or protection from removal, exclusion, or deportation? – No	CheckBox	Check this box if the applicant has never applied for relief or protection from removal, exclusion, or deportation.
Have you EVER applied for any kind of relief or protection from removal, exclusion, or deportation? – Yes	CheckBox	Check this box if you have ever filed an application for any form of relief or protection from removal, exclusion, or deportation in U.S. immigration proceedings.
Yes – been a J nonimmigrant exchange visitor subject to the two-year foreign residence requirement	CheckBox	Check this box if you have ever held J nonimmigrant exchange visitor status that carried a two-year foreign residence obligation.
No—J nonimmigrant exchange visitor subject to the two-year foreign residence requirement	CheckBox	Check this box to indicate that you have never been a J-1 exchange visitor who was required to fulfill the two-year foreign residence rule.
Have you complied with the foreign residence requirement? – No	CheckBox	Select this box if the applicant was a J nonimmigrant exchange visitor subject to the two-year foreign residence requirement and has not complied with that requirement.
Have you complied with the foreign residence requirement? Yes	CheckBox	Check this box if, as a J-visa exchange visitor subject to the two-year foreign residence rule, you have fulfilled that residency requirement before applying.
Final order of exclusion, deportation, or removal – No	CheckBox	Check this box if you have never been issued a final order of exclusion, deportation, or removal.
Have you ever been issued a final order of exclusion, deportation, or removal? – Yes	CheckBox	Check this box if you have at any time been issued a final order of exclusion, deportation, or removal.
Yes – assisted or participated in selling, providing, or transporting weapons used against another person	CheckBox	Check this box if you have ever assisted or participated in selling, providing, or transporting weapons to someone who you know used them against another person.
No (to assisted or participated in selling, providing, or transporting weapons to someone who used them against another person)	CheckBox	Check this box if you have never assisted or participated in selling, providing, or transporting weapons to any person who used them against another person.
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?	CheckBox	Check this box if the applicant has never worked, volunteered, or otherwise served in any facility or situation that involved detaining persons.
Have you EVER worked, volunteered, or otherwise served in any prison, jail, prison camp, detention facility, labor camp, or any other situation that involved detaining persons? – Yes	CheckBox	Select this box if you have at any time worked, volunteered, or otherwise served in a prison, jail, prison camp, detention facility, labor camp, or any other environment where persons were detained.
Have you ever been a member of a group that used or threatened to use weapons – Yes	CheckBox	Check this box if you have ever belonged to, assisted, or participated in any organization or unit in which you or others used or threatened to use any type of weapon against any person.
No, never participated in any weapon-using or threatening organization	CheckBox	Check this box if you have never been a member of, assisted, or participated in any group, unit, or organization that used or threatened to use weapons against any person.
Institution Name/Location – Row 2	Text	Provide the full name, city, and state of the second institution where you were institutionalized.
Institution Name/Location – Row 3	Text	Provide the full name, city, and state of the third institution where you were institutionalized.
Institution Name/Location – Row 4	Text	Provide the full name, city, and state of the fourth institution where you were institutionalized.
Reason for Institutionalization – Row 1	Text	Explain why you were institutionalized (e.g., medical treatment, mental health care) for the first institution.
Reason for Institutionalization – Row 2	Text	Explain why you were institutionalized for the second institution.
Reason for Institutionalization – Row 3	Text	Explain why you were institutionalized for the third institution.
Reason for Institutionalization – Row 4	Text	Explain why you were institutionalized for the fourth institution.
Institution Start Date – Row 1	Text	Enter the date (MM/DD/YYYY) when your stay at the institution in Row 1 began.
Institution Start Date – Row 2	Text	Enter the date when your stay at the institution in Row 2 began.
Institution Start Date – Row 3	Text	Enter the date when your stay at the institution in Row 3 began.
Institution Start Date – Row 4	Text	Enter the date when your stay at the institution in Row 4 began.
Institution End Date – Row 1	Text	Enter the date (MM/DD/YYYY) when your stay at the institution in Row 1 ended. If ongoing, write “Present.”
Institution End Date – Row 2	Text	Enter the date when your stay at the institution in Row 2 ended, or write “Present.”
Institution End Date – Row 3	Text	Enter the date when your stay at the institution in Row 3 ended, or write “Present.”
Institution End Date – Row 4	Text	Enter the date when your stay at the institution in Row 4 ended, or write “Present.”
Benefit Received – Row 1	Text	Provide the name of the first public cash benefit (e.g., SSI, TANF) that you have received.
Benefit Received – Row 2	Text	Provide the name of the second public cash benefit that you have received.
Benefit Received – Row 3	Text	Provide the name of the third public cash benefit that you have received.
Benefit Dollar Amount – Row 1	Text	State the total dollar amount you received for the benefit in Row 1 during the period indicated.
Benefit Dollar Amount – Row 2	Text	State the total amount of money received for the benefit in Row 2 during the stated period.
Accompanying another foreign national who requires protection or guardianship and is certified as helpless	CheckBox	Check this box if you are accompanying and acting as guardian for a foreign national who has been medically certified as helpless due to sickness, disability, or infancy and is inadmissible without your protection.
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	CheckBox	Check this box if you have ever assisted in detaining, retaining, or withholding custody of a U.S. citizen child outside the United States from the U.S. citizen who holds legal custody of that child.
