Application for Waiver of Grounds of Inadmissibility

OMB No. 1615-0032; Expires 12/31/09

Instructions for I-690, Application for
Waiver of Grounds of Inadmissibility

Department of Homeland Security
U. S. Citizenship and Immigration Services

Instructions
Please read these instructions carefully to properly complete this form. If you need more space to complete an answer, use a
separate sheet(s) of paper. Write your name and Alien Registration Number (A #), if any, at the top of each sheet of paper
and indicate the section and number of the item to which the answer refers.

What Is the Purpose of This Form?
This form is used to apply for a waiver of inadmissibility by
an applicant for adjustment of status under section 245A or
210 of the Immigration and Nationality Act (INA).

Who May File This Form I-690?

You can apply for a waiver of the vaccination requirements
without filing this form and without paying a fee, if:
1. You initially did not submit proof that you have received
the required vaccines, but you are now vaccinated; or
2. It is not medically appropriate for you to have one or more
of the missing vaccines. The physician will make this
certification according to the applicable regulations
published by the Department of Health and Human
Services (HHS) and the accompanying technical
instructions for physicians designated to perform the
required medical examination. These instructions are
published by the Centers for Disease Control and
Prevention (CDC). According to these technical
instructions, "not medically appropriate" covers the
following situations:

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Special Instructions for Individuals Applying for a
Waiver of One or More of the Medical Grounds
Under Section 212(a)(1)(A) of the INA

1. Applicants Who Require a Waiver for Tuberculosis (TB).
The physician or medical facility that will provide the
required treatment to you must fill out Part C of the
accompanying TB supplement. If that physician or health
care facility is not part of the state or local health
department, the local health department in the jurisdiction
where you will reside must also complete and sign Part D.
If you are outside of the United States, a relative in the
United States must complete this process for you.
After the TB supplement is completed, attach the
supporting documents and file your waiver application. If
you are inadmissible because of TB and your waiver
application does not include a properly completed TB
supplement, your waiver application will be returned to
you.
2. Applicants Requesting a Waiver of the Vaccination
Requirements of INA 212(a)(1)(A)(ii).
If your waiver application is based on religious or moral
objections to vaccinations, you must establish that:
A. You object to vaccinations in any form; and
B. You object because of your religious beliefs or moral
convictions (you do not need to be a member of a
"mainstream" or recognized religion); and

A. The vaccination is not recommended by the Advisory
Committee for Immunization Practices (ACIP) for your
age group; or
B. The vaccination is medically inadvisable; or

C There is an insufficient interval between doses for
vaccines requiring a series of doses; or
D. It is not the flu season (for the flu vaccine only).

Applicants Who Have a Physical or Mental Disorder With
Associated Harmful Behavior - INA 212(a)(1)(A)(iii)(I) or (II)
If the examining physician determines that you have a
physical or mental disorder with associated harmful behavior,
or a past history of a physical or mental disorder with harmful
behavior that is likely to recur, the medical examination report
completed by the designated physician will, at a minimum,
contain the following information, as required by HHS
regulations at 42 CFR part 34 and the accompanying technical
instructions published by the CDC:

1. A complete medical history, including the details of any
prior or current hospitalization, treatment or care;
2. The current findings, diagnosis and prognosis; and

C. Your beliefs are sincere.
At a minimum, you must submit a personal statement
describing the basis of your objection.

3. Any other information necessary for USCIS to determine,
in consultation with HHS, the terms and conditions that
should be imposed on the waiver, if it is granted.
Form I-690 Instructions (Rev. 12/08/09)Y

Applicants Who Are Inadmissible Because of Substance or
Drug Abuse or Substance or Drug Addiction - INA 212(a)
(1)(A)(iv)

General Instructions
Step 1. Fill Out the Form I-690

The designated physician will determine whether you are
currently using, or have used in the past, any controlled or
psychoactive substance. The examining physician will make
this determination during the required medical exam,
according to the applicable HHS regulations at 42 CFR part 34
and the accompanying technical instructions published by the
CDC.
If you are inadmissible under INA 212(a)(1)(A)(iv) due to
drug abuse or drug addiction, you may apply for a waiver.
USCIS will exercise discretion in determining whether to
grant this waiver, after consulting with HHS, and if you are
not inadmissible on any other grounds that cannot be waived.

A separate waiver application must be filed by each applicant
who is inadmissible.
1. Type or print legibly in black ink.
2. If extra space is needed to complete any item, attach a
continuation sheet, indicate the item number, and date and
sign each sheet.
3. Answer all questions fully and accurately. State that an
item is not applicable with "N/A." If the answer is "none,"
write none.

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You are not inadmissible under INA 212(a)(1)(A)(iv) if the
designated physician that performed the required medical
exam determined that you are in remission for prior drug use
or abuse, or that your prior drug use was strictly experimental.
The designated physician will determine whether any prior
drug use is in remission, or whether it was strictly
experimental, based on the applicable HHS regulations and the
accompanying technical instructions published by the CDC.
Note the following key items:

1. If you engaged in the use of any controlled substance, and
such use was illegal at the place where it occurred, your
admission to the examining physician may be sufficient to
make you inadmissible on criminal grounds under INA
212(a)(2)(A)(i)(II) relating to any controlled substance
violation (U.S. or foreign).

