Enter your A-Number if one has been assigned. Do not enter a USCIS receipt number in this field.

Enter your USCIS Online Account Number if you have one. It is different from your A-Number and receipt number.

Enter your Family Name, Given Name and Middle Name exactly according to your legal identity records.

List all other names you have ever used, including former legal names, maiden names, aliases and nicknames.

Provide the complete mailing address where USCIS correspondence can reach you. If you are outside the United States, provide a U.S. mailing address if available; otherwise provide your foreign mailing address.

If your physical residence differs from your mailing address, provide your actual physical address.

Enter your U.S. Social Security Number if one has been issued. Do not enter a foreign tax or national identification number.

Provide your date of birth, city or town of birth, province where applicable, and country of birth.

Enter your current country of citizenship or nationality.

If a Department of State consular officer has already interviewed you, provide your DOS consular case number if available.

Provide the city and country of the U.S. Embassy or Consulate where your visa application is being or will be processed.

Answer whether you previously filed Form I-212, Application for Permission to Reapply for Admission After Deportation or Removal.

Provide the I-212 receipt number if available, the office or location where it was filed, and the filing date.

Enter the actual date of the applicable U.S. entry, starting with the most recent arrival.

Provide the immigration classification or status you had when you entered the United States.

Provide the location where you entered the United States.

Enter the U.S. city or town where you lived during that period of stay.

For additional periods, provide the entry date, departure date, immigration status, entry location and U.S. city or town where you lived.

Select every applicable race category listed on the form.

Enter height in feet and inches and weight in pounds as requested.

Select the eye-color option that applies.

Select the hair-color option that applies.

Select this ground when you have been found inadmissible because of a communicable disease classified as significant under the applicable public-health rules.

Select the applicable vaccination ground when seeking the permitted exemption because vaccination conflicts with qualifying religious beliefs or moral convictions.

Select this ground when a physical or mental disorder and associated harmful behavior, or a history likely to recur, has caused the relevant inadmissibility finding.

Select this ground when you have been found inadmissible for qualifying conduct or a conviction involving moral turpitude.

The form includes the limited waiver-related ground involving a single offense of simple possession of 30 grams or less of marijuana.

Select when this specific multiple-conviction inadmissibility ground applies to you.

The form covers applicable inadmissibility involving prostitution, procurement, or receiving proceeds from prostitution within the relevant statutory period or circumstances.

Select this ground when the applicable conduct involving procurement, attempted procurement or importation for prostitution applies.

Select this ground where the inadmissibility finding concerns other unlawful commercialized vice, whether or not connected to prostitution.

Select this ground when the specific inadmissibility provision involving serious criminal activity and immunity from prosecution applies.

Select this ground when the applicable inadmissibility finding concerns membership in or affiliation with a Communist or another totalitarian party or related organization.

Select this ground when you were found inadmissible for seeking an immigration benefit through fraud or a material misrepresentation.

For TPS applicants, the current form separately identifies a false representation of U.S. citizenship.

Select this ground when the government has found that you knowingly encouraged, assisted, induced or helped another person enter the United States in violation of law under the applicable provision.

Select when you are subject to the applicable civil penalty for document-related violations covered by this inadmissibility ground.

Certain departures after more than 180 days but less than one year of unlawful presence can trigger a three-year inadmissibility bar.

Certain departures after one year or more of unlawful presence can trigger a ten-year inadmissibility bar.

For the standard unlawful-presence waiver under INA 212(a)(9)(B)(v), the relevant extreme-hardship qualifying relative is generally a U.S. citizen or lawful permanent resident spouse or parent, subject to the applicant's specific category and applicable law.

The form contains a limited I-601 selection for certain NACARA and HRIFA applicants who are inadmissible because of a previous removal. Other applicants generally address this type of permission through Form I-212 where required.

The form also contains a limited ground for certain NACARA, HRIFA and qualifying VAWA applicants involving reentry or attempted reentry after specified prior unlawful presence or removal history.

Health-related communicable disease ground where applicable.

Select when the specified health-related ground applies.

Select when the applicable drug-abuse or addiction inadmissibility ground applies.

The TPS section identifies the applicable single-offense simple-possession ground involving 30 grams or less of marijuana.

Select when the prostitution-related inadmissibility ground applies.

Select when procurement or attempted procurement for prostitution applies.

Select where this separate commercialized-vice ground applies.

Select when this specific ground applies.

Select when the applicable inadmissibility finding concerns failure to attend a removal proceeding.

Select when fraud or material misrepresentation caused the inadmissibility finding.

Select when the specific false-claim ground applies.

Select when the applicable alien-smuggling ground applies.

Select when you are subject to the applicable document-related civil penalty.

Select when the form's inadmissibility ground concerning departure or remaining abroad to avoid qualifying U.S. military service applies.

Select when the applicable polygamy ground applies.

Select when the specific guardianship or protection ground described by the form applies.

Select when the applicable child-custody inadmissibility ground applies.

Select when an unlawful voting inadmissibility ground applies.

