Form I-485 – Part 9d: General Eligibility (Public Charge)

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Part 9d: General Eligibility (Public Charge)

57. What is the size of your household?

Please enter your household size.

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58. Indicate your annual household income.

$0-27,000

$27,001-52,000

$52,001-85,000

$85,001-141,000

Over $141,000

Please select one option.

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59. Identify the total value of your household assets.

$0-18,400

$18,401-136,000

$136,001-321,400

$321,401-707,100

Over $707,100

Please select one option.

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60. Identify the total value of your household liabilities.

$1-10,100

$10,101-57,700

$57,701-186,800

Over $186,800

Please select one option.

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61. What is the highest degree or grade of school you have completed?

Less than a high school diploma

High school diploma, GED, or alternative credential

Associate's degree

Bachelor's degree

Master's degree

Professional degree

Doctorate degree

Please select one option.

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62. List your certifications, licenses, skills obtained through work experience, and educational certificates.

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63. Have you ever received Supplemental Security Income (SSI), Temporary Assistance for Needy Families (TANF), or state, Tribal, territorial, or local cash benefit programs for income maintenance?

Yes

Please select Yes or No.

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64. Have you ever received long-term institutionalization at government expense?

Yes

Please select Yes or No.

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65. Benefits Received

Benefit Record 1

Benefit Received

Start Date

End Date

Dollar Amount

Exempt?

Yes No

66. Long-Term Institutionalization

Institution Record 1

Institution Name/City/State

Date From

Date To

Reason

Exempt?

Yes No

Next: Part 9e: General Eligibility (Illegal Entries)

Part 9d: General Eligibility (Public Charge)

56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box):

65. Benefits Received

66. Long-Term Institutionalization

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Part 9d: General Eligibility (Public Charge)

56. I am exempt from the public charge ground of inadmissibility because I am a/an (select only one box):

65. Benefits Received

66. Long-Term Institutionalization