{ "fields": [ { "fieldKey": "form1_0_pageset_0_page1_0_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[0].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_attorneystatebarnumber_0", "label": "To be completed by an attorney or accredited representative, if any. Enter Attorney State Bar Number, if applicable.", "pdfFieldName": "form1[0].#subform[0].AttorneyStateBarNumber[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_checkbox1_0", "label": "To be completed by an attorney or accredited representative, if any. Select this box if Form G-28 is attached.", "pdfFieldName": "form1[0].#subform[0].CheckBox1[0]", "dataType": "checkbox", "isRequired": false, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_volagnumber_0", "label": "To be completed by an attorney or accredited representative, if any. Enter Volag Number, if any.", "pdfFieldName": "form1[0].#subform[0].VolagNumber[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_uscisonlineacctnumber_0", "label": "To be completed by an attorney or accredited representative, if any. Enter Attorney or Accredited Representative U S C I S Online Account Number, if any.", "pdfFieldName": "form1[0].#subform[0].USCISOnlineAcctNumber[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_aliennumber_0", "label": "Enter Alien Registration Number (A. Number).", "pdfFieldName": "form1[0].#subform[0].AlienNumber[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_pt1line1_familyname_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence} 1. Your Current Legal Name (Do not provide a nickname). Enter Family Name, Last Name.", "pdfFieldName": "form1[0].#subform[0].Pt1Line1_FamilyName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_pt1line1_givenname_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence} 1. Your Current Legal Name (Do not provide a nickname). Enter Given Name (First Name).", "pdfFieldName": "form1[0].#subform[0].Pt1Line1_GivenName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_pt1line1_middlename_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence} 1. Your Current Legal Name (Do not provide a nickname). Enter Middle Name.", "pdfFieldName": "form1[0].#subform[0].Pt1Line1_MiddleName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_pt1line2_familyname_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 2. Other Names You Have Used Since Birth (if applicable) Provide all other names you have ever used, including your family name at birth, other legal names, nicknames, aliases, and assumed names. Enter Family Name, Last Name.", "pdfFieldName": "form1[0].#subform[0].Pt1Line2_FamilyName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_pt1line2_givenname_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 2. Other Names You Have Used Since Birth (if applicable) Provide all other names you have ever used, including your family name at birth, other legal names, nicknames, aliases, and assumed names. Enter Given Name, First Name.", "pdfFieldName": "form1[0].#subform[0].Pt1Line2_GivenName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_pt1line2_middlename_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 2. Other Names You Have Used Since Birth (if applicable) Provide all other names you have ever used, including your family name at birth, other legal names, nicknames, aliases, and assumed names. Enter Middle Name (if applicable)", "pdfFieldName": "form1[0].#subform[0].Pt1Line2_MiddleName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_pt1line2a_familyname_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 2. Other Names You Have Used Since Birth (if applicable) Provide all other names you have ever used, including your family name at birth, other legal names, nicknames, aliases, and assumed names. Enter Family Name, Last Name.", "pdfFieldName": "form1[0].#subform[0].Pt1Line2a_FamilyName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_pt1line2a_givenname_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 2. Other Names You Have Used Since Birth (if applicable) Provide all other names you have ever used, including your family name at birth, other legal names, nicknames, aliases, and assumed names. Enter Given Name, First Name.", "pdfFieldName": "form1[0].#subform[0].Pt1Line2a_GivenName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_pt1line2a_middlename_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 2. Other Names You Have Used Since Birth (if applicable) Provide all other names you have ever used, including your family name at birth, other legal names, nicknames, aliases, and assumed names. Enter Middle Name (if applicable)", "pdfFieldName": "form1[0].#subform[0].Pt1Line2a_MiddleName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_pt1line3_dob_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 3. Date of Birth. Enter the 2- digit Month, 2-digit Day and 4-digit Year.", "pdfFieldName": "form1[0].#subform[0].Pt1Line3_DOB[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_pt1line3_yn_0", "label": "Part 1. Information About You (individual applying for lawful permanent residence). Have you ever used any other date of birth? Select Yes.", "pdfFieldName": "form1[0].#subform[0].Pt1Line3_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_pt1line3_yn_1", "label": "Part 1. Information About You (individual applying for lawful permanent residence). Have you ever used any other date of birth? Select Yes.", "pdfFieldName": "form1[0].#subform[0].Pt1Line3_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_pt1line3a_otherdob_0", "label": "Part 1. Information About You (individual applying for lawful permanent residence). If you answered \"Yes,\" provide all other dates of birth. Enter the 2- digit Month, 2-digit Day and 4-digit Year.", "pdfFieldName": "form1[0].#subform[0].Pt1Line3A_OtherDOB[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_subform_0_pt1line3b_otherdob_0", "label": "Part 1. Information About You (individual applying for lawful permanent residence). If you answered \"Yes,\" provide all other dates of birth. Enter the 2- digit Month, 2-digit Day and 4-digit Year.", "pdfFieldName": "form1[0].#subform[0].Pt1Line3B_OtherDOB[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 1", "pageNumber": 1 }, { "fieldKey": "form1_0_pageset_0_page1_1_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[1].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_aliennumber_1", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[1].AlienNumber[1]", "dataType": "text", "isRequired": false, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line6_cb_sex_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 6. Sex. Select Female.", "pdfFieldName": "form1[0].#subform[1].Pt1Line6_CB_Sex[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line6_cb_sex_1", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 6. Sex. Select Male.", "pdfFieldName": "form1[0].#subform[1].Pt1Line6_CB_Sex[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line7_citytownofbirth_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 7. Place of Birth. Enter the city / town of birth", "pdfFieldName": "form1[0].#subform[1].Pt1Line7_CityTownOfBirth[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line7_countryofbirth_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 7. Place of Birth. Enter the country of birth.", "pdfFieldName": "form1[0].#subform[1].Pt1Line7_CountryOfBirth[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line8_countryofcitizenshipnationality_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 8. Enter Country of Citizenship or Nationality.", "pdfFieldName": "form1[0].#subform[1].Pt1Line8_CountryofCitizenshipNationality[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line9_uscisaccountnumber_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 9. U SC I S Online Account Number, if any. Enter 12 characaters.", "pdfFieldName": "form1[0].#subform[1].Pt1Line9_USCISAccountNumber[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line10_passportnum_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). Recent Immigration History.If you last entered the United States using a passport or travel document, provide the following information. Enter Passport or Travel Document Number Used at Last Arrival.", "pdfFieldName": "form1[0].#subform[1].Pt1Line10_PassportNum[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line10_expdate_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). Recent Immigration History. 10. Enter Expiration Date of this Passport or Travel Document. Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[1].Pt1Line10_ExpDate[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line10_passport_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). Recent Immigration History. 10. Enter Country that Issued this Passport or Travel Document.", "pdfFieldName": "form1[0].#subform[1].Pt1Line10_Passport[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line10_visanum_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). Recent Immigration History. 10. Enter Nonimmigrant Visa Number Used During Most Recent Arrival, if any.", "pdfFieldName": "form1[0].#subform[1].Pt1Line10_VisaNum[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line10_citytown_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). Recent Immigration History. Place and Date of Last Arrival into the United States. Enter City or Town.", "pdfFieldName": "form1[0].#subform[1].Pt1Line10_CityTown[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line10_state_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). Recent Immigration History. Place and Date of Last Arrival into the United States. State. This is a drop-down list and you will select a state from a list of States.", "pdfFieldName": "form1[0].#subform[1].Pt1Line10_State[0]", "dataType": "select", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line10_dateofarrival_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). Recent Immigration History. Place and Date of Last Arrival into the United States. Enter Date of Last Arrival.Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[1].Pt1Line10_DateofArrival[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line10_nonimmdate_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). Recent Immigration History. 10. Enter Date Nonimmigrant Visa was Issued. Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[1].Pt1Line10_NonImmDate[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line4_aliennumber_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). Enter Alien Registration Number (A. number), if any. Enter 9 digit number.", "pdfFieldName": "form1[0].#subform[1].Pt1Line4_AlienNumber[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line4_yn_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 4. Do you have a Alien Registration Number? Select Yes.", "pdfFieldName": "form1[0].#subform[1].Pt1Line4_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line4_yn_1", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 4. Do you have a Alien Registration Number? Select No.", "pdfFieldName": "form1[0].#subform[1].Pt1Line4_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line5_yn_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 5. Have you ever used, or been assigned, any other A-Number? Select Yes.", "pdfFieldName": "form1[0].#subform[1].Pt1Line5_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line5_yn_1", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 5. Have you ever used, or been assigned, any other A-Number? Select No.", "pdfFieldName": "form1[0].#subform[1].Pt1Line5_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line5a_anumber_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 5. If you answered \"Yes,\" Provide the A-Numbers.", "pdfFieldName": "form1[0].#subform[1].Pt1Line5A_ANumber[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line5b_anumber_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 5. If you answered \"Yes,\" Provide the A-Numbers.", "pdfFieldName": "form1[0].#subform[1].Pt1Line5B_ANumber[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt2line11_cb_0", "label": "Part 1. Application Type or Filing Category. I am applying to register lawful permanent residence or adjust status to that of a lawful permanent resident based on the following immigrant category (select only one box). (See the Form I - 4 85 Instructions for more information, including any Additional Instructions that relate to the immigrant category you select.). 1. F. Special Programs Based on Certain Public Laws. Select The Cuban Adjustment Act.", "pdfFieldName": "form1[0].#subform[1].Pt2Line11_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt2line11_cb_1", "label": "Part 2. Application Type or Filing Category. I am applying to register lawful permanent residence or adjust status to that of a lawful permanent resident based on the following immigrant category (select only one box). (See the Form I - 4 85 Instructions for more information, including any Additional Instructions that relate to the immigrant category you select.). 1. F. Special Programs Based on Certain Public Laws. Select The Cuban Adjustment Act.", "pdfFieldName": "form1[0].#subform[1].Pt2Line11_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt2line11_cb_2", "label": "Part 2. Application Type or Filing Category. I am applying to register lawful permanent residence or adjust status to that of a lawful permanent resident based on the following immigrant category (select only one box). (See the Form I - 4 85 Instructions for more information, including any Additional Instructions that relate to the immigrant category you select.). 1. F. Special Programs Based on Certain Public Laws. Select The Cuban Adjustment Act.", "pdfFieldName": "form1[0].#subform[1].Pt2Line11_CB[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line11_other_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). Recent Immigration History. When I last arrived in the United States, I. 25. D. Enter Other.", "pdfFieldName": "form1[0].#subform[1].Pt1Line11_Other[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt2line11_cb_3", "label": "Part 2. Application Type or Filing Category. I am applying to register lawful permanent residence or adjust status to that of a lawful permanent resident based on the following immigrant category (select only one box). (See the Form I - 4 85 Instructions for more information, including any Additional Instructions that relate to the immigrant category you select.). 1. F. Special Programs Based on Certain Public Laws. Select The Cuban Adjustment Act.", "pdfFieldName": "form1[0].#subform[1].Pt2Line11_CB[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line11_admitted_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). Recent Immigration History. When I last arrived in the United States, I. 25. D. Enter Other.", "pdfFieldName": "form1[0].#subform[1].Pt1Line11_Admitted[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_subform_1_pt1line11_paroled_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). Recent Immigration History. When I last arrived in the United States, I. 25. D. Enter Other.", "pdfFieldName": "form1[0].#subform[1].Pt1Line11_Paroled[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 2", "pageNumber": 2 }, { "fieldKey": "form1_0_pageset_0_page1_2_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[2].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_aliennumber_2", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[2].AlienNumber[2]", "dataType": "text", "isRequired": false, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_p1line12_familyname_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 12. If you were issued a Form I-94 Arrival/Departure Record, provide the information from your most recent Form I-94 below:. Enter Family Name (Last Name)", "pdfFieldName": "form1[0].#subform[2].P1Line12_FamilyName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_p1line13_givenname_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 12. If you were issued a Form I-94 Arrival/Departure Record, provide the information from your most recent Form I-94 below:. Enter Given Name (First Name)", "pdfFieldName": "form1[0].#subform[2].P1Line13_GivenName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line12_date_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 12. Enter Expiration Date of Authorized Stay Shown on Form I - 94. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. or Type or print \"D/S\" for Duration of Status.", "pdfFieldName": "form1[0].#subform[2].Pt1Line12_Date[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line12_status_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 12. Enter Immigration Status on Form I - 94 (for example, class of admission, or paroled, if paroled).", "pdfFieldName": "form1[0].#subform[2].Pt1Line12_Status[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_p1line12_i94_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). Recent Immigration History. If you were issued a Form I-94 Arrival-Departure Record Number. 26. A. Enter Form I - 94 Arrival-Departure Record Number.", "pdfFieldName": "form1[0].#subform[2].P1Line12_I94[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line13_yn_0", "label": "Part 1. Information About You (individual applying for lawful permanent residence). 13. Was your last arrival the first time you were physically present in the United States? Select Yes.", "pdfFieldName": "form1[0].#subform[2].Pt1Line13_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line13_yn_1", "label": "Part 1. Information About You (individual applying for lawful permanent residence). 13. Was your last arrival the first time you were physically present in the United States? Select No.", "pdfFieldName": "form1[0].#subform[2].Pt1Line13_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line15_date_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 15. Enter Expiration Date of Current Immigration Status (mm/dd/yyyy) or Type or Print \"D/S\" for Duration of Status", "pdfFieldName": "form1[0].#subform[2].Pt1Line15_Date[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line16_yn_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 16. Have you ever been issued an \"alien crewman\" visa? Select Yes.", "pdfFieldName": "form1[0].#subform[2].Pt1Line16_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line17_yn_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 17.0Did you last arrive in the United States to join a vessel as a seaman or crewman, or while serving in any capacity aboard a vessel or aircraft? Select No.", "pdfFieldName": "form1[0].#subform[2].Pt1Line17_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line17_yn_1", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 17.0Did you last arrive in the United States to join a vessel as a seaman or crewman, or while serving in any capacity aboard a vessel or aircraft? Select Yes.", "pdfFieldName": "form1[0].#subform[2].Pt1Line17_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line16_yn_1", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 16. Have you ever been issued an \"alien crewman\" visa? Select No.", "pdfFieldName": "form1[0].#subform[2].Pt1Line16_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18us_unit_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. Select Suite.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18US_Unit[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18us_unit_1", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. Select Floor.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18US_Unit[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18us_aptsteflrnumber_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18US_AptSteFlrNumber[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18us_unit_2", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Select Apartment.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18US_Unit[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_cityortown_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. Enter city or town.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_CityOrTown[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_state_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. State. This is a drop-down list and you will select a state from a list of States.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_State[0]", "dataType": "select", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_zipcode_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. Enter 5-digit Zip Code", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_ZipCode[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_streetnumbername_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Enter Street Number and Name.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_StreetNumberName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_part1_item18_incareofname_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. Your Current U.S. Physical Address. Enter In Care Of Name (if any).", "pdfFieldName": "form1[0].#subform[2].Part1_Item18_InCareOfName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_date_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. Enter Date you First Resided at This Address. Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_Date[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_yn_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Is this your current mailing address? Select Yes.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_yn_1", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Is this your current mailing address? Select No. If you answered \"No,\" provide your current mailing address.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_currentunit_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. Your Current Mailing Address (Safe or Alternate Mailing Address). Select Apartment.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_CurrentUnit[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_currentunit_1", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. Your Current Mailing Address (Safe or Alternate Mailing Address). .Select Suite.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_CurrentUnit[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_currentunit_2", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. Your Current Mailing Address (Safe or Alternate Mailing Address). Select Floor.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_CurrentUnit[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_currentaptsteflrnumber_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. Your Current Mailing Address (Safe or Alternate Mailing Address). If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_CurrentAptSteFlrNumber[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_currentcityortown_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. Your Current Mailing Address (Safe or Alternate Mailing Address). Enter city or town.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_CurrentCityOrTown[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_currentstate_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. Your Current Mailing Address (Safe or Alternate Mailing Address). State. This is a drop-down list and you will select a state from a list of States.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_CurrentState[0]", "dataType": "select", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_currentzipcode_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. Your Current Mailing Address (Safe or Alternate Mailing Address). Enter 5-digit Zip Code", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_CurrentZipCode[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_currentstreetnumbername_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. Your Current Mailing Address (Safe or Alternate Mailing Address). Enter In Care Of Name (if any). Enter Street Number and Name.", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_CurrentStreetNumberName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line18_currentincareofname_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence) 18. Your Current Mailing Address (Safe or Alternate Mailing Address). Enter In Care Of Name (if any).", "pdfFieldName": "form1[0].#subform[2].Pt1Line18_CurrentInCareOfName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_subform_2_pt1line14_status_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 14. What is you current immigration status (if it has changed since your last arrival)? Enter immigration status.", "pdfFieldName": "form1[0].#subform[2].Pt1Line14_Status[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 3", "pageNumber": 3 }, { "fieldKey": "form1_0_pageset_0_page1_3_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[3].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_aliennumber_3", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[3].AlienNumber[3]", "dataType": "text", "isRequired": false, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_last5yrs_yn_0", "label": "Part 1. Information About You (individual applying for lawful permanent residence). 18. Have you resided at your current address for at least 5 years? Select Yes.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_last5yrs_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_last5yrs_yn_1", "label": "Part 1. Information About You (individual applying for lawful permanent residence). 18. Have you resided at your current address for at least 5 years? Select No. If you answered \"No,\" provide your prior address(es) for the last 5 years. Use the space provided in Part 14. Additional Information, if necessary.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_last5yrs_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_priorincareofname_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. Enter In Care Of Name (if any).", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_PriorInCareOfName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_priorstreetname_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. Enter Street Number and Name.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_PriorStreetName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_prioraddress_unit_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. Check Apartment.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_PriorAddress_Unit[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_prioraddress_unit_1", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. Check Suite.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_PriorAddress_Unit[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_prioraddress_unit_2", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. Check Floor.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_PriorAddress_Unit[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_prioraddress_number_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_PriorAddress_Number[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_priorcity_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. Enter City or Town.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_PriorCity[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_priorstate_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. State. This is a drop-down list and you will select a state from a list of States.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_PriorState[0]", "dataType": "select", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_priorzipcode_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. Enter 5-digit Zip Code.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_PriorZipCode[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_priorprovince_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. Enter Province.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_PriorProvince[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_priorpostalcode_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. Enter Postal Code.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_PriorPostalCode[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_priorcountry_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. Enter Country.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_PriorCountry[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_priordatefrom_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. Dates of Residence. Enter Date From. Enter as 2 digit month, 2 digit day and 4 digit year.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_PriorDateFrom[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18priordateto_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. Dates of Residence. Enter Date To. Enter as 2 digit month, 2 digit day and 4 digit year.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18PriorDateTo[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_recentstreetname_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Most Recent Address Outside the United States. Provide your most recent physical address outside the United States where you lived for more than one year (if not already listed above). Enter Street Number and Name.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_RecentStreetName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_recentunit_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Most Recent Address Outside the United States. Check Apartment.