Form 9; instructions 21.

12/15/17. We will publish a new edition of this form soon. In the meantime, you may file using the 12/15/17 edition. You can find the edition date at the bottom of the page on the form and instructions.

Mail your Form I-601A to the Chicago Lockbox facility.

For U.S. Postal Service (USPS):
USCIS
P.O. Box 4599
Chicago, IL 60680
 
For FedEx, UPS, and DHL deliveries:
USCIS
Attn: I-601A
131 S. Dearborn, 3rd Floor
Chicago, IL 60603-5517

We will reject your form if any of the following are missing:

• Part 1 – Information About You
  • Alien Registration Number (A-Number) (if any)
  • Family Name
  • Your U.S Physical Address
  • Date of Birth
  • Country of Birth
• Part 3 – Information About Your Immigrant Visa Case
  • Basis on which you are immigrating to the United States (1.a. – 1.e.)
  • DOS Diversity Visa Case Number (KCC Case Number) (if applicable)
  • USCIS receipt number for your approved immigrant visa petition (Form I-130, I-140 or I-360) (if applicable)
  • DOS Consular Case Number (NVC Case Number) (if applicable)

Filing Tips for Form I-601A, Application for Provisional Unlawful Presence Waiver

Include all required supporting documentation and evidence listed in the form instructions, including:

• Evidence that you are the beneficiary of an approved immigrant visa petition, Diversity Visa Program selectee, or derivative including:
  • A copy of your DOS immigrant visa processing fee receipt (IV Fee Payment Receipt). The fee receipt must show that the fee has been paid in full. Documents such as the Immigrant Visa Application Processing Fee Bill Invoice, Affidavit of Support (AOS) Fee receipt or a receipt showing the payment is in process are not sufficient and could cause delays in processing your case. See the National Visa Center website at nvc.state.gov to learn how to obtain your immigrant visa fee receipt.

Or

• A printout from the Electronic Diversity Visa Entrant Status Check page at dvlottery.state.gov confirming that you are a DV Program selectee or derivative.
  • If you have any attachments, make sure your name and either your A-Number or Forms I-130, I-140 or I-360 receipt number are on every page.

Don’t forget to sign your form! We will reject any unsigned form.

$630. If you are younger than 79, you must also pay $85 for biometric services. You may pay the fee with a money order, personal check, or cashier’s check.  When filing at a USCIS Lockbox facility, you may also pay by credit card using Form G-1450, Authorization for Credit Card Transactions. If you pay by check, you must make your check payable to the U.S. Department of Homeland Security. Please note that service centers are not able to process credit card payments.

Please do not submit this checklist with your Form I-601A. It is an optional tool to use as you prepare your form, but does not replace statutory, regulatory, and form instruction requirements. We recommend that you review these requirements before completing and submitting your form. Do not send original documents unless specifically requested in the form instructions or applicable regulations.

If you submit any documents (copies or original documents, if requested) in a foreign language, you must include a full English translation along with a certification from the translator verifying that the translation is complete and accurate, and that they are competent to translate from the foreign language to English.

Did you provide the following?

• Your immigrant visa petition approval notice or Department of State (DOS) Electronic Diversity Visa Entrant Status Check printout (if applicable)
• A copy of your Department of Justice EOIR Administrative Closure Order (if applicable)
• A copy of your Form I-797, Notice of Action, showing we approved your  Form I-212, Application for Permission to Reapply for Admission into the United States After Deportation or Removal (if applicable)
• Your DOS Immigrant Visa Processing Fee Receipt (for immediate relatives, family-sponsored, and employment-based immigrant visa applicants)
• Evidence of your relationship to your qualifying relative (if applicable)
• Evidence of U.S. citizenship or lawful permanent resident status of your qualifying relative (if applicable)
• Evidence of your admission or parole
• Evidence of extreme hardship 
• Evidence your case warrants a favorable exercise of discretion
   

E-Notification: If you want to receive an email and/or text message that your Form I-212 has been accepted at a USCIS Lockbox facility, complete Form G-1145, E-Notification of Application/Petition Acceptance, and clip it to the first page of your application.