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Application To Adjust Status From Temporary To Permanent Resident I-698 - Official Federal Forms
| Application To Adjust Status From Temporary To Permanent Resident Form. This is a national form and can be used in US Citizenship And Immigration Services . |
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OMB No. 1615-0035 Expires 03/31/2015 Department of Homeland Security U.S. Citizenship and Immigration Services Form I-698, Application to Adjust Status From Temporary to Permanent Resident (Under Section 245A of the INA) Do not write in this block - For USCIS use only. Action Block Fee Stamp Remarks START HERE - Type or print in black ink. If you need more space, see Page 3 of the instructions. 1. Name Family Name (in capital letters) Given Name Middle Name A-Number 2. Gender Male Female 3. Name as it appears on Form I-688, Temporary Resident Card 4. Telephone Number (include area code) Home Work 5. Reason for difference in name, if any. (marriage, divorce, etc.) 6. Home Address in the United States In care of Street Number and Name City 7. Mailing Address in the United States (if different from address in Number 6 above) In care of Street Number and Name City 8. Place of Birth (City or Town) County, Province, or State Country State Zip Code Country of Citizenship/Nationality Apt. # State Zip Code Apt. # 9. Date of Birth (mm/dd/yyyy) 10. Your Mother's First Name 11. Your Father's First Name 12. Your U.S. Social Security No. 13. Marital Status Married Never Married Separated Divorced Widowed Form I-698 (Rev. 03/11/13) Y American LegalNet, Inc. www.FormsWorkFlow.com 14. Absences from the United States since becoming a temporary resident alien. List most recent absence first. If you have a single absence in excess of 30 days or if the total of all your absences exceeds 90 days, explain and attach any relevant information. Country Purpose of Trip From (mm/dd/yyyy) To (mm/dd/yyyy) Total Days Absent 15. When applying for temporary resident status, I did did not submit a Form I-693, Medical Examination of Aliens Seeking Adjustment of Status, with my application that included a serologic (blood) test for human immunodeficiency virus (HIV) infection. (If you did not, submit Form I-693 that includes a serologic test for HIV.) 16. Concerning the requirement of minimal understanding of ordinary English and a knowledge and understanding of the history and Government of the United States (check appropriate block under Section A or B): A. I will satisfy these requirements by: Examination at the time of interview for permanent residence. Satisfactorily pursuing a course of study recognized by the Secretary of Homeland Security. B. I have satisfied these requirements by: Having satisfactorily pursued a course of study recognized by the Secretary of Homeland Security. (Attach appropriate documentation.) Exemption because I am 65 years of age or older, under 16 years of age, or I am physically unable to comply. (If you are physically unable to comply, explain and attach relevant documentation.) If you answer "Yes" to any of the questions numbered 17 through 37, explain your answer on a separate sheet of paper. 17. Have you ever assisted in the persecution of any person or persons on account of race, religion, political opinion, nationality, or membership in a particular social group? 18. Have you ever been treated for a mental disorder, drug addiction, or alcoholism? 19. Have you ever committed a crime or offense for which you were not arrested? Have you ever been arrested, cited, or detained by any law enforcement officer (including Immigration and Customs Enforcement (ICE), Customs and Border Protection (CBP), former Immigration and Naturalization Service (INS), and/or military officers) for any reason? Yes No Yes Yes Yes No No No Form I-698 (Rev. 03/11/13) Y Page 2 American LegalNet, Inc. www.FormsWorkFlow.com Have you ever been charged with committing any crime or offense? Have you ever been convicted of a crime or offense? Have you ever been in jail or prison? Have you ever been placed in an alternative sentencing or a rehabilitative program (for example: diversion, deferred prosecution, withheld adjudication, deferred adjudication)? Have you ever received a suspended sentence, been placed on probation, or been paroled? 20. Have you, or a dependent member of your immediate family, ever received public assistance from any source, including, but not limited to, the U.S. Government, any State, county, city, or municipality? If "Yes" provide the names(s) of the recipients(s) and U.S. Social Security Number(s). Name of Recipient (Family Name, Given Name, Middle Name) Yes Yes Yes Yes Yes Yes No No No No No No U.S. Social Security Number 21. Have you ever: a. Within the past 10 years been a prostitute or procured anyone for prostitution, or intend to engage in such activities in the future? b. Engaged in any unlawful commercialized vice, including, but not limited to, illegal gambling? c. Knowingly encouraged, induced, assisted, abetted, or aided any alien to try to enter the United States illegally? d. Illicitly trafficked in any controlled substance, or knowingly assisted, abetted, or colluded in the illicit trafficking of any controlled substance? 22. Have you ever engaged in, conspired to engage in, or do you intend to engage in, or have you ever solicited membership or funds for, or have you through any means ever assisted or provided any type of material support to any person or organization that has ever engaged or conspired to engage in sabotage, kidnapping, political assassination, hijacking, or any other form of terrorist activity? 23. Do you intend to engage in the United States in: a. Espionage? b. Any activity a purpose of which is opposition to, or the control or overthrow of, the Government of the United States, by force, violence, or other unlawful means? c. Any activity to violate or evade any law prohibiting the export from the United States of goods, technology, or sensitive information? 24. Have you ever been a member of, or in any way affiliated with, a Communist Party or any other totalitarian party? Yes Yes Yes No No No Yes Yes Yes Yes No No No No Yes No Yes No Form I-698 (Rev. 03/11/13) Y Page 3 American LegalNet, Inc. www.FormsWorkFlow.com 25. Did you, during the period from March 23, 1933, to May 8, 1945, in association with either the Nazi Government of Germany or any organization or government associated or allied with the Nazi Government of Germany, ever order, incite, assist, or otherwise participate in the persecution of any person because of race, religion, national origin, or political opinion? 26. Have you ever engaged in genocide, or otherwise ordered, incited, assisted, or otherwise participated in the killing of any person because of race, religion, nationali
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