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_RecentUnit[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_recentunit_1", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Most Recent Address Outside the United States. Check Suite.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_RecentUnit[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_recentunit_2", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Most Recent Address Outside the United States. Check Floor.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_RecentUnit[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_recentnumber_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Most Recent Address Outside the United States. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_RecentNumber[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_recentcity_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Most Recent Address Outside the United States. Enter City or Town.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_RecentCity[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_recentstate_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Most Recent Address Outside the United States. State. This is a drop-down list and you will select a state from a list of States.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_RecentState[0]", "dataType": "select", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_recentzipcode_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Most Recent Address Outside the United States. Enter 5-digit Zip Code.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_RecentZipCode[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_recentprovince_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. Enter Province.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_RecentProvince[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_recentpostalcode_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Prior Address. Enter Postal Code.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_RecentPostalCode[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_recentcountry_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Most Recent Address Outside the United States. Enter Country.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_RecentCountry[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_recentdatefrom_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Most Recent Address Outside the United States. Dates of Residence. Enter Date From. Enter as 2 digit month, 2 digit day and 4 digit year.", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_RecentDateFrom[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line18_recentdateto_0", "label": "Part 1. Information About You (Person applying for lawful permanent residence). 18. Most Recent Address Outside the United States. Dates of Residence. Enter Date To. Enter as 2 digit month, 2 digit day and 4 digit", "pdfFieldName": "form1[0].#subform[3].Pt1Line18_RecentDateTo[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line19_yn_0", "label": "Part 1. Information About You (individual applying for lawful permanent residence). 19. Social Security Card. Has the Social Security Administration (SSA) ever officially issued a Social Security card to you? Select No.", "pdfFieldName": "form1[0].#subform[3].Pt1Line19_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line19_yn_1", "label": "Part 1. Information About You (individual applying for lawful permanent residence). 19. Social Security Card. Has the Social Security Administration (SSA) ever officially issued a Social Security card to you? Select Yes.", "pdfFieldName": "form1[0].#subform[3].Pt1Line19_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line19_ssn_0", "label": "Part 1. Information About You (individual applying for lawful permanent residence). 19. Social Security Card. Provide your U.S. Social Security Number (SSN). Enter 9 digit social security number.", "pdfFieldName": "form1[0].#subform[3].Pt1Line19_SSN[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line19_ssa_yn_0", "label": "Part 1. Information About You (individual applying for lawful permanent residence). 19. Social Security Card. Do you want the SSA to issue you a Social Security card? Select Yes.", "pdfFieldName": "form1[0].#subform[3].Pt1Line19_SSA_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line19_ssa_yn_1", "label": "Part 1. Information About You (individual applying for lawful permanent residence). 19. Social Security Card. Do you want the SSA to issue you a Social Security card? Select No.", "pdfFieldName": "form1[0].#subform[3].Pt1Line19_SSA_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line19_consent_yn_0", "label": "Part 1. Information About You (individual applying for lawful permanent residence). 19. Social Security Card. Consent for Disclosure: I authorize disclosure of information from this application to the SSA as required for the purpose of assigning me an SSN and issuing me a Social Security Card. Select Yes.", "pdfFieldName": "form1[0].#subform[3].Pt1Line19_Consent_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_subform_3_pt1line19_consent_yn_1", "label": "Part 1. Information About You (individual applying for lawful permanent residence). 19. Social Security Card. Consent for Disclosure: I authorize disclosure of information from this application to the SSA as required for the purpose of assigning me an SSN and issuing me a Social Security Card. Select No.", "pdfFieldName": "form1[0].#subform[3].Pt1Line19_Consent_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 4", "pageNumber": 4 }, { "fieldKey": "form1_0_pageset_0_page1_4_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[4].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_aliennumber_4", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[4].AlienNumber[4]", "dataType": "text", "isRequired": false, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line1_yn_0", "label": "Part 2. Application Type or Filing Category. 1. Are you filing for adjustment of status with the Executive Office for Immigration Review (EOIR) while in removal, exclusion, rescission, or deportation proceedings? Select Yes.", "pdfFieldName": "form1[0].#subform[4].Pt2Line1_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line1_yn_1", "label": "Part 2. Application Type or Filing Category. 1. Are you filing for adjustment of status with the Executive Office for Immigration Review (EOIR) while in removal, exclusion, rescission, or deportation proceedings? Select No.", "pdfFieldName": "form1[0].#subform[4].Pt2Line1_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line2_receipt_0", "label": "Part 2. Application Type or Filing Category. 2. Enter Receipt Number of Underlying Petition, if any.", "pdfFieldName": "form1[0].#subform[4].Pt2Line2_Receipt[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line2_date_0", "label": "Part 2. Application Type or Filing Category. 2. Enter Priority Date from Underlying Petition, if any. Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[4].Pt2Line2_Date[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line2_familyname_0", "label": "Part 2. Information About You. 2. Principal Applicant's Name. Enter Family Name, Last Name.", "pdfFieldName": "form1[0].#subform[4].Pt2Line2_FamilyName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line2_givenname_0", "label": "Part 2. Information About You. 2. Principal Applicant's Name. Enter Given Name, Last Name.", "pdfFieldName": "form1[0].#subform[4].Pt2Line2_GivenName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line2_middlename_0", "label": "Part 2. Information About You. 2. Principal Applicant's Name. Enter Middle Name, if applicable.", "pdfFieldName": "form1[0].#subform[4].Pt2Line2_MiddleName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt1line2_dob_0", "label": "Part 2. Information About You. 2. Other Information. Principal Applicant's Date of Birth. Enter the 2- digit Month, 2-digit Day and 4-digit Year.", "pdfFieldName": "form1[0].#subform[4].Pt1Line2_DOB[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line2_aliennumber_0", "label": "Part 2. Information About You. 2. Other Information. Enter Principal Applicant's Alien Registration Number (A. number(, if any. Enter 9 digit number.", "pdfFieldName": "form1[0].#subform[4].Pt2Line2_AlienNumber[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line2_cb_0", "label": "Part 2. Application Type or Filing Category. 2. I am filing this Form I- 4 8 5 as a (select only one box). Select Principal Applicant.", "pdfFieldName": "form1[0].#subform[4].Pt2Line2_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line2_cb_1", "label": "Part 2. Application Type or Filing Category. 2. Select Derivative Applicant (Provide the following information about the principal applicant.)", "pdfFieldName": "form1[0].#subform[4].Pt2Line2_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line3a_cb_0", "label": "Part 2. Application Type or Filing Category. I am applying based on the following category (You must select ONLY ONE category. If you are filing as a derivative applicant, select the appropriate box based on the category under which the principal applicant is applying or has applied. See the Form I-485 Instructions for more information, including any Additional Instructions that relate to the immigrant category you select.): 3.a Family-based. Immediate relative of a U.S. citizen, Form I-130, I-129F, or I-360 (select your specific category below): Select Spouse of a U.S. Citizen.", "pdfFieldName": "form1[0].#subform[4].Pt2Line3a_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line3a_cb_1", "label": "3.b. Immediate relative of a U.S. citizen, Form I-130, I-129F, or I-360 (select your specific category below): Select Unmarried child under 21 years of age of a U.S. citizen.", "pdfFieldName": "form1[0].#subform[4].Pt2Line3a_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line3a_cb_2", "label": "3.b. Immediate relative of a U.S. citizen, Form I-130, I-129F, or I-360 (select your specific category below): Select Parent of a U.S. citizen (if the citizen is at least 21 years of age).", "pdfFieldName": "form1[0].#subform[4].Pt2Line3a_CB[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line3a_cb_3", "label": "3.b. Immediate relative of a U.S. citizen, Form I-130, I-129F, or I-360 (select your specific category below): Select Person admitted to the United States as a fiancé(e) or child of a fiancé(e) of a U.S. citizen (K-1/K-2 Nonimmigrant).", "pdfFieldName": "form1[0].#subform[4].Pt2Line3a_CB[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line3a_cb_4", "label": "3.b. Immediate relative of a U.S. citizen, Form I-130, I-129F, or I-360 (select your specific category below): Select Widow or widower of a U.S. citizen.", "pdfFieldName": "form1[0].#subform[4].Pt2Line3a_CB[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line3a_cb_5", "label": "3.b. Immediate relative of a U.S. citizen, Form I-130, I-129F, or I-360 (select your specific category below): Select Spouse, child, or parent of a deceased U.S. active-duty service member in the armed forces under the National Defense Authorization Act (NDAA).", "pdfFieldName": "form1[0].#subform[4].Pt2Line3a_CB[5]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line3a_cb_6", "label": "3.a. Family-based. Other relative of a U.S. citizen under the family-based preference categories, Form I-130 (select your specific category below): Select Unmarried son or daughter of a U.S. citizen and I am 21 years of age or older.", "pdfFieldName": "form1[0].#subform[4].Pt2Line3a_CB[6]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line3a_cb_7", "label": "3.a. Family-based. Other relative of a U.S. citizen under the family-based preference categories, Form I-130 (select your specific category below): Select Married son or daughter of a U.S. Citizen", "pdfFieldName": "form1[0].#subform[4].Pt2Line3a_CB[7]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line3a_cb_8", "label": "3.a. Family-based. Other relative of a U.S. citizen under the family-based preference categories, Form I-130 (select your specific category below): Select Brother or sister of a U.S. citizen (if the citizen is at least 21 years of age).", "pdfFieldName": "form1[0].#subform[4].Pt2Line3a_CB[8]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line3a_cb_9", "label": "3.a. Family-based. Relative of a lawful permanent resident under the family-based preference categories, Form I-130 (select your specific category below): Select Spouse of a lawful permanent resident.", "pdfFieldName": "form1[0].#subform[4].Pt2Line3a_CB[9]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line3a_cb_10", "label": "3.a. Family-based. Relative of a lawful permanent resident under the family-based preference categories, Form I-130 (select your specific category below): Select Unmarried child under 21 years of age of a lawful permanent resident.", "pdfFieldName": "form1[0].#subform[4].Pt2Line3a_CB[10]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line3a_cb_11", "label": "3.a. Family-based. Relative of a lawful permanent resident under the family-based preference categories, Form I-130 (select your specific category below): Select Unmarried son or daughter of a lawful permanent resident and I am 21 years of age or older.", "pdfFieldName": "form1[0].#subform[4].Pt2Line3a_CB[11]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line3a_cb_12", "label": "3.a. Family-based. VAWA self-petitioner (victim of battery or extreme cruelty), Form I-360 (select your specific category below): Select VAWA self-petitioning spouse of a U.S. citizen or lawful permanent resident.", "pdfFieldName": "form1[0].#subform[4].Pt2Line3a_CB[12]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line3a_cb_13", "label": "3.a. Family-based. VAWA self-petitioner (victim of battery or extreme cruelty), Form I-360 (select your specific category below): Select VAWA self-petitioning child of a U.S. citizen or lawful permanent resident.", "pdfFieldName": "form1[0].#subform[4].Pt2Line3a_CB[13]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_subform_4_pt2line3a_cb_14", "label": "3.a. Family-based. VAWA self-petitioner (victim of battery or extreme cruelty), Form I-360 (select your specific category below): Select VAWA self-petitioning parent of a U.S. citizen (if the citizen is at least 21 years of age).", "pdfFieldName": "form1[0].#subform[4].Pt2Line3a_CB[14]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 5", "pageNumber": 5 }, { "fieldKey": "form1_0_pageset_0_page1_5_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[5].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_aliennumber_5", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[5].AlienNumber[5]", "dataType": "text", "isRequired": false, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3b_cb526_0", "label": "Part 2. Application Type or Filing Category. 3.b. Employment-based. Select Alien Investor, Form I-526 or Form I-526E.", "pdfFieldName": "form1[0].#subform[5].Pt2Line3b_CB526[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3b_cb140_0", "label": "3.b. Employment-based. Alien Workers, Form I-140 (select your category below and answer the following questions below, as applicable): Select Alien of Extraordinary Ability.", "pdfFieldName": "form1[0].#subform[5].Pt2Line3b_CB140[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3b_cb140_1", "label": "3.b. Employment-based. Alien Workers, Form I-140 (select your category below and answer the following questions below, as applicable): Select Outstanding Professor or Researcher.", "pdfFieldName": "form1[0].#subform[5].Pt2Line3b_CB140[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3b_cb140_2", "label": "3.b. Employment-based. Alien Workers, Form I-140 (select your category below and answer the following questions below, as applicable): Select Multinational Executive or Manager.", "pdfFieldName": "form1[0].#subform[5].Pt2Line3b_CB140[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3b_cb140_3", "label": "3.b. Employment-based. Alien Workers, Form I-140 (select your category below and answer the following questions below, as applicable): Select Member of the Professions Holding an Advanced Degree or Alien of Exceptional Ability (who is NOT seeking a National Interest Waiver)", "pdfFieldName": "form1[0].#subform[5].Pt2Line3b_CB140[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3b_cb140_4", "label": "3.b. Employment-based. Alien Workers, Form I-140 (select your category below and answer the following questions below, as applicable): Select A Professional (at a minimum, requiring a bachelor's degree or a foreign degree equivalent to a U.S. bachelor's degree)", "pdfFieldName": "form1[0].#subform[5].Pt2Line3b_CB140[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3b_cb140_5", "label": "3.b. Employment-based. Alien Workers, Form I-140 (select your category below and answer the following questions below, as applicable): Select A Skilled Worker (requiring at least 2 years of specialized training or experience)", "pdfFieldName": "form1[0].#subform[5].Pt2Line3b_CB140[5]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3b_cb140_6", "label": "3.b. Employment-based. Alien Workers, Form I-140 (select your category below and answer the following questions below, as applicable): Select Any Other Worker (requiring less than 2 years of training or experience)", "pdfFieldName": "form1[0].#subform[5].Pt2Line3b_CB140[6]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3b_cb140_7", "label": "3.b. Employment-based. Alien Workers, Form I-140 (select your category below and answer the following questions below, as applicable): Select An Alien Applying For a National Interest Waiver (who IS a member of the professions holding an advanced degree or an alien of exceptional ability)", "pdfFieldName": "form1[0].#subform[5].Pt2Line3b_CB140[7]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3b_cb140assoc_0", "label": "3.b. Employment-based. Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the principal applicant, if you are a derivative applicant)? Select N/A (I am adjusting on the basis of a Form I-140 self-petition).", "pdfFieldName": "form1[0].#subform[5].Pt2Line3b_CB140Assoc[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3b_cb140assoc_1", "label": "3.b. Employment-based. Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the principal applicant, if you are a derivative applicant)? Select No.", "pdfFieldName": "form1[0].#subform[5].Pt2Line3b_CB140Assoc[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3b_cb140assoc_2", "label": "3.b. Employment-based. Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the principal applicant, if you are a derivative applicant)? Select Yes.", "pdfFieldName": "form1[0].#subform[5].Pt2Line3b_CB140Assoc[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2relative_cb_0", "label": "3.b. Employment-based. Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the principal applicant, if you are a derivative applicant)? If you answered \"Yes,\" is this relative your (select only one box): Select Father.", "pdfFieldName": "form1[0].#subform[5].Pt2Relative_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2relative_cb_1", "label": "3.b. Employment-based. Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the principal applicant, if you are a derivative applicant)? If you answered \"Yes,\" is this relative your (select only one box): Select Mother.", "pdfFieldName": "form1[0].#subform[5].Pt2Relative_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2relative_cb_2", "label": "3.b. Employment-based. Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the principal applicant, if you are a derivative applicant)? If you answered \"Yes,\" is this relative your (select only one box): Select Child.", "pdfFieldName": "form1[0].#subform[5].Pt2Relative_CB[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2relative_cb_3", "label": "3.b. Employment-based. Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the principal applicant, if you are a derivative applicant)? If you answered \"Yes,\" is this relative your (select only one box): Select Adult Son.", "pdfFieldName": "form1[0].#subform[5].Pt2Relative_CB[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2relative_cb_4", "label": "3.b. Employment-based. Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the principal applicant, if you are a derivative applicant)? If you answered \"Yes,\" is this relative your (select only one box): Select Adult Daughter.", "pdfFieldName": "form1[0].#subform[5].Pt2Relative_CB[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2relative_cb_5", "label": "3.b. Employment-based. Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the principal applicant, if you are a derivative applicant)? If you answered \"Yes,\" is this relative your (select only one box): Select Brother.", "pdfFieldName": "form1[0].#subform[5].Pt2Relative_CB[5]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2relative_cb_6", "label": "3.b. Employment-based. Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the principal applicant, if you are a derivative applicant)? If you answered \"Yes,\" is this relative your (select only one box): Select Sister.", "pdfFieldName": "form1[0].#subform[5].Pt2Relative_CB[6]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2relative_cb_7", "label": "3.b. Employment-based. Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the principal applicant, if you are a derivative applicant)? If you answered \"Yes,\" is this relative your (select only one box): Select None of These.", "pdfFieldName": "form1[0].#subform[5].Pt2Relative_CB[7]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2relativetype_cb_0", "label": "Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the principal applicant, if you are a derivative applicant)? Is the relative above a:. Select U.S. Citizen.", "pdfFieldName": "form1[0].#subform[5].Pt2RelativeType_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2relativetype_cb_1", "label": "Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the principal applicant, if you are a derivative applicant)? Is the relative above a: Select U.S. National.", "pdfFieldName": "form1[0].#subform[5].Pt2RelativeType_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2relativetype_cb_2", "label": "Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the principal applicant, if you are a derivative applicant)? Is the relative above a: Select Lawful Permanent Resident.", "pdfFieldName": "form1[0].#subform[5].Pt2RelativeType_CB[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2relativetype_cb_3", "label": "Did a relative file the associated Form I-140 for you (or for the principal applicant if you are a derivative applicant) or does a relative have a significant ownership interest (5 percent or more) in the business that filed Form I-140 for you (or for the principal applicant, if you are a derivative applicant)? Is the relative above a: Select None of These.", "pdfFieldName": "form1[0].#subform[5].Pt2RelativeType_CB[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3c_cb_0", "label": "Part 2. Application Type or Filing Category. 3.c. Special Immigrant. Select Certain Afghan or Iraqi National, Form I-360 or Form DS-157", "pdfFieldName": "form1[0].#subform[5].Pt2Line3c_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3c_cb_1", "label": "Part 2. Application Type or Filing Category. 3.c. Special Immigrant. Select Special Immigrant Juvenile, Form I-360.", "pdfFieldName": "form1[0].#subform[5].Pt2Line3c_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3c_cb_2", "label": "Part 2. Application Type or Filing Category. 3.c. Special Immigrant. Select Certain G-4 International Organization or Family Member or NATO-6 Employee or Family Member, Form I-360", "pdfFieldName": "form1[0].#subform[5].Pt2Line3c_CB[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3c_cb_3", "label": "Part 2. Application Type or Filing Category. 3.c. Special Immigrant. Select Certain International Broadcaster, Form I-360", "pdfFieldName": "form1[0].#subform[5].Pt2Line3c_CB[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3c_cb_4", "label": "Part 2. Application Type or Filing Category. 3.c. Special Immigrant. Select Panama Canal Zone Employees, Form I-360", "pdfFieldName": "form1[0].#subform[5].Pt2Line3c_CB[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3c_cb_5", "label": "Part 2. Application Type or Filing Category. 3.c. Special Immigrant. Select Certain U.S. Armed Forces Members (also known as the Six and Six program), Form I-360", "pdfFieldName": "form1[0].#subform[5].Pt2Line3c_CB[5]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3c_cb_6", "label": "Part 2. Application Type or Filing Category. 3.c. Special Immigrant. Select Certain Physicians, Form I-360", "pdfFieldName": "form1[0].#subform[5].Pt2Line3c_CB[6]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3c_cb_7", "label": "Part 2. Application Type or Filing Category. 3.c. Special Immigrant. Select Certain Employee or Former Employee of the U.S. Government Abroad, DS-1884", "pdfFieldName": "form1[0].#subform[5].Pt2Line3c_CB[7]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3c_cb_8", "label": "3. c. Special Immigrant. Religious Worker, Form I- 3 6 0 (select your specific category below): Select Other Religious Worker.", "pdfFieldName": "form1[0].#subform[5].Pt2Line3c_CB[8]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_subform_5_pt2line3c_cb_9", "label": "3. c. Special Immigrant. Religious Worker, Form I- 3 6 0 (select your specific category below): Select Minister of Religion.", "pdfFieldName": "form1[0].#subform[5].Pt2Line3c_CB[9]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 6", "pageNumber": 6 }, { "fieldKey": "form1_0_pageset_0_page1_6_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[6].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3d_asyleerefugeecb_0", "label": "Part 2. Application Type or Filing Category. 3.d. Asylee or Refugee. Select Asylum Status (Immigration and Nationality Act (INA) section 208), Form I-589 or Form I-730.", "pdfFieldName": "form1[0].#subform[6].Pt2Line3d_AsyleeRefugeeCB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3d_asyleerefugeecb_1", "label": "Part 2. Application Type or Filing Category. 3.d. Asylee or Refugee. Select Refugee Status (INA section 207), Form I-590 or Form I-730.", "pdfFieldName": "form1[0].#subform[6].Pt2Line3d_AsyleeRefugeeCB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3e_cb_0", "label": "Part 2. Application Type or Filing Category. 3.e. Human Trafficking Victim or Crime Victim. Select Human Trafficking Victim (T Nonimmigrant), Form I-914 or Derivative Family Member, Form I-914A", "pdfFieldName": "form1[0].#subform[6].Pt2Line3e_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3e_cb_1", "label": "Part 2. Application Type or Filing Category. 3.e. Human Trafficking Victim or Crime Victim. Select Victim of Qualifying Criminal Activity (U Nonimmigrant), Form I-918, Derivative Family Member, Form I-918A, or Qualifying Family Member, Form I-929.", "pdfFieldName": "form1[0].#subform[6].Pt2Line3e_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_aliennumber_6", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[6].AlienNumber[6]", "dataType": "text", "isRequired": false, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3f_cb_0", "label": "Part 2. Application Type or Filing Category. 3.f. Special Programs Based on Certain Public Laws. Select The Cuban Adjustment Act.", "pdfFieldName": "form1[0].#subform[6].Pt2Line3f_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3f_cb_1", "label": "Part 2. Application Type or Filing Category. 3.f. Special Programs Based on Certain Public Laws. Select A Victim of Battery or Extreme Cruelty as a Spouse or Child Under the Cuban Adjustment Act", "pdfFieldName": "form1[0].#subform[6].Pt2Line3f_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3f_cb_2", "label": "Part 2. Application Type or Filing Category. 3.f. Special Programs Based on Certain Public Laws. Select Applicant Adjusting Based on Dependent Status Under the Haitian Refugee Immigrant Fairness Act.", "pdfFieldName": "form1[0].#subform[6].Pt2Line3f_CB[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3f_cb_3", "label": "Part 2. Application Type or Filing Category. 3.f. Special Programs Based on Certain Public Laws. Select A Victim of Battery or Extreme Cruelty as a Spouse or Child Applying Based on Dependent Status Under the Haitian Refugee Immigrant Fairness Act.", "pdfFieldName": "form1[0].#subform[6].Pt2Line3f_CB[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3f_cb_4", "label": "Part 2. Application Type or Filing Category. 3.f. Special Programs Based on Certain Public Laws. Select Lautenberg Parolees", "pdfFieldName": "form1[0].#subform[6].Pt2Line3f_CB[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3f_cb_5", "label": "Part 2. Application Type or Filing Category. 3.f. Special Programs Based on Certain Public Laws. Select Diplomats or High-Ranking Officials Unable to Return Home (Section 13 of the Act of September 11, 1957).", "pdfFieldName": "form1[0].#subform[6].Pt2Line3f_CB[5]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3f_cb_6", "label": "Part 2. Application Type or Filing Category. 