TI-485: Application to Register Tribal Membership

General Eligibility and Inadmissibility Grounds

Have you EVER been a member of, involved in, or in any way associated with any organization, association, fund, foundation, party, club, society, or similar group in the Tribal Nations or in any other location in the worldincluding any military service?

Yes
No

If you answered "Yes", complete Items below.

Name of Organization 1

Organization 1 Location

City State / Province / Region Country

Nature of Group

Dates of Membership or Dates of Involvement

From (mm/dd/yyyy)

MM

DD

YYYY

To (mm/dd/yyyy)

MM

DD

YYYY

Name of Organization 2

Organization 2 Location

City State / Province / Region Country

Nature of Group

Dates of Membership or Dates of Involvement

From (mm/dd/yyyy)

MM

DD

YYYY

To (mm/dd/yyyy)

MM

DD

YYYY

Name of Organization 3

Organization 3 Location

City State / Province / Region Country

Nature of Group

Dates of Membership or Dates of Involvement

From (mm/dd/yyyy)

MM

DD

YYYY

To (mm/dd/yyyy)

MM

DD

YYYY

Choose the answer that you think is correct. If you answer “Yes” to any questions (or if you answer "No," but are unsure of your answer), provide an explanation of the events and circumstances in the space provided

Have you EVER been denied admission to the Tribal Nations?*

Yes
No

Explanation

Have you EVER been denied a visa to the Tribal Nations?*

Yes
No

Explanation

Have you EVER violated the terms or conditions of your temporary tribal status?*

Yes
No

Explanation

Are you presently or have you EVER been in removal proceedings?*

Yes
No

Explanation

Have you EVER been issued a final order of removal?*

Yes
No

Explanation

Have you EVER had a prior final order of removal reinstated?*

Yes
No

Explanation

Have you EVER held tribal membership status which was later rescinded?*

Yes
No

Explanation

Have you EVER been granted voluntary departure by an immigration officer or an immigration judge but failed to depart within the allotted time?*

Yes
No

Explanation

Have you EVER applied for any kind of relief or protection from removal?*

Yes
No

Explanation

Criminal Acts and Violations

For the next section, you must answer "Yes" to any question that applies to you, even if your records were sealed or otherwise cleared, or even if anyone, including a judge, law enforcement officer, or attorney, told you that you no longer have a record. You must also answer "Yes" to the following questions whether the action or offense occurred here in the Tribal Nations or anywhere else in the world. If you answer "Yes", use the space provided for explanation. Additional Information to provide an explanation that includes why you were arrested, cited, detained, or charged; where you were arrested, cited, detained, or charged; when (date) the event occurred; and the outcome or disposition (for example, no charges filed, charges dismissed, jail, probation, community service).

Have you EVER been arrested, cited, charged, or detained for any reason by any law enforcement official (including but not limited to any U.S. immigration official or any official of the U.S. armed forces or U.S. Coast Guard)?*

Yes
No

Explanation

Have you EVER committed a crime of any kind (even if you were not arrested, cited, charged with, or tried for that crime)?*

Yes
No

Explanation

Have you EVER pled guilty to or been convicted of a crime or offense (even if the violation was subsequently expunged or sealed by a court, or if you were granted a pardon, amnesty, a rehabilitation decree, or other act of clemency)?*

Yes
No

NOTE: If you were the beneficiary of a pardon, amnesty, a rehabilitation decree, or other act of clemency, provide documentation of that post-conviction action

Explanation

Have you EVER been ordered punished by a judge or had conditions imposed on you that restrained your liberty (such as a prison sentence, suspended sentence, house arrest, parole, alternative sentencing, drug or alcohol treatment, rehabilitative programs or classes, probation, or community service)?*

Yes
No

Explanation

Have you EVER been a defendant or the accused in a criminal proceeding (including pre-trial diversion, deferred prosecution, deferred adjudication, or any withheld adjudication)?*

Yes
No

Explanation

Have you EVER violated (or attempted or conspired to violate) any controlled substance law or regulation of a state, the Tribal Nations, or a foreign country?*

