Form I-698 - Application To Adjust Status From Temporary To Permanent Resident (Under Section 245a Of The Ina)

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Application to Adjust Status From Temporary
to Permanent Resident (Under Section 245A of the INA)
USCIS
Form I-698
Department of Homeland Security
OMB No. 1615-0035
U.S. Citizenship and Immigration Services
Expires 03/31/2019
Receipt
Action Block
Applicant Interviewed
Date:
For
USCIS
Date of Adjustment
Use
Only
Remarks
Date:
START HERE - Type or print in black ink.
Part 1. Information About You
1.
Full Legal Name
Family Name (Last Name)
Given Name (First Name)
Middle Name
2.
Name as it Appears on Your Employment Authorization Document (Form I-766)
A.
Family Name (Last Name)
Given Name (First Name)
Middle Name
B.
Provide the reason for a difference in the names, if any (marriage, divorce, etc.)
3.
Any Other Names Used
A.
Family Name (Last Name)
Given Name (First Name)
Middle Name
B.
Family Name (Last Name)
Given Name (First Name)
Middle Name
4.
A.
If your native alphabet does not use Roman letters, type or print your name in your native alphabet.
Family Name (Last Name)
Given Name (First Name)
Middle Name
B.
Language of Your Native Alphabet
5.
U.S. Mailing Address
In Care Of Name
Street Number and Name
Apt.
Ste.
Flr.
Number
City or Town
State
ZIP Code
6.
Is your current U.S. mailing address the same as your U.S. physical address?
Yes
No
If you answered "No," provide your U.S. physical address in Item Number 7.
Page 1 of 9
Form I-698 03/03/17 Y

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