Immigration Form I-485

IMMIGRATION FORM I-485 — APPLICATION TO REGISTER PERMANENT RESIDENCE OR ADJUST STATUS

Applicant Name:   Alien Registration Number (A-Number):   Date of Birth:

Recitals

WHEREAS, Applicant, identified above, seeks to apply for adjustment of status to that of a lawful permanent resident pursuant to applicable immigration statutes and regulations; and

WHEREAS, Applicant asserts eligibility for adjustment under the immigration classification: , and submits evidence in support of that claim; and

WHEREAS, by submitting this Form I-485 and accompanying documentation, Applicant attests to the truthfulness and completeness of the statements made herein under penalty of perjury.

NOW, THEREFORE, in consideration of the representations herein and to effectuate the statutory process for adjustment of status, Applicant completes this form and provides the certifications, authorizations, and acknowledgments set forth below.

1. Applicant Information

2. Basis for Adjustment / Eligibility

Applicant claims eligibility for adjustment of status under one or more of the following statutory bases. Applicant must indicate each basis asserted and attach documentary proof. Mark all that apply:

  Family-based (immediate relative or preference category)      Employment-based      Asylee/Refugee adjustment      Registry      Other:

Applicant certifies that all documentary evidence submitted in support of the asserted basis is genuine, and that Applicant will promptly notify the adjudicating authority of any change in circumstances that affects eligibility.

3. Immigration History and Admissions

Have you ever been arrested, charged, convicted, or pleaded guilty to any criminal offense in any jurisdiction?    Yes    No

Have you ever been placed in removal, exclusion, rescission, or deportation proceedings, or been ordered removed or excluded?    Yes    No

4. Medical Examination

Applicant shall submit Form I-693, Report of Medical Examination and Vaccination Record, completed and signed by a designated civil surgeon. Applicant affirms that the medical examination required by statute has been completed and attached where applicable.

5. Criminal History and Grounds of Inadmissibility

Applicant acknowledges that certain criminal convictions, participation in persecution, or other statutory grounds may render Applicant inadmissible. Applicant must disclose comprehensively and attach certified dispositions where applicable.

6. Supporting Documents and Evidence

Applicant shall attach all documents required to establish eligibility, including but not limited to birth certificates, marriage certificates, I-130 or I-140 approval notices (if applicable), affidavits of support, employment letters, and certified criminal court records. Applicant certifies that all copies are true and complete.

7. Fees and Payment

Applicant affirms that the required filing fee and biometric services fee (if applicable) are submitted in accordance with applicable fee schedules. Fee waivers or reductions, if requested, must be supported by a separate written request and accompanying evidence of inability to pay.

8. Declaration, Release, and Certification

I hereby swear or affirm, under penalty of perjury under the laws of the United States of America, that I am the person named in this application and that the information provided in this application and in the supporting documents is true and correct to the best of my knowledge. I understand that any false statement or concealment of a material fact may subject me to criminal penalties and removal from the United States.

I authorize the release and exchange of information contained in this application and in supporting documents to any law enforcement or government agency as required for adjudication, background checks, or national security purposes. I understand that the adjudicating authority may require fingerprints, photographs, and other biometrics for identification and security checks.

By signing below, Applicant certifies that the statements in this application are complete, true, and correct. Applicant understands that this certification is a material representation.

Notices

Any notice required or permitted by this application will be deemed received when delivered to the addresses provided above. Applicant must notify the adjudicating authority of any change of address within the time period required by applicable regulations; failure to do so may affect ongoing proceedings.

Governing Law; Entire Agreement; Severability

This application and any adjudication thereof shall be governed by and construed in accordance with the immigration laws and regulations of the United States and the applicable rules of the adjudicating authority. This Form I-485, together with submitted supporting documents, constitutes the entire written record of Applicant's request for adjustment of status under the asserted basis and supersedes any prior oral or written communications concerning the same subject matter. If any provision of this application is held invalid, illegal, or unenforceable, the remaining provisions shall continue in full force and effect.

Amendments; Waiver; Counterparts

Any amendment to this application shall be in writing and signed by Applicant. No failure to exercise any right or remedy shall operate as a waiver thereof unless in writing and signed by the party granting the waiver. This application may be executed in counterparts, each of which shall be considered an original for all purposes.

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