Pages 4-7,
Part 5. Processing
Information
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[Page 4]
Part 5. Processing Information
[new]
Answer the following questions about
the family member for whom you are filing this supplement. For
the purposes of this supplement, you must answer "Yes"
to the following questions, if applicable, even if your family
member's records were sealed or otherwise cleared or if anyone,
including a judge, law enforcement officer, or attorney, told your
family member that he or she no longer has a record.
NOTE: If you answer “Yes”
to ANY question in Part 5., provide an explanation
in the space provided in Part 11. Additional Information.
NOTE: Answering "Yes"
does not necessarily mean that U.S. Citizenship and Immigration
Services (USCIS) will deny your Supplement A, Petition for
Qualifying Family Member of U-1 Recipient.
Has your family member EVER:
1.a. Committed a crime or
offense for which he or she has not been arrested?
Yes
No
1.b. Been arrested, cited,
or detained by any law enforcement officer (including Department
of Homeland Security (DHS), former Immigration and Nationalization
Service (INS), and military officers) for any reason?
Yes
No
1.c. Been charged with
committing any crime or offense?
Yes
No
1.d. Been convicted of a
crime or offense (even if the violation was subsequently expunged
or pardoned)?
Yes
No
1.e. Been placed in an
alternative sentencing or a rehabilitative program (for example,
diversion, deferred prosecution, withheld adjudication, deferred
adjudication)?
Yes
No
1.f. Received a suspended
sentence, been placed on probation, or been paroled?
Yes
No
1.g. Been held in jail or
prison?
Yes
No
1.h. Been the beneficiary of
a pardon, amnesty, rehabilitation, or other act of clemency or
similar action?
Yes
No
1.i. Exercised diplomatic
immunity to avoid prosecution for a criminal offense in the United
States?
Yes
No
Information About Arrests,
Citations, Detentions, or Charges
2.a Why was your family
member arrested, cited, detained, or charged?
2.b. Date of arrest,
citation, detention, or charge (mm/dd/yyyy)
Where was your family member
arrested, cited, detained, or charged?
2.c. City or Town
2.d. State
2.e. Country
2.f. Outcome or disposition
(for example, no charges filed, charges dismissed, jail,
probation)
3.a Why was your family
member arrested, cited, detained, or charged?
3.b. Date of arrest,
citation, detention, or charge (mm/dd/yyyy)
Where was your family member
arrested, cited, detained, or charged?
3.c. City or Town
3.d. State
3.e. Country
3.f. Outcome or disposition
(for example, no charges filed, charges dismissed, jail,
probation)
[Page 5]
Has your family member EVER:
4.a. Engaged in, or does he
or she intend to engage in, prostitution or procurement of
prostitution?
Yes
No
4.b. Engaged in any unlawful
commercialized vice, including, but not limited to, illegal
gambling?
Yes
No
4.c. Knowingly encouraged,
induced, assisted, abetted, or aided any alien to try to enter the
United States illegally?
Yes
No
4.d. Illicitly trafficked in
any controlled substance or knowingly assisted, abetted, or
colluded in the illicit trafficking of any controlled substance?
Yes
No
Has your family member EVER
committed, planned or prepared, participated in, threatened to,
attempted to, conspired to commit, gathered information for, or
solicited funds for any of the following:
5.a. Hijacking or sabotage
of any conveyance (including an aircraft, vessel, or vehicle)?
Yes
No
5.b. Seizing or detaining,
and threatening to kill, injure, or continue to detain, another
individual in order to compel a third person (including a
governmental organization) to do or abstain from doing any act as
an explicit or implicit condition for the release of the
individual seized or detained?
Yes
No
5.c. Assassination?
Yes
No
5.d. The use of any firearm
with intent to endanger, directly or indirectly, the safety of one
or more individuals or to cause substantial damage to property?
Yes
No
5.e. The use of any
biological agent, chemical agent, nuclear weapon or device,
explosive, or other weapon or dangerous device, with intent to
endanger, directly or indirectly, the safety of one or more
individuals or to cause substantial damage to property?
