I-612, Application for Waiver of the Foreign Residence Requirement (under Section 212(e) of the Immigration and Nationality Act, as Amended)

Purpose of Form

J-1 and J-2 visas holders and their families may use this form to apply for a waiver of the two-year foreign residence requirement.

Number of Pages

Form 7; Instructions 7.

Edition Date

04/24/17. Starting 07/24/2017, we will only accept the 04/24/17 edition. Until then, you can use the 12/23/16 edition. You can find the edition date at the bottom of the page on the form and instructions.

Where to File

If You Are Filing Form I-612 Because Of:	Mail Your Form To:
Exceptional hardship to your U.S. citizen or lawful permanent resident spouse or child; or Your belief that returning your country of nationality or last residence would subject you to persecution on account of race, religion, or political opinion	For U.S. Postal Service: USCIS California Service Center I-612 Unit P.O. Box 30112 Laguna Niguel, CA 92607-0112 For express or courier delivery: USCIS California Service Center 24000 Avila Rd. 2nd Floor, Room 2312 Laguna Niguel, CA 92677
You received a request from an interested U.S. government agency; You received a written statement from your country of nationality or last foreign residence that it has no objection to the waiver; or A state department’s department of public health, or its equivalent, sent a request to the U.S. Department of State for you to work in a medically underserved area (Conrad Waiver Program)	The address listed on the Department of State’s website.

If You Are Filing Form I-612 Because Of:

Mail Your Form To:

Exceptional hardship to your U.S. citizen or lawful permanent resident spouse or child; or
Your belief that returning your country of nationality or last residence would subject you to persecution on account of race, religion, or political opinion

For U.S. Postal Service:

USCIS California Service Center
I-612 Unit
P.O. Box 30112
Laguna Niguel, CA 92607-0112

For express or courier delivery:

USCIS California Service Center
24000 Avila Rd.
2nd Floor, Room 2312
Laguna Niguel, CA 92677

You received a request from an interested U.S. government agency;
You received a written statement from your country of nationality or last foreign residence that it has no objection to the waiver; or
A state department’s department of public health, or its equivalent, sent a request to the U.S. Department of State for you to work in a medically underserved area (Conrad Waiver Program)

The address listed on the Department of State’s website.

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