Form I-485 Instructions 04/01/24 Page 9 of 41
For Part 8., Item Number 67., please list all of your certications, licenses, skills obtained through work experience,
and educational certicates. This includes but is not limited to your workforce skills, training, licenses for specic
occupations or professions, foreign language skills, and certicates documenting mastery or apprenticeships in skilled
trades or professions. Educational certicates are issued by an educational institution (or a training provider) and
certify that an occupation specic program of study was completed.
If you answer “Yes” to Part 8., Item Number 68.a., complete the table in Part 8., Item Number 68.c., showing the
dates of receipt and dollar amount received of public cash assistance for income maintenance: Supplemental Security
Income (SSI); Temporary Assistance for Needy Families (TANF); State, Tribal, territorial, or local cash benet
programs for income maintenance (often called “General Assistance” in the State context, but which also exist under
other names).
NOTE: Item Numbers 68.a. - 68.d. are only asking about public benets (in other words, public cash assistance
for income maintenance and long-term institutionalization at government expense) you received in the past or are
currently receiving at the time the Form I-485 is led, and where you were/are a listed beneciary. Do not include
any public benets for which you are not listed as a beneciary, even if you assisted with the application. Do not
include benets that you only applied for, or were approved to receive in the future but have not received in the past
and/or are not currently receiving. Do not include public benets you received only on behalf of another individual.
If you answer “Yes” to Part 8., Item Number 68.b., complete the table Part 8., Item Number 68.d. showing the
name, city, and state of each institution in which you received long-term institutionalization at government expense.
Do not include imprisonment for conviction of a crime or institutionalization for short periods for rehabilitation
purposes. If you believe that your institutionalization violated Federal law, including the American Disabilities Act or
the Rehabilitation Act, you must submit documentation to support your claim.
For more information on the receipt of public benets and its impact on public charge
inadmissibility determinations, please see USCIS Policy Manual Volume 8, Part G, at
https://www.uscis.gov/policy-manual/volume-8-part-g and the Public Charge Resources web content at
https://www.uscis.gov/green-card/green-card-processes-and-procedures/public-charge/public-charge-resources.
11. Part 10. Applicant’s Statement, Contact Information, Declaration, Certication, and Signature. Select the
appropriate box to indicate whether you read this application yourself or whether you had an interpreter assist you.
If someone assisted you in completing the application, select the box indicating that you used a preparer. Further,
you must sign and date your application and provide your daytime telephone number, mobile telephone number (if
any), and email address (if any). Every application MUST contain the signature of the applicant (or parent or legal
guardian, if applicable). A stamped or typewritten name in place of a signature is not acceptable.
12. Part 11. Interpreter’s Contact Information, Certication, and Signature. If you used anyone as an interpreter
to read the Instructions and questions on this application to you in a language in which you are uent, the interpreter
must ll out this section, provide his or her name, the name and address of his or her business or organization (if any),
his or her daytime telephone number, his or her mobile telephone number (if any), and his or her email address (if
any). The interpreter must sign and date the application.
13. Part 12. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other
Than the Applicant. This section must contain the signature of the person who completed your application, if
other than you, the applicant. If the same individual acted as your interpreter and your preparer, that person should
complete both Part 11. and Part 12. If the person who completed this application is associated with a business or
organization, that person should complete the business or organization name and address information. Anyone who
helped you complete this application MUST sign and date the application. A stamped or typewritten name in place
of a signature is not acceptable. If the person who helped you prepare your application is an attorney or accredited
representative, he or she may be obliged to also submit a completed Form G-28, Notice of Entry of Appearance as
Attorney or Accredited Representative, along with your application.