Fillable Printable Form I-485
What is a Form I-485 ?
Form I-485, also known as Application to Register Permanent Residence or Adjust Status, is a form submitted to the United States Citizenship and Immigration Services (USCIS) used by people in the United States. Form I-485 is used to apply for lawful permanent resident status. More information about Form I-485 and its separate instructions is at USCIS. Edit, fill and sign form I-485 online at HandyPDF.
Fillable Printable Form I-485
What is a Form I-485 ?
Form I-485, also known as Application to Register Permanent Residence or Adjust Status, is a form submitted to the United States Citizenship and Immigration Services (USCIS) used by people in the United States. Form I-485 is used to apply for lawful permanent resident status. More information about Form I-485 and its separate instructions is at USCIS. Edit, fill and sign form I-485 online at HandyPDF.
Form I-485
Form I-485 06/26/17 N Page 1 of 18
1.b.
1.c.
1.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Your Current Legal Name (do not provide a
nickname)
Application to Register Permanent Residence
or Adjust Status
Department of Homeland Security
U.S. Citizenship and Immigration Services
USCIS
Form I-485
OMB No. 1615-0023
Expires 06/30/2019
Priority Date:
Country Chargeable:
INA 209(a)
INA 249
Section of Law
INA 245(a)
INA 245(i)
INA 245(m)
Sec. 13, Act of 9/11/57
Cuban Adjustment Act
Other
Lawful Permanent
Resident as of:
Date of
Initial Interview:
Action BlockReceipt
Interview
Waived
Applicant
Interviewed
Date Form I-693 Received:
Attorney State Bar Number
(if applicable)
Select this box if
Form G-28 is
attached.
Volag Number
(if any)
Attorney or Accredited Representative
USCIS Online Account Number (if any)
To be completed by an attorney or accredited representative (if any).
For USCIS Use Only
START HERE - Type or print in black ink.►
NOTE TO ALL APPLICANTS: If you do not completely fill out this application or fail to submit required documents listed in the
Instructions, U.S. Citizenship and Immigration Services (USCIS) may deny your application.
Part 1. Information About You (Person applying
for lawful permanent residence)
►
A-
A-Number
NOTE: Provide all other names you have ever used, including
your family name at birth, other legal names, nicknames,
aliases, and assumed names. If you need extra space to
complete this section, use the space provided in Part 14.
Additional Information.
Other Names You Have Used Since Birth (if
applicable)
2.b.
2.c.
2.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
3.b.
3.c.
3.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
5. Date of Birth (mm/dd/yyyy)
NOTE: In addition to providing your actual date of birth,
include any other dates of birth you have used in
connection with any legal names or non-legal names in
the space provided in Part 14. Additional Information.
FemaleMaleSex6.
INA 209(b)
4.b.
4.c.
4.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Preference Category:
Other Information About You
City or Town of Birth7.
Form I-485 06/26/17 N Page 2 of 18
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A-
A-Number
Country of Birth8.
Country of Citizenship or Nationality9.
Part 1. Information About You (Person applying
for lawful permanent residence) (continued)
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A-
Alien Registration Number (A-Number) (if any)10.
NOTE: If you have EVER used other A-Numbers,
include the additional A-Numbers in the space provided
in Part 14. Additional Information.
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11. USCIS Online Account Number (if any)
U.S. Mailing Address
City or Town13.d.
ZIP Code
13.f.
State
13.e.
Street Number
and Name
13.b.
13.c. Apt.
Flr.Ste.
13.a. In Care Of Name (if any)
Passport Number Used at Last Arrival15.
Travel Document Number Used at Last Arrival16.
Recent Immigration History
17. Expiration Date of this Passport or Travel Document
(mm/dd/yyyy)
Country that Issued this Passport or Travel Document18.
Nonimmigrant Visa Number from this Passport (if any)19.
20.a.
Place of Last Arrival into the United States
City or Town
20.b.
State
Date of Last Arrival (mm/dd/yyyy)
21.
Provide the information for Item Numbers 15. - 19. if you last
entered the United States using a passport or travel document.
City or Town14.d.
ZIP Code
14.f.
State
14.e.
Street Number
and Name
14.b.
14.c. Apt.
Flr.Ste.
14.a. In Care Of Name (if any)
Alternate and/or Safe Mailing Address
If you are applying based on the Violence Against Women Act
(VAWA) or as a special immigrant juvenile, human trafficking
victim (T nonimmigrant), or victim of a qualifying crime (U
nonimmigrant) and you do not want USCIS to send notices
about this application to your home, you may provide an
alternative and/or safe mailing address.