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? – No	CheckBox	Check this box if you have never assisted in detaining, retaining, or withholding custody of a U.S. citizen child outside the United States from a U.S. citizen custodian.
No (response to “Have you EVER voted in violation of any Federal, state, or local constitutional provision, statute, ordinance, or regulation in the United States?”)	CheckBox	Check this box if the applicant has never voted in violation of any federal, state, or local constitutional provision, statute, ordinance, or regulation in the United States.
Have you EVER voted in violation of any Federal, state, or local constitutional provision, statute, ordinance, or regulation in the United States? Yes	CheckBox	Check this box if you have at any time voted in the United States in a way that violated any federal, state, or local constitutional provision, statute, ordinance, or regulation.
Have you EVER renounced U.S. citizenship to avoid being taxed by the United States? – Yes	CheckBox	Select this box if you have at any time formally renounced your U.S. citizenship in order to avoid taxation by the United States.
No – I have never renounced U.S. citizenship to avoid being taxed by the United States	CheckBox	Select this box if you have not renounced your U.S. citizenship in order to avoid U.S. taxation.
No – not under a final order of civil penalty for violating INA section 274C for use of fraudulent documents	CheckBox	Check this box if you have never been subject to a final civil penalty for using fraudulent immigration documents under the referenced law.
Yes – Applicant under a final civil penalty order for violating INA section 274C for use of fraudulent documents	CheckBox	Check this box if the applicant is subject to a final civil penalty order for misuse of fraudulent documents to obtain an immigration benefit.
Have you EVER been a stowaway on a vessel or aircraft arriving in the United States? – No	CheckBox	Check this box if the applicant has never been a stowaway on any vessel or aircraft entering the United States.
Have you EVER been a stowaway on a vessel or aircraft arriving in the United States? – Yes	CheckBox	Check this box if you have at any time hidden aboard a ship or airplane to enter the United States as a stowaway.
Have you EVER knowingly encouraged, induced, assisted, abetted, or aided any foreign national to enter or try to enter the United States illegally (alien smuggling)? – Yes	CheckBox	Check this box if you have ever knowingly encouraged, induced, assisted, abetted, or aided another person’s unlawful entry into the United States.
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)? – No	CheckBox	Check this box if you have never encouraged, induced, assisted, abetted, or aided any foreign national in attempting to enter the United States illegally.
Have you EVER falsely claimed to be a U.S. citizen (in writing or any other way)? Yes	CheckBox	Select this box if you have ever falsely claimed to be a U.S. citizen in writing or by any other means.
Have you EVER falsely claimed to be a U.S. citizen (in writing or any other way)? – No	CheckBox	Select this box if you have never falsely claimed to be a U.S. citizen in writing or by any other means.
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? – No	CheckBox	Check this box if you have never failed or refused to attend any removal proceeding filed against you on or after April 1, 1997.
If your answer to Item Number 69.a is "Yes," do you believe you had reasonable cause? – Yes	CheckBox	Check this box if you failed or refused to attend a removal proceeding on or after April 1, 1997 and you believe you had reasonable cause for doing so.
Do you have reasonable cause? No	CheckBox	Check this box if you failed or refused to attend a removal proceeding filed on or after April 1, 1997 and you do not believe you had reasonable cause for that failure or refusal.
General Information
PDF417BarCode1	Text	This field contains a barcode that encodes specific information about the form and its version.
Immigration Information
A-Number	Text	Provide your Alien Registration Number (A-Number) exactly as it appears on your immigration documents. If you do not yet have an A-Number, leave this field blank. Max length: 9 characters
Income Information
Annual household income: $0–27,000	CheckBox	Check this box if your total household income for the most recent year falls between $0 and $27,000 when reporting income for the public charge evaluation.
$27,001-52,000	CheckBox	Check this box if your annual household income falls between $27,001 and $52,000.
$52,001-85,000	CheckBox	Select this box if your total annual household income falls between $52,001 and $85,000 when reporting income for the public charge assessment.
$85,001-141,000	CheckBox	Check this box if your household’s annual income falls between $85,001 and $141,000.
Indicate your annual household income: Over $141,000	CheckBox	Check this box if your household’s total annual income exceeds $141,000.
Information About Your Children
Part 6. Information About Your Children. Child Three. 13. Enter Alien Registration Number (A. Number), if any	Text	Enter the Alien Registration Number (A-Number) of your third child, if they have one. This number is typically 9 digits long. Max length: 9 characters
Information About Your Immigrant Category
Receipt Number of Underlying Petition	Text	Enter the USCIS receipt number (e.g., SRC1234567890) from the Form I-130, I-140, I-360, or other immigrant petition on which this adjustment application is based. This number is found on the petition’s I-797 receipt notice.
Priority Date from Underlying Petition	Text	Provide the priority date that appears on the I-797 for the immigrant petition listed above, formatted as MM/DD/YYYY. If no priority date is assigned, leave blank.
Internal Use
PDF417BarCode1	Text	This is a barcode field for internal use. No input is required.
Interpreter Information
Interpreter’s Mobile Telephone Number	Text	Provide the interpreter’s mobile or cell phone number, including area code and international dialing code if outside the U.S. Leave blank if not applicable. Max length: 15 characters
Interpreter’s Other Language	Text	Enter the non-English language in which the interpreter is fluent. This is the language the interpreter used to translate the form for the applicant. Max length: 18 characters
Interpreter’s Date of Signature	Text	Type the date (MM/DD/YYYY) on which the interpreter actually signed the form.
