Permanent Resident Cancellation of Removal Application Form
Share information about your residency and removal proceedings so your case can be reviewed. This is an initial intake form, not a government filing.
Applicant Information
Full Legal Name
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Contact Information (Email, Phone Number, and Mailing Address)
*
Residency and Immigration History
Date and place you became a lawful permanent resident
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U.S. residence history, including places and dates relevant to continuous residence
*
Removal Proceedings
Current Removal Proceedings
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Prior Immigration History
*
Eligibility Information
Criminal or Other Relevant History (include dates and outcomes, or state “None”)
Qualifying Relatives and Hardship (identify relatives and relationships, and describe relevant hardship information)
Supporting Materials
Supporting Documents (Upload redacted copies; do not include unredacted sensitive personal or financial identifiers)
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