Yes
No
Has your family member EVER
been a member of, solicited money or members for, provided support
for, attended military training (as defined in section 2339D(c)(1)
of Title 18, United States Code) by or on behalf of, or been
associated with any other group of two or more individuals,
whether organized or not, which has been designated as, or has
engaged in or has a subgroup which has been designated as, or has
engaged in:
6.a. A terrorist
organization under section 219 of the Immigration and Nationality
Act (INA)?
Yes
No
6.b. Hijacking or sabotage
of any conveyance (including an aircraft, vessel, or vehicle)?
Yes
No
6.c. Seizing or detaining,
and threatening to kill, injure, or continue to detain, another
individual in order to compel a third person (including a
governmental organization) to do or abstain from doing any act as
an explicit or implicit condition for the release of the
individual seized or detained?
Yes
No
6.d. Assassination?
Yes
No
6.e. The use of any firearm
with intent to endanger, directly or indirectly, the safety of one
or more individuals or to cause substantial damage to property?
Yes
No
6.f. The use of any
biological agent, chemical agent, nuclear weapon or device,
explosive, or other weapon or dangerous device, with intent to
endanger, directly or indirectly, the safety of one or more
individuals or to cause substantial damage to property?
Yes
No
6.g. Soliciting money or
members or otherwise providing material support to a terrorist
organization?
Yes
No
Does your family member intend to
engage in the United States in:
7.a. Espionage?
Yes
No
7.b. Any unlawful activity,
or any activity the purpose of which is in opposition to, or the
control, or overthrow of the Government of the United States?
Yes
No
7.c. Solely, principally, or
incidentally in any activity related to espionage or sabotage or
to violate any law involving the export of goods, technology, or
sensitive information?
Yes
No
8. Has your family member
EVER been or does he or she continue to be a member of the
Communist or other totalitarian party, except when membership was
involuntary?
Yes
No
[Page 6]
9. Has your family member
EVER, during the period of March 23, 1933 to May 8, 1945,
in association with either the Nazi Government of Germany or any
organization or government associated or allied with the Nazi
Government of Germany, ordered, incited, assisted or otherwise
participated in the persecution of any person because of race,
religion, nationality, membership in a particular social group or
political opinion?
Yes
No
Has your family member EVER
ordered, incited, called for, committed, assisted, helped with, or
otherwise participated in any of the following:
10.a. Acts involving torture
or genocide?
Yes
No
10.b. Killing any person?
Yes
No
10.c. Intentionally and
severely injuring any person?
Yes
No
10.d. Engaging in any kind
of sexual conduct or relations with any person who was being
forced or threatened?
Yes
No
10.e. Limiting or denying
any person's ability to exercise religious beliefs?
Yes
No
10.f. The persecution of any
person because of race, religion, national origin, membership in a
particular social group, or political opinion?
Yes
No
10.g. Displacing or moving
any person from their residence by force, threat of force,
compulsion, or duress?
Yes
No
NOTE: If you answered "Yes"
to any question in Item Numbers 10.a. - 10.g., please
describe the circumstances in the spaces provided in Part 11.
Additional Information.
11. Has your family member
EVER advocated that another person commit any of the acts
described in Item Numbers 10.a. - 10.g., urged, or
encouraged another person, to commit such acts?
Yes
No
Has your family member EVER
been present or nearby when any person was:
12.a. Intentionally killed,
tortured, beaten, or injured?
Yes
No
12.b. Displaced or moved
from his or her residence by force, compulsion, or duress?
Yes
No
12.c. In any way compelled
or forced to engage in any kind of sexual contact or relations?
Yes
No
Has your family member EVER:
13.a. Served in, been a
member of, assisted in, or participated in any military unit,
paramilitary unit, police unit, self-defense unit, vigilante unit,
rebel group, guerilla group, militia, or other insurgent
organization?
Yes
No
13.b. Served in any prison,
jail, prison camp, detention facility, labor camp, or any other
situation that involved detaining persons?
Yes
No
13.c. Served in, been a
member of, assisted in, or participated in any group, unit, or
organization of any kind in which you or other persons
transported, possessed, or used any type of weapon?
Yes
No
NOTE: If you answered "Yes"
to any question in Item Numbers 13.a. - 13.c., please
describe the circumstances in Part 11. Additional Information.
Has your family member EVER:
14.a. Received any type of
military, paramilitary, or weapons training?
