TABLE OF CHANGES – FORM
Form I-601, Application for Waiver of Grounds of Inadmissibility
OMB Number: 1615-0029
Reason for Revision: Biometrics Rule Project Phase: NPRM
Legend for Proposed Text:
Expires 10/31/2021 Edition Date 10/15/2019 |
Current Page Number and Section |
Current Text |
Proposed Text |
Pages 1-2, Part 1. Information About You |
[page 1]
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Other Names Used
List all other names you have ever used, including maiden names, aliases, and nicknames. If you need extra space to complete this section, use the space provided in Part 10. Additional Information.
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[page 1]
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Other Names Used
List all other names you have ever used, including maiden names, aliases, and nicknames. If you need extra space to complete this section, use the space provided in Part 9. Additional Information.
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Pages 2-3, Part 2. U.S. Entry Information |
[page 2]
Part 2. U.S. Entry Information
Provide information for your previous periods of stay in the United States, beginning with your most recent arrival date.
NOTE: If you need extra space to complete this section, use the space provided in Part 10. Additional Information.
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[page 2]
Part 2. U.S. Entry Information
Provide information for your previous periods of stay in the United States, beginning with your most recent arrival date.
NOTE: If you need extra space to complete this section, use the space provided in Part 9. Additional Information.
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Page 3, Part 3. Biographic Information |
[page 3]
Part 3. Biographic Information (for USCIS Applicant only)
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 Native Hawaiian or Other Pacific Islander
3. Height Feet Inches
4. Weight Pounds
5. Eye Color (Select only one box) Black Blue Brown Gray Green Hazel Maroon Pink Unknown/Other
6. Hair Color (Select only one box) Bald (No hair) Black Blond Brown Gray Red Sandy White Unknown/Other
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[page 3]
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Pages 3-5, Part 4. Reasons for Inadmissibility
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[page 3]
Part 4. Reasons for Inadmissibility
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If you are seeking a waiver of inadmissibility because you have a Class A Tuberculosis condition (as defined by U.S. Department of Health and Human Services (HHS) regulations), you must complete Part 11. of this application.
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[page 5]
If you need extra space to complete your statement, use the space provided in Part 10. Additional Information or attach a separate letter. If you include a separate letter, indicate in Item Number 39. that you are attaching a letter.
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[page 3]
Part 3. Reasons for Inadmissibility
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If you are seeking a waiver of inadmissibility because you have a Class A Tuberculosis condition (as defined by U.S. Department of Health and Human Services (HHS) regulations), you must complete Part 10. of this application.
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[page 5]
If you need extra space to complete your statement, use the space provided in Part 9. Additional Information or attach a separate letter. If you include a separate letter, indicate in Item Number 39. that you are attaching a letter.
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Page 6, Part 5. Information About Your Qualifying Relatives |
[page 6]
Part 5. Information About Your Qualifying Relatives
Provide information for your U.S. citizen or lawful permanent resident through whom you are eligible to submit this application. In Item Number 9., provide a statement explaining the extreme hardship that you or your qualifying relative (U.S. citizen, lawful permanent resident, or other qualified parent or child) has or will experience if you are refused the immigration benefit you are seeking. It is not necessary for an SIJ to complete Part 5. of the application.
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Select this box if you have additional relatives through whom you claim eligibility and use the space provided in Part 10. Additional Information to provide the same information as requested in Part 5., Item Numbers 1.a. - 8.
Statement From Applicant (Extreme Hardship)
In the space provided below, explain the extreme hardship that your qualifying relative (or yourself if you are a VAWA self- petitioner) would experience if you are refused the immigration benefit you are seeking. For more information on extreme hardship, see Form I-601 Instructions. If you need extra space to complete your statement, use the space provided in Part 10. Additional Information or attach a separate letter. Indicate in Item Number 9. if you are attaching a separate letter. The letter must be submitted at the same time as your Form I-601 application.
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[page 6]
Part 4. Information About Your Qualifying Relatives
Provide information for your U.S. citizen or lawful permanent resident through whom you are eligible to submit this application. In Item Number 9., provide a statement explaining the extreme hardship that you or your qualifying relative (U.S. citizen, lawful permanent resident, or other qualified parent or child) has or will experience if you are refused the immigration benefit you are seeking. It is not necessary for an SIJ to complete Part 4. of the application.
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Select this box if you have additional relatives through whom you claim eligibility and use the space provided in Part 9. Additional Information to provide the same information as requested in Part 4., Item Numbers 1.a. - 8.
Statement From Applicant (Extreme Hardship)
In the space provided below, explain the extreme hardship that your qualifying relative (or yourself if you are a VAWA self- petitioner) would experience if you are refused the immigration benefit you are seeking. For more information on extreme hardship, see Form I-601 Instructions. If you need extra space to complete your statement, use the space provided in Part 9. Additional Information or attach a separate letter. Indicate in Item Number 9. if you are attaching a separate letter. The letter must be submitted at the same time as your Form I-601 application.
