Information Collection

Supplement A to Form I-485, Adjustment of Status Under Section 245(i)

IC 218034 under ICR 201607-1615-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 A Supplement A to Form I-485, Adjustment of Status Under Section 245(i)	Form
I485-INS-SUPP A-30 Day-07082016.pdf	Instruction
I485-INS-SUPP A-Comp+AC21+FR(062617-N)-11212016.pdf	Instruction
Form I-485 Supplem Supplement A to Form I-485, Adjustment of Status Under S I485-FRM-SUPP A-30 Day-07252016.pdf www.uscis.gov/I-485	Form
I-485 Supplement A Supplement A to Form I-485, Adjustment of Status Under S I485-FRM-SUPP A-Comp+AC21+FR(062617-N)-11212016.pdf	Form

IC Title:

Supplement A to Form I-485, Adjustment of Status Under Section 245(i)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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 to Form I-485, Adjustment of Status Under Section 245(i)	I485-FRM-SUPP A-Comp+AC21+FR(062617-N)-11212016.pdf		Yes	No	Fillable Printable
Instruction			I485-INS-SUPP A-Comp+AC21+FR(062617-N)-11212016.pdf		Yes	No	Printable Only
Form	Form I-485 Supplement A	Supplement A to Form I-485, Adjustment of Status Under Section 245(i)	I485-FRM-SUPP A-30 Day-07252016.pdf	www.uscis.gov/I-485	Yes	No	Fillable Printable
Instruction			I485-INS-SUPP A-30 Day-07082016.pdf		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: 36,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	36,000	32,112	3,888
Annual IC Time Burden (Hours)	45,000	44,160	840
Annual IC Cost Burden (Dollars)	0	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.