3.f. Special Programs Based on Certain Public Laws. Select Nationals of Vietnam, Cambodia, and Laos Applying for Adjustment of Status Under section 586 of Public Law 106-429", "pdfFieldName": "form1[0].#subform[6].Pt2Line3f_CB[6]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line1g_othereligibility_0", "label": "Part 2. Application Type or Filing Category. 3.g. Additional Options. Enter Other Eligibility.", "pdfFieldName": "form1[0].#subform[6].Pt2Line1g_OtherEligibility[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3g_cb_0", "label": "Part 2. Application Type or Filing Category. 3.g. Additional Options. Select Diversity Visa Program.", "pdfFieldName": "form1[0].#subform[6].Pt2Line3g_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3g_cb_1", "label": "Part 2. Application Type or Filing Category. 3.g. Additional Options. Select Continuous Residence in the United States Since Before January 1, 1972 (\"Registry\")", "pdfFieldName": "form1[0].#subform[6].Pt2Line3g_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3g_cb_2", "label": "Part 2. Application Type or Filing Category. 3.g. Additional Options. Select Individual Born in the United States Under Diplomatic Status", "pdfFieldName": "form1[0].#subform[6].Pt2Line3g_CB[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3g_cb_3", "label": "Part 2. Application Type or Filing Category. 3.g. Additional Options. Select S Nonimmigrants and Qualifying Family Members (can only adjust in this category with an approved Form I-854B filed by a law enforcement officer)", "pdfFieldName": "form1[0].#subform[6].Pt2Line3g_CB[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3g_cb_4", "label": "Part 2. Application Type or Filing Category. 3.g. Additional Options. Select Other Eligibility.", "pdfFieldName": "form1[0].#subform[6].Pt2Line3g_CB[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3d_asylum_0", "label": "Part 2. Application Type or Filing Category. 3.d. Asylee or Refugee. If you selected asylum, date you were granted asylum (mm/dd/yyyy). Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[6].Pt2Line3d_Asylum[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3d_refugee_0", "label": "Part 2. Application Type or Filing Category. 3.d. Asylee or Refugee. If you selected refugee, date of initial admission as refugee (mm/dd/yyyy). Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[6].Pt2Line3d_Refugee[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line1g_dv_0", "label": "Part 2. Application Type or Filing Category. 3.g. Additional Options. If you selected Diversity Visa program, provide your Diversity Visa Rank Number.", "pdfFieldName": "form1[0].#subform[6].Pt2Line1g_DV[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line3f_cb_7", "label": "Part 2. Application Type or Filing Category. 3.f. Special Programs Based on Certain Public Laws. Select Applicant Adjusting Under the Amerasian Act (October 22, 1982), Form I-360.", "pdfFieldName": "form1[0].#subform[6].Pt2Line3f_CB[7]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line5_cb_0", "label": "Part 2. Application Type or Filing Category. 5. Are you 21 years of age or older and applying for adjustment based on classification as a child, under the provisions of the Child Status Protection Act (CSPA)? Select No. NOTE: For more information to determine if you are eligible under CSPA, see the Who May File Form I-485 section of these Instructions.", "pdfFieldName": "form1[0].#subform[6].Pt2Line5_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line5_cb_1", "label": "Part 2. Application Type or Filing Category. 5. Are you 21 years of age or older and applying for adjustment based on classification as a child, under the provisions of the Child Status Protection Act (CSPA)? Select Yes.", "pdfFieldName": "form1[0].#subform[6].Pt2Line5_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line4_cb_0", "label": "Part 2. Application Type or Filing Category. 4. If you selected a family-based, employment-based, special immigrant, or Diversity Visa immigrant category listed above in Item Numbers 3.a. - 3.g. as the basis for your application for adjustment of status, are you applying for adjustment based on INA section 245(i)? Select No.", "pdfFieldName": "form1[0].#subform[6].Pt2Line4_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_subform_6_pt2line4_cb_1", "label": "Part 2. Application Type or Filing Category. 4. If you selected a family-based, employment-based, special immigrant, or Diversity Visa immigrant category listed above in Item Numbers 3.a. - 3.g. as the basis for your application for adjustment of status, are you applying for adjustment based on INA section 245(i)? Select Yes.", "pdfFieldName": "form1[0].#subform[6].Pt2Line4_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 7", "pageNumber": 7 }, { "fieldKey": "form1_0_pageset_0_page1_7_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[7].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_aliennumber_7", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[7].AlienNumber[7]", "dataType": "text", "isRequired": false, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt4line1_yn_0", "label": "Part 4. Additional Information About You. 1. Have you ever applied for an immigrant visa to obtain permanent resident status at a U.S. Embassy or U.S. Consulate abroad? Select No.", "pdfFieldName": "form1[0].#subform[7].Pt4Line1_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt4line1_yn_1", "label": "Part 4. Additional Information About You. 1. Have you ever applied for an immigrant visa to obtain permanent resident status at a U.S. Embassy or U.S. Consulate abroad? Select Yes.", "pdfFieldName": "form1[0].#subform[7].Pt4Line1_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt4line4_date_0", "label": "Part 4. Additional Information About You. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. through 4. below. 4. Enter Date of Decision. Enter as 2 digit month, 2 digit day and 4 digit year.", "pdfFieldName": "form1[0].#subform[7].Pt4Line4_Date[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt3line1_cb_0", "label": "Part 3. Request for Exemption for Intending Immigrant's Affidavit of Support Under Section 213A of the INA. I am requesting an exemption from submitting an Affidavit of Support Under Section 213A of the INA (Form I-864 or Form I-864EZ) because (select only one): 1.a. Select I have earned or can receive credit for 40 qualifying quarters (credits) of work in the United States (as defined by the Social Security Act (SSA)). (Attach your SSA earnings statements. Do not count any quarters during which you received a means-tested public benefit.)", "pdfFieldName": "form1[0].#subform[7].Pt3Line1_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt3line1_cb_1", "label": "Part 3. Request for Exemption for Intending Immigrant's Affidavit of Support Under Section 213A of the INA. I am requesting an exemption from submitting an Affidavit of Support Under Section 213A of the INA (Form I-864 or Form I-864EZ) because (select only one): 1.b. Select I am under 18 years of age, unmarried, the child of a U.S. citizen, am not likely to become a public charge, and will automatically become a U.S. citizen under INA section 320, upon my admission as a lawful permanent resident.", "pdfFieldName": "form1[0].#subform[7].Pt3Line1_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt3line1_cb_2", "label": "Part 3. Request for Exemption for Intending Immigrant's Affidavit of Support Under Section 213A of the INA. I am requesting an exemption from submitting an Affidavit of Support Under Section 213A of the INA (Form I-864 or Form I-864EZ) because (select only one): 1.c. Select I am applying under the widow or widower of a U.S. citizen (Form I-360) immigrant category.", "pdfFieldName": "form1[0].#subform[7].Pt3Line1_CB[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt3line1_cb_3", "label": "Part 3. Request for Exemption for Intending Immigrant's Affidavit of Support Under Section 213A of the INA. I am requesting an exemption from submitting an Affidavit of Support Under Section 213A of the INA (Form I-864 or Form I-864EZ) because (select only one): 1.d. Select I am applying as a VAWA self-petitioner.", "pdfFieldName": "form1[0].#subform[7].Pt3Line1_CB[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt3line1_cb_4", "label": "Part 3. Request for Exemption for Intending Immigrant's Affidavit of Support Under Section 213A of the INA. I am requesting an exemption from submitting an Affidavit of Support Under Section 213A of the INA (Form I-864 or Form I-864EZ) because (select only one): 1.e. Select None of these exemptions apply to me and I am not required by statute to submit an Affidavit of Support Under Section 213A of the INA, nor am I required to request an exemption.", "pdfFieldName": "form1[0].#subform[7].Pt3Line1_CB[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt4line2_citytown_0", "label": "Part 4. Additional Information About You. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. through 4. below. 2. Location of U.S. Embassy or U.S. Consulate. Enter City or Town.", "pdfFieldName": "form1[0].#subform[7].Pt4Line2_CityTown[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt4line2_citytownofbirth_0", "label": "Part 4. Additional Information About You. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. through 4. below. Enter Country.", "pdfFieldName": "form1[0].#subform[7].Pt4Line2_CityTownOfBirth[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt4line5_yn_0", "label": "Part 4. Additional Information About You. 5. Have you previously applied for permanent residence while in the United States? Select No.", "pdfFieldName": "form1[0].#subform[7].Pt4Line5_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt4line5_yn_1", "label": "Part 4. Additional Information About You. 5. Have you previously applied for permanent residence while in the United States? Select Yes.", "pdfFieldName": "form1[0].#subform[7].Pt4Line5_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt4line6_yn_0", "label": "Part 4. Additional Information About You. 6. Have you ever held lawful permanent resident status which was later rescinded under INA section 246? Select No.", "pdfFieldName": "form1[0].#subform[7].Pt4Line6_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt4line6_yn_1", "label": "Part 4. Additional Information About You. 6. Have you ever held lawful permanent resident status which was later rescinded under INA section 246? Select Yes.", "pdfFieldName": "form1[0].#subform[7].Pt4Line6_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt4line7_employername_0", "label": "Part 4. Additional Information About You. Employment and Educational History. 7. Provide ALL of your employment and educational history for the last 5 years as indicated in the Instructions. Provide your current employment or school attended first. Include periods of self-employment, unemployment, or retirement. For each period of unemployment or retirement, list source of financial support. If you have additional employment or educational history, use the space provided in Part 14. Additional Information. Enter Employer or School (current or most recent)", "pdfFieldName": "form1[0].#subform[7].Pt4Line7_EmployerName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt4line7_employername_1", "label": "Part 4. Additional Information About You. Employment and Educational History. 7. Provide ALL of your employment and educational history for the last 5 years as indicated in the Instructions. Provide your current employment or school attended first. Include periods of self-employment, unemployment, or retirement. For each period of unemployment or retirement, list source of financial support. If you have additional employment or educational history, use the space provided in Part 14. Additional Information. Enter Your Occupation (if unemployed or retired, so state)", "pdfFieldName": "form1[0].#subform[7].Pt4Line7_EmployerName[1]", "dataType": "text", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt4line7_employername_2", "label": "Part 4. Additional Information About You. Employment and Educational History. 7.Provide ALL of your employment and educational history for the last 5 years as indicated in the Instructions. Provide your current employment or school attended first. Include periods of self-employment, unemployment, or retirement. For each period of unemployment or retirement, list source of financial support. If you have additional employment or educational history, use the space provided in Part 14. Additional Information. Enter Name of Employer, Company, or School.", "pdfFieldName": "form1[0].#subform[7].Pt4Line7_EmployerName[2]", "dataType": "text", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt4line3_decision_0", "label": "Part 4. Additional Information About You. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. through 4. below. 3. Enter Decision (for example, approved, refused, denied, withdrawn).", "pdfFieldName": "form1[0].#subform[7].Pt4Line3_Decision[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_subform_7_pt3line1_cb_5", "label": "Part 3. Request for Exemption for Intending Immigrant's Affidavit of Support Under Section 213A of the INA. I am requesting an exemption from submitting an Affidavit of Support Under Section 213A of the INA (Form I-864 or Form I-864EZ) because (select only one): 1.f. Select None of these exemptions apply to me and I am not requesting an exemption as I am required to submit an Affidavit of Support Under Section 213A of the INA.", "pdfFieldName": "form1[0].#subform[7].Pt3Line1_CB[5]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 8", "pageNumber": 8 }, { "fieldKey": "form1_0_pageset_0_page1_8_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[8].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_aliennumber_8", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[8].AlienNumber[8]", "dataType": "text", "isRequired": false, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_part4line7_streetname_0", "label": "Part 4. Additional Information About You. Address of Employer, Company, or School. 7. Enter Street Number and Name.", "pdfFieldName": "form1[0].#subform[8].Part4Line7_StreetName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line7_unit_0", "label": "Part 4. Additional Information About You. Address of Employer, Company, or School. 7. Check Apartment.", "pdfFieldName": "form1[0].#subform[8].P4Line7_Unit[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line7_unit_1", "label": "Part 4. Additional Information About You. Address of Employer, Company, or School. 7. Check Suite.", "pdfFieldName": "form1[0].#subform[8].P4Line7_Unit[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line7_unit_2", "label": "Part 4. Additional Information About You. Address of Employer, Company, or School. 7. Check Floor.", "pdfFieldName": "form1[0].#subform[8].P4Line7_Unit[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line7_number_0", "label": "Part 4. Additional Information About You. Address of Employer, Company, or School. 7. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.", "pdfFieldName": "form1[0].#subform[8].P4Line7_Number[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line7_city_0", "label": "Part 4. Additional Information About You. Address of Employer, Company, or School. 7. Enter City or Town.", "pdfFieldName": "form1[0].#subform[8].P4Line7_City[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line7_state_0", "label": "Part 4. Additional Information About You. Address of Employer, Company, or School. 7. State. This is a drop-down list and you will select a state from a list of States.", "pdfFieldName": "form1[0].#subform[8].P4Line7_State[0]", "dataType": "select", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line7_zipcode_0", "label": "Part 4. Additional Information About You. Address of Employer, Company, or School. 7. Enter 5-digit Zip Code.", "pdfFieldName": "form1[0].#subform[8].P4Line7_ZipCode[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line7_postalcode_0", "label": "Part 4. Additional Information About You. Address of Employer, Company, or School. 7. Enter Postal Code.", "pdfFieldName": "form1[0].#subform[8].P4Line7_PostalCode[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line7_province_0", "label": "Part 4. Additional Information About You. Address of Employer, Company, or School. 7. Enter Province.", "pdfFieldName": "form1[0].#subform[8].P4Line7_Province[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line7_country_0", "label": "Part 4. Additional Information About You. Address of Employer, Company, or School. 7. Enter Country.", "pdfFieldName": "form1[0].#subform[8].P4Line7_Country[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_pt4line7_datefrom_0", "label": "Part 4. Additional Information About You. 7. Dates of Employment, Unemployment, or School Attendance. Enter Date From. Enter as 2 digit month, 2 digit day and 4 digit year.", "pdfFieldName": "form1[0].#subform[8].Pt4Line7_DateFrom[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_pt4line7_dateto_0", "label": "Part 4. Additional Information About You. 7. Dates of Employment, Unemployment, or School Attendance. Enter Date To. Enter as 2 digit month, 2 digit day and 4 digit year.", "pdfFieldName": "form1[0].#subform[8].Pt4Line7_DateTo[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_part4line7_streetname_1", "label": "Part 4. Additional Information About You. 7. If unemployed or retired, source of financial support. Enter source of financial support.", "pdfFieldName": "form1[0].#subform[8].Part4Line7_StreetName[1]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_pt4line8_occupation_0", "label": "Part 4. Additional Information About You. 8. Provide your most recent employer or school outside of the United States (if not already listed above). Enter Your Occupation (if unemployed or retired, so state)", "pdfFieldName": "form1[0].#subform[8].Pt4Line8_Occupation[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_pt4line8_employername_0", "label": "Part 4. Additional Information About You. 8. Provide your most recent employer or school outside of the United States (if not already listed above). Enter Name of Employer, Company, or School.", "pdfFieldName": "form1[0].#subform[8].Pt4Line8_EmployerName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line8_streetname_0", "label": "Part 4. Additional Information About You. 8. Provide your most recent employer or school outside of the United States (if not already listed above). Address of Employer, Company or School. Enter Street Number and Name.", "pdfFieldName": "form1[0].#subform[8].P4Line8_StreetName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line8_unit_0", "label": "Part 4. Additional Information About You. 8. Provide your most recent employer or school outside of the United States (if not already listed above). Address of Employer, Company or School. Check Apartment.", "pdfFieldName": "form1[0].#subform[8].P4Line8_Unit[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line8_unit_1", "label": "Part 4. Additional Information About You. 8. Provide your most recent employer or school outside of the United States (if not already listed above). Address of Employer, Company or School. Check Suite.", "pdfFieldName": "form1[0].#subform[8].P4Line8_Unit[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line8_unit_2", "label": "Part 4. Additional Information About You. 8. Provide your most recent employer or school outside of the United States (if not already listed above). Address of Employer, Company or School. Check Floor.", "pdfFieldName": "form1[0].#subform[8].P4Line8_Unit[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line8_number_0", "label": "Part 4. Additional Information About You. 8. Provide your most recent employer or school outside of the United States (if not already listed above). Address of Employer, Company or School. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.", "pdfFieldName": "form1[0].#subform[8].P4Line8_Number[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line8_city_0", "label": "Part 4. Additional Information About You. 8. Provide your most recent employer or school outside of the United States (if not already listed above). Address of Employer, Company or School. City or Town. Enter City or Town.", "pdfFieldName": "form1[0].#subform[8].P4Line8_City[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line8_state_0", "label": "Part 4. Additional Information About You. 8. Provide your most recent employer or school outside of the United States (if not already listed above). Address of Employer, Company or School. State. This is a drop-down list and you will select a state from a list of States.", "pdfFieldName": "form1[0].#subform[8].P4Line8_State[0]", "dataType": "select", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line8_zipcode_0", "label": "Part 4. Additional Information About You. 8. Provide your most recent employer or school outside of the United States (if not already listed above). Address of Employer, Company or School. Zip Code. Enter 5-digit Zip Code.", "pdfFieldName": "form1[0].#subform[8].P4Line8_ZipCode[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line8_postalcode_0", "label": "Enter Postal Code.", "pdfFieldName": "form1[0].#subform[8].P4Line8_PostalCode[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line8_province_0", "label": "Enter Province.", "pdfFieldName": "form1[0].#subform[8].P4Line8_Province[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_p4line8_country_0", "label": "Part 4. Additional Information About You. 8. Provide your most recent employer or school outside of the United States (if not already listed above). Address of Employer, Company or School. Country. Enter Country.", "pdfFieldName": "form1[0].#subform[8].P4Line8_Country[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_pt4line8_datefrom_0", "label": "Part 4. Additional Information About You. 8. Provide your most recent employer or school outside of the United States (if not already listed above). Dates of Employment, Unemployment, Retirement, or School Attendance. Enter Date From. Enter as 2 digit month, 2 digit day and 4 digit year.", "pdfFieldName": "form1[0].#subform[8].Pt4Line8_DateFrom[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_pt4line8_dateto_0", "label": "Part 4. Additional Information About You. 8. Provide your most recent employer or school outside of the United States (if not already listed above). Dates of Employment, Unemployment, Retirement, or School Attendance. Enter Date To. Enter as 2 digit month, 2 digit day and 4 digit year.", "pdfFieldName": "form1[0].#subform[8].Pt4Line8_DateTo[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_part4line8_streetname_0", "label": "Part 4. Additional Information About You. 8. Provide your most recent employer or school outside of the United States (if not already listed above). Dates of Employment, Unemployment, Retirement, or School Attendance. If unemployed or retired, source of financial support. Enter source of financial support.", "pdfFieldName": "form1[0].#subform[8].Part4Line8_StreetName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_pt5line1_familyname_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 1. 1. Parent 1's Legal Name. Enter Family Name, Last Name.", "pdfFieldName": "form1[0].#subform[8].Pt5Line1_FamilyName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_pt5line1_givenname_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 1. 1. Parent 1's Legal Name. Enter Given Name, First Name.", "pdfFieldName": "form1[0].#subform[8].Pt5Line1_GivenName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_pt5line1_middlename_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 1. 1. Parent 1's Legal Name. Enter Middle Name, if applicable.", "pdfFieldName": "form1[0].#subform[8].Pt5Line1_MiddleName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_pt5line2_givenname_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 1. 2. Parent 1's Name at Birth (if different than above). Enter Given Name, First Name.", "pdfFieldName": "form1[0].#subform[8].Pt5Line2_GivenName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_pt5line3_dateofbirth_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 1. 3. Enter Date of Birth. Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[8].Pt5Line3_DateofBirth[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_pt5line2_familyname_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 1. 2. Parent 1's Name at Birth (if different than above). Enter Family Name, Last Name.", "pdfFieldName": "form1[0].#subform[8].Pt5Line2_FamilyName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_subform_8_pt5line2_middlename_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 1. 2. Parent 1's Name at Birth (if different than above). Enter Middle Name, if applicable.", "pdfFieldName": "form1[0].#subform[8].Pt5Line2_MiddleName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 9", "pageNumber": 9 }, { "fieldKey": "form1_0_pageset_0_page1_9_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[9].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_aliennumber_9", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[9].AlienNumber[9]", "dataType": "text", "isRequired": false, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt5line5_citytownofbirth_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 1. 4. Enter Country of Birth.", "pdfFieldName": "form1[0].#subform[9].Pt5Line5_CityTownOfBirth[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt5line6_familyname_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 2. 5. Parent 2's Legal Name. Enter Family Name, Last Name.", "pdfFieldName": "form1[0].#subform[9].Pt5Line6_FamilyName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt5line6_givenname_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 2. 5. Parent 2's Legal Name. Enter Given Name, First Name.", "pdfFieldName": "form1[0].#subform[9].Pt5Line6_GivenName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt5line6_middlename_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 2. 5. Parent 2's Legal Name. Enter Middle Name, if applicable.", "pdfFieldName": "form1[0].#subform[9].Pt5Line6_MiddleName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt5line8_dateofbirth_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 2. 7. Enter Date of Birth. Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[9].Pt5Line8_DateofBirth[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt5line7_familyname_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 2. 6. Parent 2's Name at Birth (if different than above). Enter Family Name, Last Name.", "pdfFieldName": "form1[0].#subform[9].Pt5Line7_FamilyName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt5line7_givenname_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 2. 6. Parent 2's Name at Birth (if different than above). Enter Given Name, First Name.", "pdfFieldName": "form1[0].#subform[9].Pt5Line7_GivenName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt5line7_middlename_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 2. 6. Parent 2's Name at Birth (if different than above). Enter Middle Name, if applicable.", "pdfFieldName": "form1[0].#subform[9].Pt5Line7_MiddleName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt5line10_citytownofbirth_0", "label": "Part 5. Information About Your Parents. Information About Your Parent 2. 8. Enter Country of Birth.", "pdfFieldName": "form1[0].#subform[9].Pt5Line10_CityTownOfBirth[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt6line1_maritalstatus_0", "label": "Part 6. Information About Your Marital History. 1. What is your current marital status? Select Divorced.", "pdfFieldName": "form1[0].#subform[9].Pt6Line1_MaritalStatus[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt6line1_maritalstatus_1", "label": "Part 6. Information About Your Marital History. 1. What is your current marital status? Select Single, Never Married.", "pdfFieldName": "form1[0].#subform[9].Pt6Line1_MaritalStatus[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt6line1_maritalstatus_2", "label": "Part 6. Information About Your Marital History. 1. What is your current marital status? Select Widowed.", "pdfFieldName": "form1[0].#subform[9].Pt6Line1_MaritalStatus[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt6line1_maritalstatus_3", "label": "Part 6. Information About Your Marital History. 1. What is your current marital status? Select Married.", "pdfFieldName": "form1[0].#subform[9].Pt6Line1_MaritalStatus[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt6line1_maritalstatus_4", "label": "Part 6. Information About Your Marital History. 1. What is your current marital status? Select Marriage Annulled.", "pdfFieldName": "form1[0].#subform[9].Pt6Line1_MaritalStatus[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt6line1_maritalstatus_5", "label": "Part 6. Information About Your Marital History. 1. What is your current marital status? Select Legally Separated.", "pdfFieldName": "form1[0].#subform[9].Pt6Line1_MaritalStatus[5]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt5line2_ynna_0", "label": "Part 5. Information About Your Marital History. 