[Beneficiary’s Name]

[Beneficiary’s Address]
Mobile No: [XXXXXXX]
E-mail: ____________

[Date]

United States Department of Homeland Security

US Citizenship and Immigration Services

Nature of Submission:
 I-485 Immediate Relative (Spouse) Family Based Adjustment of Status

Filing concurrently:
 I-765 Application for Employment Authorization
 I-131 Application for Travel Document (Advance Parole)

To whom it may concern:

I entered the United States of America with a K1 visa last [Date of Entry]. My port of entry was [Port of
Entry Place]. I am now applying for Adjustment of Status based on marriage to [Name of Petitioner], a US
citizen. We were married on [Date of Marriage] here in [Place of Marriage].

Please find enclosed forms I-485, I-765 and I-131 with their corresponding supporting documents.

I-485 Form and Supporting Documents

Immediate Relative (Spouse) Family Based Adjustment of Status

1. Payment in the amount of US$ 1,225 (Filing fee + Biometrics fee)

2. Form G-1145
3. Duly accomplished I-485 form
4. Copy of I-797, Notice of Approval for the I-129F petition and NVC acceptance letter
5. Certified copy of marriage certificate
6. Copy of birth certificate
7. Copy of biographic page of passport
8. Copy of K1 visa page
9. Copy of Form I-94, Arrival-Departure Record
10. (2) 2”X 2” size colored photos with name and A# at the back
11. Copy of Vaccination Documentation Worksheet, Form DS-3025
12. Sealed envelope for the Form I-693 signed by a USCIS recommended civil surgeon
13. Duly accomplished form I-864, Affidavit of support from my husband along with the following
documents:
a. Employment letter
b. Recent three (3) months paystubs
c. Copies of Form 1040 for the past three (3) years
d. Copies of W2’s for years the past three (3) years
e. Copies of IRS tax transcripts for the past three (3) years
 f. Biographic page of passport of petitioner
g. Copy of birth certificate of the petitioner

I-765 Form and Supporting Documents

Application for Employment Authorization

1. Form G-1145
2. Duly accomplished I-765 form
3. Copy of biographic page of passport
4. Copy of K1 visa page and form I-94 (front and back)
5. Certified copy of marriage certificate
6. (2) 2”X 2” size colored photos with name and A# at the back

I-131 Form and Supporting Documents

Application for Travel Document (Advance Parole)

1. Form G-1145
2. Duly accomplished I-131 form
3. Copy of biographic page of passport
4. Copy of K1 visa page and form I-94 (front and back)
5. Certified copy of marriage certificate
6. (2) 2”X 2” size colored photos with name and A# at the back

Copies of documents submitted are exact photocopies of unaltered documents and I understand that I
may be requested to submit original documents to an Immigration Officer if requested

Sincerely yours,

[Beneficiary’s Signature]
[Beneficiary’s Name]
The Applicant