Yes
No

Explanation

Have you EVER been convicted of two or more offenses (other than purely political offenses) for which the combined sentences to confinement were five years or more?*

Yes
No

Explanation

Have you EVER illicitly (illegally) trafficked or benefited from the trafficking of any controlled substances, such as chemicals, illegal drugs, or narcotics?*

Yes
No

Explanation

Have you EVER knowingly aided, abetted, assisted, conspired, or colluded in the illicit trafficking of any illegal narcotic or other controlled substances?*

Yes
No

Explanation

Are you the spouse, son, or daughter of a foreign national who illicitly trafficked or aided (or otherwise abetted, assisted, conspired, or colluded) in the illicit trafficking of a controlled substance, such as chemicals, illegal drugs, or narcotics and you obtained, within the last five years, any financial or other benefit from the illegal activity of your spouse or parent, although you knew or reasonably should have known that the financial or other benefit resulted from the illicit activity of your spouse or parent?*

Yes
No

Explanation

Have you EVER engaged in prostitution or are you coming to the Tribal Nations to engage in prostitution?*

Yes
No

Explanation

Have you EVER directly or indirectly procured (or attempted to procure) or imported prostitutes or persons for the purpose of prostitution?*

Yes
No

Explanation

Have you EVER received any proceeds or money from prostitution?*

Yes
No

Explanation

Do you intend to engage in illegal gambling or any other form of commercialized vice, such as prostitution, bootlegging, or the sale of child pornography, while in the Tribal Nations?*

Yes
No

Explanation

Have you EVER exercised immunity (diplomatic or otherwise) to avoid being prosecuted for a criminal offense in the Tribal Nations?*

Yes
No

Explanation

Have you EVER, while serving as a foreign government official, been responsible for or directly carried out violations of religious freedoms?*

Yes
No

Explanation

Have you EVER induced by force, fraud, or coercion (or otherwise been involved in) the trafficking of persons for commercial sex acts?*

Yes
No

Explanation

Have you EVER trafficked a person into involuntary servitude, peonage, debt bondage, or slavery? Trafficking includes recruiting, harboring, transporting, providing, or obtaining a person for labor or services through the use of force, fraud, or coercion.*

Yes
No

Explanation

Have you EVER knowingly aided, abetted, assisted, conspired, or colluded with others in trafficking persons for commercial sex acts or involuntary servitude, peonage, debt bondage, or slavery?*

Yes
No

Explanation

Are you the spouse, son or daughter of a foreign national who engaged in the trafficking of persons and have received or obtained, within the last five years, any financial or other benefits from the illicit activity of your spouse or your parent, although you knew or reasonably should have known that this benefit resulted from the illicit activity of your spouse or parent?

Yes
No

Explanation

Have you EVER engaged in money laundering or have you EVER knowingly aided, assisted, conspired, or colluded with others in money laundering or do you seek to enter the Tribal Nations to engage in such activity?*

Yes
No

Explanation

Security and Related

Do you intend to:

Engage in any activity that violates or evades any law relating to espionage (including spying) or sabotage in the Tribal Nations?*

Yes
No

Explanation

Engage in any activity in the Tribal Nations that violates or evades any law prohibiting the export from the Tribal Nations of goods, technology, or sensitive information?*

Yes
No

Explanation

Engage in any activity whose purpose includes opposing, controlling, or overthrowing the Tribal Nations by force, violence, or other unlawful means while in the Tribal Nations*

Yes
No

Explanation

Engage in any other unlawful activity?*

Yes
No

Explanation

Are you engaged in or, upon your entry into the Tribal Nations, do you intend to engage in any activity that could have potentially serious adverse foreign policy consequences for the Tribal Nations?*

Yes
No

Explanation

Have you EVER:

Committed, threatened to commit, attempted to commit, conspired to commit, incited, endorsed, advocated, planned, or prepared any of the following: hijacking, Sabotage, kidnapping, political assassination, or use of a weapon or explosive to harm another individual or cause substantial damage to property?*