When I last arrived in the United States, I:
Was inspected at a port of entry and admitted as (for
example, exchange visitor; visitor, waived through;
temporary worker; student):
22.a.
U.S. Social Security Number (if any)
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12.
Was inspected at a port of entry and paroled as (for
example, humanitarian parole, Cuban parole):
22.b.
Came into the United States without admission or
parole.
22.c.
Other:
22.d.
If you were issued a Form I-94 Arrival-Departure Record Number:
Expiration Date of Authorized Stay Shown on Form I-9423.b.
(mm/dd/yyyy)
23.c. Status on Form I-94 (for example, class of admission, or
paroled, if paroled)
Form I-94 Arrival-Departure Record Number 23.a.
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Form I-485 06/26/17 N Page 3 of 18
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A-
A-Number
Part 1. Information About You (Person applying
for lawful permanent residence) (continued)
Provide your name exactly as it appears on your Form I-94 (if
any)
25.b.
25.c.
25.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Part 2. Application Type or Filing Category
NOTE: Attach a copy of the Form I-797 receipt or approval
notice for the underlying petition or application, as appropriate.
I am applying to register lawful permanent residence or adjust
status to that of a lawful permanent resident based on the
following immigrant category
(select only one box).
(See the
Form I-485 Instructions for more information, including any
Additional Instructions that relate to the immigrant category
you select.):
1.a. Family-based
Immediate relative of a U.S. citizen, Form I-130
Other relative of a U.S. citizen or relative of a lawful
permanent resident under the family-based preference
categories, Form I-130
Person admitted to the United States as a fiancé(e) or
child of a fiancé(e) of a U.S. citizen, Form I-129F
(K-1/K-2 Nonimmigrant)
Widow or widower of a U.S. citizen, Form I-360
VAWA self-petitioner, Form I-360
Alien worker, Form I-140
Alien entrepreneur, Form I-526
Employment-based 1.b.
Special Immigrant
Special immigrant juvenile, Form I-360
Certain Afghan or Iraqi national, Form I-360
Religious worker, Form I-360
Certain international broadcaster, Form I-360
Certain G-4 international organization or family
member or NATO-6 employee or family member,
Form I-360
1.c.
Asylee or Refugee
Asylum status (INA section 208), Form I-589 or
Form I-730
Refugee status (INA section 207), Form I-590 or
Form I-730
1.d.
Human Trafficking Victim or Crime Victim
Crime victim (U Nonimmigrant), Form I-918,
derivative family member, Form I-918A, or
qualifying family member, Form I-929
Human trafficking victim (T Nonimmigrant), Form
I-914 or derivative family member, Form I-914A
1.e.
Dependent status under the Haitian Refugee
Immigrant Fairness Act for battered spouses and
children
Diplomats or high ranking officials unable to return
home (Section 13 of the Act of September 11, 1957)
Lautenberg Parolees
Dependent status under the Haitian Refugee
Immigrant Fairness Act
Indochinese Parole Adjustment Act of 2000
The Cuban Adjustment Act for battered spouses and
children
The Cuban Adjustment Act
Special Programs Based on Certain Public Laws1.f.
Additional Options
Diversity Visa program
Individual born in the United States under diplomatic
status
Continuous residence in the United States since
before January 1, 1972 ("Registry")
Other eligibility
1.g.
Are you applying for adjustment based on the
Immigration and Nationality Act (INA) section 245(i)?
Yes No
2.
NOTE: If you answered "Yes" to Item Number 2., you
must have selected a family-based, employment-based,
special immigrant, or Diversity Visa immigrant category
listed above in Item Numbers 1.a. - 1.g. as the basis for
your application for adjustment of status. Fill out the rest
of this application and Supplement A to Form I-485,
Adjustment of Status Under Section 245(i) (Supplement
A). For detailed filing instructions, read the Form I-485
Instructions (including any Additional Instructions that
relate to the immigrant category that you selected in Item
Numbers 1.a. - 1.g.) and Supplement A Instructions.
What is your current immigration status (if it has changed
since your arrival)?
24.
Form I-485 06/26/17 N Page 4 of 18
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A-
A-Number
Part 2. Application Type or Filing Category
(continued)
Information About Your Immigrant Category
If you are the principal applicant, provide the following
information.
Receipt Number of Underlying Petition (if any)3.
