Form I-485 - Application To Register Permanent Residence Or Adjust Status - Department Of Homeland Security Page 11
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A-Number
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42.
Have you EVER trafficked a person into involuntary
Part 8. General Eligibility and Inadmissibility
servitude, peonage, debt bondage, or slavery? Trafficking
Grounds (continued)
includes recruiting, harboring, transporting, providing, or
obtaining a person for labor or services through the use of
31.
Have you EVER been convicted of two or more offenses
force, fraud, or coercion.
Yes
No
(other than purely political offenses) for which the
combined sentences to confinement were five years or
43.
Have you EVER knowingly aided, abetted, assisted,
more?
Yes
No
conspired, or colluded with others in trafficking persons
for commercial sex acts or involuntary servitude,
32.
Have you EVER illicitly (illegally) trafficked or benefited
peonage, debt bondage, or slavery?
Yes
No
from the trafficking of any controlled substances, such as
chemicals, illegal drugs, or narcotics?
Yes
No
44.
Are you the spouse, son or daughter of a foreign national
who engaged in the trafficking of persons and have
33.
Have you EVER knowingly aided, abetted, assisted,
received or obtained, within the last five years, any
conspired, or colluded in the illicit trafficking of any
financial or other benefits from the illicit activity of your
illegal narcotic or other controlled substances?
spouse or your parent, although you knew or reasonably
Yes
No
should have known that this benefit resulted from the illicit
activity of your spouse or parent?
Yes
No
34.
Are you the spouse, son, or daughter of a foreign national
who illicitly trafficked or aided (or otherwise abetted,
45.
Have you EVER engaged in money laundering or have
assisted, conspired, or colluded) in the illicit trafficking of
you EVER knowingly aided, assisted, conspired, or
a controlled substance, such as chemicals, illegal drugs, or
colluded with others in money laundering or do you seek
narcotics and you obtained, within the last five years, any
to enter the United States to engage in such activity?
financial or other benefit from the illegal activity of your
Yes
No
spouse or parent, although you knew or reasonably should
have known that the financial or other benefit resulted
from the illicit activity of your spouse or parent?
Security and Related
Yes
No
Do you intend to:
35.
Have you EVER engaged in prostitution or are you
46.a. Engage in any activity that violates or evades any law
coming to the United States to engage in prostitution?
relating to espionage (including spying) or sabotage in the
Yes
No
United States?
Yes
No
36.
Have you EVER directly or indirectly procured (or
46.b. Engage in any activity in the United States that violates or
attempted to procure) or imported prostitutes or persons
evades any law prohibiting the export from the United
for the purpose of prostitution?
Yes
No
States of goods, technology, or sensitive information?
Yes
No
37.
Have you EVER received any proceeds or money from
prostitution?
Yes
No
46.c. Engage in any activity whose purpose includes opposing,
controlling, or overthrowing the U.S. Government by
38.
Do you intend to engage in illegal gambling or any other
force, violence, or other unlawful means while in the
form of commercialized vice, such as prostitution,
United States?
Yes
No
bootlegging, or the sale of child pornography, while in the
United States?
Yes
No
46.d. Engage in any activity that could endanger the welfare,
safety, or security of the United States?
39.
Have you EVER exercised immunity (diplomatic or
Yes
No
otherwise) to avoid being prosecuted for a criminal
offense in the United States?
Yes
No
46.e.
Engage in any other unlawful activity?
Yes
No
Have you EVER, while serving as a foreign government
40.
47.
Are you engaged in or, upon your entry into the United
official, been responsible for or directly carried out
States, do you intend to engage in any activity that could
violations of religious freedoms?
Yes
No
have potentially serious adverse foreign policy
consequences for the United States?
Yes
No
Have you EVER induced by force, fraud, or coercion (or
41.
otherwise been involved in) the trafficking of persons for
commercial sex acts?
Yes
No
Form I-485 06/26/17 N
Page 11 of 18
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