Form I-601 - Application For Waiver Of Grounds Of Inadmissibility - U.s. Citizenship And Immigration Services Page 4
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12Part 4. Reasons for Inadmissibility (continued)
Section B
9.
I came to the United States or I am coming to the
I am applying for adjustment of status based on a valid T
United States to engage in any other unlawful
nonimmigrant status or based on classification as a Special
commercialized vice whether or not it is related to
Immigrant Juvenile and I believe or I was told that I am
prostitution.
inadmissible because:
10.
I have been involved in serious criminal activity and
19.
Specify (Review Form I-601 Instructions for a
have asserted immunity from prosecution.
detailed explanation of the individual grounds of
inadmissibility related to your Form I-601.)
11.
I am or I have been a member of or affiliated with the
Communist or any other totalitarian party (or
subdivision or affiliate of the party,) domestic or
foreign.
I have sought to procure an immigration benefit by
12.
Section C
fraud or by concealing or misrepresenting a material
fact (immigration fraud or misrepresentation.)
I am applying for TPS and I believe or I was told that I am
inadmissible because:
13.
I have been engaged in alien smuggling.
Select all grounds that you believe, according to the best of your
14.
I am subject to a civil penalty because I was the
knowledge, or that you were told apply to you.
subject of a final order for violation of the
Immigration and Nationality Act (INA) section 274C.
20.
I have a communicable disease of public health
significance. (A list of communicable diseases of
I am subject to the 3-year or the 10-year bar to
15.
public health significance can be found in the Specific
admissibility because I was previously unlawfully
Instructions section of Form I-601 Instructions.)
present in the United States in excess of either 180
days or one year or more, respectively, and
21.
I have or had a physical or mental disorder and
subsequently departed the United States.
behavior (or a history of behavior that is likely to
recur) associated with the disorder, which has posed or
I was previously removed from the United States.
16.
may pose a threat to the property, safety, or welfare of
(See instructions for Nicaraguan Adjustment and
myself or others.
Central American Relief Act (NACARA) and Haitian
Refugee Immigration Fairness Act (HRIFA) applicants
I am or have been a drug abuser or drug addict as
22.
only. All other applicants file Form I-212.)
described in U.S. Department of Health and Human
Services (HHS) Regulations. See 42 CFR 34.
17.
I have been ordered removed or I have been
I have been involved in a controlled substance
unlawfully present in the United States for more than
23.
violation according to the laws and regulations of any
one year, in the aggregate, and I subsequently
state, the United States, or a foreign country related
reentered or attempted to reenter without being
to a single offense of simple possession of 30 grams
admitted. (See instructions for NACARA, HRIFA,
or less of marijuana.
and the instructions for approved Violence Against
Women Act (VAWA) self-petitioners only. Other
24.
I am coming to the U.S. to engage in prostitution or,
applicants file Form I-212.)
in the past 10 years, I have engaged in prostitution
18.
Other (specify):
(including receiving the proceeds of, in full or in
part,) procurement of prostitution, or I continue to
engage in prostitution or procurement of prostitution.
In the past 10 years, I have (either directly or indirectly,)
25.
procured, attempted to procure, or to import prostitutes
or persons for the purpose of prostitution.
I came to the United States or I am coming to the
26.
United States to engage in any other unlawful
commercialized vice, whether or not it is related to
prostitution.
27.
I have been involved in serious criminal activity and
have asserted immunity from prosecution.
I did not attend or did not remain at a removal
28.
proceeding to determine my inadmissibility or
deportability.
Form I-601 08/21/17 N
Page 4 of 12
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