Form I-485 - Application To Register Permanent Residence Or Adjust Status
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6OMB No. 1615-0023; Expires 12/31/2010
Form I-485, Application to Register
Department of Homeland Security
Permanent Residence or Adjust Status
U.S. Citizenship and Immigration Services
START HERE - Type or Print (Use black ink)
For USCIS Use Only
Part 1. Information About You
Returned
Receipt
Family Name (Last Name)
Given Name (First Name)
Middle Name
Address - Street Number and Name
Apt. #
Resubmitted
C/O (in care of)
City
State
Zip Code
Reloc Sent
Date of Birth (mm/dd/yyyy)
Country of Birth
Country of Citizenship/Nationality
U.S. Social Security # (if any)
A # (if any)
Reloc Rec'd
Date of Last Arrival (mm/dd/yyyy)
I-94 #
Applicant
Current USCIS Status
Expires on (mm/dd/yyyy)
Interviewed
Part 2. Application Type (Check one)
Section of Law
I am applying for an adjustment to permanent resident status because:
Sec. 209(a), INA
Sec. 209(b), INA
a.
An immigrant petition giving me an immediately available immigrant visa number
Sec. 13, Act of 9/11/57
that has been approved. (Attach a copy of the approval notice, or a relative, special
Sec. 245, INA
immigrant juvenile, or special immigrant military visa petition filed with this
Sec. 249, INA
application that will give you an immediately available visa number, if approved.)
Sec. 1 Act of 11/2/66
Sec. 2 Act of 11/2/66
b.
My spouse or parent applied for adjustment of status or was granted lawful
Other
permanent residence in an immigrant visa category that allows derivative status
for spouses and children.
Country Chargeable
c.
I entered as a K-1 fiancé(e) of a U.S. citizen whom I married within 90 days of
entry, or I am the K-2 child of such a fiancé(e). (Attach a copy of the fiancé(e)
petition approval notice and the marriage certificate.)
Eligibility Under Sec. 245
Approved Visa Petition
d.
I was granted asylum or derivative asylum status as the spouse or child of a person
Dependent of Principal Alien
granted asylum and am eligible for adjustment.
Special Immigrant
e.
I am a native or citizen of Cuba admitted or paroled into the United States after
Other
January 1, 1959, and thereafter have been physically present in the United States
for at least 1 year.
Preference
f.
I am the husband, wife, or minor unmarried child of a Cuban described above in
Action Block
(e), and I am residing with that person, and was admitted or paroled into the United
States after January 1, 1959, and thereafter have been physically present in the
United States for at least 1 year.
g.
I have continuously resided in the United States since before January 1, 1972.
h.
Other basis of eligibility. Explain (for example, I was admitted as a refugee, my
status has not been terminated, and I have been physically present in the United
States for 1 year after admission). If additional space is needed, see Page 2 of the
instructions.
I am already a permanent resident and am applying to have the date I was granted
To be Completed by
permanent residence adjusted to the date I originally arrived in the United States as
Attorney or Representative, if any
a nonimmigrant or parolee, or as of May 2, 1964, whichever date is later, and:
Fill in box if Form G-28 is attached to
(Check one)
represent the applicant.
i.
I am a native or citizen of Cuba and meet the description in (e) above.
VOLAG #
j.
I am the husband, wife, or minor unmarried child of a Cuban and meet the
ATTY State License #
description in (f) above.
Form I-485 (Rev. 07/15/10) Y
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