Application for Replacement/Initial Nonimmigrant Arrival-Departure Document

[I-102, Application for Replacement/Initial Nonimmigrant Arrival – Departure Document (Form I-94 or I-95)]

IMPORTANT: Information on this site may be outdated. For up-to-date instructions and filing fees check always with the USCIS site:
http://www.uscis.gov/forms

Purpose of Form :

For a nonimmigrant to apply for a new or replacement Form I-94 or I-95 Nonimmigrant Arrival-Departure Document.

Number of Pages :

6

Edition Date :

10/26/05. Prior versions acceptable.

Where to File :

Please go to Special Instructions and view the Note on Where to FIle form I-102.

Filing Fee :

$160.00

Special Instructions :

Note on Filing Fee’s for I-102:

You do not need to pay a fee to request to correct your Form I-94, I-95 or I-20ID if the error(s) on your document was made by USCIS, through no fault of your own.

Please consult the “Paying Fees” section of your local office or Service Center page to learn which forms of payment are accepted. Acceptable forms of payment may vary by office. Checks must be made payable to Department of Homeland Security or U.S. Citizenship & Immigration Services.

Note on Where to File for I-102 :

If you are filing to replace a Form I-95, file this application at the local office having jurisdiction over where you are temporarily located.

If you were not issued a Form I-94 at admission to the U.S., or are filing this application with an application for extension of stay or change of status, file this application where you are filing the accompanying extension of stay or change of status application.

To request to correct an inaccurate Form I-94, I-95 or I-20ID, submit your application at the local office having jurisdiction over where you are temporarily located. Contact that office for further instructions.

In all other instances, file this application with the Service Center having jurisdiction over the state where you are temporarily located.

Download Form I-102 (117KB PDF)

Department of Homeland Security
U.S. Citizenship and Immigration Services
OMB No. 1615-0079; Expires 06/30/07
I-102, Application for Replacement/Initial Nonimmigrant Arrival – Departure Document

Instructions

Please read these instructions carefully to properly complete this form. If you need more space to complete an answer, use a separate sheet (s) of paper. Write your name and Alien Registration Number (A #), if you have one, at the top of each sheet and indicate the number of the item to which the answer refers. The U.S. Citizenship and Immigration Services (USCIS) is comprised of offices of the former Immigration and Naturalization Service (INS).

You should use Form I-102 to:

Use Form I-102 to request a new or replacement of an incorrect, lost, stolen or damaged Nonimmigrant Arrival Departure Document.

You will need to give us:

  • A completed and signed Form I-102
  • Evidence of eligibility
  • Filing fee

See Step 3 for specific filing instructions.

When Should I Use Form I-102?

As a nonimmigrant visitor to the United States, you should use Form I-102 to apply to the U.S. Citizenship and Immigration Services (USCIS) for a new or replacement:

Form I-94, Nonimmigrant Arrival – Departure Record;

Form I-94W, Nonimmigrant Visa Waiver Arrival -Departure Record; or

Form I-95, Crewman Landing Permit.

How Do I File Form I-102?

A separate Form I-102 must be filed for each person seeking the immigration benefit. Follow the steps below to complete your application:

Step 1 – Reason for Filing Form I-102

Step 2 – Fill Out the Form I-102

Step 3 – Submit Your Application

Replace your lost, stolen or mutilated Form I-94, I-94W or I-95;

Receive an initial Form I-94 if you were not issued one when you entered as a nonimmigrant, and you are filing this form with an application for extension of stay or change of status;

Receive a corrected Form I-94, I-94W or Form I-95 if you were issued one with incorrect information when you entered as a nonimmigrant or refugee; or to>

Receive an initial Form I-94 if you were not issued one when you were originally admitted into the United States due to your military membership as described below:

  • A nonimmigrant member of the U.S. armed forces; or
  • A nonimmigrant member of the North Atlantic Treaty Organization (NATO) armed forces or civilian component; or
  • A nonimmigrant member of the Partnership for Peace military program under the Status of Forces Agreement (SOFA).

ADVISORY: Do not use this form to request an action on a Form I-94 issued by the U.S. Customs and Border Protection (CBP). If you are seeking a new Form I-94 based on a Form I-94 issued at a port-of-entry or otherwise by CBP, you should contact the nearest CBP office or port-of-entry and inquire about their procedures, or visit the CBP’s website at www.cbp.gov.