2. If you are married, is your spouse a current member of the U.S. armed forces or U.S. Coast Guard? Select No.", "pdfFieldName": "form1[0].#subform[9].Pt5Line2_YNNA[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt5line2_ynna_1", "label": "Part 5. Information About Your Marital History. 2. If you are married, is your spouse a current member of the U.S. armed forces or U.S. Coast Guard? Select Yes.", "pdfFieldName": "form1[0].#subform[9].Pt5Line2_YNNA[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt5line2_ynna_2", "label": "Part 5. Information About Your Marital History. 2. If you are married, is your spouse a current member of the U.S. armed forces or U.S. Coast Guard? Select Not Applicable.", "pdfFieldName": "form1[0].#subform[9].Pt5Line2_YNNA[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt6line3_timesmarried_0", "label": "Part 5. Information About Your Marital History. 3. How many times have you been married (including your current marriage, marriages abroad, annulled marriages and marriages to the same person)? Enter Number.", "pdfFieldName": "form1[0].#subform[9].Pt6Line3_TimesMarried[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt6line4_familyname_0", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated) 4. Current Spouse's Legal Name. Enter Family Name, Last Name.", "pdfFieldName": "form1[0].#subform[9].Pt6Line4_FamilyName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt6line4_givenname_0", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated) 4. Current Spouse's Legal Name. Enter Given Name, First Name.", "pdfFieldName": "form1[0].#subform[9].Pt6Line4_GivenName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt6line4_middlename_0", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated) 4. Current Spouse's Legal Name. Enter Middle Name, if applicable.", "pdfFieldName": "form1[0].#subform[9].Pt6Line4_MiddleName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt6line5_aliennumber_0", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated) 5. Enter Current Spouse's Alien Registration Number (A. number(, if any. Enter 9 digit number.", "pdfFieldName": "form1[0].#subform[9].Pt6Line5_AlienNumber[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt5line8_dateofbirth_1", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated) 6. Enter Current Spouse's Date of Birth. Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[9].Pt5Line8_DateofBirth[1]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_pt6line7_country_0", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated) 7. Enter Current Spouse's Country of Birth.", "pdfFieldName": "form1[0].#subform[9].Pt6Line7_Country[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_p6line8_country_0", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated) 8. Current Spouse's Current Physical Address. Country. Enter Country.", "pdfFieldName": "form1[0].#subform[9].P6Line8_Country[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_part6line8_streetname_0", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated) 8. Current Spouse's Current Physical Address. Enter Street Number and Name.", "pdfFieldName": "form1[0].#subform[9].Part6Line8_StreetName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_p6line8_city_0", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated) 8. Current Spouse's Current Physical Address. City or Town. Enter City or Town.", "pdfFieldName": "form1[0].#subform[9].P6Line8_City[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_p6line8_postalcode_0", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated) 8. Current Spouse's Current Physical Address. Postal Code. Enter Postal Code.", "pdfFieldName": "form1[0].#subform[9].P6Line8_PostalCode[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_p6line8_province_0", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated) 8. Current Spouse's Current Physical Address. Province. Enter Province.", "pdfFieldName": "form1[0].#subform[9].P6Line8_Province[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_p6line8_unit_0", "label": "Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address 3. Check Apartment.", "pdfFieldName": "form1[0].#subform[9].P6Line8_Unit[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_p6line8_unit_1", "label": "Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address 3. Check Suite.", "pdfFieldName": "form1[0].#subform[9].P6Line8_Unit[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_p6line8_unit_2", "label": "Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address 3. Check Floor.", "pdfFieldName": "form1[0].#subform[9].P6Line8_Unit[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_p6line8_number_0", "label": "Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address. 3. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.", "pdfFieldName": "form1[0].#subform[9].P6Line8_Number[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_p6line8_state_0", "label": "Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address 3. Select State from List of States.", "pdfFieldName": "form1[0].#subform[9].P6Line8_State[0]", "dataType": "select", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_subform_9_p6line8_zipcode_0", "label": "Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address 3. Enter 5-digit Zip Code.", "pdfFieldName": "form1[0].#subform[9].P6Line8_ZipCode[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 10", "pageNumber": 10 }, { "fieldKey": "form1_0_pageset_0_page1_10_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[10].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_aliennumber_10", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[10].AlienNumber[10]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line10_citytownofbirth_0", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated). 9. Place of Marriage to Current Spouse. Enter City or Town.", "pdfFieldName": "form1[0].#subform[10].Pt6Line10_CityTownOfBirth[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line10_state_0", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated). 9. Place of Marriage to Current Spouse. Enter State or Province.", "pdfFieldName": "form1[0].#subform[10].Pt6Line10_State[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line10_country_0", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated). 9. Place of Marriage to Current Spouse. Enter Country.", "pdfFieldName": "form1[0].#subform[10].Pt6Line10_Country[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt5line8_dateofbirth_2", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated). 9. Place of Marriage to Current Spouse. Date of Marriage to Current Spouse. Enter Date of Birth. Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[10].Pt5Line8_DateofBirth[2]", "dataType": "text", "isRequired": true, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line11_yn_0", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated). 10. Is your current spouse applying with you? 10. Is your current spouse applying with you? Select No.", "pdfFieldName": "form1[0].#subform[10].Pt6Line11_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line11_yn_1", "label": "Part 6. Information About Your Marital History. Information About Your Current Marriage (including if you are legally separated). 10. Is your current spouse applying with you? Select Yes.", "pdfFieldName": "form1[0].#subform[10].Pt6Line11_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line12_familyname_0", "label": "Part 6. Information About Your Marital History. Information About Prior Marriages (if any). 11. Prior Spouse's Legal Name (provide family name before marriage) Enter Family Name, Last Name.", "pdfFieldName": "form1[0].#subform[10].Pt6Line12_FamilyName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line12_givenname_0", "label": "Part 6. Information About Your Marital History. Information About Prior Marriages (if any). 11. Prior Spouse's Legal Name (provide family name before marriage) Enter Given Name, First Name.", "pdfFieldName": "form1[0].#subform[10].Pt6Line12_GivenName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line12_middlename_0", "label": "Part 6. Information About Your Marital History. Information About Prior Marriages (if any). 11. Prior Spouse's Legal Name (provide family name before marriage) Enter Middle Name,if applicable.", "pdfFieldName": "form1[0].#subform[10].Pt6Line12_MiddleName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt5line8_dateofbirth_3", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any). 12. Enter Prior Spouses Date of Birth. Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[10].Pt5Line8_DateofBirth[3]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line15_country_0", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any). 14. Enter Prior Spouse's Country of Citizenship or Nationality.", "pdfFieldName": "form1[0].#subform[10].Pt6Line15_Country[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line14_country_0", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any).13. Enter Prior Spouse's Country of Birth.", "pdfFieldName": "form1[0].#subform[10].Pt6Line14_Country[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line16_dateofbirth_0", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any). 15. Enter Date of Marriage to Prior Spouse. Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[10].Pt6Line16_DateofBirth[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line10_citytownofbirth_1", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any). 16. Place of Marriage to Prior Spouse. Enter City or Town.", "pdfFieldName": "form1[0].#subform[10].Pt6Line10_CityTownOfBirth[1]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line10_state_1", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any). 16. Place of Marriage to Prior Spouse. Enter State or Province.", "pdfFieldName": "form1[0].#subform[10].Pt6Line10_State[1]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line10_country_1", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any). 16. Place of Marriage to Prior Spouse. Enter Country", "pdfFieldName": "form1[0].#subform[10].Pt6Line10_Country[1]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line18_citytownofbirth_0", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any). 17. Place Where Marriage with Prior Spouse Legally Ended. Enter City or Town.", "pdfFieldName": "form1[0].#subform[10].Pt6Line18_CityTownOfBirth[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line18_state_0", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any).17. Place Where Marriage with Prior Spouse Legally Ended. Enter State or Province.", "pdfFieldName": "form1[0].#subform[10].Pt6Line18_State[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line18_country_0", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any).17. Place Where Marriage with Prior Spouse Legally Ended. Enter Country.", "pdfFieldName": "form1[0].#subform[10].Pt6Line18_Country[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line16_dateofbirth_1", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any).17. Enter Date of Marriage with Prior Spouse Legally Ended. Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[10].Pt6Line16_DateofBirth[1]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line19_maritalstatus_0", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any). 18. How Marriage Ended with Prior Spouse (Select one). Select Spouse Deceased.", "pdfFieldName": "form1[0].#subform[10].Pt6Line19_MaritalStatus[0]", "dataType": "checkbox", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line19_maritalstatus_1", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any). 18. How Marriage Ended with Prior Spouse (Select one). Select Annulled.", "pdfFieldName": "form1[0].#subform[10].Pt6Line19_MaritalStatus[1]", "dataType": "checkbox", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line19_maritalstatus_2", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any). 18. How Marriage Ended with Prior Spouse (Select one). Select Other (Explain)", "pdfFieldName": "form1[0].#subform[10].Pt6Line19_MaritalStatus[2]", "dataType": "checkbox", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line19_maritalstatus_3", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any). 18. How Marriage Ended with Prior Spouse (Select one). Select Divorced.", "pdfFieldName": "form1[0].#subform[10].Pt6Line19_MaritalStatus[3]", "dataType": "checkbox", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_subform_10_pt6line19_howmarriageendedother_0", "label": "Part 6. Information About Your Marital History. Information About Your Prior Marriages (if any). 18. How Marriage Ended with Prior Spouse (Select one). If you selected Other (Explain) enter explanation.", "pdfFieldName": "form1[0].#subform[10].Pt6Line19_HowMarriageEndedOther[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 11", "pageNumber": 11 }, { "fieldKey": "form1_0_pageset_0_page1_11_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[11].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_aliennumber_11", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[11].AlienNumber[11]", "dataType": "text", "isRequired": false, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt6line1_totalchildren_0", "label": "Part 7. Information About Your Children. 1. Indicate the total number of ALL living children anywhere in the world (including adult sons and daughters) that you have. NOTE: The term \"children\" includes all biological or legally adopted children, as well as current stepchildren, of any age, whether born in the United States or other countries, married or unmarried, living with you or elsewhere and includes any missing children and those born to you outside of marriage. Enter Number.", "pdfFieldName": "form1[0].#subform[11].Pt6Line1_TotalChildren[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line2_familyname_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 2. Child 1. Current Legal Name. Enter Family Name, Last Name.", "pdfFieldName": "form1[0].#subform[11].Pt7Line2_FamilyName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line2_givenname_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 2. Child 1. Current Legal Name. Enter Given Name, First Name.", "pdfFieldName": "form1[0].#subform[11].Pt7Line2_GivenName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line2_middlename_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 2. Child 1. Current Legal Name. Enter Middle Name, if applicable.", "pdfFieldName": "form1[0].#subform[11].Pt7Line2_MiddleName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line2_aliennumber_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 2. Child 1. Enter Alien Registration Number (A. number(, if any. Enter 9 digit number.", "pdfFieldName": "form1[0].#subform[11].Pt7Line2_AlienNumber[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line2_dateofbirth_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 2. Child 1. Enter Date of Birth. Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[11].Pt7Line2_DateofBirth[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line2_country_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 2. Child 1. Enter Country of Birth.", "pdfFieldName": "form1[0].#subform[11].Pt7Line2_Country[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line2_yn_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 2. Child 1. Is this child also applying now on a separate Form I- 4 8 5? Select No.", "pdfFieldName": "form1[0].#subform[11].Pt7Line2_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line2_yn_1", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 2. Child 1. Is this child also applying now on a separate Form I- 4 8 5? Select Yes.", "pdfFieldName": "form1[0].#subform[11].Pt7Line2_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line2_relationship_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 2. Child 1. Enter What is your child's relationship to you? (for example, biological child, stepchild, legally adopted child)", "pdfFieldName": "form1[0].#subform[11].Pt7Line2_Relationship[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line3_familyname_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 3. Child 2. Current Legal Name. Enter Family Name, Last Name.", "pdfFieldName": "form1[0].#subform[11].Pt7Line3_FamilyName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line3_givenname_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 3. Child 2. Current Legal Name. Enter Given Name, First Name.", "pdfFieldName": "form1[0].#subform[11].Pt7Line3_GivenName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line3_middlename_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 3. Child 2. Current Legal Name. Enter Middle Name, if applicable.", "pdfFieldName": "form1[0].#subform[11].Pt7Line3_MiddleName[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line3_aliennumber_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 3. Child 2. Enter Alien Registration Number (A. number(, if any. Enter 9 digit number.", "pdfFieldName": "form1[0].#subform[11].Pt7Line3_AlienNumber[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line3_dateofbirth_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 3. Child 2. Enter Date of Birth. Enter as 2-digit Month, 2-digit Day, and 4-digit Year.", "pdfFieldName": "form1[0].#subform[11].Pt7Line3_DateofBirth[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line3_country_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 3. Child 2. Enter Country of Birth.", "pdfFieldName": "form1[0].#subform[11].Pt7Line3_Country[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line3_yn_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 3. Child 2. Is this child also applying now on a separate Form I- 4 8 5? Select No.", "pdfFieldName": "form1[0].#subform[11].Pt7Line3_YN[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line3_yn_1", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 3. Child 2. Is this child also applying now on a separate Form I- 4 8 5? Select Yes.", "pdfFieldName": "form1[0].#subform[11].Pt7Line3_YN[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_subform_11_pt7line3_relationship_0", "label": "Part 7. Information About Your Children. Provide the following information for each of your children. If you have more than two children, use the space provided in \rPart 14. Additional Information. 3. Child 2. Enter What is your child's relationship to you? (for example, biological child, stepchild, legally adopted child)", "pdfFieldName": "form1[0].#subform[11].Pt7Line3_Relationship[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 12", "pageNumber": 12 }, { "fieldKey": "form1_0_pageset_0_page1_12_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[12].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_aliennumber_12", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[12].AlienNumber[12]", "dataType": "text", "isRequired": false, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line1_ethnicity_0", "label": "Part 8. Biographic Information. 1. Ethnicity (Select only one box). Select Hispanic or Latino.", "pdfFieldName": "form1[0].#subform[12].Pt7Line1_Ethnicity[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line1_ethnicity_1", "label": "Part 8. Biographic Information. 1. Ethnicity (Select only one box). Select Not Hispanic or Latino.", "pdfFieldName": "form1[0].#subform[12].Pt7Line1_Ethnicity[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line2_race_0", "label": "Part 8. Biographic Information. 2. Race (Select all applicable boxes). Select Asian.", "pdfFieldName": "form1[0].#subform[12].Pt7Line2_Race[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line2_race_1", "label": "Part 8. Biographic Information. 2. Race (Select all applicable boxes). Select White.", "pdfFieldName": "form1[0].#subform[12].Pt7Line2_Race[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line2_race_2", "label": "Part 8. Biographic Information. 2. Race (Select all applicable boxes). Select Black or African American.", "pdfFieldName": "form1[0].#subform[12].Pt7Line2_Race[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line2_race_3", "label": "Part 8. Biographic Information. 2. Race (Select all applicable boxes). Select American Indian or Alaska Native.", "pdfFieldName": "form1[0].#subform[12].Pt7Line2_Race[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line2_race_4", "label": "Part 8. Biographic Information. 2. Race (Select all applicable boxes). Select Native Hawaiian or Other Pacific Islander.", "pdfFieldName": "form1[0].#subform[12].Pt7Line2_Race[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line3_heightfeet_0", "label": "Part 8. Biographic Information. 3. Height. Feet. This is a drop-down. Select Number of Feet from a list of numbers.", "pdfFieldName": "form1[0].#subform[12].Pt7Line3_HeightFeet[0]", "dataType": "select", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line3_heightinches_0", "label": "Part 8. Biographic Information. 3. Height. Inches. This is a drop-down. Select Number of Inches from a list of numbers.", "pdfFieldName": "form1[0].#subform[12].Pt7Line3_HeightInches[0]", "dataType": "select", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line4_weight1_0", "label": "Part 8. Biographic Information. 4. Weight. Pounds. Enter first digit of Weight in Pounds.", "pdfFieldName": "form1[0].#subform[12].Pt7Line4_Weight1[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line4_weight2_0", "label": "Part 8. Biographic Information. 4. Weight. Pounds. Enter second digit of Weight in Pounds.", "pdfFieldName": "form1[0].#subform[12].Pt7Line4_Weight2[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line4_weight3_0", "label": "Part 8. Biographic Information. 4. Weight. Pounds. Enter third digit of Weight in Pounds.", "pdfFieldName": "form1[0].#subform[12].Pt7Line4_Weight3[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line5_eyecolor_0", "label": "Part 8. Biographic Information. 5. Eye Color (Select only one box). Select Blue.", "pdfFieldName": "form1[0].#subform[12].Pt7Line5_Eyecolor[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line5_eyecolor_1", "label": "Part 8. Biographic Information. 5. Eye Color (Select only one box). Select Black.", "pdfFieldName": "form1[0].#subform[12].Pt7Line5_Eyecolor[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line5_eyecolor_2", "label": "Part 8. Biographic Information. 5. Eye Color (Select only one box). Select Brown.", "pdfFieldName": "form1[0].#subform[12].Pt7Line5_Eyecolor[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line5_eyecolor_3", "label": "Part 8. Biographic Information. 5. Eye Color (Select only one box). Select Gray.", "pdfFieldName": "form1[0].#subform[12].Pt7Line5_Eyecolor[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line5_eyecolor_4", "label": "Part 8. Biographic Information. 5. Eye Color (Select only one box). Select Green.", "pdfFieldName": "form1[0].#subform[12].Pt7Line5_Eyecolor[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line5_eyecolor_5", "label": "Part 8. Biographic Information. 5. Eye Color (Select only one box). Select Hazel.", "pdfFieldName": "form1[0].#subform[12].Pt7Line5_Eyecolor[5]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line5_eyecolor_6", "label": "Part 8. Biographic Information. 5. Eye Color (Select only one box). Select Maroon.", "pdfFieldName": "form1[0].#subform[12].Pt7Line5_Eyecolor[6]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line5_eyecolor_7", "label": "Part 8. Biographic Information. 5. Eye Color (Select only one box). Select Pink.", "pdfFieldName": "form1[0].#subform[12].Pt7Line5_Eyecolor[7]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line5_eyecolor_8", "label": "Part 8. Biographic Information. 5. Eye Color (Select only one box). Select Unknown / Other.", "pdfFieldName": "form1[0].#subform[12].Pt7Line5_Eyecolor[8]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line6_haircolor_0", "label": "Part 8. Biographic Information. 6. Hair Color (Select only one box). Select Bald (No hair).", "pdfFieldName": "form1[0].#subform[12].Pt7Line6_Haircolor[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line6_haircolor_1", "label": "Part 8. Biographic Information. 6. Hair Color (Select only one box). Select Black.", "pdfFieldName": "form1[0].#subform[12].Pt7Line6_Haircolor[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line6_haircolor_2", "label": "Part 8. Biographic Information. 6. Hair Color (Select only one box). Select Blond.", "pdfFieldName": "form1[0].#subform[12].Pt7Line6_Haircolor[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line6_haircolor_3", "label": "Part 8. Biographic Information. 6. Hair Color (Select only one box). Select Brown.", "pdfFieldName": "form1[0].#subform[12].Pt7Line6_Haircolor[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line6_haircolor_4", "label": "Part 8. Biographic Information. 6. Hair Color (Select only one box). Select Gray.", "pdfFieldName": "form1[0].#subform[12].Pt7Line6_Haircolor[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line6_haircolor_5", "label": "Part 8. Biographic Information. 6. Hair Color (Select only one box). Select Red.", "pdfFieldName": "form1[0].#subform[12].Pt7Line6_Haircolor[5]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line6_haircolor_6", "label": "Part 8. Biographic Information. 6. Hair Color (Select only one box). Select Sandy.", "pdfFieldName": "form1[0].#subform[12].Pt7Line6_Haircolor[6]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line6_haircolor_7", "label": "Part 8. Biographic Information. 6. Hair Color (Select only one box). Select White.", "pdfFieldName": "form1[0].#subform[12].Pt7Line6_Haircolor[7]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt7line6_haircolor_8", "label": "Part 8. Biographic Information. 6. Hair Color (Select only one box). Select Unknown / Other.", "pdfFieldName": "form1[0].#subform[12].Pt7Line6_Haircolor[8]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt8line1_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Choose the answer that you think is correct in Part 9. 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 14. Additional Information. 1. Have you EVER been a member of, involved in, or in any way associated with any organization, association, fund, foundation, party, club, society, or similar group in the United States or in any other location in the world? Select No.", "pdfFieldName": "form1[0].#subform[12].Pt8Line1_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt8line1_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Choose the answer that you think is correct in Part 9. 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 14. Additional Information. 1. Have you EVER been a member of, involved in, or in any way associated with any organization, association, fund, foundation, party, club, society, or similar group in the United States or in any other location in the world? Select Yes. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[12].Pt8Line1_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt9line2_organization1_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 1. 2. Enter Name of Organization.", "pdfFieldName": "form1[0].#subform[12].Pt9Line2_Organization1[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt9line3_citytownofbirth_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 1. 3. Enter City or Town.", "pdfFieldName": "form1[0].#subform[12].Pt9Line3_CityTownOfBirth[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt9line3_state_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 1. 3. Enter State or Province.", "pdfFieldName": "form1[0].#subform[12].Pt9Line3_State[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt9line3_country_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 1. 3. Enter Country.", "pdfFieldName": "form1[0].#subform[12].Pt9Line3_Country[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt9line4_familyname_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 1. 4. Enter Nature of Organization, including its purposes and activities, whether illicit or legitimate.", "pdfFieldName": "form1[0].#subform[12].Pt9Line4_FamilyName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt9line4_involvement_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 1. 5. Enter Nature of involvement in organization, including role or positions(s) held, whether illicit or legitimate.", "pdfFieldName": "form1[0].#subform[12].Pt9Line4_Involvement[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt9line5_datefrom_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 1. 5. Dates of Membership or Dates of Involvement. Enter Date From. Enter as 2 digit month, 2 digit day and 4 digit year.", "pdfFieldName": "form1[0].#subform[12].Pt9Line5_DateFrom[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt9line5_dateto_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 1. 5. Dates of Membership or Dates of Involvement. Enter Date To. Enter as 2 digit month, 2 digit day and 4 digit year.", "pdfFieldName": "form1[0].#subform[12].Pt9Line5_DateTo[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_subform_12_pt9line6_organization2_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 2. 6. Enter Name of Organization.", "pdfFieldName": "form1[0].#subform[12].Pt9Line6_Organization2[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 13", "pageNumber": 13 }, { "fieldKey": "form1_0_pageset_0_page1_13_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[13].