Yes
No
14.b. Been a member of,
assisted in, or participated in any group, unit, or organization
of any kind in which you or other persons used any type of weapon
against any person or threatened to do so?
Yes
No
14.c. Assisted or
participated in selling or providing weapons to any person who to
your knowledge used them against another person, or in
transporting weapons to any person who to your knowledge used them
against another person?
Yes
No
NOTE: If you answered "Yes"
to any question in Item Numbers 14.a. - 14.c., please
describe the circumstances in Part 11. Additional Information.
Has your family member EVER:
15.a. Recruited, enlisted,
conscripted, or used any person under 15 years of age to serve in
or help an armed force or group?
Yes
No
15.b. Used any person under
15 years of age to take part in hostilities, or to help or provide
services to people in combat?
Yes
No
16. Is your family member
NOW in removal, exclusion, rescission, or deportation
proceedings?
Yes
No
17. Has your family member
EVER had removal, exclusion, rescission, or deportation
proceedings initiated against him or her?
Yes
No
[Page 7]
18. Has your family member
EVER been removed, excluded, or deported from the United
States?
Yes
No
19. Has your family member
EVER been ordered to be removed, excluded, or deported from
the United States?
Yes
No
20. Has your family member
EVER been denied a visa or denied admission to the United
States?
Yes
No
[moved down from above]
21. Has your family member
EVER been granted voluntary departure by an immigration
officer or an immigration judge and failed to depart within the
allotted time?
Yes
No
22. Is your family member
NOW under a final order or civil penalty for violating
section 274C of the INA (producing and/or using false
documentation to unlawfully satisfy a requirement of the INA)?
Yes
No
23. Has your family member
EVER, by fraud or willful misrepresentation of a material
fact, sought to procure or procured a visa or other documentation,
for entry into the United States or any immigration benefit?
Yes
No
24. Has your family member
EVER left the United States to avoid being drafted into the
U.S. Armed Forces or U.S. Coast Guard?
Yes
No
25. Has your family member
EVER been a J nonimmigrant exchange visitor who was subject
to the 2-year foreign residence requirement and not yet complied
with that requirement or obtained a waiver of such?
Yes
No
26. Has your family member
EVER detained, retained, or withheld the custody of a
child, having a lawful claim to United States citizenship, outside
the United States from a United States citizen granted custody?
Yes
No
27. Does your family member
plan to practice polygamy in the United States?
Yes
No
28. Has your family member
EVER entered the United States as a stowaway?
Yes
No
29.a. Does your family
member NOW have a communicable disease of public health
significance?
Yes
No
29.b. Does your family
member NOW have or has your family member EVER had a
physical or mental disorder and behavior (or a history of behavior
that is likely to recur) associated with the disorder which has
posed or may pose a threat to the property, safety, or welfare of
yourself or others?
Yes
No
29.c. Is your family member
NOW or has your family member EVER been a drug
abuser or drug addict?
Yes
No
[new]
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[Page 4]
Part 5.
Arrival/Departure Information
and General Inadmissibility Grounds
NOTE: If
you answer “Yes” to any of the below inadmissibility
questions, please refer to the Form I-918 Instructions, Waiver of
Grounds of Inadmissibility section, as you may be required to file
a Form I-192 waiver.
Item
Numbers 1. - 30.,
about the qualifying family
member for whom you are filing this Supplement A. If you answer
“Yes” to any questions (or if you answer “No,”
but are unsure of your answer), provide an explanation of the
events and circumstances in the space provided in Part
10. Additional Information.
For
the purposes of this supplement, you
must answer "Yes" to the following questions, if
applicable, even if your qualifying
family member's records were sealed
or otherwise cleared or if anyone, including a judge, law
enforcement officer, or attorney, told your qualifying
family member that they no longer
have a record.
[deleted]
[moved to Item
Number 22.]
[Reformatted
and renumbered to be Item Number
2.]
1.
Has
your qualifying family member
EVER
been denied a
visa or denied admission
to the United States?
Yes/No
[deleted]
2.
Is
your qualifying family member
presently or has
your qualifying family member
EVER
been in exclusion, deportation, removal, or rescission
proceedings?
