Form I-751 - Petition To Remove Conditions On Residence Page 3
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11Part 3. Basis for Petition
Other Information
2.a.
Family Name
Joint Filing
(Last Name)
My conditional residence is based on my marriage or my
2.b.
Given Name
(First Name)
parent's marriage to a U.S. citizen or lawful permanent resident,
and I am filing this joint petition together with (Select only one
2.c.
Middle Name
box):
3.
Date of Birth (mm/dd/yyyy)
1.a.
My spouse.
My parent's spouse because I am unable to be
1.b.
4.
U.S. Social Security Number (if any)
included in a joint petition filed by my parent and my
►
parent's spouse.
5.
A-Number (if any)
OR (Select all applicable boxes in the next section.)
►
A-
Waiver or Individual Filing Request
Physical Address
My conditional residence is based on my marriage or my
parent's marriage to a U.S. citizen or lawful permanent resident,
6.a.
Street Number
and Name
I am unable to file a joint petition with my spouse or my
parent's spouse, because:
6.b.
Apt.
Ste.
Flr.
1.c.
My spouse is deceased.
6.c. City or Town
My marriage was entered in good faith, but the
1.d.
marriage was terminated through divorce or
6.d. State
6.e. ZIP Code
annulment.
6.f.
Province
I entered the marriage in good faith, and, during the
1.e.
marriage, I was battered, or was the subject of
6.g.
Postal Code
extreme cruelty, by my U.S. citizen or lawful
permanent resident spouse.
6.h. Country
My parent entered the marriage in good faith, and,
1.f.
during the marriage, I was battered, or was subjected
to extreme cruelty, by my parent's U.S. citizen or
lawful permanent resident spouse or by my
Part 5. Information About Your Children
conditional resident parent.
Provide information on all of your children. If you need extra
The termination of my status and removal from the
1.g.
space to complete this section, use the space provided in
United States would result in an extreme hardship.
Part 11. Additional Information.
Child 1
Part 4. Information About the U.S. Citizen or
1.a.
Family Name
Lawful Permanent Resident Spouse. If Filing as
(Last Name)
a Child Separately, Information About the U.S.
1.b.
Given Name
(First Name)
Citizen or Lawful Permanent Resident
Stepparent Through Whom You Gained Your
1.c.
Middle Name
Conditional Residence.
2.
Date of Birth (mm/dd/yyyy)
Relationship
3.
A-Number (if any)
1.a.
Spouse or Former Spouse
►
A-
1.b.
Parent's Spouse or Former Spouse
4.
Is this child living with you?
Yes
No
5.
Is this child applying with you?
Yes
No
Form I-751 12/23/16 N
Page 3 of 11
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