Application for Suspension of Deportation or Special Rule Cancellation of Removal (Pursuant to Section 203 of Public Law 105-100 (NACARA))

• Legal Form Number: I-881
• Section: Citizenship and Immigration Services (United States of America)
• Issuer: Citizenship and Immigration Services (United States of America)

Page 1 of 15Form I-881 Edition 12/02/21

Application for Suspension of Deportation or

Special Rule Cancellation of Removal

(Pursuant to Section 203 of Public Law 105-100, NACARA)

Department of Homeland Security

U.S. Citizenship and Immigration Services

USCIS

Form I-881

OMB No. 1615-0072

Expires 12/31/2023

For

USCIS

Use

Only

EOIR ActionsDecisionReturned

Granted suspension of deportation or

special rule cancellation of removal and

adjustment of status

Receipt

Resubmitted

Reloc Sent

Reloc Rec'd

Referred to Immigration Judge in

accordance with 8 CFR Section 240.70

(Adjudicating Officer's Signature)

(Office Location)(Date of Action)

To be completed by an

Attorney or Accredited

Representative (if any).

Attorney State Bar Number

(if applicable) Attorney or Accredited Representative

USCIS Online Account Number (if any)

Select this box if

Form G-28 is

attached.

Part 1. Information About You

START HERE - Type or print in black ink.►

1.b.

1.c.

1.a. Family Name

(Last Name)

Given Name

(First Name)

Middle Name

Your Current Legal Name

Other Names You Have Used Since Birth

(if applicable)

Provide all other names you have ever been known by or used,

including aliases, maiden name, and nicknames. Make sure to

include all variations of your name as it appears on identity

documents, passports, birth certificates, bank loan documents,

etc. If you need extra space to complete this section, use the

space provided in Part 15. Additional Information.

2.b.

2.c.

2.a. Family Name

(Last Name)

Given Name

(First Name)

Middle Name

3.b.

3.c.

3.a. Family Name

(Last Name)

Given Name

(First Name)

Middle Name

U.S. Mailing Address

4.d. City or Town

4.e. State 4.f. ZIP Code

Street Number

and Name

4.b.

4.c. Flr.Apt. Ste.

4.a. In Care Of Name (if any)

Other Information About You

Date of Birth (mm/dd/yyyy)5.

6. Gender Male Female

7. City or Town of Birth

Country of Birth

8.

Alien Registration Number (A-Number/USCIS Number)

(if any)

10.

A-

Country of Citizenship or Nationality

9.

USCIS Online Account Number (if any)11.

►