Form I-485 - Application To Register Permanent Residence Or Adjust Status Page 2
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18►
A-Number
A-
Recent Immigration History
Part 1. Information About You (Person applying
for lawful permanent residence) (continued)
Provide the information for Item Numbers 15. - 19. if you last
entered the United States using a passport or travel document.
8.
Country of Birth
15.
Passport Number Used at Last Arrival
9.
Country of Citizenship or Nationality
16.
Travel Document Number Used at Last Arrival
10.
Alien Registration Number (A-Number) (if any)
►
17.
Expiration Date of this Passport or Travel Document
A-
(mm/dd/yyyy)
NOTE: If you have EVER used other A-Numbers,
include the additional A-Numbers in the space provided
18.
Country that Issued this Passport or Travel Document
in Part 14. Additional Information.
11.
USCIS Online Account Number (if any)
19.
Nonimmigrant Visa Number from this Passport (if any)
►
12.
U.S. Social Security Number (if any)
Place of Last Arrival into the United States
►
20.a.
City or Town
U.S. Mailing Address
20.b. State
13.a. In Care Of Name (if any)
21.
Date of Last Arrival (mm/dd/yyyy)
13.b.
Street Number
When I last arrived in the United States, I:
and Name
22.a.
Was inspected at a port of entry and admitted as (for
13.c.
Apt.
Ste.
Flr.
example, exchange visitor; visitor, waived through;
temporary worker; student):
13.d.
City or Town
13.e.
State
13.f.
ZIP Code
22.b.
Was inspected at a port of entry and paroled as (for
example, humanitarian parole, Cuban parole):
Alternate and/or Safe Mailing Address
If you are applying based on the Violence Against Women Act
22.c.
Came into the United States without admission or
(VAWA) or as a special immigrant juvenile, human trafficking
parole.
victim (T nonimmigrant), or victim of a qualifying crime (U
22.d.
nonimmigrant) and you do not want USCIS to send notices
Other:
about this application to your home, you may provide an
alternative and/or safe mailing address.
If you were issued a Form I-94 Arrival-Departure Record Number:
14.a. In Care Of Name (if any)
23.a.
Form I-94 Arrival-Departure Record Number
►
14.b.
Street Number
and Name
23.b.
Expiration Date of Authorized Stay Shown on Form I-94
14.c.
Apt.
Ste.
Flr.
(mm/dd/yyyy)
23.c. Status on Form I-94 (for example, class of admission, or
14.d.
City or Town
paroled, if paroled)
14.e.
State
14.f.
ZIP Code
Form I-485 06/26/17 N
Page 2 of 18
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