USCIS · Official form

Form I-612, Application for Waiver of the Foreign Residence Requirement (Under Section 212(e) of the Immigration and Nationality Act, as Amended)

Form I-612 asks USCIS to waive the two-year home residence requirement that binds many J-1 exchange visitors, based on exceptional hardship or fear of persecution. Fill in the official PDF below and download it.

Fill out I-612 in the editor Download the blank PDF Quick fill on this page

This is the genuine USCIS PDF, unmodified. Source: USCIS official page.

What is I-612?

Form I-612 is filed by J-1 exchange visitors (and their J-2 dependents) who are subject to the two-year foreign residence requirement of INA section 212(e). That requirement obliges certain exchange visitors to return to their home country for two years before they can obtain an H or L visa, permanent residence, or a change of status. Form I-612 covers two of the waiver bases: exceptional hardship to a US citizen or lawful permanent resident spouse or child, and fear of persecution in the home country.

Other waiver bases work differently. No-objection statements, interested government agency requests, and Conrad 30 physician waivers all start with the Department of State using Form DS-3035, and USCIS acts only after the State Department makes a favorable recommendation. For the hardship and persecution bases, USCIS decides the underlying question itself through Form I-612 before the case goes to the State Department for its recommendation.

Who files I-612?

J-1 exchange visitors subject to the section 212(e) two-year home residence requirement
Applicants whose US citizen or permanent resident spouse or child would face exceptional hardship
Applicants who would face persecution on account of race, religion, or political opinion if they returned home
J-2 dependents subject to the requirement through the principal exchange visitor

How to fill out I-612

Confirm you are subject to section 212(e); your DS-2019 and visa stamp usually note it, and the Department of State can issue an advisory opinion if it is unclear.
Complete your personal information, exchange program details, and the basis for the waiver.
For a hardship waiver, document the exceptional hardship your US citizen or permanent resident spouse or child would suffer both if they relocated with you and if they stayed behind.
For a persecution waiver, document the persecution you would face on account of race, religion, or political opinion.
Download the finished PDF, sign it, and file it with the fee at the USCIS address in the current instructions. USCIS coordinates with the Department of State before a final decision.

Quick fill I-612 on this page

Prefer to see the form itself while you type? Open I-612 in the editor to fill it on the actual pages, add a signature, and download.

These are the form's own fields, in the order they appear on the pages. Fill in what you know; anything left blank stays a fillable field in the PDF, so you can finish it in any PDF reader. Nothing you type here is sent to USCIS.

Page 1 38 fields

Page 2 16 fields

Part 1. Information About You. Other Information. 14. Enter Country of Last Foreign Residence .

Part 2. Reason for Foreign Residence Requirement. I believe I am subject to the foreign residence requirement because (Select all

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. I am applying for a waiver of the foreign residence requirement

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Spouse. 3. C. Enter Middle Name.

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Spouse. 3. B. Enter Given Name (First Name.)

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. List all J-2 dependents that are included in this application.

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Spouse. 4. Enter Date of Birth. Enter as 2

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Spouse. 5. Enter Country of Birth.

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Spouse. 7. Enter Country of Last Foreign

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Spouse. 6. Enter Country of Citizenship or

Part 1. Information About You. Other Information. 12. Enter Country of Birth.

Part 1. Information About You. Other Information. 13. Enter Country of Citizenship or Nationality.

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. I am applying for a waiver of the foreign residence requirement

Page 3 36 fields

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 18. A. Enter Family Name (Last

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 18. B. Enter First Name (Given

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 18. C. Enter Middle Name.

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 8. C. Enter Middle Name.

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. If you need extra space to complete

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 8. B. Enter First Name (Given Name).

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 9. Enter Date of Birth. Enter as 2

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 10. Enter Country of Birth.

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 12. Enter Country of Last Foreign

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 11. Enter Country of Citizenship or

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 13. C. Enter Middle Name.

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 13. A. Enter Family Name (Last

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 13. B. Enter First Name (Given

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 15. Enter Country of Birth.