Yes/No/Unknown
[deleted]
If you
answered "Yes," to Item
Number 2., select the type of
proceedings. If your qualifying family member was in proceedings
in the past and is no longer in proceedings, provide the date of
action. If they are currently in proceedings, select the box next
to “Present.” If you answered “Unknown”
to Item Number 2.,
use the space provided in Part 10.
Additional Information to provide
an explanation. You may also use the space provided in Part
10. Additional Information to
provide information about more than one type of proceeding, if
necessary.
☐Removal
☐Exclusion
☐Deportation
☐Rescission
☐Unknown
Date:
(mm/dd/yyyy):
3.
Has
your qualifying family member EVER
been issued a final order of exclusion, deportation, or removal?
Yes/No/Unknown
4.
Has your qualifying family member EVER
departed the United States on their own after having been ordered
excluded, deported, or removed from the United States?
Yes/No
5.
Since April 1, 1997, has your qualifying family member been
unlawfully present in the United States:
A. For
more than 180 days but less than a year, and then departed the
United States? [ ] Yes [ ] No
B. For
one year or more and then departed the United States? [ ] Yes [ ]
No
NOTE:
Your qualifying family member was unlawfully present in the United
States if they entered the United States without being inspected
and admitted or paroled, or if they legally entered the United
States but they stayed longer than permitted.
6.
Since April 1, 1997, have they EVER
reentered or attempted to reenter the United States without being
inspected and admitted or paroled after:
A.
Having been unlawfully present in the United States for more than
one year in the aggregate? [ ] Yes [ ] No
B.
Having been deported, excluded, or removed from the United States?
[ ] Yes [ ] No
If
your answer is “Yes,” please provide an explanation
including the date(s) of departure, re-entry or attempted reentry
of your qualifying family member in Part
10. Additional Information.
Criminal
Acts and Violations
For Item
Numbers 7. - 30.,
you must answer "Yes" to any question that applies to
your qualifying family member, even if their records were sealed
or otherwise cleared, or even if anyone, including a judge, law
enforcement officer, or attorney, told them they no longer have a
record. You must also answer "Yes" to the following
questions whether the action or offense occurred here in the
United States or anywhere else in the world. If you answer "Yes"
to Item Numbers 7. - 30.,
use the space provided in Part 10.
Additional Information to provide
an explanation that includes why your qualifying family member was
arrested, cited, detained, or charged; where they were arrested,
cited, detained, or charged; when (date) the event occurred; and
the outcome or disposition (for example, no charges filed, charges
dismissed, jail, probation, community service).
NOTE:
Answering "Yes" does not necessarily mean that U.S.
Citizenship and Immigration Services (USCIS) will deny your
Supplement A, Petition for Qualifying Family Member of U-1
Recipient.
[Page 5]
7.
Has your qualifying family member EVER
been
arrested, cited, charged, or detained for any reason by any law
enforcement official (including but not limited to any U.S.
immigration official or any official of the U.S. armed forces or
U.S. Coast Guard or by a similar official of a country other than
the United States)?
Yes/No
8.
Has your qualifying family member EVER
committed a crime of any kind (even if they were not arrested,
cited, charged with, tried for that crime, or convicted)?
Yes/No
9.
Has your qualifying family member EVER
pled guilty to or been convicted of a crime or offense (even if
the violation was subsequently expunged or sealed by a court, or
if they were granted a pardon, amnesty, a rehabilitation decree,
or other act of clemency)? If you answer “Yes,”
provide documentation of the post-conviction action.
Yes/No
10.
Has your qualifying family member EVER
been ordered, punished by a judge, or had conditions imposed on
them that restrained their liberty (such as a prison sentence,
suspended sentence, house arrest, parole, alternative sentencing,
drug or alcohol treatment, rehabilitative programs or classes,
probation, or community service)?
Yes/No
11.
Has your qualifying family member EVER
been convicted of two or more offenses (other than purely
political offenses) for which the combined sentences to
confinement were five years or more?
12.
Has your qualifying family member EVER
exercised immunity (diplomatic or otherwise) to avoid being
prosecuted for a criminal offense in the United States?
Yes/No
13.
Has your qualifying family member EVER,
while serving as a foreign government official, been responsible
for or directly carried out violations of religious freedoms?
Yes/No
14.