Part 11. Interpreter's Contact Information, Certification, and Signature. Interpreter's Signature. 7. A. Interpreter's Signature. This signature field can not be signed with a digital signature and the signee's name can not be typewritten into this space. This is a protected field. Print and sign in ink	Text	The interpreter must print and sign their name in ink. Digital signatures and typewritten names are not allowed. Max length: 1 characters
Interpreter's Contact Information
Interpreter’s Apartment/Suite/Floor	Text	If applicable, enter the apartment, suite, or floor number that is part of the interpreter’s mailing address. Leave blank if not needed. Max length: 6 characters
Interpreter’s Mailing Address – Ste.	CheckBox	Check this box when the interpreter’s mailing address includes a suite number.
Interpreter’s Postal Code	Text	If the mailing address is outside the United States, enter the foreign postal code. Leave blank for U.S. addresses. Max length: 9 characters
Interpreter’s ZIP Code	Text	Enter the 5-digit (or 5+4) ZIP Code for the interpreter’s U.S. mailing address. Leave blank if the address is outside the United States. Max length: 5 characters
Interpreter’s State	ComboBox	If the mailing address is within the United States, select or enter the two-letter state abbreviation (e.g., CA for California). Leave blank if the address is outside the U.S. CO GA GU IN FM CA AR NC NH VT ME MT MH MD AK VI AS VA WA WI AA MP WY NM TX PA AL MO TN HI IA OK MI PW DE FL LA KY WV NE SC PR IL NY AE SD MS ND NJ KS OR ID MN UT DC OH NV RI MA CT AZ AP
Interpreter’s Country	Text	Enter the full name of the country associated with the interpreter’s mailing address.
Interpreter’s Province	Text	If the mailing address is outside the United States and requires a province, enter the full name of the province. Leave blank for U.S. addresses. Max length: 20 characters
Interpreter’s Daytime Telephone Number	Text	Provide the interpreter’s primary daytime phone number, including area code and, if outside the U.S., the international dialing code. Max length: 15 characters
Interpreter’s Email Address	Text	Enter a valid email address where the interpreter can be contacted regarding this application. Max length: 38 characters
Interpreter's Information
Interpreter’s Business or Organization Name	Text	If the interpreter works for, or is contracted through, a company or organization, enter that entity’s full legal name. Leave blank if the interpreter is self-employed or independent. Max length: 34 characters
Interpreter’s Given Name (First Name)	Text	Provide the interpreter’s legal first name exactly as it appears on their official identity documents.
Interpreter’s Family Name (Last Name)	Text	Provide the interpreter’s legal last name exactly as it appears on their official identity documents.
Interpreter’s City or Town	Text	Enter the city or town for the interpreter’s mailing address. Max length: 20 characters
Interpreter’s Street Number and Name	Text	Enter the street number and street name for the interpreter’s mailing address (e.g., 123 Main St). Do not include apartment or suite information here. Max length: 25 characters
Ste.	CheckBox	Check this box when the interpreter’s mailing address includes a suite and you will provide the suite number in the adjoining field.
Apt.	CheckBox	Check this box when the interpreter’s mailing address is an apartment unit.
Interview Details
Part 13. Signature at Interview. Subscribed to and sworn to (affirmed) before me. Enter U S C I S Officer's Printed Name or Stamp	Text	Enter the printed name or stamp of the USCIS officer who is conducting the interview. Max length: 38 characters
Part 13. Signature at Interview. Subscribed to and sworn to (affirmed) before me. Applicant's Signature. This signature field can not be signed with a digital signature and the signee's name can not be typewritten into this space. This is a protected field. Print and sign in ink	Text	Applicant must sign this field in ink during the interview. Digital signatures or typewritten names are not allowed. Max length: 1 characters
Part 13. Signature at Interview. Subscribed to and sworn to (affirmed) before me. Enter Date of Signature. Enter as 2 digit month, 2 digit day and 4 digit year	Text	Enter the date of the applicant's signature in the format MM/DD/YYYY.
First correction page number	Text	Enter the number of the first page on which you made handwritten or other corrections to your Form I-485 that will be reviewed during the interview.
Last correction page number	Text	Enter the number of the last page that contains corrections to your Form I-485. If corrections appear on only one page, repeat the same page number here.
First additional-page number	Text	Provide the number of the first supplemental or continuation sheet (labeled as an additional page) that you are submitting with your Form I-485.
Last additional-page number	Text	Provide the number of the last supplemental or continuation sheet submitted with your Form I-485. If only one extra page is submitted, repeat that page number here.
Mailing Address
Street Number and Name (U.S. Mailing Address)	Text	Write the street number and street name where you want USCIS correspondence delivered (e.g., 123 Main St). Do not include the apartment, suite, or floor here. Max length: 25 characters
Flr.	CheckBox	Check this box when you are providing your U.S. mailing address and need to indicate the floor number of the building where you receive mail.
Apt.	CheckBox	Check this box if your U.S. mailing address includes an apartment number.
