Form I-690 - Application For Waiver Of Grounds Of Inadmissibility Page 2
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8Part 1. Information About You (the Applicant) (continued)
Physical Address
Street Number and Name
Apt.
Ste.
Flr. Number
4.
City or Town
State
ZIP Code
Province
Postal Code
Country
Other Information
5.
City/Town/Village of Birth
6.
Country of Birth
7.
Date of Birth (mm/dd/yyyy)
8.
Alien Registration Number (if any)
►
A-
9.
USCIS Online Account Number (if any)
10.
U.S. Social Security Number (if any)
►
►
Part 2. Additional Information About You
(mm/dd/yyyy) ►
1.
Date Primary Application Filed
2.
Type of Primary Application
Permanent Residence (Form I-698)
Temporary Residence (Form I-687 or Form I-700)
►
3.
Relating Receipt Number
4.
I am applying for a waiver of (Select all that apply):
INA section (Please see the instructions for more information on these sections)
212 (a) (1)(A)(i), (ii), (iii) or (iv)
212 (a)(2)(A)(i)(II)
212 (a)(6)(A)(i)
212(a)(6)(C)(i) or (ii)
212(a)(6)(D) and/or (E)
212(a)(8)(A) and/or (B)
212(a)(9)(A)(i) or (ii)
212(a)(9)(B)(i)(I) or (i)(II)
212(a)(9)(C)(i)(I) or (i)(II)
212 (a)(10)(A), (B), (C), (D) and/or Other Inadmissibility - Specify below
5.
List specific reasons for inadmissibility.
Form I-690 12/23/16 N
Page 2 of 8
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Parent category: Legal