Instructions For Form I-485 Supplement A (Page 4 of 4) in pdf

Instructions For Form I-485 Supplement A Page 4

Penalties

If you knowingly and willfully falsify or conceal a material fact or submit a false document with your Form I-485 Supplement A, we

will deny your Form I-485 Supplement A and may deny any other immigration benefit.

In addition, you will face severe penalties provided by law and may be subject to criminal prosecution.

Privacy Act Notice

We ask for the information on this form, and associated evidence, to determine if you have established eligibility for the immigration

benefit for which you are filing. Our legal right to ask for this information can be found in the Immigration and Nationality Act, as

amended. We may provide this information to other government agencies. Failure to provide this information, and any requested

evidence, may delay a final decision or result in denial of your Form I-485 Supplement A.

Paperwork Reduction Act

An agency may not conduct or sponsor an information collection and a person is not required to respond to a collection of information

unless it displays a currently valid OMB control number. The public reporting burden for this collection of information is estimated

at 13 minutes per response, including the time for reviewing instructions, and completing and submitting the form. Send comments

regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to:

U.S. Citizenship and Immigration Services, Regulatory Coordination Division, Office of Policy and Strategy, 20 Massachusetts Ave

NW, Washington, DC 20529-2140; OMB No. 1615-0023. Do not mail your completed Form I-485 Supplement A to this address.

Checklist

I signed the form at Part D.

I included the appropriate fees (if any).

If I checked box b. or d. in Question 1., Part B, I included evidence of my physical presence in the United States on

December 21, 2000.

Form I-485 Supplement A Instructions 01/17/17 N Page 4

Instructions For Form I-485 Supplement A Page 4