Form I-485 - Application To Register Permanent Residence Or Adjust Status - Department Of Homeland Security Page 3
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A-Number
A-
1.d.
Asylee or Refugee
Part 1. Information About You (Person applying
Asylum status (INA section 208), Form I-589 or
for lawful permanent residence) (continued)
Form I-730
24.
What is your current immigration status (if it has changed
Refugee status (INA section 207), Form I-590 or
since your arrival)?
Form I-730
1.e.
Human Trafficking Victim or Crime Victim
Provide your name exactly as it appears on your Form I-94 (if
Human trafficking victim (T Nonimmigrant), Form
any)
I-914 or derivative family member, Form I-914A
25.a. Family Name
Crime victim (U Nonimmigrant), Form I-918,
(Last Name)
derivative family member, Form I-918A, or
25.b.
Given Name
qualifying family member, Form I-929
(First Name)
1.f.
Special Programs Based on Certain Public Laws
25.c.
Middle Name
The Cuban Adjustment Act
The Cuban Adjustment Act for battered spouses and
Part 2. Application Type or Filing Category
children
NOTE: Attach a copy of the Form I-797 receipt or approval
Dependent status under the Haitian Refugee
notice for the underlying petition or application, as appropriate.
Immigrant Fairness Act
I am applying to register lawful permanent residence or adjust
Dependent status under the Haitian Refugee
status to that of a lawful permanent resident based on the
Immigrant Fairness Act for battered spouses and
following immigrant category (select only one box). (See the
children
Form I-485 Instructions for more information, including any
Lautenberg Parolees
Additional Instructions that relate to the immigrant category
Diplomats or high ranking officials unable to return
you select.):
home (Section 13 of the Act of September 11, 1957)
1.a. Family-based
Indochinese Parole Adjustment Act of 2000
Immediate relative of a U.S. citizen, Form I-130
1.g.
Additional Options
Other relative of a U.S. citizen or relative of a lawful
permanent resident under the family-based preference
Diversity Visa program
categories, Form I-130
Continuous residence in the United States since
Person admitted to the United States as a fiancé(e) or
before January 1, 1972 ("Registry")
child of a fiancé(e) of a U.S. citizen, Form I-129F
Individual born in the United States under diplomatic
(K-1/K-2 Nonimmigrant)
status
Widow or widower of a U.S. citizen, Form I-360
Other eligibility
VAWA self-petitioner, Form I-360
1.b.
Employment-based
2.
Are you applying for adjustment based on the
Alien worker, Form I-140
Immigration and Nationality Act (INA) section 245(i)?
Yes
No
Alien entrepreneur, Form I-526
1.c.
Special Immigrant
NOTE: If you answered "Yes" to Item Number 2., you
must have selected a family-based, employment-based,
Religious worker, Form I-360
special immigrant, or Diversity Visa immigrant category
listed above in Item Numbers 1.a. - 1.g. as the basis for
Special immigrant juvenile, Form I-360
your application for adjustment of status. Fill out the rest
Certain Afghan or Iraqi national, Form I-360
of this application and Supplement A to Form I-485,
Adjustment of Status Under Section 245(i) (Supplement
Certain international broadcaster, Form I-360
A). For detailed filing instructions, read the Form I-485
Instructions (including any Additional Instructions that
Certain G-4 international organization or family
relate to the immigrant category that you selected in Item
member or NATO-6 employee or family member,
Numbers 1.a. - 1.g.) and Supplement A Instructions.
Form I-360
Form I-485 06/26/17 N
Page 3 of 18
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