Instructions For Form I-601a - Application For Provisional Unlawful Presence Waiver Page 21

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Is My Form I-601A Complete?
Ensure that you have completed ALL of the following actions before you file your Form I-601A with USCIS.
If I am filing as the principal or derivative beneficiary or as the self-petitioner of an approved immigrant visa petition,
I placed documentation showing that I paid DOS the immigrant visa processing fee on top of my Form I-601A and
supporting documentation.
If I am filing as a Diversity Visa program selectee or derivative, I placed documentation showing that I (or my
parent or spouse) was selected by DOS to participate in the DV Program on top of my Form I-601A and supporting
documentation.
If I am in removal, exclusion, or deportation proceedings, I included a copy of my administrative closure order from
the U.S. Department of Justice, Executive Office for Immigration Review (EOIR).
If I have an administratively final order of removal, exclusion, or deportation that has been entered or issued against
me (including an in absentia order under INA section 240(b)(5)) but I applied for and USCIS already approved, an
application for permission to reapply for admission to the United States after deportation or removal (Form I-212),
I included my USCIS Receipt number in Part 1., Item Number 29.b. on Form I-601A or I included a copy of the
approval notice that USCIS sent when it notified me of the Form I-212 approval, or both.
I included arrest records and conviction documents for any criminal offenses, if applicable.
I completed every applicable item on my Form I-601A, including my full name, my U.S. mailing and physical
addresses, and my date of birth. I attached documents to support my statements, when requested, on Form I-60lA or
in the What Evidence Should I Submit With Form I-601A section of these Instructions.
In Part 3. Information About Your Immigrant Visa Case, I provided information about the approved immigrant
visa petition (Form I-130, Form I-140, or Form I-360) that was filed on my (or my spouse’s or parent’s) behalf, or that
I filed as a self-petitioner, and I attached a copy (if available) of the immigrant visa petition approval notice (Form
I-797, Notice of Action).
In Part 3., I provided information about my DOS immigrant visa case.
In Part 4. Information About Your Qualifying Relative, I provided information about my qualifying relatives and
I explained the extreme hardship to my qualifying relatives in Part 4. I also explained in Part 4. why USCIS should
approve my application for a provisional unlawful presence waiver as a matter of discretion.
I read the Penalties section of these Instructions and I (or a parent or legal guardian, if applicable) signed this Form
I-601A.
I included the required filing fee and biometric services fee in the form of checks or money orders as described in the
What Is the Filing Fee section of these Instructions.
Form I-601A Instructions 12/23/16 N
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