Priority Date from Underlying Petition (if any)4.
(mm/dd/yyyy)
If you are a derivative applicant (the spouse or unmarried
child under 21 years of age of a principal applicant), provide the
following information for the principal applicant.
Principal Applicant's Name
5.b.
5.c.
5.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
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A-
Principal Applicant's A-Number (if any)6.
Principal Applicant's Date of Birth7.
(mm/dd/yyyy)
Receipt Number of Principal's Underlying Petition (if any)8.
Priority Date of Principal Applicant's Underlying Petition
9.
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Part 3. Additional Information About You
1. Have you ever applied for an immigrant visa to obtain
permanent resident status at a U.S. Embassy or U.S.
Consulate abroad?
NoYes
If you answered "Yes" to Item Number 1., complete
Item Numbers 2.a. - 4. below. If you need extra space to
complete this section, use the space provided in Part 14.
Additional Information.
Location of U.S. Embassy or U.S. Consulate
2.a.
City
Country
2.b.
4. Date of Decision (mm/dd/yyyy)
Decision (for example, approved, refused, denied,
withdrawn)
3.
(if any) (mm/dd/yyyy)
Address History
Provide physical addresses for everywhere you have lived
during the last five years, whether inside or outside the United
States. Provide your current address first. If you need extra
space to complete this section, use the space provided in
Part 14. Additional Information.
City or Town5.c.
5.f.
5.h.
Province
Country
5.g.
Postal Code
ZIP Code
5.e.
State
5.d.
Street Number
and Name
5.a.
5.b. Apt.
Flr.Ste.
Physical Address 1 (current address)
Dates of Residence
From (mm/dd/yyyy)
To (mm/dd/yyyy)
6.a.
6.b.
City or Town7.c.
7.f.
7.h.
Province
Country
7.g.
Postal Code
ZIP Code
7.e.
State
7.d.
Street Number
and Name
7.a.
7.b. Apt.
Flr.Ste.
Physical Address 2
Form I-485 06/26/17 N Page 5 of 18
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A-
A-Number
Part 3. Additional Information About You
(continued)
Dates of Residence
From (mm/dd/yyyy)
To (mm/dd/yyyy)
8.a.
8.b.
Provide your most recent address outside the United States
where you lived for more than one year (if not already listed
above).
City or Town9.c.
9.f.
9.h.
Province
Country
9.g.
Postal Code
ZIP Code
9.e.
State
9.d.
Street Number
and Name
9.a.
9.b. Apt.
Flr.Ste.
Dates of Residence
From (mm/dd/yyyy)
To (mm/dd/yyyy)
10.a.
10.b.
Provide your employment history for the last five years,
whether inside or outside the United States. Provide the most
recent employment first. If you need extra space to complete
this section, use the space provided in Part 14. Additional
Information.
Name of Employer or Company
Employer 1 (current or most recent)
Employment History
11.
City or Town12.c.
12.f.
12.h.
Province
Country
12.g.
Postal Code
ZIP Code
12.e.
State
12.d.
Street Number
and Name
12.a.
12.b. Apt.
Flr.Ste.
Address of Employer or Company
Your Occupation
13.
Dates of Employment
From (mm/dd/yyyy)
To (mm/dd/yyyy)
14.a.
14.b.
Name of Employer or Company15.
Employer 2
City or Town16.c.
16.f.
16.h.
Province
Country
16.g.
Postal Code
ZIP Code
16.e.
State
16.d.
Street Number
and Name
16.a.
16.b. Apt.
Flr.Ste.
Address of Employer or Company
Your Occupation
17.
Dates of Employment
From (mm/dd/yyyy)
To (mm/dd/yyyy)
18.a.
18.b.
Form I-485 06/26/17 N Page 6 of 18
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A-
A-Number
Part 3. Additional Information About You
(continued)
Provide your most recent employment outside of the United
States (if not already listed above).
Name of Employer or Company19.
City or Town20.c.
20.f.
20.h.
Province
Country
20.g.
Postal Code
ZIP Code
20.e.
State
20.d.
Street Number
and Name
20.a.
20.b. Apt.
Flr.Ste.
Address of Employer or Company
Your Occupation
21.
Dates of Employment
From (mm/dd/yyyy)
To (mm/dd/yyyy)
22.a.
22.b.
Part 4. Information About Your Parents
Parent 1's Legal Name
Information About Your Parent 1
1.b.
1.c.
1.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Parent 1's Name at Birth (if different than above)
2.b.
