Form I-485

Form I-485
Last Name
First Name
Middle Name
Other Names Used
Date of Birth

MonthDayYear
Date
Other Date of Birth Used?
Other Dates of Birth
Sex
City of Birth
Country of Birth
Country of Citizenship
A-Number
Other A-Numbers
USCIS Online Account Number
Passport Number
Country of Issuance
Passport Expiration Date

MonthDayYear
Date
Visa Number
Visa Issue Date

MonthDayYear
Date
Date of Last Arrival

MonthDayYear
Date
Place of Last Arrival (City/State)
Class of Admission
Parole?
Entered Without Inspection?
I-94 Number
Status on I-94
I-94 Expiration Date

MonthDayYear
Date
Ethnicity
Race
Height
Weight
Eye Color
Hair Color
Address, Contact & SSA
Current Physical Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Date Moved Into Current Physical Address

MonthDayYear
Date
Mailing Address Same as Physical Address?
Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Address History for the Last 5 Years
Most Recent Address Outside the United States (if lived there 1 year or more)
Have You Been Issued a Social Security Number?
Social Security Number
Do You Want the Social Security Administration to Issue You a Social Security Card?
Consent to Disclose Information to the Social Security Administration
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Mobile Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Eligibility, Filing Basis & Prior Immigration History
Filing basis
Family-based category

Other family relationship
Employment-based category

Other employment-based
Special immigrant category

Other special immigrant
Refugee or asylee category

Other
Victims category

Other
Special programs category

Other special program
Are you applying under INA 245(i)?
Are you eligible for CSPA protection?
Are you exempt from filing a support affidavit?
Have you previously applied for an immigrant visa?
Immigrant visa application decision and date
Have you previously applied for a green card?
Have you previously held lawful permanent resident status?
Employment and school history for the last 5 years
If unemployed, provide support information
Membership in organizations or groups
Immigration violations and status issues
Criminal history
Security or terrorism-related questions
Household size, income, assets, liabilities, education, and public benefits
Immigration fraud or misrepresentation questions
Removal, unlawful entry, or deportation questions
Other inadmissibility or eligibility concerns
Family Information
Parent 1 Name

First NameMiddle NameLast Name
Parent 1 Date of Birth

MonthDayYear
Date
Parent 1 Country
Parent 2 Name

First NameMiddle NameLast Name
Parent 2 Date of Birth

MonthDayYear
Date
Parent 2 Country
Marital Status
Current Spouse Name

First NameMiddle NameLast Name
Current Spouse A-Number
Current Spouse Date of Birth

MonthDayYear
Date
Current Spouse Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Marriage Date

MonthDayYear
Date
Marriage Place
Prior Spouse Name

First NameMiddle NameLast Name
Prior Spouse Date of Birth

MonthDayYear
Date
Prior Marriage Date

MonthDayYear
Date
Prior Divorce Date

MonthDayYear
Date
How Prior Marriage Ended
Total Number of Children
Signature & Declaration
Signature
Date Signed

MonthDayYear
Date
Should be Empty:

Form I-485

Address, Contact & SSA

Eligibility, Filing Basis & Prior Immigration History

Family Information

Signature & Declaration