Form EOIR-42B: Application for Cancellation of Removal and Adjustment of Status for Certain Nonpermanent Residents

Do not leave any questions unanswered or blank. If any questions do not apply to you, write "none" or "not applicable" in the appropriate space.

In 16, list the locations in the United States where you have resided, with Street and Number, Apt. or Room #, City or Town, State, Zip Code, Resided From and Resided To (Month, Day, Year). List the PRESENT ADDRESS FIRST, and work back in time for at least 10 years.

In 17, check all that apply: your removal would result in exceptional and extremely unusual hardship to your spouse, father, mother or child/children, who is a UNITED STATES CITIZEN or LAWFUL PERMANENT RESIDENT.

Check the box if you, or your child, have been battered or subject to extreme cruelty by a United States citizen or lawful permanent resident spouse or parent.

Enter (Month, Day, Year) after "I have resided in the United States since", with the exception of absences described in question #23.

In 23, list all departures from and returns to the United States regardless of how briefly you were absent from the United States. If you have never departed from the United States since your original date of entry, please mark an X in this box.

Unless you are incarcerated or detained in a facility which prevents your compliance with this instruction, you must submit two glossy, unretouched, color photographs of yourself taken within 30 days of the date of this application. These photos must have a white background and must not be mounted.

Part 8 is the signature of the person preparing the form, if other than the applicant.

Under B, you have been battered or subjected to extreme cruelty in the United States by your United States citizen or lawful permanent resident spouse or parent, or you are the parent of a child of a United States citizen or lawful permanent resident and the child has been battered or subjected to extreme cruelty in the United States by such citizen or lawful permanent resident parent.

Under B, prior to the service of the Notice to Appear, you have maintained continuous physical presence in the United States for three (3) years or more and you have been a person of good moral character as defined in section 101(f) of the INA during such period.

Under B, you are not inadmissible under sections 212(a)(2) or 212(a)(3) of the INA, you are not deportable under section 237(a)(1)(G) or sections 237(a)(2)-(4) of the INA, and you have not been convicted of an aggravated felony as defined under the INA.

Under B, your removal would result in extreme hardship to you or your child who is the child of a United States citizen or lawful permanent resident; or you are a child whose removal would result in extreme hardship to you or your parent.

Under B, you are deserving of a favorable exercise of discretion on your application.

You must first comply with the DHS instructions for providing biometric and biographic information to USCIS, which involves sending a copy of the application to the appropriate USCIS Service Center.

You must then serve the documents for Form EOIR-42B on the Assistant Chief Counsel for DHS, U.S. Immigration and Customs Enforcement (ICE).

Before you file your Form EOIR-42B with the Immigration Court, you must pay the required $100 filing fee and the biometrics fee to the DHS (checked October 20, 2026). If you are unable to pay the filing fee, you may ask the Immigration Judge to permit you to file your Form EOIR-42B without fee (fee waiver).

Presenting false answers or false documents may subject you to criminal prosecution under 18 U.S.C. section 1546 and/or subject you to civil penalties under 8 U.S.C. section 1324c if you submit your application knowing that the application, or any supporting document, contains any false statement with respect to a material fact, or if you swear or affirm that the contents of your application and the supporting documents are true, knowing that the application or any supporting documents contain any false statement with respect to a material fact. If convicted, you could be fined up to $250,000, imprisoned for up to ten (10) years, or both (checked October 20, 2026).

You are not eligible for cancellation of removal under section 240A(b)(1) of the INA if you entered the United States as a crewman after June 30, 1964. Or you were admitted to the United States as, or later became, a nonimmigrant exchange alien as defined in section 101(a)(15)(J) of the INA in order to receive graduate medical education or training, regardless of whether you are subject to or have fulfilled the 2-year foreign residence requirement of section 212(e) of the INA. Were admitted to the United States as, or later became, a nonimmigrant exchange alien as defined in section 101(a)(15)(J) of the INA, other than to receive graduate medical education or training, and are subject to the 2-year foreign residence requirement of section 212(e) of the INA, but have neither fulfilled nor obtained a waiver of that requirement. Or you are an alien who is either inadmissible under section 212(a)(3) of the INA or deportable under section 237(a)(4) of the INA. Are an alien who ordered, incited, assisted, or otherwise participated in the persecution of an individual because of the individual's race, religion, nationality, membership in a particular social group, or political opinion. Or you are an alien who was previously granted relief under section 244(a) of the INA, or section 212(c) of the INA as such sections were in effect prior to the enactment of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, whose removal has previously been cancelled under section 240A of the INA.