Form I-687 - Application For Status As A Temporary Resident Under Section 245a Of The Immigration And Nationality Act Page 2

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13. Have you previously applied for temporary residence as a Legalization applicant?
No
Yes
If Yes, give date, place of filing, and final disposition, if known.
14. Do you have other records with USCIS (or the former INS)?
No
Yes
If Yes, give file numbers. A #
Other
15. When did you first come to the U.S.?
16. Manner of Entry
(mm/dd/yyyy)
Without a visa
With a visa (visitor, student, etc.) specify:
17. Place of first entry into U.S. to reside:
Port of Entry (City and State):
Border - Not through a Port of Entry (State):
Living A #
18. Mother's Name
(Maiden Name, Last Name, First Name)
Deceased (year)
Immigration Status
Living A #
19. Father's Name
(Last Name, First Name)
Deceased (year)
Immigration Status
20. List your present and past husbands/wives and all of your sons and daughters (if additional space is needed, use separate paper).
Family Name
Given Name
A #
Country of Birth
Relationship
Family Name
Given Name
A #
Country of Birth
Relationship
Family Name
Given Name
A #
Country of Birth
Relationship
Family Name
Given Name
A #
Country of Birth
Relationship
Family Name
Given Name
A #
Country of Birth
Relationship
Family Name
Given Name
A #
Country of Birth
Relationship
Form I-687 (11/23/10) Y Page 2

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