Part 1. Information About You (Person applying for lawful permanent residence). U.S. Mailing Address. 12. C. Enter Apartment, Suite or Floor Number	Text	Enter the apartment, suite, or floor number of your U.S. mailing address. Maximum length is 6 characters. Max length: 6 characters
Ste. (Suite)	CheckBox	Check this box when providing your U.S. mailing address if you are specifying a suite number in lieu of an apartment or floor designation.
City or Town (U.S. Mailing Address)	Text	Enter the city, town, or village of your U.S. mailing address. Max length: 20 characters
ZIP Code (U.S. Mailing Address)	Text	Enter the 5-digit (or ZIP+4) postal code for your U.S. mailing address. Max length: 5 characters
State (U.S. Mailing Address)	ComboBox	Provide the two-letter postal abbreviation for the U.S. state, territory, or District of Columbia associated with your mailing address. CO GA GU IN FM CA AR NC NH VT ME MT MH MD AK VI AS VA WA WI AA MP WY NM TX PA AL MO TN HI IA OK MI PW DE FL LA KY WV NE SC PR IL NY AE SD MS ND NJ KS OR ID MN UT DC OH NV RI MA CT AZ AP
In Care Of Name (U.S. Mailing Address)	Text	If someone else will receive your USCIS mail for you, enter that person’s full name (e.g., a relative, attorney, or landlord). If all mail should come directly to you, leave this line blank. Max length: 34 characters
Part 1. Information About You (Person applying for lawful permanent residence). Alternate and/or Safe Mailing Address. 13. C. Enter Apartment, Suite or Floor Number	Text	Enter the apartment, suite, or floor number of your alternate and/or safe mailing address. Max length: 6 characters
Ste.	CheckBox	Check this box if the safe mailing address you provide includes a suite number.
City or Town (Alternate/Safe Mailing Address)	Text	Enter the city, town, or village for the alternate or safe mailing address. Max length: 20 characters
ZIP Code (Alternate/Safe Mailing Address)	Text	Enter the 5-digit (or ZIP+4) ZIP code for the alternate or safe mailing address. Max length: 5 characters
State (Alternate/Safe Mailing Address)	ComboBox	Give the two-letter postal code for the state, territory, or District of Columbia of the alternate/safe address. CO GA GU IN FM CA AR NC NH VT ME MT MH MD AK VI AS VA WA WI AA MP WY NM TX PA AL MO TN HI IA OK MI PW DE FL LA KY WV NE SC PR IL NY AE SD MS ND NJ KS OR ID MN UT DC OH NV RI MA CT AZ AP
In Care Of Name (Alternate/Safe Mailing Address)	Text	If you are using an alternative address for safety reasons (e.g., VAWA, T, or U applicant), type the full name of the person or organization that will receive your mail. Leave blank if not applicable. Max length: 34 characters
Marital History
Divorced	CheckBox	Check this box if your current marital status is divorced, meaning you have had a prior marriage that has been legally ended.
Single, Never Married	CheckBox	Select this box if you are currently single and have never been married.
Widowed	CheckBox	Check this box if the applicant’s current marital status is widowed because their spouse has died and they have not remarried.
Married	CheckBox	Check this box if you are currently married when filing the adjustment of status application.
Marriage Annulled	CheckBox	Check this box if your current marital status is annulled, meaning your previous marriage was declared legally null and void.
Legally Separated	CheckBox	Check this box if the applicant’s current marital status is that they are legally separated from their spouse.
Spouse a current member of the U.S. armed forces or U.S. Coast Guard: No	CheckBox	Select this box if you are married and your spouse is not currently serving in the U.S. armed forces or Coast Guard.
Yes (spouse is a current member of the U.S. armed forces or U.S. Coast Guard)	CheckBox	Check this box if your spouse is currently serving in the U.S. armed forces or the U.S. Coast Guard.
N/A	CheckBox	Check this box if the question about your spouse’s membership in the U.S. armed forces or U.S. Coast Guard does not apply to you (for example, if you are not married).
Total Number of Marriages	Text	State how many times you have been married in total, including annulled marriages and multiple marriages to the same person. Max length: 5 characters
Prior Spouse – Family Name (Last Name)	Text	Enter the last (family) name of your prior spouse exactly as it appeared before marriage.
Prior Spouse – Given Name (First Name)	Text	Enter the first (given) name of your prior spouse.
Prior Spouse – Middle Name	Text	Enter the middle name of your prior spouse. If none, leave blank.
Prior Spouse – Date of Birth	Text	Provide your prior spouse’s date of birth in MM/DD/YYYY format.
Date of Marriage to Prior Spouse	Text	Enter the exact date (MM/DD/YYYY) on which you married your prior spouse.
Place of Marriage to Prior Spouse – Country	Text	Write the country where the marriage to your prior spouse occurred.
Place of Marriage to Prior Spouse – State/Province	Text	Write the state or province where the marriage to your prior spouse occurred.
Place of Marriage to Prior Spouse – City/Town	Text	Write the city or town where the marriage to your prior spouse occurred.
Date Marriage with Prior Spouse Legally Ended	Text	Enter the date (MM/DD/YYYY) the marriage with your prior spouse was legally terminated (e.g., divorce decree, annulment, death).
Place Marriage with Prior Spouse Ended – City/Town	Text	Provide the city or town where the legal termination of the marriage occurred.
Place Marriage with Prior Spouse Ended – State/Province	Text	Provide the state or province where the legal termination of the marriage occurred.
