I-751 Petition to Remove the Conditions on Residence

USCIS
Form I-751

Petition to Remove Conditions on Residence
Department of Homeland Security
U.S. Citizenship and Immigration Services
Receipt

For
USCIS
Use
Only

OMB No. 1615-0038
Expires 12/31/2019

Action Block

Remarks

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Not for
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05/15/2020

Reloc Sent
Reloc Received
Date (mm/dd/yyyy)
Date (mm/dd/yyyy)
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Date (mm/dd/yyyy)
Date (mm/dd/yyyy)
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Petitioner interviewed on (mm/dd/yyyy)

To be completed by an
attorney or accredited
representative (if any).

Select this box if
Form G-28 is
attached.

/

/

/

Approved under INA 216(c)(4)(C) Battered Spouse/Child

Attorney State Bar Number
(if applicable)

Attorney or Accredited Representative
USCIS Online Account Number (if any)

►START HERE - Type or print in black ink.

Part 1. Information About You, the Conditional
Resident

5.

Country of Birth

1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)

6.

Country of Citizenship or Nationality (provide all that
apply)

7.

Alien Registration Number (A-Number) (if any)
► A-

8.

U.S. Social Security Number (if any)
►

9.

USCIS Online Account Number (if any)

1.c. Middle Name

Other Names Used

List all other names you have ever used, including aliases,
maiden name, and nicknames. If you need extra space to
complete this section, use the space provided in Part 11.
Additional Information.
2.a. Family Name
(Last Name)
2.b. Given Name
(First Name)

►

Marital Status
10.

2.c. Middle Name
3.a. Family Name
(Last Name)
3.b. Given Name
(First Name)
3.c. Middle Name

Marital Status
Single

Married

Divorced

Widowed

11.

Date of Marriage (mm/dd/yyyy)

12.

Place of Marriage

13.

If the marriage through which you gained conditional
residence has ended, provide the date it ended (date of
divorce or date of death) (mm/dd/yyyy)

14.

Conditional Residence Expires On (mm/dd/yyyy)

Other Information
4.

Date of Birth (mm/dd/yyyy)

Form I-751 12/05/17 N

Page 1 of 9

Part 1. Information About You, the Conditional
Resident (continued)

21.

Yes
22.

Mailing Address
15.a. In Care Of Name

Apt.

Ste.

15.d. City or Town
15.e. State
16.

23.

Physical Address
17.a. In Care Of Name

Part 2. Biographic Information

1.

Ethnicity (Select only one box)
Hispanic or Latino
Not Hispanic or Latino

2.

Race (Select all applicable boxes)
White
Asian
Black or African American
American Indian or Alaska Native

17.b. Street Number
and Name

Native Hawaiian or Other Pacific Islander

Ste.

17.d. City or Town
17.e. State

Flr.

17.f. ZIP Code

3.

Height

4.

Weight

5.

Eye Color (Select only one box)

Additional Information About You
18.

19.

20.

Is your spouse or parent's spouse currently serving with or
employed by the U.S. Government and serving outside
the United States?
Yes
No

15.f. ZIP Code

Is your physical address different than your mailing
address?
Yes
No

Apt.

Have you resided at any other address since you became a
permanent resident?
Yes
No

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If you answered “Yes” to Item Number 16., provide your
physical address below.

17.c.

No

If you answered “Yes” to Item Number 22., provide a list of all
addresses where you have resided since becoming a permanent
resident and the dates you resided at those locations in the space
provided in Part 11. Additional Information.

15.b. Street Number
and Name
15.c.

If you are married, is this a different marriage than the
one through which you gained conditional resident status?

Are you in removal, deportation, or rescission
proceedings?
Yes

No

Was a fee paid to anyone other than an attorney in
connection with this petition?
Yes

No

Have you ever been arrested, detained, charged, indicted,
fined, or imprisoned for breaking or violating any law or
ordinance (excluding traffic regulations), or committed
any crime which you were not arrested in the United
States or abroad?
Yes
No

6.

Feet

Inches
Pounds

Black
Gray

Blue

Brown

Green

Hazel

Maroon

Pink

Unknown/Other

Hair Color (Select only one box)
Bald (No hair)
Brown
Sandy

Black
Gray
White

Blond
Red
Unknown/Other

If you answered "Yes" to Item Number 20., provide a detailed
explanation in Part 11. Additional Information or on a
separate sheet of paper, and refer to the What Initial Evidence
Is Required section of the Form I-751 instructions to determine
what criminal history document to include with your petition.

Form I-751 12/05/17 N

Page 2 of 9

Part 3. Basis for Petition
Joint Filing
My conditional residence is based on my marriage or my
parent's marriage to a U.S. citizen or lawful permanent resident,
and I am filing this joint petition together with (Select only one
box):

Other Information
2.a. Family Name
(Last Name)
2.b. Given Name
(First Name)
2.c. Middle Name
3.