2. The USCIS officer reviewing your primary benefit
application (Form I-687, Form I-698 and/or Form I-485)
will determine whether this admission to the designated
physician makes you inadmissible under INA 212(a)(2)(A)
(i)(II).

What Is the Filing Fee?

The filing fee for Form I-690 application is $185.00.

Use the following guidelines when you prepare your check or
money order for the Form I-690.:
1. The check or money order must be drawn on a bank or
other financial institution located in the United States and
must be payable in U.S. currency; and
2. Make the check or money order payable to U.S.
Department of Homeland Security, unless:

A. If you live in Guam and are filing your petition there,
make it payable to Treasurer, Guam.
B. If you live in the U.S. Virgin Islands and are filing your
petition there, make it payable to Commissioner of
Finance of the Virgin Islands.
C. If you live outside the United States, Guam, or the U.S.
Virgin Islands, contact the nearest U.S. consulate or
embassy for instructions on the method of payment.

3. The only drug offense under INA 212(a)(2)(A)(i)(II) that
can be waived is one offense of simple possession of
marijuana (30 grams or less).

NOTE: Please spell out U.S. Department of Homeland
Security; do not use the initials "USDHS" or "DHS."

4. Any willful concealment or misrepresentation of any
material fact made to procure an immigration benefit
(including any willful concealments or misrepresentations
made to avoid being found inadmissible under any
provision) will result in the denial of this waiver
application and your primary benefit application. You may
also become subject to additional penalties under the law.

Notice to Those Making Payment by Check. If you send us
a check, it will be converted into an electronic funds transfer
(EFT). This means we will copy your check and use the
account information on it to electronically debit your account
for the amount of the check. The debit from your account will
usually take 24 hours, and will be shown on your regular
account statement.

Form I-690 Instructions (Rev. 12/08/09)Y Page 2

You will not receive your original check back. We will
destroy your original check, but we will keep a copy of it. If
the EFT cannot be processed for technical reasons, you
authorize us to process the copy in place of your original
check. If the EFT cannot be completed because of insufficient
funds, we may try to make the transfer up to two times.

How to Check If the Fees Are Correct.
The form and biometric fees on this form are current as the
edition date appearing in the lower right corner of this page.
However, because USCIS fees change periodically, you can
verify if the fees are correct by following one of the steps below:
1. Visit our Internet Web site at www.uscis.gov, select
"Forms" check the appropriate fee;
2. Review the Fee Schedule included in your form package, if
you called us to request the form; or

immigration laws, regulations and procedures by telephoning
our National Customer Service Center at 1-800-375-5283 or
visiting our internet website at www.uscis.gov.
As an altenative to waiting in line for assistance at your local
USCIS office, you can now schedule an appointment through
our Internet-based system, InfoPass. To access the system,
visit our Web site. Use the InfoPass appointment scheduler
and follow the screen prompts to set up your
appointment.InfoPass generates an electronic appointment
notice that appears on the screen.

Penalties.
If you knowingly and willfully falsify or conceal a material
fact or submit a false document with this request, we will deny
the benefit you are filing for, and may deny any other
immigration benefit.

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3. Telephone our National Customer Service Center at
1-800-375-5283 and ask for the fee information.

Where to File?

You must file this waiver application with the USCIS office
that has jurisdiction over your primary benefit application -Form I-687, Form I-698 and/or Form I-485.

Address Changes.

If you change your address and you have an application or
petition pending with USCIS, you may change your address
on-line at www.uscis.gov, click on "Change of Address" and
follow the prompts or by completing and mailing Form
AR-11, Alien's Change of Address Card, to:
U.S. Citizenship and Immigration Services
Change of Address
P.O. Box 7134
London, KY 40742-7134

For commercial overnight or fast freight services only, mail to:
U.S. Citizenship and Immigration Services
Change of Address
1084-I South Laurel Road
London, KY 40744

USCIS Forms and Information.

In addition, you will face severe penalties provided by law,
and may be subject to criminal prosecution.

Privacy Act Notice.

We ask for the information on this form, and associated
evidence, to determine if you have established eligibility for
the immigration benefit for which you are filing. Our legal
right to ask for this information can be found in the
Immigration and Nationality Act, as amended. We may
provide this information to other government agencies. Failure
to provide this information, and any requested evidence, may
delay a final decision or result in denial of your Form I-690.

Paperwork Reduction Act.

An agency may not conduct or sponsor an information
collection and a person is not required to respond to a
collection of information unless it displays a currently valid
OMB control number. The public reporting burden for this
collection of information is estimated at 15 minutes per
response, including the time for reviewing instructions,
completing and submitting the form. Send comments
regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing
this burden, to: U.S. Citizenship and Immigration Services,
Regulatory Products Division, 111 Massachusetts Avenue,
N.W., 3rd Floor, Suite 3008, Washington, DC 20529-2210.
OMB No. 1615-0032. Do not mail your application to this
address.

To order USCIS forms, call our toll-free number at 1-800870-3676. You can also get USCIS forms and information on
Form I-690 Instructions (Rev. 12/08/09)Y Page 3