Principal Applicant's A#
Temporary Resident Status as an alien who illegally entered the U.S. prior to January 1, 1982.
Department of Homeland Security
U.S. Citizenship and Immigration Services
Do not write in this block. For USCIS Use Only.
START HERE - Please type or print in capital letters in black ink. If you need more space, use a separate sheet(s) of paper.
1. I hereby apply for status as indicated by the block checked below.
Temporary Resident Status as an alien who entered the U.S. as a nonimmigrant prior to January 1, 1982, and whose authorized
stay expired before such date or whose unlawful status was known to the Government as of January 1, 1982.
3. Date of Birth (mm/dd/yyyy)
Family Name (in capital letters)
This applicant's A#
4. Other Names Used or Known by (Including maiden name, if married)
5. Telephone Numbers (Including Area Codes)
6. Home Address in the U.S.
In care of
7. Mailing Address in the U.S. (if different from address in Number 6.)
In care of
8. Last Address Outside the U.S.
Form I-687 (05/27/08)Y
9. Country of
City or Town
10. Place of Birth
OMB No.1615-0090; Expires 06/30/2010
U.S. Social Security #
Form I-687, Application for Status as a
Temporary Resident Under Section 245A of the INA
11. Marital Status
If Yes, give date, place of filing and final disposition, if known.
15. Do you have other records with USCIS (or the former INS)?
If Yes, give file numbers. A#
14. Have you previously applied for temporary residence as a Legalization applicant?
24. Type of visa issued
(B-2, F-1, etc.)
16. When did you last come to the U.S.? 17. Manner of Entry
With a visa (visitor, student, etc.) specify
Without a visa