Form I-485 -U.s. Citizenship Immigration And Service - Department Of Homeland Security Page 2
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2Part C. Additional Eligibility Information (Continued)
e.
You are a native or citizen of Cuba, or the spouse or child of such alien, who was not lawfully inspected or admitted to the
United States;
f.
You are a special immigrant retired international organization employee or family member;
g.
You are a special immigrant physician;
h.
You are a public interest parolee, who was denied refugee status, and are from the former Soviet Union, Vietnam, Laos or
Cambodia (a "Lautenberg Parolee" under Public Law 101-167); or
i.
You are eligible under the Immigration Nursing Relief Act.
No. I am not applying for adjustment of status for any of these reasons. (Go to next question)
Yes. I am applying for adjustment of status for any one of these reasons. (If you answered "Yes," do not file this form.)
2. Do any of the following conditions describe you?
a.
You are already a lawful permanent resident of the United States.
b. You have continuously maintained lawful immigration status in the United States since November 5, 1986.
c. You are applying to adjust status as the spouse or unmarried minor child of a U.S. citizen or the parent of a U.S. citizen
child at least 21 years of age, and you were inspected and lawfully admitted to the United States.
No. None of these conditions describe me. (Go to Part D. Signature)
Yes. If you answered "Yes," do not file this form.
Part D. Signature
Read the information on penalties in the instructions before completing this section.
I certify, under penalty of perjury under the laws of the United States of America, that this application and the evidence submitted
with it is all true and correct. I authorize the release of any information from my records that the U.S. Citizenship and Immigration
Services needs to determine eligibility for the benefit being sought.
Signature
Date
Print Name
Part E. Signature of Person Preparing Form, If Other Than Above
Read the information on penalties in the instructions before completing this section.
I certify, under penalty of perjury under the laws of the United States of America, that I prepared this form at the request of the above
person and that to the best of my knowledge the contents of this application are all true and correct.
Date
Signature
Print Name
Daytime Phone Number
(Area Code and Number)
Firm Name and Address
E-Mail Address, if any
Form I-485 Supplement A (Rev. 01/18/11)Y Page 2
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