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_aliennumber_13", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[13].AlienNumber[13]", "dataType": "text", "isRequired": false, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt9line7_citytownofbirth_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 2. 7. Enter City or Town.", "pdfFieldName": "form1[0].#subform[13].Pt9Line7_CityTownOfBirth[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt9line7_state_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 2. 7. Enter State or Province.", "pdfFieldName": "form1[0].#subform[13].Pt9Line7_State[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt9line7_country_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 2.7. Enter Country.", "pdfFieldName": "form1[0].#subform[13].Pt9Line7_Country[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt9line8_familyname_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 2. 8. Enter Nature of Organization, including its purposes and activities, whether illicit or legitimate.", "pdfFieldName": "form1[0].#subform[13].Pt9Line8_FamilyName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt9line8_involvement_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 2. 8. Enter Nature of involvement in organization, including role or positions(s) held, whether illicit or legitimate.", "pdfFieldName": "form1[0].#subform[13].Pt9Line8_Involvement[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt9line9_datefrom_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 2. 9. Dates of Membership or Dates of Involvement. Enter Date From. Enter as 2 digit month, 2 digit day and 4 digit year.", "pdfFieldName": "form1[0].#subform[13].Pt9Line9_DateFrom[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt9line9_dateto_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. If you answered \"Yes\" to Item Number 1., complete Item Numbers 2. - 9. If you were a member of more than two organizations, use the space provided in Part 14. Additional Information. Organization 2. 9. Dates of Membership or Dates of Involvement. Enter Date To. Enter as 2 digit month, 2 digit day and 4 digit year.", "pdfFieldName": "form1[0].#subform[13].Pt9Line9_DateTo[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt9line10_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 10. Have you EVER been denied admission to the United States? Select No.", "pdfFieldName": "form1[0].#subform[13].Pt9Line10_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt9line10_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 10. Have you EVER been denied admission to the United States? Select Yes.", "pdfFieldName": "form1[0].#subform[13].Pt9Line10_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt9line11_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 11. Have you EVER been denied a visa to the United States? Select Yes.", "pdfFieldName": "form1[0].#subform[13].Pt9Line11_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt9line11_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 11. Have you EVER been denied a visa to the United States? Select No.", "pdfFieldName": "form1[0].#subform[13].Pt9Line11_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line13_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 13. Have you EVER violated the terms or conditions of your nonimmigrant status? Select No.", "pdfFieldName": "form1[0].#subform[13].Pt8Line13_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line13_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 13. Have you EVER violated the terms or conditions of your nonimmigrant status? Select Yes.", "pdfFieldName": "form1[0].#subform[13].Pt8Line13_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line18_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 14. Are you presently or have you EVER been in removal, exclusion, rescission, or deportation proceedings, including expedited removal proceedings? Select Yes.", "pdfFieldName": "form1[0].#subform[13].Pt8Line18_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line18_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 14. Are you presently or have you EVER been in removal, exclusion, rescission, or deportation proceedings, including expedited removal proceedings? Select No.", "pdfFieldName": "form1[0].#subform[13].Pt8Line18_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line19_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 15. Have you EVER been issued a final order of exclusion, deportation, or removal? Select No.", "pdfFieldName": "form1[0].#subform[13].Pt8Line19_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line19_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 15. Have you EVER been issued a final order of exclusion, deportation, or removal? Select Yes.", "pdfFieldName": "form1[0].#subform[13].Pt8Line19_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt9line12_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 12. Have you EVER worked in the United States without authorization? Select Yes.", "pdfFieldName": "form1[0].#subform[13].Pt9Line12_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt9line12_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 12. Have you EVER worked in the United States without authorization? Select No.", "pdfFieldName": "form1[0].#subform[13].Pt9Line12_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line20_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 16. Have you EVER had a prior final order of exclusion, deportation, or removal reinstated? Select Yes.", "pdfFieldName": "form1[0].#subform[13].Pt8Line20_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line20_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 16. Have you EVER had a prior final order of exclusion, deportation, or removal reinstated? Select No.", "pdfFieldName": "form1[0].#subform[13].Pt8Line20_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line17_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 17. Have you EVER been granted voluntary departure by an immigration officer or an immigration judge but failed to depart within the allotted time? Select Yes.", "pdfFieldName": "form1[0].#subform[13].Pt8Line17_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line17_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 17. Have you EVER been granted voluntary departure by an immigration officer or an immigration judge but failed to depart within the allotted time? Select No.", "pdfFieldName": "form1[0].#subform[13].Pt8Line17_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line23_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 18. Have you EVER applied for any kind of relief or protection from removal, exclusion, or deportation? Select No.", "pdfFieldName": "form1[0].#subform[13].Pt8Line23_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line23_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 18. Have you EVER applied for any kind of relief or protection from removal, exclusion, or deportation? Select Yes.", "pdfFieldName": "form1[0].#subform[13].Pt8Line23_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line24a_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 19. Have you EVER been a J nonimmigrant exchange visitor who was subject to the two-year foreign residence requirement? Select Yes.", "pdfFieldName": "form1[0].#subform[13].Pt8Line24a_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line24a_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 19. Have you EVER been a J nonimmigrant exchange visitor who was subject to the two-year foreign residence requirement? Select No.", "pdfFieldName": "form1[0].#subform[13].Pt8Line24a_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line24b_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 20. If you answered \"Yes\" to Item Number 19., Have you complied with the foreign residence requirement? Select No.", "pdfFieldName": "form1[0].#subform[13].Pt8Line24b_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line24b_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 20. If you answered \"Yes\" to Item Number 19., Have you complied with the foreign residence requirement? Select Yes.", "pdfFieldName": "form1[0].#subform[13].Pt8Line24b_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line24c_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 21. If you answered \"Yes\" to Item Number 19. and \"No\" to Item Number 20., have you been granted a waiver or has Department of State issued a favorable waiver recommendation letter for you? Select Yes.", "pdfFieldName": "form1[0].#subform[13].Pt8Line24c_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line24c_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 21. If you answered \"Yes\" to Item Number 19. and \"No\" to Item Number 20., have you been granted a waiver or has Department of State issued a favorable waiver recommendation letter for you? Select No.", "pdfFieldName": "form1[0].#subform[13].Pt8Line24c_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line22_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. For Item Numbers 22. - 41., you must answer \"Yes\" to any question that applies to you, even if your records were sealed or otherwise cleared, or even if anyone, including a judge, law enforcement officer, or attorney, told you that you 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 22. - 41., use the space provided in Part 14. Additional Information to provide an explanation for each offense, if applicable, that includes a description of the criminal offense; where the criminal offense occurred; when the criminal offense occurred; whether you were arrested, cited, charged, or detained for the criminal offense you committed; and the outcome or disposition of that criminal offense (for example, convicted, placement in a diversion program, no charges filed, charges dismissed, jail, prison, detention, probation, or community service). Your explanation must include the duration of any sentence to confinement (even if suspended). 22. Have you EVER been arrested, cited, charged, or permitted to participate in a diversion program (including pre-trial diversion, deferred prosecution, deferred adjudication, or any withheld adjudication), or detained for any reason by any law enforcement official in any country 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? Select Yes.", "pdfFieldName": "form1[0].#subform[13].Pt8Line22_YesNo[0]", "dataType": "checkbox", "isRequired": false, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_subform_13_pt8line22_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. For Item Numbers 22. - 41., you must answer \"Yes\" to any question that applies to you, even if your records were sealed or otherwise cleared, or even if anyone, including a judge, law enforcement officer, or attorney, told you that you 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 22. - 41., use the space provided in Part 14. Additional Information to provide an explanation for each offense, if applicable, that includes a description of the criminal offense; where the criminal offense occurred; when the criminal offense occurred; whether you were arrested, cited, charged, or detained for the criminal offense you committed; and the outcome or disposition of that criminal offense (for example, convicted, placement in a diversion program, no charges filed, charges dismissed, jail, prison, detention, probation, or community service). Your explanation must include the duration of any sentence to confinement (even if suspended). 22. Have you EVER been arrested, cited, charged, or permitted to participate in a diversion program (including pre-trial diversion, deferred prosecution, deferred adjudication, or any withheld adjudication), or detained for any reason by any law enforcement official in any country 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? Select No.", "pdfFieldName": "form1[0].#subform[13].Pt8Line22_YesNo[1]", "dataType": "checkbox", "isRequired": false, "sectionName": "Page 14", "pageNumber": 14 }, { "fieldKey": "form1_0_pageset_0_page1_14_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[14].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_aliennumber_14", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[14].AlienNumber[14]", "dataType": "text", "isRequired": false, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt9line23_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 23. Have you EVER committed a crime of any kind (even if you were not arrested, cited, charged with, or tried for that crime, or convicted)? Select No.", "pdfFieldName": "form1[0].#subform[14].Pt9Line23_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt9line23_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 23. Have you EVER committed a crime of any kind (even if you were not arrested, cited, charged with, or tried for that crime, or convicted)? Select Yes.", "pdfFieldName": "form1[0].#subform[14].Pt9Line23_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt9line24_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 24. Have you 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 you were granted a pardon, amnesty, a rehabilitation decree, or other act of clemency)? Select Yes. NOTE: If you were the beneficiary of a pardon, amnesty, a rehabilitation decree, or other act of clemency, provide documentation of that post-conviction action.", "pdfFieldName": "form1[0].#subform[14].Pt9Line24_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt9line24_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 24. Have you 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 you were granted a pardon, amnesty, a rehabilitation decree, or other act of clemency)? Select No.", "pdfFieldName": "form1[0].#subform[14].Pt9Line24_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line25_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 25. Have you EVER been ordered punished by a judge or had conditions imposed on you that restrained your 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)? Select No.", "pdfFieldName": "form1[0].#subform[14].Pt8Line25_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line25_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 25. Have you EVER been ordered punished by a judge or had conditions imposed on you that restrained your 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)? Select Yes.", "pdfFieldName": "form1[0].#subform[14].Pt8Line25_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line26_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 26. Have you EVER violated (or attempted or conspired to violate) any controlled substance law or regulation of a state, the United States, or a foreign country? Select No.", "pdfFieldName": "form1[0].#subform[14].Pt8Line26_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line26_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 26. Have you EVER violated (or attempted or conspired to violate) any controlled substance law or regulation of a state, the United States, or a foreign country? Select Yes.", "pdfFieldName": "form1[0].#subform[14].Pt8Line26_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line27_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 27. Have you EVER trafficked in or benefited from, or knowingly aided, abetted, assisted, conspired or colluded in the illegal trafficking of any controlled substances, such as chemicals, illegal drugs, or narcotics? Select No.", "pdfFieldName": "form1[0].#subform[14].Pt8Line27_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line27_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 27. Have you EVER trafficked in or benefited from, or knowingly aided, abetted, assisted, conspired or colluded in the illegal trafficking of any controlled substances, such as chemicals, illegal drugs, or narcotics? Select Yes.", "pdfFieldName": "form1[0].#subform[14].Pt8Line27_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line28_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 28. Are you the spouse, son, or daughter of an alien who illicitly trafficked or aided (or otherwise abetted, assisted, conspired, or colluded) in the illicit trafficking of a controlled substance, such as chemicals, illegal drugs, or narcotics and you obtained, within the last five years, any financial or other benefit from the illegal activity of your spouse or Parent? Select No.", "pdfFieldName": "form1[0].#subform[14].Pt8Line28_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line28_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 28. Are you the spouse, son, or daughter of an alien who illicitly trafficked or aided (or otherwise abetted, assisted, conspired, or colluded) in the illicit trafficking of a controlled substance, such as chemicals, illegal drugs, or narcotics and you obtained, within the last five years, any financial or other benefit from the illegal activity of your spouse or Parent? Select Yes.", "pdfFieldName": "form1[0].#subform[14].Pt8Line28_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line29_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 29. If your answer to Item Number 28. is \"Yes,\" did you know or should you have reasonably known that the financial or other benefit you obtained resulted from this activity of your spouse or parent? Select No.", "pdfFieldName": "form1[0].#subform[14].Pt8Line29_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line29_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 29. If your answer to Item Number 28. is \"Yes,\" did you know or should you have reasonably known that the financial or other benefit you obtained resulted from this activity of your spouse or parent? Select Yes.", "pdfFieldName": "form1[0].#subform[14].Pt8Line29_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line30_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 30. Have you EVER engaged in prostitution or are you coming to the United States to engage in prostitution? Select No.", "pdfFieldName": "form1[0].#subform[14].Pt8Line30_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line30_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 30. Have you EVER engaged in prostitution or are you coming to the United States to engage in prostitution? Select Yes.", "pdfFieldName": "form1[0].#subform[14].Pt8Line30_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line31_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 31. Have you EVER directly or indirectly procured or attempted to procure, or imported prostitutes or persons for the purpose of prostitution? Select Yes.", "pdfFieldName": "form1[0].#subform[14].Pt8Line31_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line31_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 31. Have you EVER directly or indirectly procured or attempted to procure, or imported prostitutes or persons for the purpose of prostitution? Select No.", "pdfFieldName": "form1[0].#subform[14].Pt8Line31_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line32_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 32. Have you EVER received any proceeds or money from prostitution? Select Yes.", "pdfFieldName": "form1[0].#subform[14].Pt8Line32_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line32_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 32. Have you EVER received any proceeds or money from prostitution? Select No.", "pdfFieldName": "form1[0].#subform[14].Pt8Line32_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line34_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 34. Have you EVER exercised immunity (diplomatic or otherwise) to avoid being prosecuted for a criminal offense in the United States? Select No.", "pdfFieldName": "form1[0].#subform[14].Pt8Line34_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line34_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 34. Have you EVER exercised immunity (diplomatic or otherwise) to avoid being prosecuted for a criminal offense in the United States? Select Yes.", "pdfFieldName": "form1[0].#subform[14].Pt8Line34_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line33_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 33. Do you intend to engage in illegal gambling or any other form of commercialized vice, such as prostitution, bootlegging, or the sale of child pornography, while in the United States? Select Yes.", "pdfFieldName": "form1[0].#subform[14].Pt8Line33_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line33_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 33. Do you intend to engage in illegal gambling or any other form of commercialized vice, such as prostitution, bootlegging, or the sale of child pornography, while in the United States? Select No.", "pdfFieldName": "form1[0].#subform[14].Pt8Line33_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line35a_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 35. A. Have you EVER served as a foreign government official? Select Yes.", "pdfFieldName": "form1[0].#subform[14].Pt8Line35a_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line35a_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 35. A. Have you EVER served as a foreign government official? Select No.", "pdfFieldName": "form1[0].#subform[14].Pt8Line35a_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line36_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 36. Have you EVER induced by force, fraud, or coercion (or otherwise been involved in) the trafficking of another person for commercial sex acts (sex trafficking)? Select No.", "pdfFieldName": "form1[0].#subform[14].Pt8Line36_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line36_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 36. Have you EVER induced by force, fraud, or coercion (or otherwise been involved in) the trafficking of another person for commercial sex acts (sex trafficking)? Select Yes. NOTE: Sex trafficking involves inducing or causing an adult to engage in a commercial sex act (any sex act performed for anything of value) through fraud, force, or coercion, or inducing or causing any person under 18 years of age to engage in a commercial sex act (even without force, fraud, or coercion). Sex trafficking may include recruiting, enticing, harboring, transporting, providing, obtaining, advertising, maintaining, patronizing, or soliciting by any means a person to engage in the commercial sex act knowing (or, in the case of advertising, with reckless disregard of the fact) that the person is under 18 years of age or that force, fraud, or coercion was used to induce or cause the person to engage in the commercial sex act. Sex trafficking may also include knowingly benefiting financially or by receiving anything of value, from participation in a venture involving sex trafficking.", "pdfFieldName": "form1[0].#subform[14].Pt8Line36_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line37_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 37. Have you EVER trafficked a person into involuntary servitude, peonage, debt bondage, or slavery? Trafficking includes recruiting, harboring, transporting, providing, or obtaining a person for labor or services through the use of force, fraud, or coercion. Select No.", "pdfFieldName": "form1[0].#subform[14].Pt8Line37_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line37_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 37. Have you EVER trafficked a person into involuntary servitude, peonage, debt bondage, or slavery? Trafficking includes recruiting, harboring, transporting, providing, or obtaining a person for labor or services through the use of force, fraud, or coercion. Select Yes.", "pdfFieldName": "form1[0].#subform[14].Pt8Line37_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line35b_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 35 B. If your answer to Item Number 35.a. is \"Yes,\" have you EVER been responsible for, enforced, or directly carried out violations of religious freedoms? Select No.", "pdfFieldName": "form1[0].#subform[14].Pt8Line35b_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_subform_14_pt8line35b_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 35 B. If your answer to Item Number 35.a. is \"Yes,\" have you EVER been responsible for, enforced, or directly carried out violations of religious freedoms? Select Yes.", "pdfFieldName": "form1[0].#subform[14].Pt8Line35b_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 15", "pageNumber": 15 }, { "fieldKey": "form1_0_pageset_0_page1_15_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[15].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_aliennumber_15", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[15].AlienNumber[15]", "dataType": "text", "isRequired": false, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line38_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 38. Have you EVER knowingly aided, abetted, assisted, conspired, or colluded with others in trafficking in persons for commercial sex acts or involuntary servitude, peonage, debt bondage, or slavery? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line38_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line38_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 38. Have you EVER knowingly aided, abetted, assisted, conspired, or colluded with others in trafficking in persons for commercial sex acts or involuntary servitude, peonage, debt bondage, or slavery? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line38_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt9line39_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 39. Are you the spouse, son or daughter of an alien who engaged in the trafficking in persons and have received or obtained, within the last five years, any financial or other benefits from the illicit activity of your spouse or your parent? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt9Line39_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt9line39_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 39. Are you the spouse, son or daughter of an alien who engaged in the trafficking in persons and have received or obtained, within the last five years, any financial or other benefits from the illicit activity of your spouse or your parent? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt9Line39_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line41_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 41. Have you EVER engaged in money laundering or have you EVER knowingly aided, assisted, conspired, or colluded with others in money laundering or do you seek to enter the United States to engage in such activity? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line41_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line41_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 41. Have you EVER engaged in money laundering or have you EVER knowingly aided, assisted, conspired, or colluded with others in money laundering or do you seek to enter the United States to engage in such activity? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line41_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line40_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 40. If your answer is \"Yes\" to Item Number 39., did you know or reasonably should have known that this benefit resulted from this activity of your spouse or parent? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line40_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line40_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Criminal Acts and Violations. 40. If your answer is \"Yes\" to Item Number 39., did you know or reasonably should have known that this benefit resulted from this activity of your spouse or parent? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line40_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line42_a_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Do you intend to: 42. A. Engage in any activity that violates or evades any law relating to espionage (including spying) or sabotage in the United States? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line42\\.a_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line42_a_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Do you intend to: 42. A. Engage in any activity that violates or evades any law relating to espionage (including spying) or sabotage in the United States? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line42\\.a_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line42_b_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Do you intend to: 42. 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? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line42\\.b_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line42_b_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Do you intend to: 42. 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? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line42\\.b_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line42c_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Do you intend to: 42. 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? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line42c_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line42c_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Do you intend to: 42. 