Place Marriage with Prior Spouse Ended – Country	Text	Provide the country where the legal termination of the marriage occurred.
Parent Information
Parent 1 Family Name (Last Name) – Current	Text	Enter your parent’s current legal family (last) name.
Parent 1 Given Name (First Name) – Current	Text	Enter your parent’s current legal given (first) name.
Parent 1 Middle Name – Current	Text	Enter your parent’s current legal middle name, if any. If none, leave blank.
Parent 1 Family Name at Birth	Text	Provide your parent’s family (last) name as it appeared on their birth record, if different from current.
Parent 1 Given Name at Birth	Text	Provide your parent’s given (first) name as it appeared on their birth record, if different.
Parent 1 Middle Name at Birth	Text	Provide your parent’s middle name as it appeared on their birth record, if different.
Parent 1 Date of Birth	Text	Enter your parent’s date of birth in MM/DD/YYYY format.
Sex – Female	CheckBox	Check this box when Parent 1’s sex is female.
Sex – Male	CheckBox	Check this box to indicate that the parent’s sex is male.
Parent 2 – Birth Name: Given Name (First Name)	Text	If Parent 2’s first name at birth was different from their current first name, enter the original first name here; otherwise, repeat the current first name.
Parent 2 – Birth Name: Middle Name	Text	If Parent 2 had a different middle name at birth, enter it here; otherwise, repeat the current middle name or write “N/A.”
Parent 2 – Current Country of Residence	Text	Enter the country where Parent 2 presently lives. Write out the full country name.
Parent 2 – Current City or Town of Residence	Text	Provide the city, town, or village where Parent 2 currently resides. If deceased or address unknown, write “N/A.”
Parent 2 – Country of Birth	Text	Indicate the country where Parent 2 was born, using the current country name if it has changed since the time of birth.
Sex – Female	CheckBox	Check this box when the second parent’s sex is female.
Parent 2’s Sex – Male	CheckBox	Check this box when the second parent’s sex is male.
Parent One Information
Parent 1 City or Town of Birth	Text	Enter the name of the city or town where your parent was born.
Parent 1 Country of Birth	Text	Enter the country in which your parent was born.
Parent 1 – Current Country of Residence	Text	Enter the country where Parent 1 presently lives (or last lived if their current address is unknown). Write the full country name, not an abbreviation.
Parent 1 – Current City or Town of Residence	Text	State the city, town, or village where Parent 1 currently resides. If the parent is deceased or the address is unknown, write “N/A.”
Parent Two Information
Parent 2 – Family Name (Last Name)	Text	Write Parent 2’s legal last name (surname) exactly as it appears on official identity documents.
Parent 2 – Given Name (First Name)	Text	Enter Parent 2’s legal first (given) name. Do not include nicknames or initials unless that is the entire legal name.
Parent 2 – Middle Name	Text	If Parent 2 has a middle name, list it here in full. If none, enter “N/A.”
Parent 2 – Date of Birth	Text	Provide Parent 2’s date of birth in the format MM/DD/YYYY.
Parent 2 – City or Town of Birth	Text	Indicate the city, town, or village where Parent 2 was born, as shown on their birth certificate or other official record.
Parent 2 – Birth Name: Family Name (Last Name)	Text	If Parent 2’s last name at birth was different from their current last name, enter the original last name here; otherwise, repeat the current last name.
Personal Information
A-Number – Digit Box 3	Text	Enter the third digit of your 9-digit Alien Registration Number (A-Number). Provide exactly one numerical digit (0-9); leave no spaces or other characters.
Current Legal Given Name (First Name)	Text	Enter your current legal first name exactly as it appears on your official documents, without nicknames.
A-Number – Digit Box	Text	Enter the following numeric digit of your nine-digit Alien Registration Number (A-Number). Make sure to place only one digit in this individual box, keeping the original order.
A-Number – Digit Box 2	Text	Enter the second digit of your 9-digit Alien Registration Number (A-Number). Provide exactly one numerical digit (0-9); leave no spaces or other characters.
Other Name Used – Given Name (First Name)	Text	Provide any other first name you have ever used since birth (e.g., nickname used legally, anglicized name). If none, leave blank.
Other Name Used – Middle Name	Text	Enter any other middle name you have ever used. If none, leave blank.
Additional Other Name – Family Name (Last Name)	Text	If you have used another different last name not already listed, enter it here. Use this box only if applicable.
Additional Other Name – Given Name (First Name)	Text	If you have used another different first name not already listed, enter it here. Use this box only if applicable.
Additional Other Name – Middle Name	Text	If you have used another different middle name not already listed, enter it here. Use this box only if applicable.
Date of Birth	Text	Type your full date of birth in MM/DD/YYYY format.
Sex: Female	CheckBox	Check this box if your sex is female.
Sex – Male	CheckBox	Check this box if your sex is male.
Additional Other Name 2 – Family Name (Last Name)	Text	Enter any additional last name you have ever used that has not yet been reported. Leave blank if not applicable.
Additional Other Name 2 – Given Name (First Name)	Text	Enter any additional first name you have ever used that has not yet been reported. Leave blank if not applicable.
Additional Other Name 2 – Middle Name	Text	Enter any additional middle name you have ever used that has not yet been reported. Leave blank if not applicable.