Yes
No

Explanation

Recruited members or asked for money or things of value for a group or organization that did any of the activities?*

Yes
No

Explanation

Provided money, a thing of value, services or labor, or any other assistance or support for any of the activities?*

Yes
No

Explanation

Provided money, a thing of value, services or labor, or any other assistance or support for an individual, group, or organization who did any of the activities?*

Yes
No

Explanation

Have you EVER received any type of military, paramilitary, or weapons training?*

Yes
No

Explanation

Do you intend to engage in any of the activities listed?*

Yes
No

Explanation

NOTE: If you answered “Yes” to any part of the previous questions in this section, explain what you did, including the dates and location of the circumstances, or what you intend to do in the space provided.

Are you the spouse or child of an individual who EVER:

Committed, threatened to commit, attempted to commit, conspired to commit, incited, endorsed, advocated, planned, or prepared any of the following: hijacking, sabotage, kidnapping, political assassination, or use of a weapon or explosive to harm another individual or cause substantial damage to property?*

Yes
No

Explanation

Participated in, or been a member or a representative of a group or organization that did any of the activities described above?*

Yes
No

Explanation

Recruited members, or asked for money or things of value, for a group or organization that did any of the activities described above?*

Yes
No

Explanation

Provided money, a thing of value, services or labor, or any other assistance or support for any of the activities described above?*

Yes
No

Explanation

Provided money, a thing of value, services or labor, or any other assistance or support to an individual, group, or organization who did any of the activities described above?*

Yes
No

Explanation

Received any type of military, paramilitary, or weapons training from a group or organization that did any of the activities described above?*

Yes
No

Explanation

NOTE: If you answered “Yes” to any part of the previous section, explain the relationship and what occurred, including the dates and location of the circumstances, in the space provided below.

Have you EVER assisted or participated in selling, providing, or transporting weapons to any person who, to your knowledge, used them against another person?*

Yes
No

Explanation

Have you EVER worked, volunteered, or otherwise served in any prison, jail, prison camp, detention facility, labor camp, or any other situation that involved detaining persons?*

Yes
No

Explanation

Have you EVER been a member of, assisted, or participated in any group, unit, or organization of any kind in which you or other persons used any type of weapon against any person or threatened to do so?*

Yes
No

Explanation

Have you EVER served in, been a member of, assisted, or participated in any military unit, paramilitary unit, police unit, self-defense unit, vigilante unit, rebel group, guerilla group, militia, insurgent organization, or any other armed group?*

Yes
No

Explanation

Have you EVER been a member of, or in any way affiliated with, the Communist Party or any other totalitarian party (in the Tribal Nations or abroad)?*

Yes
No

Explanation

During the period from March 23, 1933 to May 8, 1945, did you ever order, incite, assist, or otherwise participate in the persecution of any person because of race, religion, national origin, or political opinion, in association with either the Nazi government of Germany or any organization or government associated or allied with the Nazi government of Germany?*

Yes
No

Explanation

Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following:

Acts involving torture or genocide?*

Yes
No

Explanation

Killing any person?*

Yes
No

Explanation

Intentionally and severely injuring any person?*

Yes
No

Explanation

Engaging in any kind of sexual contact or relations with any person who did not consent or was unable to consent, or was being forced or threatened?*

Yes
No

Explanation

Limiting or denying any person's ability to exercise religious beliefs?*

Yes
No

Explanation

Have you EVER recruited, enlisted, conscripted, or used any person under 15 years of age to serve in or help an armed force or group?*

Yes
No

Explanation

Have you EVER used any person under 15 years of age to take part in hostilities, or to help or provide services to people in combat?*

Yes
No

Explanation

You may need to file Form NI-864..
I am EXEMPT from filing Form NI-864 because:

I have filed an Economic Tribal Membership Petition by Newcomer Investor*

Yes
No

Illegal Entries and Other Immigration Violations

Have you EVER failed or refused to attend or to remain in attendance at any removal proceeding filed against you on or after April 1, 1997?*

Yes
No

If your answer to "Yes," to the previous quesion, do you believe you had reasonable cause?*

Yes
No

If your answer to the previous question is "Yes," attach a written statement explaining why you had reasonable cause.