Step 1. Reason for Filing Form I-102.

The following is a brief description of eligibility categories. Check the box in Part 2 of Form I-102 that matches your reason for filing.

After determining which category best applies, you must submit evidence that proves eligibility. Each category has specific evidence requirements. See Step 3, Submit Your Form I-102, for information on what evidence is required.

Use black ink. Type or print clearly using capital letters. If an item does not apply to you, write “N/A.” If the answer is none, write “NONE.”

This form is divided into Parts 1 through 5. The following information should help you fill out the form.

Part 1. Information about you.

Family Name (Last name) – Give your legal name. If you have two last names, include both and use a hyphen (-) between the names, if appropriate.

Address – Give your physical street address. This must include a street number and name or a rural route number. Do not put a post office box (P.O. Box) number here.

A # – This is your immigration file number. If you do not have an Alien Registration Number or do not know it, leave this blank.

U.S. Social Security # – If you do not have a U.S. Social Security number, leave this blank.

Date of Last Admission – Give the day of your last actual entry into the United States.

Current Nonimmigrant Status – Give your current status. If you were granted a change of status, provide the status noting the change.

Expires on – Give the day your authorized stay in the United States ends.

Numbers on Forms I-94, I-94W or I-95 Arrival-Departure Document – Give the number that is at the top of the document you originally received at the time of entry. If you did not receive a Form I-94 at entry, write N/A.

Part 2 – Reason for application.

Place a check in the box that corresponds with your reason
for filing.

Part 3 – Processing information.

Numbers 1 – 3 – Give all information requested.

Part 4 – Signature.

As the applicant, you must sign and date the application. If you do not sign the form, it will be returned as incomplete.

Daytime Telephone Number – Give a phone number with the area code where you can be reached during the day.

Part 5 – Signature of person preparing form, if other than applicant.

If you, the applicant, did not fill out the Form I-102, the preparer must also sign, date and give his or her address, daytime phone number and fax number.

Step 2. Fill Out the Form I-102.

Notice: USCIS wants to make sure that you receive the requested benefit. To do this, we may ask for more evidence, interview you and/or conduct an investigation. If you give us false documents, misrepresent facts or otherwise engage in fraud, USCIS will take appropriate action. This means we will not only deny your application, you may lose current and future immigration benefits. You may also face penalties, including criminal and/or civil prosecution leading to fines and/or imprisonment.

Step 3. Submit Your Application.

Your application must include the following items.

Your signed and completed Form I-102. Every application must be properly signed and filed with the correct fee. If you are under 14 years of age, your parent or guardian may sign the application.

Filing Fee. The fee for filing Form I-102 is $160.00.

The fee must be submitted in the exact amount. It cannot be refunded. Do not mail cash.

You do not need to pay the fee to request USCIS to correct your Forms I-94, I-94W or Form I-95 if the error(s) on your document was made by USCIS, through no fault of you own. If, however, the error(s) was made because of information you provided or failed to provide to USCIS or the U.S. Department of State, you must pay the fee.

You do not need to pay the fee if you are a nonimmigrant military member in the U.S. armed forces or you are participating in a NATO or Partnership for Peace military program under the SOFA and you are requesting an initial or replacement Form I-94.

Use the following guidelines when you prepare your check or money order:

  • The check or money order must be drawn on a bank or other financial institution located in the United States and must be payable in U.S. currency; and
  • Make the check or money order payable to the Department of Homeland Security, unless:
  • If you live in Guam and are filing your application there, make it payable to the Treasurer, Guam.
  • If you live in the U.S. Virgin Islands and are filing your application there, make it payable to the Commissioner of Finance of the Virgin Islands.

NOTE: Please spell out Department of Homeland Security. Do not use the initials “USDHS” or “DHS.”

Your check or money order must be honored by the bank or financial institution on which it is drawn. If it is not, we will charge you a fee and invalidate your application and any document we have issued to you.

How to check if the fee is correct.