City or Town of Birth	Text	Enter the name of the city, town, or village where you were born, as it was known at the time of your birth. Max length: 20 characters
Country of Birth	Text	Type the full, official name of the country where you were physically born. Use the current country name even if it has changed since your birth.
Country of Citizenship or Nationality	Text	Enter the country of which you are presently a citizen or national. If you hold dual citizenship, list the primary country that appears on your passport.
USCIS Online Account Number	Text	If you previously created a USCIS online account (for example, when filing a form electronically), enter the 12-digit number assigned to that account. Otherwise leave blank. Max length: 12 characters
Alien Registration Number (A-Number)	Text	Provide your A-Number exactly as it appears on past USCIS correspondence or your Employment Authorization Document (EAD). It is a 7-, 8-, or 9-digit number preceded by an “A.” Leave blank if you have never been issued one. Max length: 9 characters
Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1	Text	This is a read-only field that displays your Alien Registration Number (A-Number). It is pre-populated from page 1. Max length: 9 characters
Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1	Text	This read-only field displays your Alien Registration Number (A-Number) and is pre-populated from page 1 of the form. Max length: 9 characters
Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1	Text	This is a read-only field that displays your Alien Registration Number (A-Number) and is pre-populated from page 1. Max length: 9 characters
Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1	Text	This is a read-only field that displays your Alien Registration Number (A. Number) and is pre-populated from page 1. Max length: 9 characters
Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1	Text	This is your Alien Registration Number (A. Number). It is a read-only field and pre-populates from page 1. Max length: 9 characters
Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1	Text	This field displays your Alien Registration Number (A. Number). It is a read-only field that is pre-populated from page 1 of the form. Max length: 9 characters
Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1	Text	This field displays your Alien Registration Number (A. Number). It is pre-populated from page 1 and is read-only. Max length: 9 characters
Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1	Text	This field displays your Alien Registration Number (A-Number). It is read-only and pre-populated from page 1. Max length: 9 characters
A-Number	Text	Enter your Alien Registration Number (A-Number) exactly as it appears on your immigration documents. If you do not yet have an A-Number, leave this field blank. Max length: 9 characters
Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1	Text	This field displays the Alien Registration Number (A. Number) and is read-only. It is pre-populated from page 1 of the form. Max length: 9 characters
Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1	Text	This field displays your Alien Registration Number (A. Number). It is a read-only field that pre-populates from page 1 of the form. Max length: 9 characters
Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1	Text	This field displays the Alien Registration Number (A. Number) and is pre-populated from page 1. It is a read-only field. Max length: 9 characters
Applicant’s Family Name (Last Name)	Text	Type your legal family (last) name exactly as it appears on your passport or other official documents.
Applicant’s Given Name (First Name)	Text	Type your legal first name as shown on your official identity documents.
Applicant’s Middle Name	Text	Enter your full middle name. If you have no middle name, leave this field blank or enter “N/A.”
Applicant’s A-Number (Part 14 Section)	Text	If you have been issued an Alien Registration Number (A-Number) by USCIS or DHS, enter it here; otherwise, leave blank. Max length: 9 characters
Applicant’s A-Number (Page Header)	Text	Repeat your A-Number at the top of this page so USCIS can match every sheet to your application packet. Max length: 9 characters
Place of Marriage to Current Spouse
Place of Marriage – Country	Text	State the country where the marriage ceremony with your current spouse took place.
Place of Marriage – State or Province	Text	Enter the state, province, or region where your marriage to your current spouse occurred. If not applicable, write “N/A.”
Place of Marriage – City or Town	Text	Provide the city, town, or village where you were married to your current spouse.
Preparer Information
Preparer’s Given Name (First Name)	Text	Provide the preparer’s legal first (given) name exactly as it appears in official documents.
Preparer’s Business or Organization Name	Text	If the preparer works for a business, law firm, or other organization, enter that entity’s full legal name. Leave blank if the preparer is an individual with no organization affiliation. Max length: 38 characters
Preparer’s Family Name (Last Name)	Text	Provide the preparer’s legal last (family) name exactly as it appears in official documents.
I am an attorney or accredited representative and my representation of the applicant in this case	CheckBox	Check this box when the person preparing the form is a licensed attorney or accredited representative who is formally representing the applicant in connection with this application.
Representation extends beyond preparation of this application	CheckBox	Check this box if you are an attorney or accredited representative whose representation of the applicant goes beyond merely preparing this application.
Does not extend beyond the preparation of this application	CheckBox	Check this box if you are an attorney or accredited representative whose representation of the applicant is limited solely to preparing this application and does not include any further legal representation.
Part 12. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant. Preparer's Signature. 8. A. Preparer's Signature. This signature field can not be signed with a digital signature and the signee's name can not be typewritten into this space. This is a protected field. Print and sign in ink	Text	This field is for the preparer's signature. The signature cannot be digital or typewritten. Print and sign in ink. Max length: 1 characters
Part 12. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant. Preparer's Signature. 8. B. Enter Date of Signature. Enter as 2 digit month, 2 digit day and 4 digit year	Text	Enter the date of the preparer's signature in the format MM/DD/YYYY.
