Employment Based Green Card Adjustment Checklist

Employment Based Green Card Adjustment Checklist

Checklist for Adjustment of Status based on Approved/Pending I-140
We need a completed checklist for EACH family member.
Enter Name of Business + Name of Applicant
Full legal name

First NameMiddle NameLast Name
Any other names, if ever used
Contact information
Cell Phone Number
Please enter a valid phone number.
Email
Address in the U.S.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Address Abroad

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Birth Information
Date of Birth

MonthDayYear
Date
Town of Birth
Province of Birth
Country of Birth
UPLOAD Certificate of Birth with English translation, if not in English

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Social Security Number
List of all addresses in the last 5 years, including:
Street, City, State, Zip, Date moved in (mm/dd/yyyy), Date moved out (mm/dd/yyyy)
List of all employers in the last five years, including: name of employer, address of employer, position held, employment dates (when did you start and when did you finish?)
Last employer abroad, including:
Name of employer abroad
Address of employer abroad

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position held
Employment dates (when did you start and when did you finish?)
Last Address You Lived Abroad for Longer than One Year (include street number, name, city, province, country, zip and dates you lived there in mm/dd/yyyy)
Info re. Parents, including
Parent 1 Full Legal Name

First NameLast Name
Parent 1 previous names, if applicable
Parent 1 Gender
Parent 1 Date of Birth

MonthDayYear
Date
Parent 1 city and country of birth
Parent 1 city and country of residence
Parent 2 Full Legal Name

First NameLast Name
Parent 2 previous names, if applicable
Parent 2 Gender
Parent 2 Date of Birth

MonthDayYear
Date
Parent 2 city and country of birth
Parent 2 city and country of residence
Spouse, if any
(If married) Spouse Full Legal Name

First NameLast Name
Spouse previous names, if applicable
Spouse Date of Birth

MonthDayYear
Date
Spouse Country of Birth
Spouse Location of Current Residence

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Marriage

MonthDayYear
Date
Child #1, if any
Child Full Legal Name

First NameLast Name
Child Date of Birth

MonthDayYear
Date
Child Country of Birth
Child Location of Residence

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child #2, if any
Child Full Legal Name

First NameLast Name
Child Date of Birth

MonthDayYear
Date
Child Location of Birth

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child Location of Residence

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child #3, if any
Child Full Legal Name

First NameLast Name
Child Date of Birth

MonthDayYear
Date
Child Location of Birth

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child Location of Residence

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Membership in any Organization: Have you ever been a member of any organization, group, club, society, etc? If so, please provide:
Name of Organization
Location of organization
Nature of group
Dates of membership from (mm/dd/yyyy) to (mm/dd/yyyy)
Entries/exits to/from the U.S.
List of all dates of entries/exits to/from the U.S. and the status held during those dates
Documents to Upload
GOOD COPIES of all pages of Passport, including all pages that have entries/exits

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Copy of your Birth Certificate with a translation into English and a Translator’s Certificate

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Your latest I-94 from https://i94.cbp.dhs.gov/I94/#/home

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https://i94.cbp.dhs.gov/I94/#/home
Your travel history from https://i94.cbp.dhs.gov/I94/#/history-search

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https://i94.cbp.dhs.gov/I94/#/history-search
Copies of all visas

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Copy of your most recent W-2

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Copies of 2 most recent paystubs

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Have you ever received any traffic tickets or involved in any infraction of a crime no matter how minor? If so, please let us know and please provide copies/evidence

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Copy of any/all Employment Authorization Documents/Advanced Parole issued (front and back)

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Copy of Social Security Card and Driver’s License

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Copy of marriage certificate(s), divorce decree(s), etc. If not in English, must beaccompanied by a translation in English with Translator’s Certificate

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To mail in the original, when requested:
1. Medical Exam: In the future, you will be required to make an appointment for a medical exam with USCIS -authorized doctors. If you have vaccination records, have them translated and take with you to the doctor’s office.
  1. A link to find an approved doctor is HERE: https://my.iuscis.gov/findadoctor
2. 8 Passport-style photos
If you need to provide us with additional information, please provide it here:
Additional Information
Thank you.
Should be Empty:

Employment Based Green Card Adjustment Checklist

We need a completed checklist for EACH family member.

Contact information

Birth Information

List of all addresses in the last 5 years, including:

Last employer abroad, including:

Info re. Parents, including

Spouse, if any

Child #1, if any

Child #2, if any

Child #3, if any

Membership in any Organization: Have you ever been a member of any organization, group, club, society, etc? If so, please provide:

Entries/exits to/from the U.S.

Documents to Upload

To mail in the original, when requested:

If you need to provide us with additional information, please provide it here:

Thank you.