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 14. Enter Date of Birth. Enter as 2

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 16. Enter Country of Citizenship or

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 17. Enter Country of Last Foreign

Part 4. Additional Information About You. If you need extra space to complete this section, use the space provided in Part 8. Additional

Part 4. Additional Information About You. Major field of activity (Select only one box). 2. A. Select Agriculture.

Part 4. Additional Information About You. Major field of activity (Select only one box). 2. B. Select Business Administration.

Part 4. Additional Information About You. Major field of activity (Select only one box). 2. C. Select Education.

Part 4. Additional Information About You. Major field of activity (Select only one box). 2. F. Select Medicine.

Part 4. Additional Information About You. Major field of activity (Select only one box). 2. D. Select Engineering.

Part 4. Additional Information About You. Major field of activity (Select only one box). 2. E. Select Humanities.

Part 4. Additional Information About You. Major field of activity (Select only one box). 2. G. Select Natural and Physical Sciences.

Part 4. Additional Information About You. Major field of activity (Select only one box). 2. H. Select Social Sciences.

Part 4. Additional Information About You. Major field of activity (Select only one box). 2. I. Select Other.

Part 4. Additional Information About You. 4. Enter Date of last entry into the United States as a J-1 participant in a designated exchange

Part 4. Additional Information About You. 6. If you are now abroad, enter the date of your most recent departure from the United States.

Part 4. Additional Information About You. 3. Enter Occupation.

Part 4. Additional Information About You. 5. Port-of-Entry (P O E) of last arrival in the United States as a participant in a designated

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 20. Enter Country of Birth.

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 19. Enter Date of Birth. Enter as 2

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 21. Enter Country of Citizenship or

Part 3. Reason for Application for Waiver of Foreign Residence Requirement. Information About Children. 22. Enter Country of Last Foreign

Page 4 17 fields

Part 4. Additional Information About You. Other Information About Lawful Permanent Spouse or Child. 22. Enter Basis (preference category)

Part 4. Additional Information About You. Other Information About Lawful Permanent Spouse or Child. 20. Enter Date of adjustment to lawful

Part 4. Additional Information About You. Other Information About Lawful Permanent Spouse or Child. 21. Location where your spouse or child

Part 4. Additional Information About You. If you are married, select only one box. 7. A. Select My spouse is included in this application.

Part 4. Additional Information About You. If you are married, select only one box. 7. B. Select My spouse is filing a separate application

Part 4. Additional Information About You. If you are married, select only one box. 7. C. Select My spouse is not included in this

Part 4. Additional Information About You. If you selected Part 3., Item Number 1., provide the following information about your U.S.

Part 4. Additional Information About You. 8. B. Enter Given Name (First Name.)

Part 4. Additional Information About You. 8. C. Enter Middle Name.

Part 4. Additional Information About You. U.S. citizenship of spouse or child was acquired through (Select only one box). 9. A. Select

Part 4. Additional Information About You. U.S. citizenship of spouse or child was acquired through (Select only one box). 9. B. Select

Part 4. Additional Information About You. U.S. citizenship of spouse or child was acquired through (Select only one box). 9. C. Select

Part 4. Additional Information About You. Name of the lawful permanent resident spouse or child. 18. C. Enter Middle Name.

Part 4. Additional Information About You. Name of the lawful permanent resident spouse or child. 18. B. Enter Given Name (First Name.)

Part 4. Additional Information About You. If you answered “No” to Item Number 13., submit evidence in accordance with the What Evidence

Part 4. Additional Information About You. Other Information About Lawful Permanent Spouse or Child. 19. Enter Alien Registration Number (A.

Page 5 23 fields

Part 5. Applicant's Statement, Contact Information, Declaration, Certification, and Signature. Applicant's Statement. 1. B. Select The

Part 5. Applicant's Statement, Contact Information, Declaration, Certification, and Signature. NOTE: Read the Penalties section of the Form

Part 5. Applicant's Statement, Contact Information, Declaration, Certification, and Signature. Applicant's Statement. 2. Select At my

Part 5. Applicant's Statement, Contact Information, Declaration, Certification, and Signature. Applicant's Contact Information. 3. Enter

Part 5. Applicant's Statement, Contact Information, Declaration, Certification, and Signature. Applicant's Contact Information. 5. Enter

Part 5. Applicant's Statement, Contact Information, Declaration, Certification, and Signature. Applicant's Contact Information. 4. Enter

Part 5. Applicant's Statement, Contact Information, Declaration, Certification, and Signature. Applicant's Signature. 6. B. Enter Date of

Part 6. Interpreter's Contact Information, Certification, and Signature. Provide the following information about the interpreter.