2.c.
2.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Date of Birth (mm/dd/yyyy)3.
FemaleMaleSex4.
City or Town of Birth
5.
Country of Birth6.
Current Country of Residence (if living)8.
Current City or Town of Residence (if living)7.
Information About Your Parent 2
Parent 2's Legal Name
9.b.
9.c.
9.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
City or Town of Birth
Date of Birth (mm/dd/yyyy)11.
13.
Parent 2's Name at Birth (if different than above)
10.b.
10.c.
10.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Current Country of Residence (if living)16.
Current City or Town of Residence (if living)15.
Country of Birth14.
FemaleMaleSex12.
Form I-485 06/26/17 N Page 7 of 18
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A-
A-Number
Part 5. Information About Your Marital History
What is your current marital status?1.
DivorcedSingle, Never Married
Widowed
Married
Marriage Annulled
Legally Separated
If you are married, is your spouse a current member of the
U.S. armed forces or U.S. Coast Guard?
2.
NoYesN/A
How many times have you been married (including
annulled marriages and marriages to the same person)?
3.
If you are currently married, provide the following information
about your current spouse.
Information About Your Current Marriage
(including if you are legally separated)
4.b.
4.c.
4.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Current Spouse's Legal Name
Current Spouse's Date of Birth (mm/dd/yyyy)6.
Date of Marriage to Current Spouse (mm/dd/yyyy)7.
A-Number (if any)
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A-
5.
Current Spouse's Place of Birth
Country8.c.
State or Province8.b.
City or Town8.a.
Place of Marriage to Current Spouse
Country9.c.
State or Province9.b.
City or Town9.a.
10. Is your current spouse applying with you?
NoYes
Prior Spouse's Legal Name (provide family name before
marriage)
11.b.
11.c.
11.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
If you have been married before, whether in the United States or
in any other country, provide the following information about
your prior spouse. If you have had more than one previous
marriage, use the space provided in Part 14. Additional
Information to provide the information below.
Information About Prior Marriages (if any)
Prior Spouse's Date of Birth (mm/dd/yyyy)12.
Date of Marriage to Prior Spouse (mm/dd/yyyy)13.
Place of Marriage to Prior Spouse
Country14.c.
State or Province14.b.
City or Town14.a.
Date Marriage with Prior Spouse Legally Ended 15.
(mm/dd/yyyy)
Form I-485 06/26/17 N Page 8 of 18
Part 5. Information About Your Marital History
(continued)
►
A-
A-Number
Place Where Marriage with Prior Spouse Legally Ended
City or Town
16.a.
State or Province16.b.
Country16.c.
Indicate the total number of ALL living children
(including adult sons and daughters) that you have.
1.
Part 6. Information About Your Children
NOTE: The term “children” includes all biological or
legally adopted children, as well as current stepchildren,
of any age, whether born in the United States or other
countries, married or unmarried, living with you or
elsewhere and includes any missing children and those
born to you outside of marriage.
Provide the following information for each of your children.
If you have more than three children, use the space provided in
Part 14. Additional Information.
Child 1
Current Legal Name
2.b.
2.c.
2.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
A-Number (if any)3.
Date of Birth (mm/dd/yyyy)4.
Country of Birth5.
Is this child applying with you?6. Yes No
Child 2
Current Legal Name
7.b.
7.c.
7.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
A-Number (if any)8.
Date of Birth (mm/dd/yyyy)9.
Country of Birth10.
Is this child applying with you?11. Yes No
Child 3
Current Legal Name
12.b.
12.c.
12.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
A-Number (if any)13.
Date of Birth (mm/dd/yyyy)14.
Country of Birth15.
Is this child applying with you?16. Yes No
1.
Ethnicity (Select only one box)
Part 7. Biographic Information
2.
Race (Select all applicable boxes)
Hispanic or Latino
Not Hispanic or Latino
Asian
White
Black or African American
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
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A-
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A-
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A-
Form I-485 06/26/17 N Page 9 of 18
Part 7. Biographic Information (continued)
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A-
A-Number
Height
4. Weight
Feet Inches
3.
Pounds
5.
Eye Color (Select only one box)
Hair Color (Select only one box) 6.
Part 8. General Eligibility and Inadmissibility
Grounds
1. Have you EVER been a member of, involved in, or in
any way associated with any organization, association,
fund, foundation, party, club, society, or similar group in
the United States or in any other location in the world
including any military service?
