Fillable Printable Form I-485 Supplement J
Fillable Printable Form I-485 Supplement J
Form I-485 Supplement J
Form I-485 Supplement J 06/26/17 N
Page 1 of 7
Supplement J, Confirmation of Bona Fide Job Offer or
Request for Job Portability Under INA Section 204(j)
Department of Homeland Security
U.S. Citizenship and Immigration Services
For
USCIS
Use
Only
Fee Receipt
USCIS
Form I-485
OMB No. 1615-0023
Expires 06/30/2019
NOTE: Use Form I-485, Supplement J, Confirmation of Bona Fide Job Offer or Request for Job Portability Under INA Section
204(j) (Supplement J), to either confirm that the job offered to you in Form I-140, Immigrant Petition for Alien Worker, that is the
basis of your Form I-485, Application to Register Permanent Residence or Adjust Status, remains available to you or to request job
portability under the Immigration and Nationality Act (INA) section 204(j).
Part 2. Information About You (Applicant)
START HERE - Type or print in black ink.►
Confirm that the job offered to you in the Form
I-140, that is the basis of your Form I-485, remains a
bona fide job offer that you intend to accept once
your Form I-485 is approved.
This supplement is being filed to (Select only one box):
Request job portability under INA section 204(j) to a
new, full-time, permanent job offer that you intend to
accept once your Form I-485 is approved.
1.a.
1.b.
Part 1. Reason for Filing Supplement J
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)
U.S. Mailing Address
City or Town2.d.
ZIP Code2.f.State2.e.
Street Number
and Name
2.b.
2.c.
Apt.
Flr.Ste.
2.a. In Care Of Name (if any)
►
4. USCIS Online Account Number (if any)
Date of Birth (mm/dd/yyyy)5.
Country of Birth6.
Basic Information About Your Form I-485 and the
Underlying Form I-140
Form I-485 Receipt Number (if already filed with U.S.
Citizenship and Immigration Services (USCIS))
7.
Form I-485 Filing Date (mm/dd/yyyy) (if already filed
with USCIS)
8.
Form I-140 Receipt Number 9.
Yes No Unknown
Has your Form I-140 been approved?10.
►
A-
Alien Registration Number (A-Number) (if any)3.
Other Information
Action Block
Form I-485 Supplement J 06/26/17 N
Page 2 of 7
Applicant's Statement
Select all applicable boxes.
Part 3. Applicant's Statement, Contact
Information, Certification, and Signature
NOTE: Read the Penalties section of the Supplement J
Instructions before completing this part. You must file
Supplement J while in the United States.
At my request, the preparer named in Part 4.,
2.
I can read and understand English, and I have read
and understand every question and instruction on this
supplement and my answer to every question.
1.
prepared this supplement for me based only upon
information I provided or authorized.
,
Applicant's Daytime Telephone Number3.
Applicant's Contact Information
Applicant's Mobile Telephone Number (if any)4.
Applicant's Email Address (if any)5.
Applicant's Certification
Copies of any documents I have submitted are exact
photocopies of unaltered, original documents, and I understand
that USCIS may require that I submit original documents to
USCIS at a later date. Furthermore, I authorize the release of
any information from any of my records that USCIS may need
to determine my eligibility for the immigration benefit I seek.
I further authorize release of information contained in this
supplement, in supporting documents, and in my USCIS records
to other entities and persons when necessary for the
administration and enforcement of U.S. immigration laws.
I certify, under penalty of perjury, that I provided or authorized
all of the information in my supplement, especially in Part 1.
and Part 2., I understand all of the information contained in,
and submitted with my supplement, and that all of this
information is complete, true, and correct.
I further declare, under penalty of perjury, that I have reviewed
the job offer described in Part 6. of this supplement, and I
intend to accept the position offered in Part 6. of this
supplement upon approval of my Form I-485.
Applicant's Signature
Date of Signature (mm/dd/yyyy)6.b.
Applicant's Signature (sign in ink)6.a.
Part 4. Contact Information, Declaration, and
Signature of the Person Preparing This
Supplement, if Other Than the Applicant
Provide the following information about the preparer.
Preparer's Full Name
Preparer's Given Name (First Name)1.b.
Preparer's Family Name (Last Name)1.a.
Preparer's Mailing Address
3.c. City or Town
3.d. State 3.e. ZIP Code
3.f.
Postal Code
Street Number
and Name
3.a.
3.b. Apt. Flr.Ste.
3.g.
3.h. Country
Province
Preparer's Business or Organization Name (if any)
2.
Preparer's Contact Information
Preparer's Daytime Telephone Number4.
Preparer's Email Address (if any)6.
