Information Collection

Supplement A, Adjustment of Status to Permanent Resident Under INA Section 245(i)

IC 216963 under ICR 201505-1615-002 · OMB 1615-0023.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0023 can be found here:

Documents and Forms

Document Name Document Type
Form I-485, Supplement Supplement A, Adjustment of Status to Permanent Resident Under INA Section 245(i) Form
Draft I-485 30-Day Instruction Booklet (with main and Supp A instructions).pdf www.uscis.gov/I-485 Instruction
I-485, Supplement Supplement A, Adjustment of Status to Permanent Resident I485-FRM-SUPP A-30 Day-06112015.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Supplement A, Adjustment of Status to Permanent Resident Under INA Section 245(i)	Agency IC Tracking Number:	I-485A

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	I-485, Supplement A	Supplement A, Adjustment of Status to Permanent Resident Under INA Section 245(i)	I485-FRM-SUPP A-30 Day-06112015.pdf		Yes	No	Fillable Printable
Instruction			Draft I-485 30-Day Instruction Booklet (with main and Supp A instructions).pdf	www.uscis.gov/I-485	Yes	No	Printable Only

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: USCIS Benefits Information System	FR Citation: 73 FR 56596

Number of Respondents: 25,540	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	25,540	25,540
Annual IC Time Burden (Hours)	25,540	25,540
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.