Preparer's Contact Information
Preparer’s Mobile Telephone Number	Text	If available, provide the preparer’s mobile/cell phone number, including country and area code if outside the U.S. Max length: 15 characters
Preparer’s Daytime Telephone Number	Text	Enter a phone number where the preparer can normally be reached during regular business hours, including country and area code if outside the U.S. Max length: 15 characters
Preparer’s Email Address	Text	Enter a valid email address where the preparer receives messages related to this application. Max length: 38 characters
Preparer's Mailing Address
Preparer’s City or Town	Text	Enter the city, town, or municipality for the preparer’s mailing address. Max length: 20 characters
Preparer’s Street Number and Name	Text	Enter the street number and full street name of the preparer’s mailing address. Max length: 25 characters
Preparer’s Mailing Address – Flr.	CheckBox	Check this box when the preparer’s mailing address includes a floor number.
Apt.	CheckBox	Check this box when the preparer’s mailing address includes an apartment number to indicate that the address is in an apartment unit.
Preparer’s Apartment, Suite, or Floor Number	Text	If applicable, enter the unit designator such as Apt., Ste., or Flr., followed by the number. Leave blank if none. Max length: 6 characters
Ste.	CheckBox	Check this box when the preparer’s mailing address uses a suite number rather than an apartment or floor designation.
Preparer’s Postal Code	Text	If the mailing address is outside the United States, enter the foreign postal code. Leave blank for U.S. addresses. Max length: 9 characters
Preparer’s ZIP Code	Text	Enter the five-digit (or ZIP+4) U.S. ZIP code for the preparer’s mailing address. Max length: 5 characters
Preparer’s State	ComboBox	Enter the two-letter U.S. state, territory, or military postal abbreviation for the preparer’s mailing address. CO GA GU IN FM CA AR NC NH VT ME MT MH MD AK VI AS VA WA WI AA MP WY NM TX PA AL MO TN HI IA OK MI PW DE FL LA KY WV NE SC PR IL NY AE SD MS ND NJ KS OR ID MN UT DC OH NV RI MA CT AZ AP
Preparer’s Country	Text	Enter the full country name (or standard abbreviation) for the preparer’s mailing address. Max length: 29 characters
Preparer’s Province	Text	If the mailing address is outside the United States, enter the province, prefecture, or similar level of subdivision. Leave blank for U.S. addresses. Max length: 20 characters
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.	CheckBox	Check this box when the person filling out the form is not a lawyer or accredited representative and has completed it for the applicant with the applicant’s permission.
Principal Applicant Information
Principal Applicant’s Family Name (Last Name)	Text	If you are a derivative applicant, type the legal last name of the principal applicant exactly as it appears on the immigrant petition or passport.
Principal Applicant’s Given Name (First Name)	Text	Enter the principal applicant’s first (given) name. Do not include middle names, suffixes, or titles.
Principal Applicant’s Middle Name	Text	Type the principal applicant’s full middle name. If none, enter “N/A.”
Principal Applicant’s A-Number	Text	Provide the eight- or nine-digit Alien Registration Number (A-Number) assigned to the principal applicant, if any. Omit the ‘A’ prefix and enter digits only. Max length: 9 characters
Principal Applicant’s Date of Birth	Text	Enter the principal applicant’s date of birth in MM/DD/YYYY format.
Priority Date of Principal Applicant’s Underlying Petition	Text	Provide the priority date shown on the principal applicant’s I-797 notice, using MM/DD/YYYY format.
Receipt Number of Principal Applicant’s Underlying Petition	Text	If different from the one in Item 3, type the USCIS receipt number from the principal applicant’s immigrant petition (I-130, I-140, etc.). Max length: 13 characters
Public Charge
Household Size	Text	Provide the total number of people in your household for public-charge purposes, including yourself, your spouse, children, and anyone else you claim as a dependent or whom you financially support. Enter the number as a whole integer (e.g., 4). Max length: 3 characters
Subject to public charge ground of inadmissibility – Yes	CheckBox	Check this box if, in connection with your adjustment of status application, you are subject to the public charge ground of inadmissibility.
No, not subject to the public charge ground of inadmissibility	CheckBox	Check this box if you are not considered a public charge under U.S. immigration law and therefore are not subject to the public charge ground of inadmissibility.
Yes – received long-term institutionalization at government expense	CheckBox	Check this box if you have ever been institutionalized for a long-term period at government expense.
Have you ever received long-term institutionalization at government expense? – No	CheckBox	Check this box if you have never received long-term institutionalization at government expense.
Institution Name/Location – Row 1	Text	Provide the full name, city, and state of the first institution where you were institutionalized at government expense.
Recent Immigration History
Passport Number Used at Last Arrival	Text	Provide the passport number that you presented to U.S. immigration officers the most recent time you entered the United States.
Travel Document Number Used at Last Arrival	Text	If you used a travel document other than a passport (e.g., refugee travel document, advance parole), enter its number here. Otherwise leave blank.
Expiration Date of Passport or Travel Document	Text	Enter the expiration date of the passport or travel document listed above in MM/DD/YYYY format.
Country that Issued Passport or Travel Document	Text	Write the name of the country or issuing authority that issued the passport or travel document you used at your last arrival.
Nonimmigrant Visa Number (from this Passport)	Text	If a visa was placed in the passport you used at last arrival, enter the 8-digit red visa number found in the lower right corner of the visa foil. Leave blank if not applicable.