Preparer's Mobile Telephone Number (if any)5.
Form I-485 Supplement J 06/26/17 N
Page 3 of 7
Part 4. Contact Information, Declaration, and
Signature of the Person Preparing This
Supplement, if Other Than the Applicant
(continued)
I am not an attorney or accredited representative but
have prepared this supplement on behalf of the
applicant and with the applicant's consent.
I am an attorney or accredited representative and my
representation of the applicant in this case
NOTE: If you are an attorney or accredited
representative, you may be obliged to submit a
completed Form G-28, Notice of Entry of
Appearance as Attorney or Accredited
Representative, with this supplement.
extends does not extend beyond the
7.a.
7.b.
Preparer's Statement
preparation of this supplement.
Preparer's Signature
8.a. Preparer's Signature (sign in ink)
8.b. Date of Signature (mm/dd/yyyy)
IMPORTANT: The employer confirming an
existing bona fide job offer or offering you a new,
permanent job must complete Parts 5., 6., and 7.
Preparer's Certification
By my signature, I certify, under penalty of perjury, that I
prepared this supplement at the request of the applicant. The
applicant then reviewed this completed supplement and
informed me that he or she understands all of the information
contained in, and submitted with, his or her supplement,
including the Applicant's Certification, and that all of this
information is complete, true, and correct.
Part 5. Information About the Employer
Self/Individual
Business/Organization
Type of employer (Select only one box):1.
Employer's U.S. Mailing Address
City or Town2.c.
ZIP Code2.e.State2.d.
Street Number
and Name
2.a.
2.b. Apt. Flr.Ste.
Information About the Business Entity Employer
Business or Organization Name3.
If you, the employer, are a business entity, provide the
information requested in Item Numbers 3. - 10.
Employer Identification Number
►
4.
5. Type of Business
Date Established (mm/dd/yyyy)6.
Current Number of U.S. Employees7.
Gross Annual Income
8.
Net Annual Income9.
10. NAICS Code
►
Information About the Individual Employer (if
applicable)
11.b.
11.c.
11.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Your Current Legal Name (do not provide a
nickname)
Date of Birth (mm/dd/yyyy)12.
►
U.S. Social Security Number (if any)13.
14. Annual Income
15. Occupation
$
$
$
Form I-485 Supplement J 06/26/17 N
Page 4 of 7
1. Job Title
Standard Occupational Classification (SOC) Code2.
►
-
Part 6. Information About the Job Offer
You, the employer, must provide the information requested in
Part 6.
Nontechnical Description of Job (If you need extra space
to complete this section, use the space provided in Part 9.
Additional Information.)
3.
Is this a full-time position?4.
If you answered "No" to Item Number 4., provide the
number of hours per week the applicant will work in this
position.
5.
Is this a permanent position?6.
Wages Offered (Specify hour, week, month, or year)7.
$ per
NoYes
NoYes
Employer's U.S. Physical Address
Provide the physical address where the applicant will work if
different from the employer's mailing address in Part 5., Item
Numbers 2.a. - 2.e. or the address provided in Form I-140 on
which the applicant's Form I-485 is based.
City or Town8.c.
ZIP Code
8.e.
State
8.d.
Street Number
and Name
8.a.
8.b. Apt.
Flr.Ste.
9. Is the applicant named in Part 2. of this supplement
currently employed by you?
NoYes
If you answered "Yes" to Item Number 9., when did the
applicant begin employment with you (mm/dd/yyyy)?
10.
Part 7. Statement, Contact Information,
Certification, and Signature of the Individual
Employer or Authorized Signatory of the
Business Entity Employer
NOTE: Read the Penalties section of the Supplement J
Instructions before completing this part.
Individual Employer's or Authorized Signatory's
Statement
Select all applicable boxes.
I can read and understand English, and I have read
and understand every question and instruction on this
supplement and my answer to every question.
1.
At my request, the preparer named in Part 8.,
2.
prepared this supplement for me based only upon
information I provided or authorized.
,
Individual Employer's or Authorized Signatory's
Contact Information
Individual Employer's or Authorized Signatory's Given
Name (First Name)
3.b.
Individual Employer's or Authorized Signatory's Family
Name (Last Name)
3.a.
Individual Employer's or Authorized Signatory's Title
4.
Individual Employer's or Authorized Signatory's Daytime
Telephone Number
5.
Individual Employer's or Authorized Signatory's Email
Address (if any)
7.
Individual Employer's or Authorized Signatory's Mobile
Telephone Number (if any)
6.