NoYes
If you answered "Yes" to Item Number 1., complete Item
Numbers 2. - 13.b. below. If you need extra space to complete
this section, use the space provided in Part 14. Additional
Information. If you answered "No," but are unsure of your
answer, provide an explanation of the events and circumstances
in the space provided in Part 14. Additional Information.
Organization 1
Name of Organization2.
Country3.c.
State or Province3.b.
City or Town3.a.
Nature of Group4.
Blue
Black
Brown
Gray
Green
Hazel
Maroon
Pink Unknown/Other
Bald (No hair)
Black Blond
Brown
Gray
Red
Sandy
White Unknown/Other
Dates of Membership or Dates of Involvement
From (mm/dd/yyyy)
To (mm/dd/yyyy)
5.a.
5.b.
Organization 2
Name of Organization6.
Country7.c.
State or Province7.b.
City or Town7.a.
Nature of Group8.
Dates of Membership or Dates of Involvement
From (mm/dd/yyyy)
To (mm/dd/yyyy)
Organization 3
Name of Organization10.
City or Town11.a.
9.a.
9.b.
Country11.c.
Nature of Group12.
State or Province11.b.
Dates of Membership or Dates of Involvement
From (mm/dd/yyyy)
To (mm/dd/yyyy)
13.a.
13.b.
Form I-485 06/26/17 N Page 10 of 18
Part 8. General Eligibility and Inadmissibility
Grounds (continued)
►
A-
A-Number
Answer Item Numbers 14. - 80.b. Choose the answer that you
think is correct. If you answer “Yes” to any questions (or if
you answer "No," but are unsure of your answer), provide
an explanation of the events and circumstances in the space
provided in Part 14. Additional Information.
15.
Have you EVER worked in the United States without
authorization?
16.
Have you EVER been denied a visa to the United States?
Have you EVER been denied admission to the United
States?
14.
Have you EVER violated the terms or conditions of your
nonimmigrant status?
17.
NoYes
Yes No
NoYes
NoYes
18. Are you presently or have you EVER been in removal,
exclusion, rescission, or deportation proceedings?
Yes No
20.
Have you EVER held lawful permanent resident status
which was later rescinded?
21.
Have you EVER had a prior final order of exclusion,
deportation, or removal reinstated?
Yes No
NoYes
22. Have you EVER been granted voluntary departure by an
immigration officer or an immigration judge but failed to
depart within the allotted time?
Yes No
NoYes
Have you EVER applied for any kind of relief or
protection from removal, exclusion, or deportation?
23.
24.a. Have you EVER been a J nonimmigrant exchange visitor
who was subject to the two-year foreign residence
requirement?
Yes No
If you answered "Yes" to Item Number 24.a., complete Item
Numbers 24.b. - 24.c. If you answered "No" to Item Number
24.a., skip to Item Number 25.
Have you complied with the foreign residence
requirement?
NoYes
24.b.
Have you EVER been issued a final order of exclusion,
deportation, or removal?
19.
NoYes
For Item Numbers 25. - 45., you must answer "Yes" to any
question that applies to you, even if your records were sealed or
otherwise cleared, or even if anyone, including a judge, law
enforcement officer, or attorney, told you that you no longer
have a record. You must also answer "Yes" to the following
questions whether the action or offense occurred here in the
United States or anywhere else in the world. If you answer
"Yes" to Item Numbers 25. - 45., use the space provided in
Part 14. Additional Information to provide an explanation
that includes why you were arrested, cited, detained, or charged;
where you were arrested, cited, detained, or charged; when
(date) the event occurred; and the outcome or disposition (for
example, no charges filed, charges dismissed, jail, probation,
community service).
Criminal Acts and Violations
25.
NoYes
Have you EVER committed a crime of any kind (even if
you were not arrested, cited, charged with, or tried for that
crime)?
26.
Have you EVER been arrested, cited, charged, or
detained for any reason by any law enforcement official
(including but not limited to any U.S. immigration
official or any official of the U.S. armed forces or U.S.
Coast Guard)?
Yes No
27. Have you EVER pled guilty to or been convicted of a
crime or offense (even if the violation was subsequently
expunged or sealed by a court, or if you were granted a
pardon, amnesty, a rehabilitation decree, or other act of
clemency)?
Yes No
NOTE: If you were the beneficiary of a pardon, amnesty,
a rehabilitation decree, or other act of clemency, provide
documentation of that post-conviction action.