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? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line42c_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43a_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER: 43. A. Received any weapons training, paramilitary training, or other military-type training? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43a_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43a_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER: 43. A. Received any weapons training, paramilitary training, or other military-type training? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43a_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line42d_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Do you intend to: 42. D. Engage in any other unlawful activity? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line42d_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line42d_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Do you intend to: 42. D. Engage in any other unlawful activity? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line42d_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43b_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. B. Committed kidnapping, assassination, or hijacking or sabotage of a conveyance (including an aircraft, vessel, vehicle, or train)? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43b_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43b_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. B. Committed kidnapping, assassination, or hijacking or sabotage of a conveyance (including an aircraft, vessel, vehicle, or train)? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43b_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43c_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. C. Used a weapon or explosive or any dangerous device with the intent to endanger the safety of another person or people or cause damage to property? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43c_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43c_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. C. Used a weapon or explosive or any dangerous device with the intent to endanger the safety of another person or people or cause damage to property? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43c_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43d_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. D. Threatened, attempted, conspired, prepared, or planned to do any of the things described in Item Numbers 43.b. - 43.c.? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43d_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43d_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. D. Threatened, attempted, conspired, prepared, or planned to do any of the things described in Item Numbers 43.b. - 43.c.? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43d_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43g_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. G. Recruited members or asked for money or things of value for a group or organization that did any of the activities described in Item Numbers 43. B. - 43. E.? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43g_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43g_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. G. Recruited members or asked for money or things of value for a group or organization that did any of the activities described in Item Numbers 43. B. - 43. E.? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43g_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43h_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. H. Provided money, a thing of value, services or labor, or any other assistance or support for any of the activities described in Item Numbers 43. B. - 43. E.? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43h_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43h_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. H. Provided money, a thing of value, services or labor, or any other assistance or support for any of the activities described in Item Numbers 43. B. - 43. E.? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43h_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43e_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. E. Incited, under circumstances indicating an intention to cause death or serious bodily harm/injury, any of the activities described in Item Numbers 43. B. - 43. C.? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43e_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43e_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. E. Incited, under circumstances indicating an intention to cause death or serious bodily harm/injury, any of the activities described in Item Numbers 43. B. - 43. C.? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43e_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43fyesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. F Participated in, or been a member of, a group or organization that did any of the activities described in Item Numbers 43. B. - 43. E.? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43fYesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43fyesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. F Participated in, or been a member of, a group or organization that did any of the activities described in Item Numbers 43. B. - 43. E.? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43fYesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line44_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 44. Do you intend to engage in any of the activities listed in any part of Item Numbers 43. B. - 43. E.? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line44_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line44_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 44. Do you intend to engage in any of the activities listed in any part of Item Numbers 43. B. - 43. E.? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line44_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43i_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. I. Provided money, a thing of value, services or labor, or any other assistance or support for an individual, group, or organization who did any of the activities described in Item Numbers 43. B. - 43. E.? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43i_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line43i_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 43. I. Provided money, a thing of value, services or labor, or any other assistance or support for an individual, group, or organization who did any of the activities described in Item Numbers 43. B. - 43. E.? Select Yes.", "pdfFieldName": "form1[0].#subform[15].Pt8Line43i_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line45_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 45. Do you intend to engage in any activity that could endanger the welfare, safety, or security of the United States? Select No.", "pdfFieldName": "form1[0].#subform[15].Pt8Line45_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_subform_15_pt8line45_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 45. Do you intend to engage in any activity that could endanger the welfare, safety, or security of the United States? Select Yes. NOTE: If you answered \"Yes\" to any part of Item Numbers 42.a. - 45., explain what you did, including the dates and location of the circumstances, or what you intend to do in the space provided in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[15].Pt8Line45_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 16", "pageNumber": 16 }, { "fieldKey": "form1_0_pageset_0_page1_16_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[16].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_aliennumber_16", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[16].AlienNumber[16]", "dataType": "text", "isRequired": false, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line46_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 46. Are you the spouse or child of an individual who EVER engaged in any of the activities listed in Item Numbers 43. B. - 43. I.? Select Yes. NOTE: If you answered \"Yes\" to any part of Item Number 46., explain what your parent or spouse did, including the dates and location of the circumstances in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[16].Pt8Line46_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line46_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER. 46. Are you the spouse or child of an individual who EVER engaged in any of the activities listed in Item Numbers 43. B. - 43. I.? Select No.", "pdfFieldName": "form1[0].#subform[16].Pt8Line46_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line47_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. 47. Have you EVER sold, provided, or transported weapons, or assisted any person in selling, providing, or transporting weapons, which you knew or believed would be used against another person? Select No.", "pdfFieldName": "form1[0].#subform[16].Pt8Line47_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line47_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. 47. Have you EVER sold, provided, or transported weapons, or assisted any person in selling, providing, or transporting weapons, which you knew or believed would be used against another person? Select Yes. NOTE: If you answered \"Yes\" to any part of Item Numbers 47. - 55., explain what occurred, including the dates and location of the circumstances, in the space provided in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[16].Pt8Line47_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line48_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. 48. Have you EVER worked, volunteered, or otherwise served in any prison, jail, prison camp, detention facility, labor camp, or any other place where people were detained, or have you EVER directed or participated in any other activity that involved detaining people? Select No.", "pdfFieldName": "form1[0].#subform[16].Pt8Line48_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line48_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. 48. Have you EVER worked, volunteered, or otherwise served in any prison, jail, prison camp, detention facility, labor camp, or any other place where people were detained, or have you EVER directed or participated in any other activity that involved detaining people? Select Yes. NOTE: If you answered \"Yes\" to any part of Item Numbers 47. - 55., explain what occurred, including the dates and location of the circumstances, in the space provided in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[16].Pt8Line48_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line49_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. 49. Have you EVER been a member of, assisted, 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? Select Yes. NOTE: If you answered \"Yes\" to any part of Item Numbers 47. - 55., explain what occurred, including the dates and location of the circumstances, in the space provided in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[16].Pt8Line49_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line49_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. 49. Have you EVER been a member of, assisted, 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? Select No.", "pdfFieldName": "form1[0].#subform[16].Pt8Line49_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line50_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. 50. Have you EVER served in, been a member of, assisted (helped), or participated in any military or police unit? Select No.", "pdfFieldName": "form1[0].#subform[16].Pt8Line50_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line50_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. 50. Have you EVER served in, been a member of, assisted (helped), or participated in any military or police unit? Select Yes. If you answered \"Yes\" to Item Number 50. or 51., include the name of the country, the name of the military unit or armed group, your rank or position, and your dates of involvement in your explanation in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[16].Pt8Line50_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line52_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. 52. Have you EVER been a member of, or in any way affiliated with, the Communist Party or any other totalitarian party (in the United States or abroad)? Select No.", "pdfFieldName": "form1[0].#subform[16].Pt8Line52_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line52_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. 52. Have you EVER been a member of, or in any way affiliated with, the Communist Party or any other totalitarian party (in the United States or abroad)? Select Yes. NOTE: If you answered \"Yes\" to any part of Item Numbers 47. - 55., explain what occurred, including the dates and location of the circumstances, in the space provided in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[16].Pt8Line52_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line51_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. 51. Have you EVER served in, been a member of, assisted (helped), or participated in any armed group (a group that carries weapons), for example: paramilitary unit (a group of people who act like a military group, but are not part of the official military), self-defense unit, vigilante unit, rebel group, or guerrilla group? Select Yes. If you answered \"Yes\" to Item Number 50. or 51., include the name of the country, the name of the military unit or armed group, your rank or position, and your dates of involvement in your explanation in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[16].Pt8Line51_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line51_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. 51. Have you EVER served in, been a member of, assisted (helped), or participated in any armed group (a group that carries weapons), for example: paramilitary unit (a group of people who act like a military group, but are not part of the official military), self-defense unit, vigilante unit, rebel group, or guerrilla group? Select No.", "pdfFieldName": "form1[0].#subform[16].Pt8Line51_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line55_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. 55. Have you EVER used any person under 15 years of age to take part in hostilities, for instance, participating in combat or providing services related to combat (such as sabotage or serving as a courier) or providing support services (such as transporting supplies), or attempted or worked with others to do so? Select Yes. NOTE: If you answered \"Yes\" to any part of Item Numbers 47. - 55., explain what occurred, including the dates and location of the circumstances, in the space provided in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[16].Pt8Line55_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line55_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. 55. Have you EVER used any person under 15 years of age to take part in hostilities, for instance, participating in combat or providing services related to combat (such as sabotage or serving as a courier) or providing support services (such as transporting supplies), or attempted or worked with others to do so? Select No.", "pdfFieldName": "form1[0].#subform[16].Pt8Line55_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line53d_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. 53. D. Intentionally and severely injuring or trying to injure any person? Select No.", "pdfFieldName": "form1[0].#subform[16].Pt8Line53d_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line53d_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. 53. D. Intentionally and severely injuring or trying to injure any person? Select Yes. NOTE: If you answered \"Yes\" to any part of Item Numbers 47. - 55., explain what occurred, including the dates and location of the circumstances, in the space provided in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[16].Pt8Line53d_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line54_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. 54. Have you EVER recruited, enlisted, conscripted, or used any person under 15 years of age to take part in hostilities or to serve in or help an armed force or group, or attempted or worked with others to do so? Select No.", "pdfFieldName": "form1[0].#subform[16].Pt8Line54_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line54_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. 54. Have you EVER recruited, enlisted, conscripted, or used any person under 15 years of age to take part in hostilities or to serve in or help an armed force or group, or attempted or worked with others to do so? Select Yes. NOTE: If you answered \"Yes\" to any part of Item Numbers 47. - 55., explain what occurred, including the dates and location of the circumstances, in the space provided in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[16].Pt8Line54_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line53a_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. 53. A. Torture? Select Yes. NOTE: If you answered \"Yes\" to any part of Item Numbers 47. - 55., explain what occurred, including the dates and location of the circumstances, in the space provided in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[16].Pt8Line53a_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line53a_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. 53. A. Torture? Select No.", "pdfFieldName": "form1[0].#subform[16].Pt8Line53a_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line53b_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. 53. B. Genocide? Select Yes. NOTE: If you answered \"Yes\" to any part of Item Numbers 47. - 55., explain what occurred, including the dates and location of the circumstances, in the space provided in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[16].Pt8Line53b_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line53b_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. 53. B. Genocide? Select No.", "pdfFieldName": "form1[0].#subform[16].Pt8Line53b_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line53c_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. 53. C. Killing, or trying to kill any person? Select Yes. NOTE: If you answered \"Yes\" to any part of Item Numbers 47. - 55., explain what occurred, including the dates and location of the circumstances, in the space provided in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[16].Pt8Line53c_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_subform_16_pt8line53c_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Security and Related. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. 53. C. Killing, or trying to kill any person? Select No.", "pdfFieldName": "form1[0].#subform[16].Pt8Line53c_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 17", "pageNumber": 17 }, { "fieldKey": "form1_0_pageset_0_page1_17_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[17].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_aliennumber_17", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[17].AlienNumber[17]", "dataType": "text", "isRequired": false, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Certain Afghan or Iraqi National (Form I - 3 6 0 or Form D S - 1 5 7).", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_1", "label": "Part 2. Application Type or Filing Category. I am applying to register lawful permanent residence or adjust status to that of a lawful permanent resident based on the following immigrant category (select only one box). (See the Form I - 4 85 Instructions for more information, including any Additional Instructions that relate to the immigrant category you select.). 1. F. Special Programs Based on Certain Public Laws. Select Lautenberg Parolees.", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_2", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Victim or Qualifying Criminal Activity (U Nonimmigrant) under I N A section 2 4 5(m) (Form I - 9 1 8, Form I - 9 1 8 A, or Form I - 9 2 9)", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_3", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Asylee (Form I - 5 8 9 or Form I - 7 3 0)", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_4", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Any category other than INA section 245(m), but you are in valid U nonimmigrant status at the time you file your application for adjustment of status. (This exemption only applies if, at the time of the adjudication of Form I - 4 8 5, you are still in valid U nonimmigrant status. If, at the time of adjudication of Form I - 4 8 5, you are no longer in valid U nonimmigrant status, you will be subject to the public charge ground of inadmissibility.)", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_5", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. Each alien who is subject to the public charge ground of inadmissibility in INA section 212(a)(4) must complete Item Numbers 57. - 66. An alien is subject to the public charge ground of inadmissibility if the alien does not fall under one of the categories exempt from the public charge ground of inadmissibility listed below. If you fall under one of the exempt categories listed below, please select the exempt category, and skip Item Numbers 57. - 66. If you do not fall under one of the exempt categories listed below, select \"I do not fall under any of the exempt categories listed above and will complete Item Numbers 57. - 66.\" NOTE: For more information, see Part 9. General Eligibility and Inadmissibility Grounds, Public Charge section of these Instructions. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select VAWA Self-Petitioner (Form I - 3 6 0).", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[5]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_6", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Special Immigrant Juvenile (Form I - 3 6 0).", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[6]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_7", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Cuban Adjustment Act.", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[7]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_8", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Dependent Status under the Haitian Refugee Immigrant Fairness Act for Battered Spouses and Children.", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[8]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_9", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Human Trafficking Victim (T nonimmigrant) under I N A section 2 4 5 (l) (Form I - 9 1 4 or Form I - 9 1 4 A)", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[9]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_10", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Cuban Adjustment Act for Battered Spouses and Children.", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[10]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_11", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Dependent Status under the Haitian Refugee Immigrant Fairness Act,", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[11]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_12", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Any category other than I N A section 2 4 5 (l), but you either have a pending application for T nonimmigrant status (Form I-9 1 4) that sets forth a prima facie case for eligibility or are in valid T nonimmigrant status at the time you file your application for adjustment of status. (This exemption only applies if your Form I-9 1 4 is still pending and deemed to be prima facie eligible or you are in valid T nonimmigrant status when we adjudicate your adjustment of status application.)", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[12]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_13", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Continuous Residence in the United States Since Before January 1, 1 9 7 2 (\"Registry\").", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[13]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_14", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Nicaraguans and Other Central Americans under section 2 0 3 of the Nicaraguan Adjustment and Central American Relief Act (N A C A R A).", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[14]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_15", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Amerasian Homecoming Act.", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[15]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_16", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Polish or Hungarian Parolee.", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[16]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_17", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Cuban and Haitian Entrants Applying for Adjustment of Status under section 2 0 2 of the Immigration Reform and Control Act of 1 9 8 6.", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[17]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_18", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select A Lautenberg Parolee.", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[18]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_19", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select National of Vietnam, Cambodia, or Laos Applying under the Foreign Operations, Export Financing, and Related Programs.", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[19]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_20", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select American Indian Born in Canada (I N A section 2 8 9) or the Texas Band of Kickapoo Indians of the Kickapoo Tribe of Oklahoma, Public Law 9 7 - 4 2 9 (Jan. 8, 1 9 8 3).", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[20]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_subform_17_pt9line56_cb_21", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Section 7 6 1 1 of the National Defense Authorization Act for Fiscal Year 2 0 2 0 (Liberian Refugee Immigration Fairness)", "pdfFieldName": "form1[0].#subform[17].Pt9Line56_CB[21]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 18", "pageNumber": 18 }, { "fieldKey": "form1_0_pageset_0_page1_18_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[18].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_aliennumber_18", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[18].AlienNumber[18]", "dataType": "text", "isRequired": false, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line57_householdsize_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 57. What is the size of your household? Enter the size of your household.", "pdfFieldName": "form1[0].#subform[18].Pt9Line57_HouseholdSize[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line53_cb_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 58. Indicate your annual household income. Select $0-27,000.", "pdfFieldName": "form1[0].#subform[18].Pt9Line53_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line53_cb_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 58. Indicate your annual household income. Select $27,001 - 52,000.", "pdfFieldName": "form1[0].#subform[18].Pt9Line53_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line53_cb_2", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 58. Indicate your annual household income. Select $52,001 - 85,000.", "pdfFieldName": "form1[0].#subform[18].Pt9Line53_CB[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line53_cb_3", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 58. Indicate your annual household income. Select $85,001 - 141,000.", "pdfFieldName": "form1[0].#subform[18].Pt9Line53_CB[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line53_cb_4", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 58. Indicate your annual household income. Select Over $141,001.", "pdfFieldName": "form1[0].#subform[18].Pt9Line53_CB[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line59_cb_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 59. Identify the total value of your household assets. Select $0 - 18,400.", "pdfFieldName": "form1[0].#subform[18].Pt9Line59_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line59_cb_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 59. Identify the total value of your household assets. Select $18,401 - 136,000.", "pdfFieldName": "form1[0].#subform[18].Pt9Line59_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line59_cb_2", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 59. Identify the total value of your household assets. Select $136,001 - 321,400.", "pdfFieldName": "form1[0].#subform[18].Pt9Line59_CB[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line59_cb_3", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 59. Identify the total value of your household assets. Select $321,401 - 707,100.", "pdfFieldName": "form1[0].