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Page 6, Part 6. Information About Your Other Relatives With Ties to the United States |
[page 6]
Part 6. Information About Your Other Relatives With Ties to the United States
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Select this box if you have any other relatives with ties to the United States and use the space provided in Part 10. Additional Information to provide the same information as requested in Part 6., Item Numbers 1.a. - 8.
Statement From Applicant (Discretion)
In the space provided below, explain why you believe your application should be approved as a matter of discretion, with the favorable outweighing the unfavorable factors in your case. For more information on discretion, see Form I-601 Instructions. If you need extra space to complete your statement, use the space provided in Part 10. Additional Information or attach a separate letter. Indicate in Item Number 9. if you are attaching a separate letter. The letter must be submitted at the same time as your Form I-601 application.
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[page 6]
Part 5. Information About Your Other Relatives With Ties to the United States
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Select this box if you have any other relatives with ties to the United States and use the space provided in Part 9. Additional Information to provide the same information as requested in Part 5., Item Numbers 1.a. - 8.
Statement From Applicant (Discretion)
In the space provided below, explain why you believe your application should be approved as a matter of discretion, with the favorable outweighing the unfavorable factors in your case. For more information on discretion, see Form I-601 Instructions. If you need extra space to complete your statement, use the space provided in Part 9. Additional Information or attach a separate letter. Indicate in Item Number 9. if you are attaching a separate letter. The letter must be submitted at the same time as your Form I-601 application.
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Pages 7-8, Part 7. Applicant's Statement, Contact Information, Declaration, Certification, and Signature |
[page 7]
Part 7. Applicant's Statement, Contact Information, Declaration, Certification, and Signature
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1.b. The interpreter named in Part 8. read to me every question and instruction on this application and my answer to every question, in [Fillable Field], a language in which I am fluent, and I understood everything.
2. At my request, the preparer named in Part 9., [Fillable Field], prepared this application for me based only upon information I provided or authorized.
[Page 8]
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I furthermore authorize release of information contained in this application, 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 may require me to appear for an appointment to take my biometrics (fingerprints, photograph, and/or signature) and, at that time, if I am required to provide biometrics, I will be required to sign an oath reaffirming that:
1) I reviewed and understood all of the information contained in, and submitted with, my application; and
2) All of this information was complete, true, and correct at the time of filing.
I certify, under penalty of perjury, that all of the information in my application and any document submitted with it were provided or authorized by me, that I reviewed and understand all of the information contained in, and submitted with, my application and that all of this information is complete, true, and correct.
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[page 7]
Part 6. Applicant's Statement, Contact Information, Declaration, Certification, and Signature
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1.b. The interpreter named in Part 7. read to me every question and instruction on this application and my answer to every question, in [Fillable Field], a language in which I am fluent, and I understood everything.
2. At my request, the preparer named in Part 8., [Fillable Field], prepared this application for me based only upon information I provided or authorized.
[Page 8]
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I furthermore authorize release of information contained in this application, 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.
[deleted]
I certify, under penalty of perjury, that all of the information in my application and any document submitted with it were provided or authorized by me, that I reviewed and understand all of the information contained in, and submitted with, my application and that all of this information is complete, true, and correct.
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Pages 8-9, Part 8. Interpreter's Contact Information, Certification, and Signature |
[page 8]
Part 8. Interpreter's Contact Information, Certification, and Signature
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I am fluent in English and [Fillable Field], which is the same language specified in Part 7., Item Number 1.b., and I have read to this applicant in the identified language every question and instruction on this application and his or her answer to every question. The applicant informed me that he or she understands every instruction, question, and answer on the application, including the Applicant's Declaration and Certification, and has verified the accuracy of every answer.
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[page 8]
Part 7. Interpreter's Contact Information, Certification, and Signature
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I am fluent in English and [Fillable Field], which is the same language specified in Part 6., Item Number 1.b., and I have read to this applicant in the identified language every question and instruction on this application and his or her answer to every question. The applicant informed me that he or she understands every instruction, question, and answer on the application, including the Applicant's Declaration and Certification, and has verified the accuracy of every answer.
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Page 9, Part 9. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant |
[page 9]
Part 9. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant
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[page 9]
Part 8. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant
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Page 10, Part 10. Additional Information
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[page 10]
Part 10. Additional Information
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[page 10]
Part 9. Additional Information
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Pages 11-12, Part 11. Statement for Applicants With a Class A Tuberculosis Condition (As Defined By HHS Regulations)
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[page 11]
Part 11. Statement for Applicants With a Class A Tuberculosis Condition (As Defined By HHS Regulations)
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[page 11]
Part 10. Statement for Applicants With a Class A Tuberculosis Condition (As Defined By HHS Regulations)
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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Mulvihill, Timothy R |
File Modified | 0000-00-00 |
File Created | 2021-01-13 |