City or Town of Last Arrival into the United States	Text	Type the name of the U.S. city or town where you last entered the country (port of entry). Max length: 20 characters
State of Last Arrival into the United States	ComboBox	Enter the two-letter postal abbreviation for the state where your last port of entry is located. CO GA GU IN FM CA AR NC NH VT ME MT MH MD AK VI AS VA WA WI AA MP WY NM TX PA AL MO TN HI IA OK MI PW DE FL LA KY WV NE SC PR IL NY AE SD MS ND NJ KS OR ID MN UT DC OH NV RI MA CT AZ AP
Date of Last Arrival (MM/DD/YYYY)	Text	Provide the exact date you most recently entered the United States, in MM/DD/YYYY format.
Type of Parole at Last Arrival (Item 25.b)	Text	If you were paroled into the United States, specify the exact parole program or basis (for example, humanitarian parole, Cuban parole, advance parole). Max length: 34 characters
Was inspected at a port of entry and admitted as (for example, exchange visitor; visitor, waived through; temporary worker; student)	CheckBox	Check this box if on your most recent arrival to the United States you were inspected at a port of entry and formally admitted in a specific nonimmigrant or visitor status.
Was inspected at a port of entry and paroled as (for example, humanitarian parole, Cuban parole)	CheckBox	Check this box if you were inspected at a port of entry and allowed into the United States under a parole status such as humanitarian parole or Cuban parole upon your last arrival.
Came into the United States without admission or parole.	CheckBox	Check this box if your most recent entry into the United States was made without undergoing inspection or receiving admission or parole from immigration authorities.
Other	CheckBox	Check this box when your most recent entry into the United States does not fit the inspected/admitted, inspected/paroled, or unauthorized entry categories and then provide a brief explanation.
I-94 Expiration Date (Item 26.b)	Text	Provide the expiration date of authorized stay shown on your Form I-94 in MM/DD/YYYY format. If your I-94 shows "D/S", write “D/S”.
Status/Class Listed on I-94 (Item 26.c)	Text	Enter the class of admission or parole status printed on your most recent Form I-94 (e.g., B2, F1, H1B, Parolee). Max length: 20 characters
I-94 Arrival-Departure Record Number (Item 26.a)	Text	Enter the 11-digit number from your most recent Form I-94, Arrival-Departure Record. Max length: 11 characters
Class of Admission at Last Arrival (Item 25.a)	Text	Enter the visa category or other class under which you were admitted at your most recent entry to the United States (for example, B-2 visitor, F-1 student, H-1B worker). Max length: 34 characters
Other Manner of Last Entry Explanation (Item 25.d)	Text	Describe any other manner in which you last entered the United States that is not covered by the previous options. Provide a brief explanation. Max length: 20 characters
Family Name (Last Name) on I-94 (Item 28.a)	Text	Enter your family name (last name) exactly as it appears on your Form I-94, including any hyphens, accents, or special characters.
Given Name (First Name) on I-94 (Item 28.b)	Text	Enter your given name (first name) exactly as it appears on your Form I-94.
Middle Name on I-94 (Item 28.c)	Text	Enter your middle name exactly as it appears on your Form I-94. If you do not have a middle name, enter “N/A”.
Current Immigration Status (Item 27)	Text	State your current immigration status if it has changed since your last entry (for example, H-1B worker, F-1 student, TPS). If unchanged, repeat the status shown on your I-94.
Social Security Information
No – SSA has never officially issued a Social Security card	CheckBox	Check this box if you have never been officially issued a Social Security card by the Social Security Administration.
Has the Social Security Administration (SSA) ever officially issued a Social Security card to you? Yes	CheckBox	Check this box if you have previously been issued a Social Security card by the SSA.
U.S. Social Security Number (SSN)	Text	If you already have an SSN, enter the 9-digit number exactly as it appears on your Social Security card (format: NNN-NN-NNNN). Leave blank if you have never been issued one. Max length: 9 characters
I do not want the SSA to issue me a Social Security card	CheckBox	Check this box when you do not wish to have the Social Security Administration issue you a new Social Security card.
Yes – Request SSA to issue a Social Security card	CheckBox	Check this box if you want the Social Security Administration to assign you an SSN and issue you a Social Security card under this application.
Consent for Disclosure – No	CheckBox	Check this box when you do not authorize disclosure of information from your I-485 application to the SSA for the purpose of assigning you a Social Security Number and issuing you a Social Security card.
Consent for Disclosure – Yes	CheckBox	Check this box when you want to authorize disclosure of your application information to the Social Security Administration in order to be assigned a Social Security Number and issued a Social Security card.
System Information
PDF417BarCode1	Text	This is a barcode field that contains encoded information about the form. No input is required.
Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1	Text	This field displays your Alien Registration Number (A. Number) and is read-only. It is pre-populated from page 1. Max length: 9 characters
PDF417BarCode1	Text	This field contains a barcode that is automatically generated and should not be edited.
USCIS Officer Information
Part 13. Signature at Interview. Subscribed to and sworn to (affirmed) before me. U S C I S Officer's Signature. This signature field can not be signed with a digital signature and the signee's name can not be typewritten into this space. This is a protected field. Print and sign in ink	Text	This field is for the USCIS officer's signature at the interview. The signature cannot be digital or typewritten. Print and sign in ink. Max length: 1 characters

Form I-485, Application to Register Permanent Residence Instructions