#subform[18].Pt9Line59_CB[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line59_cb_4", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 59. Identify the total value of your household assets. Select over $707,100.", "pdfFieldName": "form1[0].#subform[18].Pt9Line59_CB[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line60_cb_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 60. Identify the total value of your household liabilities (including both secured and unsecured liabilities). Select $0.", "pdfFieldName": "form1[0].#subform[18].Pt9Line60_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line60_cb_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 60. Identify the total value of your household liabilities (including both secured and unsecured liabilities). Select $1 - 10,100.", "pdfFieldName": "form1[0].#subform[18].Pt9Line60_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line60_cb_2", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 60. Identify the total value of your household liabilities (including both secured and unsecured liabilities). Select $10,101 - 57,700.", "pdfFieldName": "form1[0].#subform[18].Pt9Line60_CB[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line60_cb_3", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 60. Identify the total value of your household liabilities (including both secured and unsecured liabilities). Select $57,701 - 186,800.", "pdfFieldName": "form1[0].#subform[18].Pt9Line60_CB[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line60_cb_4", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 60. Identify the total value of your household liabilities (including both secured and unsecured liabilities). Select Over $186,800.", "pdfFieldName": "form1[0].#subform[18].Pt9Line60_CB[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line56_cb_22", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Spouse, Child, or Parent of a U.S. Active-Duty Service Member in the Armed Forces under the National Defense Authorization Act (N D A A) (Form I - 1 3 0 or Form I - 3 6 0)", "pdfFieldName": "form1[0].#subform[18].Pt9Line56_CB[22]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line56_cb_23", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select I do not fall under any of the exempt categories listed above and will complete Item Numbers 57. - 66. If you selected \"I do not fall under any of the exempt categories listed above and will complete Item Numbers 57. - 66.\" in Item Number 56., complete Item Numbers 57. - 66. below. If you selected an exempt category in Item Number 56., go to Item Number 67. If you need extra space to complete this section, use the space provided in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[18].Pt9Line56_CB[23]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line61_diploma_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. 61. Less than a high school diploma. If you select this option, indicate the highest grade of school you have completed. Enter the highest grade of school you have completed.", "pdfFieldName": "form1[0].#subform[18].Pt9Line61_diploma[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line61_cb_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 62. What is the highest degree or level of school you have completed? Select Less than a high school diploma. If you select this option, indicate the highest grade of school you have completed.", "pdfFieldName": "form1[0].#subform[18].Pt9Line61_CB[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line61_cb_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 61. What is the highest degree or level of school you have completed? Select 1 or more years of college credit, no degree.", "pdfFieldName": "form1[0].#subform[18].Pt9Line61_CB[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line61_cb_2", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 61. What is the highest degree or level of school you have completed? Select High school diploma, GED, or alternative credential.", "pdfFieldName": "form1[0].#subform[18].Pt9Line61_CB[2]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line61_cb_3", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 61. What is the highest degree or level of school you have completed? Select Associate's degree.", "pdfFieldName": "form1[0].#subform[18].Pt9Line61_CB[3]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line61_cb_4", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 61. What is the highest degree or level of school you have completed? Select Master's degree.", "pdfFieldName": "form1[0].#subform[18].Pt9Line61_CB[4]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line61_cb_5", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 61. What is the highest degree or level of school you have completed? Select Professional degree (JD, MD, DMD, etc.).", "pdfFieldName": "form1[0].#subform[18].Pt9Line61_CB[5]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line61_cb_6", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 61. What is the highest degree or level of school you have completed? Select Doctorate degree.", "pdfFieldName": "form1[0].#subform[18].Pt9Line61_CB[6]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line61_cb_7", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 61. What is the highest degree or level of school you have completed? Select Bachelor's degree.", "pdfFieldName": "form1[0].#subform[18].Pt9Line61_CB[7]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line56_cb_24", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box): Select Syrian National Adjusting Status under Public Law 1 0 6 - 3 7 8.", "pdfFieldName": "form1[0].#subform[18].Pt9Line56_CB[24]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line63_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 63. Have you ever received Supplemental Security Income (S S I), Temporary Assistance for Needy Families (T A N F), or State, Tribal, territorial, or local cash benefit programs for income maintenance (often called \"General Assistance\" in the State context, but which also exist under other names)? Select Yes.", "pdfFieldName": "form1[0].#subform[18].Pt9Line63_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line63_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 63. Have you ever received Supplemental Security Income (S S I), Temporary Assistance for Needy Families (T A N F), or State, Tribal, territorial, or local cash benefit programs for income maintenance (often called \"General Assistance\" in the State context, but which also exist under other names)? Select No.", "pdfFieldName": "form1[0].#subform[18].Pt9Line63_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line64_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 64. Have you ever received long-term institutionalization at government expense? Select Yes.", "pdfFieldName": "form1[0].#subform[18].Pt9Line64_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_pt9line64_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 64. Have you ever received long-term institutionalization at government expense? Select No.", "pdfFieldName": "form1[0].#subform[18].Pt9Line64_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_table1_0_row1_0_textfield1_0", "label": "TextField1", "pdfFieldName": "form1[0].#subform[18].Table1[0].Row1[0].TextField1[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_table1_0_row2_0_textfield2_0", "label": "TextField2", "pdfFieldName": "form1[0].#subform[18].Table1[0].Row2[0].TextField2[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_table1_0_row3_0_textfield3_0", "label": "TextField3", "pdfFieldName": "form1[0].#subform[18].Table1[0].Row3[0].TextField3[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_table1_0_row4_0_textfield4_0", "label": "TextField4", "pdfFieldName": "form1[0].#subform[18].Table1[0].Row4[0].TextField4[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_table1_0_row5_0_textfield5_0", "label": "TextField5", "pdfFieldName": "form1[0].#subform[18].Table1[0].Row5[0].TextField5[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_table1_0_row6_0_textfield6_0", "label": "TextField6", "pdfFieldName": "form1[0].#subform[18].Table1[0].Row6[0].TextField6[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_table1_0_row7_0_textfield7_0", "label": "TextField7", "pdfFieldName": "form1[0].#subform[18].Table1[0].Row7[0].TextField7[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_subform_18_table1_0_row8_0_textfield8_0", "label": "TextField8", "pdfFieldName": "form1[0].#subform[18].Table1[0].Row8[0].TextField8[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 19", "pageNumber": 19 }, { "fieldKey": "form1_0_pageset_0_page1_19_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[19].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_aliennumber_19", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[20].AlienNumber[19]", "dataType": "text", "isRequired": false, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column1row1_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter the Institution Name City and State. Row 1.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column1Row1[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column1row2_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter the Institution Name City and State. Row 2", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column1Row2[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column1row3_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter the Institution Name City and State. Row 3", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column1Row3[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column1row4_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter the Institution Name City and State. Row 4", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column1Row4[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column4row1_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter the Reason for institutionalization. Row 1", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column4Row1[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column4row2_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter the Reason for institutionalization. Row 2", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column4Row2[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column4row3_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter the Reason for institutionalization. Row 3", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column4Row3[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column4row4_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter the Reason for institutionalization. Row 4", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column4Row4[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column2row1_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 1", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column2Row1[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column2row2_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 2", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column2Row2[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column2row3_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 3", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column2Row3[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column2row4_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 4", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column2Row4[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column3row1_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 1", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column3Row1[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column3row2_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 2", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column3Row2[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column3row3_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 3", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column3Row3[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68d_column3row4_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. If your answer to Item Number 64. is \"Yes,\" list the name, city, and state for each institution, the start and end dates of each period of institutionalization, and the reason you were institutionalized and whether you were institutionalized while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter the End Date of each period. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 4", "pdfFieldName": "form1[0].#subform[20].Pt8Line68d_Column3Row4[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column1row1_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter Benefit Received. Row 1.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column1Row1[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column1row2_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter Benefit Received. Row 2.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column1Row2[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column1row3_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter Benefit Received. Row 3.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column1Row3[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column4row1_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter Dollar Amount of Benefit Received. Row 1.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column4Row1[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column4row2_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter Dollar Amount of Benefit Received. Row 2.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column4Row2[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column4row3_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter Dollar Amount of Benefit Received. Row 3.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column4Row3[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column4row4_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter Dollar Amount of Benefit Received. Row 4.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column4Row4[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column1row4_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter Benefit Received. Row 4.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column1Row4[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column2row1_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter Start Date of Benefit Received. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 1.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column2Row1[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column2row2_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter Start Date of Benefit Received. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 2.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column2Row2[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column2row3_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter Start Date of Benefit Received. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 3.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column2Row3[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column2row4_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter Start Date of Benefit Received. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 4.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column2Row4[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column3row1_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter End Date of Benefit Received. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 1.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column3Row1[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column3row2_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter End Date of Benefit Received. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 2.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column3Row2[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column3row3_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter End Date of Benefit Received. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 3.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column3Row3[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt8line68c_column3row4_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Enter End Date of Benefit Received. Enter as 2-digit Month, 2-digit Day, and 4-digit Year. Row 4.", "pdfFieldName": "form1[0].#subform[20].Pt8Line68c_Column3Row4[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line65_row1_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Select Yes. Row 1.", "pdfFieldName": "form1[0].#subform[20].Pt9Line65_Row1_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line65_row1_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Select No. Row 1.", "pdfFieldName": "form1[0].#subform[20].Pt9Line65_Row1_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line65_row2_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Select Yes. Row 2.", "pdfFieldName": "form1[0].#subform[20].Pt9Line65_Row2_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line65_row2_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Select No. Row 2.", "pdfFieldName": "form1[0].#subform[20].Pt9Line65_Row2_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line65_row3_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Select Yes. Row 3.", "pdfFieldName": "form1[0].#subform[20].Pt9Line65_Row3_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line65_row3_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Select No. Row 3.", "pdfFieldName": "form1[0].#subform[20].Pt9Line65_Row3_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line65_row4_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Select Yes. Row 4.", "pdfFieldName": "form1[0].#subform[20].Pt9Line65_Row4_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line65_row4_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 65. If your answer to Item Number 63. is \"Yes,\" list the specific benefit(s) you received, the start and end dates of each period of receipt, the dollar amount of benefits received, and whether you received the benefits while you were in an immigration category exempt from the public charge ground of inadmissibility. Select No. Row 4.", "pdfFieldName": "form1[0].#subform[20].Pt9Line65_Row4_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line66_row1_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. Have you ever received long-term institutionalization at government expense? Select Yes. Row 1", "pdfFieldName": "form1[0].#subform[20].Pt9Line66_Row1_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line66_row1_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. Have you ever received long-term institutionalization at government expense? Select No. Row 1", "pdfFieldName": "form1[0].#subform[20].Pt9Line66_Row1_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line66_row2_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. Have you ever received long-term institutionalization at government expense? Select Yes. Row 2", "pdfFieldName": "form1[0].#subform[20].Pt9Line66_Row2_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line66_row2_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. Have you ever received long-term institutionalization at government expense? Select No. Row 2", "pdfFieldName": "form1[0].#subform[20].Pt9Line66_Row2_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line66_row3_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. Have you ever received long-term institutionalization at government expense? Select Yes. Row 3", "pdfFieldName": "form1[0].#subform[20].Pt9Line66_Row3_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line66_row3_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. Have you ever received long-term institutionalization at government expense? Select No. Row 3", "pdfFieldName": "form1[0].#subform[20].Pt9Line66_Row3_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line66_row4_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. Have you ever received long-term institutionalization at government expense? Select Yes. Row 4", "pdfFieldName": "form1[0].#subform[20].Pt9Line66_Row4_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line66_row4_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Public Charge. 66. Have you ever received long-term institutionalization at government expense? Select No. Row 4", "pdfFieldName": "form1[0].#subform[20].Pt9Line66_Row4_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line67_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Illegal Entries and Other Immigration Violations. 67. Have you EVER failed or refused to attend or to remain in attendance at any removal proceeding filed against you on or after April 1, 1 9 9 7? Select No.", "pdfFieldName": "form1[0].#subform[20].Pt9Line67_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line67_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Illegal Entries and Other Immigration Violations. 67. Have you EVER failed or refused to attend or to remain in attendance at any removal proceeding filed against you on or after April 1, 1 9 9 7? Select Yes. NOTE: If your answer to Item Number 67. is \"Yes,\" attach a written statement explaining why you failed or refused to attend or remain in attendance at the removal proceeding, including any explanation of a reasonable cause for that failure or refusal.", "pdfFieldName": "form1[0].#subform[20].Pt9Line67_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line68_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Illegal Entries and Other Immigration Violations. 68. Have you EVER submitted altered, fraudulent, or counterfeit documentation to any U.S. Government official to obtain or attempt to obtain any immigration benefit, including a visa or entry into the United States? Select Yes.", "pdfFieldName": "form1[0].#subform[20].Pt9Line68_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line68_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Illegal Entries and Other Immigration Violations. 68. Have you EVER submitted altered, fraudulent, or counterfeit documentation to any U.S. Government official to obtain or attempt to obtain any immigration benefit, including a visa or entry into the United States? Select No.", "pdfFieldName": "form1[0].#subform[20].Pt9Line68_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line73_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Illegal Entries and Other Immigration Violations. 73. Are you under a final order of civil penalty for violating I N A. section 2 74 C for use of fraudulent documents? Select No.", "pdfFieldName": "form1[0].#subform[20].Pt9Line73_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line73_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Illegal Entries and Other Immigration Violations. 73. Are you under a final order of civil penalty for violating I N A. section 2 74 C for use of fraudulent documents? Select Yes.", "pdfFieldName": "form1[0].#subform[20].Pt9Line73_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line71_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Illegal Entries and Other Immigration Violations. 71. Have you EVER been a stowaway on a vessel or aircraft arriving in the United States? Select No.", "pdfFieldName": "form1[0].#subform[20].Pt9Line71_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line71_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Illegal Entries and Other Immigration Violations. 71. Have you EVER been a stowaway on a vessel or aircraft arriving in the United States? Select Yes.", "pdfFieldName": "form1[0].#subform[20].Pt9Line71_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line72_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Illegal Entries and Other Immigration Violations. 72. Have you EVER knowingly encouraged, induced, assisted, abetted, or aided any alien to enter or to try to enter the United States illegally (alien smuggling)? Select Yes.", "pdfFieldName": "form1[0].#subform[20].Pt9Line72_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line72_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Illegal Entries and Other Immigration Violations. 72. Have you EVER knowingly encouraged, induced, assisted, abetted, or aided any alien to enter or to try to enter the United States illegally (alien smuggling)? Select No.", "pdfFieldName": "form1[0].#subform[20].Pt9Line72_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line70_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Illegal Entries and Other Immigration Violations. 70. Have you EVER falsely claimed to be a U.S. citizen (in writing or any other way)? Select Yes.", "pdfFieldName": "form1[0].#subform[20].Pt9Line70_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line70_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Illegal Entries and Other Immigration Violations. 70. Have you EVER falsely claimed to be a U.S. citizen (in writing or any other way)? Select No.", "pdfFieldName": "form1[0].#subform[20].Pt9Line70_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line69_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Illegal Entries and Other Immigration Violations. 69. Have you 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 kind of immigration benefit? Select No.", "pdfFieldName": "form1[0].#subform[20].Pt9Line69_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line69_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Illegal Entries and Other Immigration Violations. 69. Have you 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 kind of immigration benefit? Select Yes.", "pdfFieldName": "form1[0].#subform[20].Pt9Line69_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line74_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Removal, Unlawful Presence, or Illegal Reentry After Previous Immigration Violations. 74. Have you EVER been excluded, deported, or removed from the United States or have you ever departed the United States on your own after having been ordered excluded, deported, or removed from the United States? Select No.", "pdfFieldName": "form1[0].#subform[20].Pt9Line74_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line74_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Removal, Unlawful Presence, or Illegal Reentry After Previous Immigration Violations. 74. Have you EVER been excluded, deported, or removed from the United States or have you ever departed the United States on your own after having been ordered excluded, deported, or removed from the United States? Select Yes.", "pdfFieldName": "form1[0].#subform[20].Pt9Line74_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line75_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Removal, Unlawful Presence, or Illegal Reentry After Previous Immigration Violations. 75. Have you EVER entered the United States without being inspected and admitted or paroled? Select Yes.", "pdfFieldName": "form1[0].#subform[20].Pt9Line75_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_subform_20_pt9line75_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Removal, Unlawful Presence, or Illegal Reentry After Previous Immigration Violations. 75. Have you EVER entered the United States without being inspected and admitted or paroled? Select No.", "pdfFieldName": "form1[0].#subform[20].Pt9Line75_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 20", "pageNumber": 20 }, { "fieldKey": "form1_0_pageset_0_page1_20_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[20].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_aliennumber_20", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[21].AlienNumber[20]", "dataType": "text", "isRequired": false, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line77_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Removal, Unlawful Presence, or Illegal Reentry After Previous Immigration Violations. 77. If you answered \"Yes\" to Item Number 76., was a severe form of trafficking in persons at least one central reason for your unlawful presence in the United States? Select Yes. NOTE: Severe trafficking in persons involves sex trafficking (the recruitment, harboring, transportation, provision, or obtaining of a person to commit a commercial sex act) induced by force, fraud, coercion, or in which the person is induced to perform such act has not reached 18 years of age, or the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.", "pdfFieldName": "form1[0].#subform[21].Pt9Line77_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line77_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Removal, Unlawful Presence, or Illegal Reentry After Previous Immigration Violations. 77. If you answered \"Yes\" to Item Number 76., was a severe form of trafficking in persons at least one central reason for your unlawful presence in the United States? Select No.", "pdfFieldName": "form1[0].