Select when this specific former-citizen ground applies.

If an applicable ground is not separately listed, use the form's Other field and identify the exact ground or circumstances.

Explain in your own words the acts, convictions, immigration events or medical conditions that caused or may cause inadmissibility.

Provide the Family Name, Given Name and Middle Name of the qualifying relative through whom you claim waiver eligibility.

Provide the qualifying relative's current physical address.

Provide the relative's daytime telephone number and email address where applicable.

State the exact relationship required by the waiver provision, such as spouse, parent, son, daughter or another relationship permitted for the specific waiver.

Provide the relative's actual immigration status, such as U.S. citizen or lawful permanent resident, where the waiver requires that status.

Enter the relative's A-Number if one has been assigned.

Provide the qualifying relative's actual date of birth.

If you have additional qualifying relatives, select the applicable box and provide the same identifying, relationship and immigration-status information in Part 10.

The current form provides a selection for a qualifying VAWA self-petitioner who is claiming extreme hardship to themselves.

K visa cases use special qualifying-relative instructions. A K-1 applicant generally identifies the U.S. citizen fiancé petitioner as the prospective spouse. K-2 cases follow the relationship instructions applicable to the child's age and circumstances.

Where your waiver requires extreme hardship, explain how refusal of the requested immigration benefit would affect the qualifying relative. The statement should be supported by real evidence rather than general assertions.

Explain the consequences if the qualifying relative remains in the United States while you remain outside the United States. Address the actual financial, medical, emotional, family, educational and other consequences that apply.

Where relevant, explain the consequences if the qualifying relative relocates abroad to remain with you. Consider the real country conditions, health care, employment, education, family ties, language, safety and other circumstances that apply.

If medical circumstances contribute to hardship, provide records from qualified medical professionals and explain how separation or relocation affects treatment, caregiving or access to care.

Document actual income, expenses, debts, housing obligations, caregiving costs and other financial consequences.

Explain genuine psychological or emotional consequences and support significant conditions with professional evidence where available.

Provide information about other U.S. citizen, lawful permanent resident or other family members whose circumstances you want USCIS to consider.

Provide the relative's current physical address.

Provide the daytime telephone number and email address where applicable.

State the person's relationship to you, current immigration status, A-Number if any, and date of birth.

Use Part 10 to provide the same information for additional relatives with relevant U.S. ties.

Where discretionary approval is required, explain why favorable factors in your case outweigh unfavorable factors.

Indicate whether you read and understood the application yourself or whether an interpreter read the application to you.

Indicate whether another person prepared the application at your request.

Provide your current daytime telephone number where applicable.

Provide your mobile telephone number where applicable.

Provide your current email address where applicable.

Read the certification carefully. By signing, you certify that the information and evidence submitted were provided or authorized by you and are complete, true and correct.

Provide the interpreter's Family Name and Given Name.

Provide the interpreter's business or organization name where applicable.

Provide the interpreter's complete mailing address.

Provide daytime telephone, mobile telephone and email information where applicable.

Identify the language in which the application was interpreted for the applicant.

The interpreter certifies fluency in English and the language used, confirms that the questions and answers were interpreted accurately, then signs and dates the section.

Provide the preparer's Family Name and Given Name.

Provide the business or organization name where applicable.

Provide the preparer's complete mailing address, daytime telephone, mobile telephone and email address where applicable.

If the preparer is an attorney or accredited representative, complete the applicable representation information and submit Form G-28 or G-28I where required.

The preparer signs and dates this section when the application was prepared by someone other than the applicant.

Provide your identifying information at the top of each additional-information page.

For every additional explanation, identify the exact Page Number, Part Number and Item Number.

If Part 10 is not enough, follow the USCIS instructions for additional pages. Identify the related question clearly and sign and date additional sheets where required.

The current Form I-601 requires Part 11 when the waiver request concerns a Class A tuberculosis condition as defined under the applicable public-health regulations.

Include relevant records identifying the inadmissibility issue, such as consular findings, USCIS notices, court documents or other immigration records when available.

Where a qualifying relative is required, provide civil records establishing the relationship, such as marriage or birth certificates, together with proof of the relative's required immigration status.

Where applicable, submit evidence supporting the claimed hardship, including relevant financial, medical, psychological, family, educational and country-condition documentation.

Provide certified court dispositions and other records required by the USCIS instructions for every relevant arrest or conviction.

Where rehabilitation is relevant, provide reliable evidence of subsequent conduct, treatment, compliance, community involvement and other factors that genuinely apply.

For health-related waiver requests, submit the medical information, physician reports and assurances required for the particular ground.

Provide documents establishing the actual circumstances of the event and evidence relevant to the statutory waiver and discretionary analysis.

Where unlawful presence is involved, document the relevant entries, departures, status periods, applications, authorized stays and other dates needed to evaluate the inadmissibility period.

Submit reliable evidence supporting the favorable factors you ask USCIS to consider.

Foreign-language documents submitted to USCIS must include a complete English translation with the translator certification required by USCIS.