Form I-485 - Application To Register Permanent Residence Or Adjust Status Page 9
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A-Number
A-
Dates of Membership or Dates of Involvement
Part 7. Biographic Information (continued)
5.a.
From (mm/dd/yyyy)
3.
Height
Feet
Inches
5.b.
To (mm/dd/yyyy)
4.
Weight
Pounds
5.
Eye Color (Select only one box)
Organization 2
6.
Name of Organization
Black
Blue
Brown
Gray
Green
Hazel
7.a.
City or Town
Maroon
Pink
Unknown/Other
6.
Hair Color (Select only one box)
7.b.
State or Province
Bald (No hair)
Black
Blond
Brown
Gray
Red
7.c.
Country
Sandy
White
Unknown/Other
Part 8. General Eligibility and Inadmissibility
8.
Nature of Group
Grounds
1.
Have you EVER been a member of, involved in, or in
Dates of Membership or Dates of Involvement
any way associated with any organization, association,
9.a.
From (mm/dd/yyyy)
fund, foundation, party, club, society, or similar group in
the United States or in any other location in the world
9.b.
To (mm/dd/yyyy)
including any military service?
Yes
No
If you answered "Yes" to Item Number 1., complete Item
Organization 3
Numbers 2. - 13.b. below. If you need extra space to complete
10.
Name of Organization
this section, use the space provided in Part 14. Additional
Information. If you answered "No," but are unsure of your
answer, provide an explanation of the events and circumstances
11.a.
City or Town
in the space provided in Part 14. Additional Information.
Organization 1
11.b.
State or Province
2.
Name of Organization
11.c.
Country
3.a.
City or Town
12.
Nature of Group
3.b.
State or Province
Dates of Membership or Dates of Involvement
3.c.
Country
13.a.
From (mm/dd/yyyy)
4.
Nature of Group
13.b.
To (mm/dd/yyyy)
Form I-485 06/26/17 N
Page 9 of 18
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