1.a.

My spouse.

1.b.

My parent's spouse because I am unable to be
included in a joint petition filed by my parent and my
parent's spouse.

Date of Birth (mm/dd/yyyy)

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4.

U.S. Social Security Number (if any)
►

5.

A-Number (if any)

► A-

OR (Select all applicable boxes in the next section.)

Waiver or Individual Filing Request

My conditional residence is based on my marriage or my
parent's marriage to a U.S. citizen or lawful permanent resident,
I am unable to file a joint petition with my spouse or my
parent's spouse, because:

Physical Address

6.a. Street Number
and Name

6.b.

Apt.

1.c.

My spouse is deceased.

6.c. City or Town

1.d.

My marriage was entered in good faith, but the
marriage was terminated through divorce or
annulment.

6.d. State

1.e.

1.f.

1.g.

I entered the marriage in good faith, and, during the
marriage, I was battered, or was the subject of
extreme cruelty, by my U.S. citizen or lawful
permanent resident spouse.

My parent entered the marriage in good faith, and,
during the marriage, I was battered, or was subjected
to extreme cruelty, by my parent's U.S. citizen or
lawful permanent resident spouse or by my
conditional resident parent.
The termination of my status and removal from the
United States would result in an extreme hardship.

6.f.

Ste.

Flr.

6.e. ZIP Code

Province

6.g. Postal Code
6.h. Country

Part 5. Information About Your Children

Provide information on all of your children. If you need extra
space to complete this section, use the space provided in
Part 11. Additional Information.
Child 1

Part 4. Information About the U.S. Citizen or
Lawful Permanent Resident Spouse. If Filing as
a Child Separately, Information About the U.S.
Citizen or Lawful Permanent Resident
Stepparent Through Whom You Gained Your
Conditional Residence.
Relationship
1.a.

Spouse or Former Spouse

1.b.

Parent's Spouse or Former Spouse

Form I-751 12/05/17 N

1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
2.

Date of Birth (mm/dd/yyyy)

3.

A-Number (if any)
► A-

4.

Is this child living with you?

Yes

No

5.

Is this child applying with you?

Yes

No

Page 3 of 9

Child 3

Part 5. Information About Your Children
(continued)

13.a. Family Name
(Last Name)
13.b. Given Name
(First Name)

Physical Address

13.c. Middle Name

6.a. Street Number
and Name
6.b.

Apt.

Ste.

14.

Date of Birth (mm/dd/yyyy)

15.

A-Number (if any)

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6.c. City or Town

► A-

6.d. State
6.f.

Flr.

6.e. ZIP Code

Province

6.g. Postal Code

16.

Is this child living with you?

Yes

No

17.

Is this child applying with you?

Yes

No

Physical Address

6.h. Country

18.a. Street Number
and Name
Apt.

18.b.

Child 2
7.a. Family Name
(Last Name)
7.b. Given Name
(First Name)

Ste.

Flr.

18.c. City or Town

18.d. State

7.c. Middle Name

18.e. ZIP Code

18.f. Province

8.

Date of Birth (mm/dd/yyyy)

18.g. Postal Code

9.

A-Number (if any)

18.h. Country

► A-

10.

Is this child living with you?

Yes

No

Child 4

11.

Is this child applying with you?

Yes

No

19.a. Family Name
(Last Name)
19.b. Given Name
(First Name)

Physical Address

19.c. Middle Name

12.a. Street Number
and Name
12.b.

Apt.

Ste.

Flr.

12.c. City or Town
12.d. State

20.

Date of Birth (mm/dd/yyyy)

21.

A-Number (if any)
► A-

12.e. ZIP Code

12.f. Province

22.

Is this child living with you?

Yes

No

23.

Is this child applying with you?

Yes

No

12.g. Postal Code
12.h. Country

Form I-751 12/05/17 N

Page 4 of 9

Part 5. Information About Your Children
(continued)

Part 6. Accommodations for Individuals With
Disabilities and/or Impairments

Physical Address

NOTE: Read the information in the Form I-751 Instructions
before completing this part.

24.a. Street Number
and Name
24.b.

Apt.

Ste.

Flr.

1.

Are you requesting an accommodation because of your
disabilities and/or impairments?
Yes
No

2.

Are you requesting an accommodation because of your
spouse's disabilities and/or impairments?

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24.c. City or Town
24.d. State

24.e. ZIP Code

24.f. Province
24.g. Postal Code

3.

Child 5
25.a. Family Name
(Last Name)
25.b. Given Name
(First Name)
25.c. Middle Name
26.

Date of Birth (mm/dd/yyyy)

27.

