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Immigration form (United States)

UNITED STATES DEPARTMENT OF JUSTICE
Immigration and Naturalization Service

FILE NO: _________________________

DATE: _________________________

Your assistance in furnishing additional identifying information is requested so that we may act upon or reply to your communication. Please fill in the necessary information and return this letter and any attached material to this office.

Type of Application (Form number if known) _________________________

Date Application was filed _________________________

Address of Service office where application or correspondence was filed _________________________

Name of applicant or petitioner _________________________

Complete present address _________________________

Address as shown on application _________________________

Other names, if any _________________________

Date of birth _________________________

Place of birth _________________________

Alien number (if known) A# _________________________

Date and place of naturalization _________________________

Type of entry (Temporary Visitor, Student, Permanent Residence Visa, Reentry Permit, etc.) _________________________

Destination in U.S. as shown on entry document _________________________

IF IMMIGRANT VISA PETITION ALSO COMPLETE THE FOLLOWING:


Name of person you desire to bring to the U.S. _________________________

Other names, if any _________________________

His/her date of birth _________________________

His/her place of birth _________________________

Alien number (if known) A# _________________________

Is prospective immigrant already in U.S.? _________________________

If yes, date of admission into U.S. _________________________

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