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ISImmigration ServicesPermanent Residence Unit · Read the instructions before you fill out this form

Application for Permanent Residence

Form IS-PR-1 (Rev. 04/2026)

Type or print in black ink and answer every question in English. If a question doesn't apply to you, write "None" or "N/A". If you leave out required information, we may reject your application.

1Information about you

Family name (last name)Haddad

Given name (first name)Omar

Middle nameKhalil

Date of birth (mm/dd/yyyy)11/04/1990

SexMaleFemale

City or town of birthAlexandria

Country of birthEgypt

Country of citizenshipEgypt

A-Number (if any)

Passport numberP07734120

Passport expires06/18/2031

2Your last arrival in the United States

Date of last arrival (mm/dd/yyyy)

Place of last arrival (city, state and port of entry)

3Address and contact information

Street number and name2840 W Lawrence Ave

Apt.2F

City or townChicago

StateIL

ZIP code60625

Daytime phone(773) 555-0164

Emailomar.haddad@example.com

4Marital history

Current marital statusSingleMarriedDivorcedWidowed

Date of marriage09/14/2021

Current spouse's name (family, given, middle)

Spouse's date of birth

5Employment

Current employer or companyLakeview Electric Co.

OccupationElectrician

Since (mm/yyyy)04/2024

6Applicant's statement and signature

I certify, under penalty of perjury, that the information in this application is complete, true and correct. I understand that knowingly false information can lead to the denial of this application. I authorize the release of any information from my records needed to decide it.

Applicant's signature

Date

For official use only

Receipt number

Date received

InterviewWaivedScheduled

Officer

IS-PR-1 (Rev. 04/2026)Page 1 of 2

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residence-application.pdfPDF · 2 pages

Filled 20 boxes from your saved details.

Where were you born?

Alexandria, Egypt

City of birth · Country of birth

When and where did you last arrive in the U.S.?

March 12, 2024, at JFK

Arrival date · Place of arrival

What's your A-Number?

What's that?

It's a number that starts with A. You'll find it on a green card or a work permit. Do you have either one?

No, I don't

A-Number

What's your wife's full name and date of birth?

Salma Youssef Nassar, July 3, 1992

Spouse's name · Spouse's birth date

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