Form I-751 - Petition To Remove Conditions On Residence Page 2

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21.
If you are married, is this a different marriage than the
Part 1. Information About You, the Conditional
one through which you gained conditional resident status?
Resident (continued)
Yes
No
Mailing Address
22.
Have you resided at any other address since you became a
permanent resident?
Yes
No
15.a.
In Care Of Name
If you answered “Yes” to Item Number 22., provide a list of all
addresses where you have resided since becoming a permanent
15.b.
Street Number
resident and the dates you resided at those locations in the space
and Name
provided in Part 11. Additional Information.
15.c.
Apt.
Ste.
Flr.
23.
Is your spouse or parent's spouse currently serving with or
employed by the U.S. Government and serving outside
15.d. City or Town
the United States?
Yes
No
15.e. State
15.f. ZIP Code
16.
Is your physical address different than your mailing
Part 2. Biographic Information
address?
Yes
No
1.
Ethnicity (Select only one box)
If you answered “Yes” to Item Number 16., provide your
Hispanic or Latino
physical address below.
Not Hispanic or Latino
2.
Race (Select all applicable boxes)
Physical Address
White
17.a.
In Care Of Name
Asian
Black or African American
17.b.
Street Number
American Indian or Alaska Native
and Name
Native Hawaiian or Other Pacific Islander
17.c.
Apt.
Ste.
Flr.
3.
Height
Feet
Inches
17.d. City or Town
4.
Weight
Pounds
17.e. State
17.f. ZIP Code
5.
Eye Color (Select only one box)
Black
Blue
Brown
Additional Information About You
Gray
Green
Hazel
18.
Are you in removal, deportation, or rescission
Maroon
Pink
Unknown/Other
proceedings?
Yes
No
6.
Hair Color (Select only one box)
19.
Was a fee paid to anyone other than an attorney in
Bald (No hair)
Black
Blond
connection with this petition?
Yes
No
Brown
Gray
Red
20.
Have you ever been arrested, detained, charged, indicted,
Sandy
White
Unknown/Other
fined, or imprisoned for breaking or violating any law or
ordinance (excluding traffic regulations), or committed
any crime which you were not arrested in the United
States or abroad?
Yes
No
If you answered "Yes" to Item Number 20., provide a detailed
explanation in Part 11. Additional Information or on a
separate sheet of paper, and refer to the What Initial Evidence
Is Required section of the Form I-751 instructions to determine
what criminal history document to include with your petition.
Form I-751 12/23/16 N
Page 2 of 11

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