Has your qualifying family member EVER
illegally trafficked or benefited from the trafficking of any
controlled substances, or knowingly aided, abetted, assisted,
conspired, or colluded in the illegal trafficking of any
controlled substances or chemicals?
Yes/No
15.
Has your qualifying family member EVER
engaged in prostitution, or do they intend to engage in any form
of commercialized vice, such as prostitution, illegal gambling,
bootlegging, or child pornography, while in the United States?
Yes/No
16.
Has your qualifying family member EVER
engaged
in money laundering or has your qualifying family member EVER
knowingly aided, assisted, conspired, or colluded with others in
money laundering or are they seeking to enter the United States to
engage in such activity?
Yes/No
17.
Has your qualifying family member EVER
trafficked,
or knowingly aided, abetted, assisted, conspired, or colluded with
others in trafficking, persons for commercial sex acts or
involuntary servitude, peonage, debt bondage, or slavery?
Trafficking includes recruiting, harboring, transporting,
providing, or obtaining a person for labor or services through
force, fraud, or coercion.
Yes/No
Security
and Related
Does
your qualifying family member intend to:
18.a.
Engage in any activity that violates or evades any law relating to
espionage (including spying) or sabotage in the United States?
Yes/No
18.b.
Engage in any activity in the United States that violates or
evades any law prohibiting the export from the United States of
goods, technology, or sensitive information?
Yes/No
18.c.
Engage in any activity whose purpose includes opposing,
controlling, or overthrowing the U.S. Government by force,
violence, or other unlawful means while in the United States?
Yes/No
Has
your qualifying family member EVER:
19.a.
Received any weapons training, paramilitary training or other
military-type training?
Yes/No
19.b.
Committed hijacking or sabotage of a conveyance (including an
aircraft, vessel, or vehicle), kidnapping, or assassination?
Yes/No
[Page 6]
19.c.
Threatened, attempted, conspired to use, or used a weapon or
explosive or any dangerous device with the intent to endanger the
safety of another person or people or cause substantial damage to
property?
Yes/No
20.
Has your qualifying family member EVER
assisted or participated in selling, providing, or transporting
weapons to any person who, to their knowledge, planned to use them
against another person?
Yes/No
21.
Has your qualifying family member EVER
worked, volunteered, or otherwise served in any prison, jail,
prison camp, detention facility, labor camp, or any other
situation that involved detaining persons?
Yes/No
22.
Has your qualifying family member EVER
served in, been a member of, assisted, or participated in any
military unit, paramilitary unit, police unit, self-defense unit,
vigilante unit, rebel group, guerilla group, militia, insurgent
organization, or any other armed group?
Yes/No
Has
your qualifying family member EVER
ordered, incited, called for, committed, assisted, helped with, or
otherwise participated in any of the following:
23.a.
Acts involving torture or genocide?
Yes/No
23.b.
Killing any person?
Yes/No
23.c.
Intentionally and severely injuring any person?
Yes/No
23.d.
Engaging in any kind of sexual contact or relations with any
person who did not consent or was unable to consent, or was being
forced or threatened?
Yes/No
23.e.
Limiting or denying any person's ability to exercise religious
beliefs?
Yes/No
24.
Has your qualifying family member EVER
recruited, enlisted, conscripted, or used any person under 15
years of age to serve in or help an armed force or group?
Yes/No
25.
Has your qualifying family member EVER
used any person under 15 years of age to take part in hostilities,
or to help or provide services to people in combat?
Yes/No
Fraud
and Misrepresentation
26.
Are you NOW under a final order or civil penalty for violating
section 274C of the INA (producing and/or using false
documentation to unlawfully satisfy a requirement of the INA)?
Yes/No
27.
Has your qualifying family member EVER
lied about, concealed, or misrepresented any information on an
application or petition to obtain a visa, other documentation
required for entry into the United States, admission to the United
States, or any other immigration benefit?
Yes/No
28.
Has your qualifying family member EVER
falsely claimed to be a U.S. citizen (in writing or any other
way)?
Yes/No
Miscellaneous
Conduct
29.
Has your qualifying family member EVER
been convicted of desertion from the U.S. armed forces?
Yes/No
30.
Has your qualifying family member NOW
or have they EVER
been a drug abuser or addict?
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