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. _________________________