Have you EVER submitted fraudulent or counterfeit documentation to any Tribal Nation Government official to obtain or attempt to obtain any immigration benefit, including a visa or entry into the Tribal Nations?*

Yes
No

Have you EVER falsely claimed to be a Tribal Nation citizen (in writing or any other way)?*

Yes
No

Have you EVER been a stowaway on a vessel or aircraft arriving in a Tribal Nation?*

Yes
No

Are you under a final order of civil penalty for violating INA section 274C for use of fraudulent documents?*

Yes
No

Removal, Unlawful Presence, or Illegal Reentry After Previous Immigration Violations

Have you EVER been excluded, deported, or removed from the Tribal Nations or have you ever departed the Tribal Nations on your own after having been ordered excluded, deported, or removed from the Tribal Nations?*

Yes
No

Have you EVER entered the Tribal Nations without being inspected and admitted or paroled?*

Yes
No

Since April 1, 1997, have you been unlawfully present in the Tribal Nations:

For more than 180 days but less than a year, and then departed the Tribal Nations?*

Yes
No

For one year or more and then departed the Tribal Nations?*

Yes
No

NOTE: You were unlawfully present in the Tribal Nations if you entered the Tribal Nations without being inspected and admitted or inspected and paroled, or if you legally entered the Tribal Nations but you stayed longer than permitted.
Since April 1, 1997, have you EVER reentered or attempted to reenter the Tribal Nations without being inspected and admitted or paroled after:

Having been unlawfully present in the Tribal Nations for more than one year in the aggregate?*

Yes
No

Having been deported, excluded, or removed from the Tribal Nations?*

Yes
No

Miscellaneous Conduct

Do you plan to practice polygamy in the Tribal Natiions?*

Yes
No

Are you accompanying another foreign national who requires your protection or guardianship but who is inadmissible after being certified by a medical officer as being helpless from sickness, physical or mental disability, or infancy, as described in INA section 232(c)?*

Yes
No

Have you EVER assisted in detaining, retaining, or withholding custody of a Tribal Nation citizen child outside the Tribal Nations from a*

Yes
No

Have you EVER voted in violation of any Federal, state, or local constitutional provision, statute, ordinance, or regulation in the Tribal Nations?*

Yes
No

Have you EVER renounced Tribal Membership to avoid being taxed by the Tribal Nations?*

Yes
No

Have you EVER applied for exemption or discharge from training or service in the Tribal Nation armed forces or in the Tribal Nation National Security Training Corps on the ground that you are a foreign national?*

Yes
No

Have you EVER been relieved or discharged from such training or service on the ground that you are a foreign national?*

Yes
No

Have you EVER been convicted of desertion from the Tribal Nation armed forces?*

Yes
No

TI-485: Application to Register Tribal Membership

Information About You

Other Information About You

Recent Immigration History

Application Type or Filing Category

Information About Your Immigrant Category

Additional Information About You

Address History

Information About Your Parents

Information About Your Marital History

Information About Your Current Marriage (including if you are legally separated)

nformation About Prior Marriages (if any)

Information About Your Children

Biographic Information

General Eligibility and Inadmissibility Grounds

Criminal Acts and Violations

Security and Related

Illegal Entries and Other Immigration Violations

Removal, Unlawful Presence, or Illegal Reentry After Previous Immigration Violations

Since April 1, 1997, have you been unlawfully present in the Tribal Nations:

Miscellaneous Conduct

Accommodations for Individuals With Disabilities and/or Impairments

Applicant's Statement, Contact Information, Certification, and Signature

Interpreter's Contact Information, Certification, and Signature

Interpreter's Contact Information

Interpreter's Signature

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

Preparer's Contact Information

Preparer's Statement

Preparer's Certification