#subform[21].Pt9Line77_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line78a_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Removal, Unlawful Presence, or Illegal Reentry After Previous Immigration Violations. Since April 1, 19 97, have you EVER reentered or attempted to reenter the United States without being inspected and admitted or paroled after: 78. A. Having been unlawfully present in the United States for more than one year in the aggregate on or after April 1, 19 97? You were unlawfully present in the United States for more than one year in the aggregate if you count all of the days during all of your stays that you were present in the United States after the expiration of the period of stay authorized by the D H S Secretary or were present in the United States without being admitted or paroled. Select No.", "pdfFieldName": "form1[0].#subform[21].Pt9Line78a_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line78a_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Removal, Unlawful Presence, or Illegal Reentry After Previous Immigration Violations. Since April 1, 19 97, have you EVER reentered or attempted to reenter the United States without being inspected and admitted or paroled after: 78. A. Having been unlawfully present in the United States for more than one year in the aggregate on or after April 1, 19 97? You were unlawfully present in the United States for more than one year in the aggregate if you count all of the days during all of your stays that you were present in the United States after the expiration of the period of stay authorized by the D H S Secretary or were present in the United States without being admitted or paroled. Select Yes.", "pdfFieldName": "form1[0].#subform[21].Pt9Line78a_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line78b_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Removal, Unlawful Presence, or Illegal Reentry After Previous Immigration Violations. 78. B. Having been deported, excluded, or removed from the United States? Select Yes.", "pdfFieldName": "form1[0].#subform[21].Pt9Line78b_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line78b_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Removal, Unlawful Presence, or Illegal Reentry After Previous Immigration Violations. 78. B. Having been deported, excluded, or removed from the United States? Select No.", "pdfFieldName": "form1[0].#subform[21].Pt9Line78b_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line76_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Removal, Unlawful Presence, or Illegal Reentry After Previous Immigration Violations. 76. Since April 1, 19 97, have you been unlawfully present in the United States? You were unlawfully present in the United States if you were present in the United States after the expiration of the period of stay authorized by the Department of Homeland Security (D H S) Secretary or were present in the United States without being admitted or paroled. Select No.", "pdfFieldName": "form1[0].#subform[21].Pt9Line76_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line76_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Removal, Unlawful Presence, or Illegal Reentry After Previous Immigration Violations. 76. Since April 1, 19 97, have you been unlawfully present in the United States? You were unlawfully present in the United States if you were present in the United States after the expiration of the period of stay authorized by the Department of Homeland Security (D H S) Secretary or were present in the United States without being admitted or paroled. Select Yes. NOTE: If you answered \"Yes\" to Item Number 76., give the dates of unlawful presence in the space provided in Part 14. Additional Information.", "pdfFieldName": "form1[0].#subform[21].Pt9Line76_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line79_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. 79. Do you plan to practice polygamy in the United States? Select Yes.", "pdfFieldName": "form1[0].#subform[21].Pt9Line79_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line79_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. 79. Do you plan to practice polygamy in the United States? Select No.", "pdfFieldName": "form1[0].#subform[21].Pt9Line79_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line80_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. 80. Are you accompanying an alien who is inadmissible and who has been certified by a medical officer as helpless from sickness, mental or physical disability, or infancy, and who requires your protection or guardianship, as described in I N A section 2 3 2 (c)? Select No.", "pdfFieldName": "form1[0].#subform[21].Pt9Line80_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line80_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. 80. Are you accompanying an alien who is inadmissible and who has been certified by a medical officer as helpless from sickness, mental or physical disability, or infancy, and who requires your protection or guardianship, as described in I N A section 2 3 2 (c)? Select Yes.", "pdfFieldName": "form1[0].#subform[21].Pt9Line80_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line81_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. 81. Have you EVER assisted in detaining, retaining, or withholding custody of a U.S. citizen child outside the United States from a person who has been granted custody of the child? Select Yes.", "pdfFieldName": "form1[0].#subform[21].Pt9Line81_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line81_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. 81. Have you EVER assisted in detaining, retaining, or withholding custody of a U.S. citizen child outside the United States from a person who has been granted custody of the child? Select No.", "pdfFieldName": "form1[0].#subform[21].Pt9Line81_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line82_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. 82. Have you EVER voted in violation of any Federal, state, or local constitutional provision, statute, ordinance, or regulation in the United States? Select No.", "pdfFieldName": "form1[0].#subform[21].Pt9Line82_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line82_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. 82. Have you EVER voted in violation of any Federal, state, or local constitutional provision, statute, ordinance, or regulation in the United States? Select Yes.", "pdfFieldName": "form1[0].#subform[21].Pt9Line82_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line83_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. 83. Have you EVER renounced U.S. citizenship to avoid being taxed by the United States? Select Yes.", "pdfFieldName": "form1[0].#subform[21].Pt9Line83_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line83_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. 83. Have you EVER renounced U.S. citizenship to avoid being taxed by the United States? Select No.", "pdfFieldName": "form1[0].#subform[21].Pt9Line83_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line84a_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. Have you EVER. 84. A. Applied for exemption or discharge from training or service in the U.S. armed forces or in the U.S. National Security Training Corps on the ground that you are an alien? Select No.", "pdfFieldName": "form1[0].#subform[21].Pt9Line84a_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line84a_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. Have you EVER. 84. A. Applied for exemption or discharge from training or service in the U.S. armed forces or in the U.S. National Security Training Corps on the ground that you are an alien? Select Yes.", "pdfFieldName": "form1[0].#subform[21].Pt9Line84a_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line84b_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. Have you EVER. 84. B. Been relieved or discharged from such training or service on the ground that you are an alien? Select No.", "pdfFieldName": "form1[0].#subform[21].Pt9Line84b_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line84b_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. Have you EVER. 84. B. Been relieved or discharged from such training or service on the ground that you are an alien? Select Yes.", "pdfFieldName": "form1[0].#subform[21].Pt9Line84b_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line84c_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. Have you EVER. 84. C. Been convicted of desertion from the U.S. armed forces? Select No.", "pdfFieldName": "form1[0].#subform[21].Pt9Line84c_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line84c_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. Have you EVER. 84. C. Been convicted of desertion from the U.S. armed forces? Select Yes.", "pdfFieldName": "form1[0].#subform[21].Pt9Line84c_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line86_nationality_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. 86. If you answered \"Yes\" to Item Number 85. what was your nationality or immigration status immediately before you left (for example, U.S. citizen or national, lawful permanent resident, nonimmigrant, parolee, present without admission or parole, or any other status)? Enter Status.", "pdfFieldName": "form1[0].#subform[21].Pt9Line86_Nationality[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line85_yesno_0", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. Have you EVER. 85. A. Have you EVER left or remained outside the United States to avoid or evade training or service in the U.S. armed forces in time of war or a period declared by the President to be a national emergency? Select No.", "pdfFieldName": "form1[0].#subform[21].Pt9Line85_YesNo[0]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_subform_21_pt9line85_yesno_1", "label": "Part 9. General Eligibility and Inadmissibility Grounds. Miscellaneous Conduct. Have you EVER. 85. A. Have you EVER left or remained outside the United States to avoid or evade training or service in the U.S. armed forces in time of war or a period declared by the President to be a national emergency? Select Yes.", "pdfFieldName": "form1[0].#subform[21].Pt9Line85_YesNo[1]", "dataType": "checkbox", "isRequired": true, "sectionName": "Page 21", "pageNumber": 21 }, { "fieldKey": "form1_0_pageset_0_page1_21_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[21].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_subform_22_aliennumber_21", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[22].AlienNumber[21]", "dataType": "text", "isRequired": false, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_subform_22_pt3line3_daytimephonenumber1_0", "label": "Part 10. Applicant's Contact Information, Certification, and Signature. Applicants Contact Information. Provide your daytime telephone number, mobile telephone number (if any), and email address (if any). 1. Enter Applicant's Daytime Telephone Number.", "pdfFieldName": "form1[0].#subform[22].Pt3Line3_DaytimePhoneNumber1[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_subform_22_pt3line5_email_0", "label": "Part 10. Applicant's Contact Information, Certification, and Signature. Applicants Contact Information. Provide your daytime telephone number, mobile telephone number (if any), and email address (if any). 3. Enter Applicant's Email Address (if any).", "pdfFieldName": "form1[0].#subform[22].Pt3Line5_Email[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_subform_22_pt3line4_mobilenumber1_0", "label": "Part 10. Applicant's Contact Information, Certification, and Signature. Applicants Contact Information. Provide your daytime telephone number, mobile telephone number (if any), and email address (if any). 2. Enter Applicant's Mobile Telephone Number (if any)", "pdfFieldName": "form1[0].#subform[22].Pt3Line4_MobileNumber1[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_subform_22_pt3line7a_signature_0", "label": "Part 10. Applicant's Contact Information, Certification, and Signature. Applicant's Certification and Signature. I certify, under penalty of perjury, that I provided or authorized all of the responses and information contained in and submitted with my application, I read and understand or, if interpreted to me in a language in which I am fluent by the interpreter listed in Part 11., understood, all of the responses and information contained in, and submitted with, my application, and that all of the responses and the information are complete, true, and correct. Furthermore, I authorize the release of any information from any and all of my records that USCIS may need to determine my eligibility for an immigration request and to other entities and persons where necessary for the administration and enforcement of U.S. immigration law. 4. Applicant's Signature. Print Signature. This form can not be signed electronically. The name of the applicant can not be typewritten into this space.", "pdfFieldName": "form1[0].#subform[22].Pt3Line7a_Signature[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_subform_22_pt3line7b_dateofsignature_0", "label": "Part 10. Applicant's Contact Information, Certification, and Signature. Applicant's Certification and Signature. I certify, under penalty of perjury, that I provided or authorized all of the responses and information contained in and submitted with my application, I read and understand or, if interpreted to me in a language in which I am fluent by the interpreter listed in Part 11., understood, all of the responses and information contained in, and submitted with, my application, and that all of the responses and the information are complete, true, and correct. Furthermore, I authorize the release of any information from any and all of my records that USCIS may need to determine my eligibility for an immigration request and to other entities and persons where necessary for the administration and enforcement of U.S. immigration law. 4. Date of Signature. Enter the 2-digit Month, 2-digit Day and 4-digit Year.", "pdfFieldName": "form1[0].#subform[22].Pt3Line7b_DateofSignature[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_subform_22_pt11line1b_givenname_0", "label": "Part 11. Interpreter's Contact Information, Certification, and Signature. Interpreter's Full Name. 1. Enter Interpreter's Given Name (First Name).", "pdfFieldName": "form1[0].#subform[22].Pt11Line1b_GivenName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_subform_22_pt11line1a_familyname_0", "label": "Part 11. Interpreter's Contact Information, Certification, and Signature. Interpreter's Full Name. 1. Enter Interpreter's Family Name (Last Name).", "pdfFieldName": "form1[0].#subform[22].Pt11Line1a_FamilyName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_subform_22_pt11line2_orgname_0", "label": "Part 11. Interpreter's Contact Information, Certification, and Signature. Interpreter's Full Name. 2. Enter Interpreter's Business or Organization Name.", "pdfFieldName": "form1[0].#subform[22].Pt11Line2_OrgName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_subform_22_p3_line4_daytimetelephonenumber_0", "label": "Part 11. Interpreter's Contact Information, Certification, and Signature. Interpreter's Contact Information. 3. Enter the Interpreter's Daytime Telephone Number.", "pdfFieldName": "form1[0].#subform[22].P3_Line4_DaytimeTelePhoneNumber[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_subform_22_p3_line5_mobiletelephonenumber_0", "label": "Part 11. Interpreter's Contact Information, Certification, and Signature. Interpreter's Contact Information. 4. Enter the Interpreter's Mobile Telephone Number (if any).", "pdfFieldName": "form1[0].#subform[22].P3_Line5_MobileTelePhoneNumber[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_subform_22_p3_line6_email_0", "label": "Part 11. Interpreter's Contact Information, Certification, and Signature. Interpreter's Contact Information. 5. Enter Interpreter's Email address, if any.", "pdfFieldName": "form1[0].#subform[22].P3_Line6_Email[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_subform_22_part11_nameoflanguage_0", "label": "Part 11. Interpreter's Contact Information, Certification, and Signature. Interpreter's Certification and Signature. I certify, under penalty of perjury, that: I am fluent in English and (enter language), and I have interpreted every question on the application and Instructions and interpreted the applicant's answers to the questions in that language, and the applicant informed me that he or she understood every instruction, question, and answer on the application.", "pdfFieldName": "form1[0].#subform[22].Part11_NameofLanguage[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_subform_22_p12_signatureapplicant_0", "label": "Part 11. Interpreter's Contact Information, Certification, and Signature. 6. Print Interpreter's Signature. This form can not be signed electronically. The name of the interpreter can not be typewritten into this space.", "pdfFieldName": "form1[0].#subform[22].P12_SignatureApplicant[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_subform_22_p13_dateofsignature_0", "label": "Part 11. Interpreter's Contact Information, Certification, and Signature. 6. Enter Date of Signature. Enter as 2 digit month, 2 digit day and 4 digit year.", "pdfFieldName": "form1[0].#subform[22].P13_DateofSignature[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 22", "pageNumber": 22 }, { "fieldKey": "form1_0_pageset_0_page1_22_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[22].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_aliennumber_22", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[23].AlienNumber[22]", "dataType": "text", "isRequired": false, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_pt12line2_businessname_0", "label": "Part 12. Contact Information, Certification, and Signature of the Person Preparing this Application, If Other Than the Applicant. Preparer's Full Name. 2. Enter Preparer's Business or Organization Name.", "pdfFieldName": "form1[0].#subform[23].Pt12Line2_BusinessName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_pt12line1_preparerfamilyname_0", "label": "Part 12. Contact Information, Certification, and Signature of the Person Preparing this Application, If Other Than the Applicant. Preparer's Full Name. 1. Enter Preparer's Family Name (Last Name).", "pdfFieldName": "form1[0].#subform[23].Pt12Line1_PreparerFamilyName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_pt12line1a_preparergivenname_0", "label": "Part 12. Contact Information, Certification, and Signature of the Person Preparing this Application, If Other Than the Applicant. Preparer's Full Name. 1. Enter Preparer's Given Name (First Name).", "pdfFieldName": "form1[0].#subform[23].Pt12Line1a_PreparerGivenName[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_pt12line3_preparerdaytimephonenumber1_0", "label": "Part 12. Contact Information, Certification, and Signature of the Person Preparing this Application, If Other Than the Applicant. Preparer's Contact Information. 3. Enter Preparer's Daytime Telephone Number.", "pdfFieldName": "form1[0].#subform[23].Pt12Line3_PreparerDaytimePhoneNumber1[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_pt12line5_prepareremail_0", "label": "Part 12. Contact Information, Certification, and Signature of the Person Preparing this Application, If Other Than the Applicant. Preparer's Contact Information. 5. Enter Preparer's Email Address, if any.", "pdfFieldName": "form1[0].#subform[23].Pt12Line5_PreparerEmail[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_pt12line4_preparermobilenumber_0", "label": "Part 12. Contact Information, Certification, and Signature of the Person Preparing this Application, If Other Than the Applicant. Preparer's Contact Information. 4. Enter Preparer's Mobile Telephone Number (if any).", "pdfFieldName": "form1[0].#subform[23].Pt12Line4_PreparerMobileNumber[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_p12line6_signaturepreparer_0", "label": "Part 12. Contact Information, Certification, and Signature of the Person Preparing this Application, If Other Than the Applicant. I certify, under penalty of perjury, that I prepared this application for the applicant at his or her request and with express consent and that all of the responses and information contained in and submitted with the application are complete, true, and correct and reflects only information provided by the applicant. The applicant reviewed the responses and information and informed me that he or she understands the responses and information in or submitted with the application. 6. Print Signature. This form can not be signed electronically. The name of the preparer can not be typewritten into this space.", "pdfFieldName": "form1[0].#subform[23].P12Line6_SignaturePreparer[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_p12line6a_dateofsignature_0", "label": "Part 12. Contact Information, Certification, and Signature of the Person Preparing this Application, If Other Than the Applicant. 6. Enter Date of Signature. Enter as 2 digit month, 2 digit day and 4 digit year.", "pdfFieldName": "form1[0].#subform[23].P12Line6a_DateofSignature[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_pt13_uscissignature_0", "label": "Part 13. Signature at Interview. Subscribed to and sworn to (affirmed) before me. U S C I S Officer's Signature. This signature field can not be signed with a digital signature and the signee's name can not be typewritten into this space. This is a protected field. Print and sign in ink.", "pdfFieldName": "form1[0].#subform[23].Pt13_USCISSignature[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_pt13_uscisofficer_0", "label": "Part 13. Signature at Interview. Subscribed to and sworn to (affirmed) before me. Enter U S C I S Officer's Printed Name or Stamp.", "pdfFieldName": "form1[0].#subform[23].Pt13_USCISOfficer[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_pt13_applicantsignature_0", "label": "Part 13. Signature at Interview. Subscribed to and sworn to (affirmed) before me. Applicant's Signature. This signature field can not be signed with a digital signature and the signee's name can not be typewritten into this space. This is a protected field. Print and sign in ink.", "pdfFieldName": "form1[0].#subform[23].Pt13_ApplicantSignature[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_pt13_dateofsignature_0", "label": "Part 13. Signature at Interview. Subscribed to and sworn to (affirmed) before me. Enter Date of Signature. Enter as 2 digit month, 2 digit day and 4 digit year.", "pdfFieldName": "form1[0].#subform[23].Pt13_DateofSignature[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_pt13_corrections1_0", "label": "NOTE: Do not complete Part 13. until the U S C I S Officer instructs you to do so at the interview. Part 13. Signature at Interview. I swear (affirm) and certify under penalty of perjury under the laws of the United States of America that I know that the contents of this Form I-485, Application to Register Permanent Residence or Adjust Status, subscribed by me, including the corrections made to this application, numbered. Enter First Number.", "pdfFieldName": "form1[0].#subform[23].Pt13_Corrections1[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_pt13_corrections2_0", "label": "Part 13. Signature at Interview. I swear (affirm) and certify under penalty of perjury under the laws of the United States of America that I know that the contents of this Form I-485, Application to Register Permanent Residence or Adjust Status, subscribed by me, including the corrections made to this application, numbered (enter number) through. Enter Second Number.", "pdfFieldName": "form1[0].#subform[23].Pt13_Corrections2[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_pt13_pages1_0", "label": "Part 13. Signature at Interview. All additional pages submitted by me with this Form I - 4 85, on numbered pages. Enter First Number.", "pdfFieldName": "form1[0].#subform[23].Pt13_Pages1[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_pt13_pages2_0", "label": "Part 13. Signature at Interview. All additional pages submitted by me with this Form I - 4 85, on numbered pages (enter number) through. Enter Second Number.", "pdfFieldName": "form1[0].#subform[23].Pt13_Pages2[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_subform_23_pt13_corrections2_1", "label": "Part 13. Signature at Interview. I swear (affirm) and certify under penalty of perjury under the laws of the United States of America that I know that the contents of this Form I-485, Application to Register Permanent Residence or Adjust Status, subscribed by me, including the corrections made to this application, numbered (enter number) through. Enter Second Number.", "pdfFieldName": "form1[0].#subform[23].Pt13_Corrections2[1]", "dataType": "text", "isRequired": true, "sectionName": "Page 23", "pageNumber": 23 }, { "fieldKey": "form1_0_pageset_0_page1_23_pdf417barcode2_0", "label": "PDF417BarCode2", "pdfFieldName": "form1[0].#pageSet[0].Page1[23].PDF417BarCode2[0]", "dataType": "text", "isRequired": false, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_aliennumber_23", "label": "Alien Registration Number (A. Number). This is a read only field. This field pre-populates from page 1.", "pdfFieldName": "form1[0].#subform[24].AlienNumber[23]", "dataType": "text", "isRequired": false, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_pt1line1_familyname_1", "label": "Part 14. Additional Information. 1. Family Name (Last Name) (This field is pre-populated from Part 1.)", "pdfFieldName": "form1[0].#subform[24].Pt1Line1_FamilyName[1]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_pt1line1_givenname_1", "label": "Part 14. Additional Information. 1. Given Name (First Name) (This field is pre-populated from Part 1.)", "pdfFieldName": "form1[0].#subform[24].Pt1Line1_GivenName[1]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_pt1line1_middlename_1", "label": "Part 14. Additional Information. 1. Middle Name (This field is pre-populated from Part 1.)", "pdfFieldName": "form1[0].#subform[24].Pt1Line1_MiddleName[1]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_pt9line3a_pagenumber_0", "label": "Part 14. Additional Information. 2. Enter Page Number.", "pdfFieldName": "form1[0].#subform[24].Pt9Line3a_PageNumber[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_pt9line3b_partnumber_0", "label": "Part 14. Additional Information. 2. Enter Part Number.", "pdfFieldName": "form1[0].#subform[24].Pt9Line3b_PartNumber[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_pt9line3c_itemnumber_0", "label": "Part 8. Additional Information. 2. Enter Item Number.", "pdfFieldName": "form1[0].#subform[24].Pt9Line3c_ItemNumber[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_pt9line3a_pagenumber_1", "label": "Part 14. Additional Information. 3. Enter Page Number.", "pdfFieldName": "form1[0].#subform[24].Pt9Line3a_PageNumber[1]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_pt9line3b_partnumber_1", "label": "Part 14. Additional Information. 3. Enter Part Number.", "pdfFieldName": "form1[0].#subform[24].Pt9Line3b_PartNumber[1]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_pt9line3c_itemnumber_1", "label": "Part 14. Additional Information. 3. Enter Item Number.", "pdfFieldName": "form1[0].#subform[24].Pt9Line3c_ItemNumber[1]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_pt9line3a_pagenumber_2", "label": "Part 14. Additional Information. 4. Enter Page Number.", "pdfFieldName": "form1[0].#subform[24].Pt9Line3a_PageNumber[2]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_pt9line3b_partnumber_2", "label": "Part 14. Additional Information. 4. Enter Part Number.", "pdfFieldName": "form1[0].#subform[24].Pt9Line3b_PartNumber[2]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_pt9line3c_itemnumber_2", "label": "Part 14. Additional Information. 4. Enter Item Number.", "pdfFieldName": "form1[0].#subform[24].Pt9Line3c_ItemNumber[2]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_pt9line3a_pagenumber_3", "label": "Part 14. Additional Information. 5. Enter Page Number.", "pdfFieldName": "form1[0].#subform[24].Pt9Line3a_PageNumber[3]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_pt9line3b_partnumber_3", "label": "Part 14. Additional Information. 5. Enter Part Number.", "pdfFieldName": "form1[0].#subform[24].Pt9Line3b_PartNumber[3]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_pt9line3c_itemnumber_3", "label": "Part 14. Additional Information. 5. Enter Item Number.", "pdfFieldName": "form1[0].#subform[24].Pt9Line3c_ItemNumber[3]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_p14_line5_additionalinfo_0", "label": "Part 14. Additional Information. 5. Enter the Additional Information.", "pdfFieldName": "form1[0].#subform[24].P14_Line5_AdditionalInfo[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_p14_line4_additionalinfo_0", "label": "Part 14. Additional Information. 4. Enter the Additional Information.", "pdfFieldName": "form1[0].#subform[24].P14_Line4_AdditionalInfo[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_p14_line3_additionalinfo_0", "label": "Part 14. Additional Information. 3. Enter the Additional Information.", "pdfFieldName": "form1[0].#subform[24].P14_Line3_AdditionalInfo[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 }, { "fieldKey": "form1_0_subform_24_p14_line2_additionalinfo_0", "label": "Part 14. Additional Information. 2. Enter the Additional Information.", "pdfFieldName": "form1[0].#subform[24].P14_Line2_AdditionalInfo[0]", "dataType": "text", "isRequired": true, "sectionName": "Page 24", "pageNumber": 24 } ] }