Application by Refugee for Waiver of Inadmissibility Grounds

• Legal Form Number: I-602
• Section: Citizenship and Immigration Services (United States of America)
• Issuer: Citizenship and Immigration Services (United States of America)

Form I-602 Edition 08/08/22 Page 1 of 10

Application by Refugee for

Waiver of Inadmissibility Grounds

Department of Homeland Security

U.S. Citizenship and Immigration Services

USCIS

Form I-602

OMB No. 1615-0069

Expires 08/31/2024

START HERE - Type or print in black ink.►

Attorney State Bar Number

(if applicable)

Select this box if

Form G-28 or

Form G-28I is

attached.

Attorney or Accredited Representative

USCIS Online Account Number (if any)

Part 1. Information About You

Your Full Legal Name

1.a.

1.b.

1.c.

Family Name (Last Name)

Given Name (First Name)

Middle Name

Relocated Received/Sent

ResubmittedInitial Receipt Action Block

Refugee status under INA 207

Adjustment of status as a refugee/asylee under INA 209 INA 212(a)(2) INA 212(a)(8)

INA 212(a)(1)

Benefits Category:

INA 212(a)(3) INA 212(a)(9)

INA 212(a)(10)

INA 212(a)(6)

Other:

For USCIS Use Only

Inadmissible Under

Place of Birth

2.a.

2.b.

2.c.

City or Town of Birth

State or Province of Birth

Country of Birth

Mailing Address

3.b.

3.c.

3.d.

3.e.

3.g.

3.i.

3.h.

3.a.

City or Town

Province

Country

Postal Code

ZIP Code3.f.State

Street Number

and Name

Apt. Ste. Flr.

In Care Of Name (if any)

NoYes

Is your current mailing address the same as your physical

address?

4.

If you answered “No” to Item Number 4., provide your

physical address in Item Numbers 5.a. - 5.h.

To be completed by an

Attorney or Accredited

Representative (if any).

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