Have you EVER been ordered punished by a judge or had
conditions imposed on you that restrained your liberty
(such as a prison sentence, suspended sentence, house
arrest, parole, alternative sentencing, drug or alcohol
treatment, rehabilitative programs or classes, probation, or
community service)?
28.
NoYes
29. Have you EVER been a defendant or the accused in a
criminal proceeding (including pre-trial diversion,
deferred prosecution, deferred adjudication, or any
withheld adjudication)?
Yes No
Yes
Have you been granted a waiver or has Department of
State issued a favorable waiver recommendation letter
for you?
No
24.c.
NoYes
30. Have you EVER violated (or attempted or conspired to
violate) any controlled substance law or regulation of a
state, the United States, or a foreign country?
Form I-485 06/26/17 N Page 11 of 18
Part 8. General Eligibility and Inadmissibility
Grounds (continued)
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A-
A-Number
Yes No
32. Have you EVER illicitly (illegally) trafficked or benefited
from the trafficking of any controlled substances, such as
chemicals, illegal drugs, or narcotics?
33.
NoYes
Have you EVER knowingly aided, abetted, assisted,
conspired, or colluded in the illicit trafficking of any
illegal narcotic or other controlled substances?
34.
No
Are you the spouse, son, or daughter of a foreign national
who illicitly trafficked or aided (or otherwise abetted,
assisted, conspired, or colluded) in the illicit trafficking of
a controlled substance, such as chemicals, illegal drugs, or
narcotics and you obtained, within the last five years, any
financial or other benefit from the illegal activity of your
spouse or parent, although you knew or reasonably should
have known that the financial or other benefit resulted
from the illicit activity of your spouse or parent?
Yes
NoYes
35. Have you EVER engaged in prostitution or are you
coming to the United States to engage in prostitution?
36. Have you EVER directly or indirectly procured (or
attempted to procure) or imported prostitutes or persons
for the purpose of prostitution?
Yes No
37.
No
Have you EVER received any proceeds or money from
prostitution?
Yes
38. Do you intend to engage in illegal gambling or any other
form of commercialized vice, such as prostitution,
bootlegging, or the sale of child pornography, while in the
United States?
Yes No
No
Have you EVER exercised immunity (diplomatic or
otherwise) to avoid being prosecuted for a criminal
offense in the United States?
Yes
39.
42.
43.
No
Yes No
Yes
Have you EVER trafficked a person into involuntary
servitude, peonage, debt bondage, or slavery? Trafficking
includes recruiting, harboring, transporting, providing, or
obtaining a person for labor or services through the use of
force, fraud, or coercion.
Have you EVER knowingly aided, abetted, assisted,
conspired, or colluded with others in trafficking persons
for commercial sex acts or involuntary servitude,
peonage, debt bondage, or slavery?
44.
NoYes
Are you the spouse, son or daughter of a foreign national
who engaged in the trafficking of persons and have
received or obtained, within the last five years, any
financial or other benefits from the illicit activity of your
spouse or your parent, although you knew or reasonably
should have known that this benefit resulted from the illicit
activity of your spouse or parent?
45.
Yes No
Have you EVER engaged in money laundering or have
you EVER knowingly aided, assisted, conspired, or
colluded with others in money laundering or do you seek
to enter the United States to engage in such activity?
Security and Related
Do you intend to:
Yes No
46.a.
Engage in any activity that violates or evades any law
relating to espionage (including spying) or sabotage in the
United States?
46.b. Engage in any activity in the United States that violates or
evades any law prohibiting the export from the United
States of goods, technology, or sensitive information?
NoYes
46.c. Engage in any activity whose purpose includes opposing,
controlling, or overthrowing the U.S. Government by
force, violence, or other unlawful means while in the
United States?
NoYes
46.d. Engage in any activity that could endanger the welfare,
safety, or security of the United States?
NoYes
40.
Yes No
Have you EVER, while serving as a foreign government
official, been responsible for or directly carried out
violations of religious freedoms?
46.e.
Yes NoEngage in any other unlawful activity?
31.
No
Have you EVER been convicted of two or more offenses
(other than purely political offenses) for which the
combined sentences to confinement were five years or
more?
Yes
NoYes
41.
Have you EVER induced by force, fraud, or coercion (or
otherwise been involved in) the trafficking of persons for
commercial sex acts?
47. Are you engaged in or, upon your entry into the United
States, do you intend to engage in any activity that could
have potentially serious adverse foreign policy
consequences for the United States?
NoYes
