Form I-485 - Application To Register Permanent Residence Or Adjust Status Page 14
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A-Number
A-
80.a. Have you EVER left or remained outside the United
Part 8. General Eligibility and Inadmissibility
States to avoid or evade training or service in the U.S.
Grounds (continued)
armed forces in time of war or a period declared by the
Since April 1, 1997, have you EVER reentered or attempted to
President to be a national emergency?
Yes
No
reenter the United States without being inspected and admitted
or paroled after:
80.b.
If your answer to Item Number 80.a. is “Yes,” what was
your nationality or immigration status immediately before
73.a.
Having been unlawfully present in the United States for
you left (for example, U.S. citizen or national, lawful
more than one year in the aggregate?
Yes
No
permanent resident, nonimmigrant, parolee, present
without admission or parole, or any other status)?
73.b.
Having been deported, excluded, or removed from the
United States?
Yes
No
Miscellaneous Conduct
Part 9. Accommodations for Individuals With
Disabilities and/or Impairments
74.
Do you plan to practice polygamy in the United States?
Yes
No
NOTE: Read the information in the Form I-485 Instructions
before completing this part.
75.
Are you accompanying another foreign national who
requires your protection or guardianship but who is
1.
Are you requesting an accommodation because of your
inadmissible after being certified by a medical officer as
disabilities and/or impairments?
Yes
No
being helpless from sickness, physical or mental
disability, or infancy, as described in INA section 232(c)?
If you answered "Yes" to Item Number 1., select any
applicable box in Item Numbers 2.a. - 2.c. and provide
Yes
No
an answer.
76.
Have you EVER assisted in detaining, retaining, or
I am deaf or hard of hearing and request the
2.a.
withholding custody of a U.S. citizen child outside the
following accommodation. (If you are requesting a
United States from a U.S. citizen who has been granted
sign-language interpreter, indicate for which
custody of the child?
Yes
No
language (for example, American Sign Language).):
77.
Have you EVER voted in violation of any Federal, state,
or local constitutional provision, statute, ordinance, or
regulation in the United States?
Yes
No
2.b.
I am blind or have low vision and request the
78.
Have you EVER renounced U.S. citizenship to avoid
following accommodation:
being taxed by the United States?
Yes
No
Have you EVER:
79.a. Applied for exemption or discharge from training or
2.c.
I have another type of disability and/or impairment.
service in the U.S. armed forces or in the U.S. National
(Describe the nature of your disability and/or
Security Training Corps on the ground that you are a
impairment and the accommodation you are
foreign national?
requesting.)
Yes
No
79.b. Been relieved or discharged from such training or service
on the ground that you are a foreign national?
Yes
No
79.c. Been convicted of desertion from the U.S. armed forces?
Yes
No
Form I-485 06/26/17 N
Page 14 of 18
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