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Full Name. 1. B. Enter Interpreter's Given Name

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Full Name. 2. Enter Interpreter's Business or

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address. 3. C. Enter City or Town.

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address. 3. A. Enter Street Number and Name.

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address. 3. B. Select Suite.

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address. 3. B. Select Floor.

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address. 3. B. Select Apartment.

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address. 3. F. Enter Province.

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address. 3. E. Enter Zip Code.

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address. 3. D. Select State from List of

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address. 3. H. Enter Country.

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Mailing Address. 3. G. Enter Postal Code.

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Contact Information. 4. Enter Interpreter's Daytime

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Contact Information. 6. Enter Interpreter's Email

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Contact Information. 5. Enter Interpreter's Mobile

Page 6 21 fields

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Signature. 6. B. Enter Date of Signature. Enter as 2

Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Certification. I certify, under penalty of perjury,

Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant. Preparer's

Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant. Provide the

Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant. Preparer's

Page 7 20 fields

Part 8. Additional Information. 3. D. Enter Additional Information.

Part 8. Additional Information. 3. A. Enter Page Number.

Part 8. Additional Information. 3. B. Enter Part Number.

Part 8. Additional Information. 3. C. Enter Item Number.

Part 8. Additional Information. 4. D. Enter Additional Information.

Part 8. Additional Information. 4. A. Enter Page Number.

Part 8. Additional Information. 4. B. Enter Part Number.

Part 8. Additional Information. 4. C. Enter Item Number.

Part 8. Additional Information. 5. D. Enter Additional Information.

Part 8. Additional Information. 5. A. Enter Page Number.

Part 8. Additional Information. 5. B. Enter Part Number.

Part 8. Additional Information. 5. C. Enter Item Number.

Part 8. Additional Information. 6. D. Enter Additional Information.

Part 8. Additional Information. 7. C. Enter Item Number.

Part 8. Additional Information. 7. B. Enter Part Number.

Part 8. Additional Information. 7. A. Enter Page Number.

Part 8. Additional Information. 7. D. Enter Additional Information.

Part 8. Additional Information. 6. A. Enter Page Number.

Part 8. Additional Information. 6. B. Enter Part Number.

Part 8. Additional Information. 6. C. Enter Item Number.

Lock the PDF after filling (values become permanent, fields are removed)

Processed on our own servers, never sent to a third-party service. Files are deleted automatically after two hours, and you can delete them sooner from the result screen.

Frequently asked questions

Do I use Form I-612 for a no-objection waiver?

No. No-objection, interested government agency, and Conrad 30 waivers start with the Department of State using Form DS-3035. Form I-612 is only for the exceptional hardship and persecution bases, which USCIS itself adjudicates.

What does exceptional hardship mean for a J-1 waiver?

Hardship clearly beyond the ordinary disruption of a two-year separation or relocation. Officers look at medical, financial, psychological, and country-condition evidence affecting your US citizen or permanent resident spouse or child in both scenarios: going with you or staying behind.

How do I know if I am subject to the two-year rule?

Check your Form DS-2019 and J-1 visa stamp for a 212(e) annotation. Funding from your home government or the US government, or skills on your country’s skills list, commonly trigger it. The Department of State can issue an advisory opinion if the annotation is missing or wrong.

Form I-612, Application for Waiver of the Foreign Residence Requirement (Under Section 212(e) of the Immigration and Nationality Act, as Amended)

What is I-612?

Who files I-612?

How to fill out I-612

Quick fill I-612 on this page

Frequently asked questions

Related forms

Form I-539, Application to Extend/Change Nonimmigrant Status

Form I-485, Application to Register Permanent Residence or Adjust Status

Form I-601, Application for Waiver of Grounds of Inadmissibility