A-Number (if any)

Are you requesting an accommodation because of your
included children's disabilities and/or impairments?
Yes

No

4.a.

I am deaf or hard of hearing and request the
following accommodation. (If you are requesting a
sign-language interpreter, indicate for which
language (for example, American Sign Language).):

4.b.

I am blind or have low vision and request the
following accommodation:

4.c.

I have another type of disability and/or impairment.
(Describe the nature of your disability and/or
impairment and the accommodation you are
requesting.):

► A-

28.

Is this child living with you?

Yes

No

29.

Is this child applying with you?

Yes

No

Physical Address
30.a. Street Number
and Name
Apt.

No

If you answered "Yes" to Item Numbers 1. - 3., select any
applicable box for Item Numbers 4.a. - 4.c. Provide
information on the disabilities and/or impairments for each
person.

24.h. Country

30.b.

Yes

Ste.

Flr.

30.c. City or Town
30.d. State

30.e. ZIP Code

30.f. Province
30.g. Postal Code
30.h. Country

Form I-751 12/05/17 N

Page 5 of 9

Part 7. Petitioner's Statement, Contact
Information, Certification, and Signature

Petitioner's Signature
6.a. Petitioner's Signature

NOTE: Read the Penalties section of the Form I-751
Instructions before completing this section. You must file Form
I-751 while in the United States.

Petitioner's Statement

NOTE TO ALL PETITIONERS: If you do not completely
fill out this petition or fail to submit required documents listed
in the Instructions, USCIS may deny your petition.

NOTE: Select the box for either Item Number 1.a. or 1.b. If
applicable, select the box for Item Number 2.
1.a.

1.b.

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I can read and understand English, and I have read
and understand every question and instruction on this
petition and my answer to every question.
The interpreter named in Part 9. read to me every
question and instruction on this petition and my
answer to every question in

,

a language in which I am fluent, and I understood
everything.
2.

6.b. Date of Signature (mm/dd/yyyy)

,

prepared this petition for me based only upon
information I provided or authorized.

Petitioner's Contact Information

Petitioner's Daytime Telephone Number

4.

Petitioner's Mobile Telephone Number (if any)

5.

Petitioner's Email Address (if any)

NOTE: Read the Penalties section of the Form I-751
Instructions before completing this section. You must file Form
I-751 while in the United States.

Spouse's or Individual's Statement

At my request, the preparer named in Part 10.,

3.

Part 8. Spouse's or Individual Listed in Part 4.'s
Statement, Contact Information, Certification,
and Signature

NOTE: Select the box for either Item Number 1.a. or 1.b. If
applicable, select the box for Item Number 2.
1.a.

I can read and understand English, and I have read
and understand every question and instruction on this
petition and the petitioner's answer to every question.

1.b.

The interpreter named in Part 9. read to me every
question and instruction on this petition and the
petitioner's answer to every question in
,

a language in which I am fluent, and I understood
everything.

2.

At my request, the preparer named in Part 10.,
,
prepared this petition for me based only upon
information I provided or authorized.

Petitioner's Certification
Copies of any documents I have submitted are exact photocopies
of unaltered, original documents, and I understand that USCIS
may require that I submit original documents to USCIS at a later
date. Furthermore, I authorize the release of any information
from any and all of my records that USCIS may need to
determine my eligibility for the immigration benefit that I seek.
I furthermore authorize release of information contained in this
petition, in supporting documents, and in my USCIS records to
other entities and persons where necessary for the administration
and enforcement of U.S. immigration laws.

Spouse's or Individual's Contact Information
3.

Spouse's or Individual's Daytime Telephone Number

4.

Spouse's or Individual's Mobile Telephone Number (if any)

5.

Spouse's or Individual's Email Address (if any)

I certify, under penalty of perjury, that I provided or authorized
all of the information in my petition, I understand all of the
information contained in, and submitted with, my petition, and
that all of this information is complete, true, and correct.

Form I-751 12/05/17 N

Page 6 of 9

Part 9. Interpreter's Contact Information,
Certification, and Signature

Part 8. Spouse's or Individual Listed in Part 4.'s
Statement, Contact Information, Certification,
and Signature (continued)

Provide the following information about the interpreter.

Spouse's or Individual's Certification

Interpreter's Full Name

Copies of any documents I have submitted are exact photocopies
of unaltered, original documents, and I understand that USCIS
may require that I submit original documents to USCIS at a later
date. Furthermore, I authorize the release of any information
from any and all of my records that USCIS may need to
determine my eligibility for the immigration benefit that I seek.

