Information Collection

Supplement A, Adjustment of Status to Permanent Resident Under INA Section 245(i)

IC 216963 under ICR 201505-1615-002 · OMB 1615-0023.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0023 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form I-485, Supplement Supplement A, Adjustment of Status to Permanent Resident Under INA Section 245(i)	Form
Draft I-485 30-Day Instruction Booklet (with main and Supp A instructions).pdf www.uscis.gov/I-485	Instruction
I-485, Supplement Supplement A, Adjustment of Status to Permanent Resident I485-FRM-SUPP A-30 Day-06112015.pdf	Form

IC Title:

Supplement A, Adjustment of Status to Permanent Resident Under INA Section 245(i)

Agency IC Tracking Number:

I-485A

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	I-485, Supplement A	Supplement A, Adjustment of Status to Permanent Resident Under INA Section 245(i)	I485-FRM-SUPP A-30 Day-06112015.pdf		Yes	No	Fillable Printable
Instruction			Draft I-485 30-Day Instruction Booklet (with main and Supp A instructions).pdf	www.uscis.gov/I-485	Yes	No	Printable Only

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: USCIS Benefits Information System

FR Citation: 73 FR 56596

Number of Respondents: 25,540

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	25,540	25,540
Annual IC Time Burden (Hours)	25,540	25,540
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.