Form I-485 - Application To Register Permanent Residence Or Adjust Status Page 10
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A-Number
A-
Criminal Acts and Violations
Part 8. General Eligibility and Inadmissibility
Grounds (continued)
For Item Numbers 25. - 45., you must answer "Yes" to any
question that applies to you, even if your records were sealed or
Answer Item Numbers 14. - 80.b. Choose the answer that you
otherwise cleared, or even if anyone, including a judge, law
think is correct. If you answer “Yes” to any questions (or if
enforcement officer, or attorney, told you that you no longer
you answer "No," but are unsure of your answer), provide
have a record. You must also answer "Yes" to the following
an explanation of the events and circumstances in the space
questions whether the action or offense occurred here in the
provided in Part 14. Additional Information.
United States or anywhere else in the world. If you answer
14.
Have you EVER been denied admission to the United
"Yes" to Item Numbers 25. - 45., use the space provided in
States?
Part 14. Additional Information to provide an explanation
Yes
No
that includes why you were arrested, cited, detained, or charged;
15.
Have you EVER been denied a visa to the United States?
where you were arrested, cited, detained, or charged; when
(date) the event occurred; and the outcome or disposition (for
Yes
No
example, no charges filed, charges dismissed, jail, probation,
16.
Have you EVER worked in the United States without
community service).
authorization?
Yes
No
25.
Have you EVER been arrested, cited, charged, or
detained for any reason by any law enforcement official
Have you EVER violated the terms or conditions of your
17.
(including but not limited to any U.S. immigration
nonimmigrant status?
Yes
No
official or any official of the U.S. armed forces or U.S.
Coast Guard)?
Yes
No
18.
Are you presently or have you EVER been in removal,
exclusion, rescission, or deportation proceedings?
26.
Have you EVER committed a crime of any kind (even if
Yes
No
you were not arrested, cited, charged with, or tried for that
crime)?
Yes
No
19.
Have you EVER been issued a final order of exclusion,
deportation, or removal?
Yes
No
27.
Have you EVER pled guilty to or been convicted of a
crime or offense (even if the violation was subsequently
20.
Have you EVER had a prior final order of exclusion,
expunged or sealed by a court, or if you were granted a
deportation, or removal reinstated?
Yes
No
pardon, amnesty, a rehabilitation decree, or other act of
clemency)?
Yes
No
21.
Have you EVER held lawful permanent resident status
which was later rescinded?
Yes
No
NOTE: If you were the beneficiary of a pardon, amnesty,
a rehabilitation decree, or other act of clemency, provide
22.
Have you EVER been granted voluntary departure by an
documentation of that post-conviction action.
immigration officer or an immigration judge but failed to
depart within the allotted time?
28.
Have you EVER been ordered punished by a judge or had
Yes
No
conditions imposed on you that restrained your liberty
(such as a prison sentence, suspended sentence, house
23.
Have you EVER applied for any kind of relief or
arrest, parole, alternative sentencing, drug or alcohol
protection from removal, exclusion, or deportation?
treatment, rehabilitative programs or classes, probation, or
Yes
No
community service)?
Yes
No
24.a. Have you EVER been a J nonimmigrant exchange visitor
who was subject to the two-year foreign residence
29.
Have you EVER been a defendant or the accused in a
requirement?
criminal proceeding (including pre-trial diversion,
Yes
No
deferred prosecution, deferred adjudication, or any
If you answered "Yes" to Item Number 24.a., complete Item
withheld adjudication)?
Yes
No
Numbers 24.b. - 24.c. If you answered "No" to Item Number
24.a., skip to Item Number 25.
30.
Have you EVER violated (or attempted or conspired to
violate) any controlled substance law or regulation of a
24.b.
Have you complied with the foreign residence
state, the United States, or a foreign country?
requirement?
Yes
No
Yes
No
24.c.
Have you been granted a waiver or has Department of
State issued a favorable waiver recommendation letter
for you?
Yes
No
Form I-485 06/26/17 N
Page 10 of 18
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