Form I-485 Supplement J 06/26/17 N
Page 5 of 7
Individual Employer's or Authorized Signatory's
Certification
Copies of any documents I have submitted are exact
photocopies of unaltered, original documents, and I understand
that, as the employer, USCIS may require that I submit original
documents to USCIS at a later date.
I authorize the release of any information from any records of
the employer that USCIS may need to determine eligibility for
the requested immigration benefit. I recognize the authority of
USCIS to conduct audits of this supplement using publicly
available open source information. I also recognize that USCIS
may verify any supporting evidence submitted in support of this
supplement through any means determined appropriate by
USCIS, including but not limited to, on-site compliance
reviews.
If filling this supplement on behalf of an organization, I certify
that I am authorized to do so by the organization.
I certify, under penalty of perjury, that I have reviewed this
supplement, and that all of the information contained in Part 5.
and Part 6. of this supplement, including all responses provided
by me to specific questions and in the supporting documents
provided by me, is complete, true, and correct.
I further declare, under penalty of perjury, and attest to the
following:
1)
I am a viable employer and I am extending a bona fide job
offer to the applicant named in Part 2. of this supplement;
The job opportunity is for full-time, permanent
employment; and
2)
3) I intend to employ the applicant in the job offer described
in Part 6. of this supplement upon the approval of the
applicant's Form I-485.
Individual Employer's or Authorized Signatory's
Signature
Date of Signature (mm/dd/yyyy)8.b.
Signature of Individual Employer or Authorized Signatory
(sign in ink)
8.a.
Preparer's Mailing Address
3.c. City or Town
3.d. State 3.e. ZIP Code
3.f.
Postal Code
Street Number
and Name
3.a.
3.b. Apt.
Flr.Ste.
3.g.
3.h. Country
Province
Preparer's Contact Information
Preparer's Daytime Telephone Number4.
Preparer's Email Address (if any)6.
Preparer's Mobile Telephone Number (if any)5.
Preparer's Business or Organization Name (if any)
2.
Part 8. Contact Information, Declaration, and
Signature of the Person Preparing This
Supplement, if Other Than the Individual
Employer or Authorized Signatory of the
Business Entity Employer
Provide the following information about the preparer.
Preparer's Full Name
Preparer's Given Name (First Name)1.b.
Preparer's Family Name (Last Name)1.a.
Part 7. Statement, Contact Information,
Certification, and Signature of the Individual
Employer or Authorized Signatory of the
Business Entity Employer (continued)
Form I-485 Supplement J 06/26/17 N
Page 6 of 7
Preparer's Certification
By my signature, I certify, under penalty of perjury, that I
prepared this supplement at the request of the individual
employer or authorized signatory. The individual employer or
authorized signatory then reviewed this completed supplement
and informed me that he or she understands all of the
information contained in, and submitted with, his or her
supplement, including the Individual Employer's or
Authorized Signatory's Certification, and that all of this
information is complete, true, and correct.
Preparer's Signature
8.a.
Preparer's Signature (sign in ink)
8.b. Date of Signature (mm/dd/yyyy)
I am not an attorney or accredited representative but
have prepared this supplement on behalf of the
individual employer or authorized signatory and with
the individual employer's or authorized signatory's
consent.
I am an attorney or accredited representative and my
representation of the individual employer or
authorized signatory in this case.
NOTE: If you are an attorney or accredited
representative, you may be obliged to submit a
completed Form G-28, Notice of Entry of
Appearance as Attorney or Accredited
Representative, with this supplement.
extends does not extend beyond the
7.a.
7.b.
Preparer's Statement
preparation of this supplement.
Part 8. Contact Information, Declaration, and
Signature of the Person Preparing This
Supplement, if Other Than the Individual
Employer or Authorized Signatory of the
Business Entity Employer (continued)
Form I-485 Supplement J 06/26/17 N
Page 7 of 7
Part 9. Additional Information
If you need extra space to provide any additional information
within this supplement, use the space below. If you need more
space than what is provided, you may make copies of this page
to complete and file with this supplement or attach a separate
sheet of paper. Type or print your name and A-Number (if any)
at the top of each sheet; indicate the Page Number, Part
Number, and Item Number to which your answer refers, and
sign and date each sheet.
A-Number (if any) ►
A-
3.a.
2.
Page Number 3.b. Part Number 3.c. Item Number
3.d.
Page Number Part Number Item Number
1.b.
1.c.
1.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
4.c.4.b.
4.d.
4.a.
Page Number
Part Number Item Number5.a.
Page Number
5.b.
Part Number
5.c.
Item Number
5.d.
Part NumberPage Number Item Number
6.d.
6.c.6.b.6.a.
7.c.7.b.7.a.
7.d.