1.a. Interpreter's Family Name (Last Name)

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I furthermore authorize release of information contained in this
petition, in supporting documents, and in my USCIS records, to
other entities and persons where necessary for the administration
and enforcement of U.S. immigration law.
I understand that USCIS will require me to appear for an
appointment to take my biometrics (fingerprints, photograph,
and/or signature) and, at that time, I will be required to sign an
oath reaffirming that:

1.b. Interpreter's Given Name (First Name)

2.

Interpreter's Business or Organization Name (if any)

Interpreter's Mailing Address

3.a. Street Number
and Name
3.b.

Apt.

1) I reviewed and provided or authorized all of the
information in my petition;

3.c. City or Town

2) I understood all of the information contained in,
and submitted with, my petition; and

3.d. State

3) All of this information was complete, true, and
correct at the time of filing.

I certify, under penalty of perjury, that I provided or authorized
all of the information in my petition, I understand all of the
information contained in, and submitted with, my petition, and
that all of this information is complete, true, and correct.

3.f.

Ste.

Flr.

3.e. ZIP Code

Province

3.g. Postal Code
3.h. Country

Interpreter's Contact Information

Spouse's or Individual's Signature

4.

Interpreter's Daytime Telephone Number

5.

Interpreter's Mobile Telephone Number (if any)

6.

Interpreter's Email Address (if any)

6.a. Spouse's or Individual's Signature

6.b. Date of Signature (mm/dd/yyyy)
NOTE TO ALL SPOUSES OR INDIVIDUALS: If you do
not completely fill out this petition or fail to submit required
documents listed in the instructions, USCIS may deny your
petition.

Interpreter's Certification
I certify, under penalty of perjury, that:
I am fluent in English and

,which

is the same language specified in Part 7., Item Number 1.b.,
and I have read to this petitioner in the identified language
every question and instruction on this petition and his or her
answer to every question. The petitioner informed me that he or
she understands every instruction, question, and answer on the
petition, including the Petitioner's Certification, and has
verified the accuracy of every answer.
Form I-751 12/05/17 N

Page 7 of 9

Part 9. Interpreter's Contact Information,
Certification, and Signature (continued)

Preparer's Statement
7.a.

I am not an attorney or accredited representative but
have prepared this petition on behalf of the petitioner
and with the petitioner's consent.

7.b.

I am an attorney or accredited representative and my
representation of the petitioner in this case
extends
does not extend beyond the
preparation of this petition.

Interpreter's Signature
7.a. Interpreter's Signature

7.b. Date of Signature (mm/dd/yyyy)

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Part 10. Contact Information, Declaration, and
Signature of the Person Preparing this Petition, if
Other Than the Petitioner
Provide the following information about the preparer.

Preparer's Full Name

1.a. Preparer's Family Name (Last Name)

1.b. Preparer's Given Name (First Name)

2.

NOTE: If you are an attorney or accredited
representative, you may need to submit a completed
Form G-28, Notice of Entry of Appearance as Attorney
or Accredited Representative, with this petition.

Preparer's Certification

By my signature, I certify, under penalty of perjury, that I
prepared this petition at the request of the petitioner. The
petitioner then reviewed this completed petition and informed
me that he or she understands all of the information contained
in, and submitted with, his or her petition, including the
Petitioner's Certification, and that all of this information is
complete, true, and correct. I completed this petition based only
on information that the petitioner provided to me or authorized
me to obtain or use.

Preparer's Business or Organization Name (if any)

Preparer's Signature

8.a. Preparer's Signature

Preparer's Mailing Address
3.a. Street Number
and Name
3.b.

Apt.

8.b. Date of Signature (mm/dd/yyyy)

Ste.

3.c. City or Town
3.d. State
3.f.

Flr.

3.e. ZIP Code

Province

3.g. Postal Code
3.h. Country

Preparer's Contact Information
4.

Preparer's Daytime Telephone Number

5.

Preparer's Mobile Telephone Number (if any)

6.

Preparer's Email Address (if any)

Form I-751 12/05/17 N

Page 8 of 9

5.a. Page Number

Part 11. Additional Information
If you need extra space to provide any additional information
within this petition, use the space below. If you need more
space than what is provided, you may make copies of this page
to complete and file with this petition or attach a separate sheet
of paper. Type or print your name and A-Number (if any) at the
top of each sheet; indicate the Page Number, Part Number,
and Item Number to which your answer refers; and sign and
date each sheet.

1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name

5.c. Item Number

5.d.

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Your Full Name

2.

5.b. Part Number

6.a. Page Number

6.b. Part Number

6.c. Item Number

7.b. Part Number

7.c. Item Number

A-Number (if any)

A-

3.a. Page Number

3.b. Part Number

3.d.

6.d.

3.c. Item Number

7.a. Page Number

7.d.
4.a. Page Number

4.b. Part Number

4.c. Item Number

4.d.

Form I-751 12/05/17 N

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