The fee on this form is current as of the edition date appearing in the lower right hand corner of this page. However, because USCIS fees change periodically, you can verify if the fee is correct by following one of the steps below:

Visit our website at www.uscis.gov and scroll down to “Forms and E-Filing” to check the appropriate fee, or

Review the Fee Schedule included in your form package, if you called us to request the form, or

Telephone our National Customer Service Center at 1-800-375-5283 and ask for the fee information.

NOTE: If your petition or application requires a biometric services fee for USCIS to take your fingerprints, photograph or signature, you can use the same procedure above to confirm the biometrics fee.

Initial Evidence. You must file your application with the required initial evidence. Attach copies, showing the front and back of the documents you need to support your application. Do not send original documents unless instructed to do so.

Lost or Stolen Form. If you are applying to replace a lost or stolen Form I-94, I-94W or I-95, submit a copy of the original or submit a copy of the biographic page from your passport and a copy of the page indicating admission as claimed, or other evidence of your admission. If you are unable to provide this evidence, submit a full explanation stating why you cannot give any of the above evidence, along with a copy of evidence of your identity and copies of any evidence in your possession to substantiate your claim. If your card was stolen, submit a copy of the police report relating to the theft.

Mutilated Form. If you are applying to replace a mutilated Form I-94, I-94W or I-95, attach the original, damaged form.

First Form I-94. If you were not issued a Form I-94 at admission and have not since been issued a Form I-94, but now require a Form I-94 for another application you are filing, submit a copy of any evidence in your possession to substantiate your claimed admission.

Nonimmigrant Military Member. If you are filing as a nonimmigrant military member in the U.S. armed forces, NATO or the Partnership for Peace program and you are requesting an initial Form I-94, contact your foreign commander or his or her designee in the United States for filing information.

Correct Inaccurate Information. If you want USCIS to correct inaccurate information on your Form I-94, I-94W or I-95, attach the Form I-94, I-94W or I-95 to your application. If you check box “f” on Part 2, Application Type, attach a statement dated and signed by you, citing specifically what information on your Form I-94, I-94W or I-95 requires correction. You must also attach evidence verifying the validity of the information submitted for correction purposes.

Translations. If you send us a document in a foreign language, it must have a full English translation that the translator has certified as complete and correct. The translator must also certify that he or she is competent to translate the foreign language into English.

Copies. If these instructions state that a copy of a document may be filed with this application and you choose to send us the original, we may keep that original for our records.

Submit Your Form I-102.

NOTE: The following instructions relate only to a Form I-102 issued by USCIS. To request an action on a Form I-94 issued by the U.S. Customs and Border Protection (CBP), refer to the Advisory under Step 1, Reason for Filing Form I-102 on Page 1 of these instructions.

Correction Request. To request USCIS to correct inaccurate information on your Forms I-94, I-94W or I-95, submit your application at the local USCIS office having jurisdiction over the area where you are temporarily located.

Contact the local USCIS office for specific information on how to file the application.

Replace Form I-95. If you are filing to replace a Form I-95, file this application at the local USCIS office having jurisdiction over where you are temporarily located.

Not Issued I-94/Extension – Status Change. If you were not issued a Form I-94 at admission or are filing this application with an application for extension of stay or change of status, file this application where you are filing the accompanying extension of stay or change of status application.

Nonimmigrant Military Member. If you are a nonimmigrant member of the U.S. armed forces, file this application at the local USCIS office having jurisdiction over the area where you are temporarily located.

NATO and SOFA Military Members. If you are in a NATO or Partnership for Peace military program under SOFA, and are seeking an initial Form I-94, submit this application through your foreign commander or his or her designee to NATO/Headquarters, Supreme Allied Commander Transformation (NATO/HQ SACT) at:

NATO/HQ SACT 7857 Blandy Road, Suite 100 ATTN: Legal Affairs Norfolk, VA 23551-2490

NATO/HQ SACT will review and forward the application to the USCIS Nebraska Service Center.

In All Other Instances. File your application as follows:

If you are currently in Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Jersey, New Hampshire, New York, Pennsylvania, Puerto Rico, Rhode Island, Vermont, Virginia, West Virginia or the U.S. Virgin Islands, mail the application to:

USCIS – Vermont Service Center 75 Lower Welden Street St. Albans, VT 05479-0001

If you are currently in Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee or Texas, mail the application to:

USCIS – Texas Service Center P.O. Box 851182 Mesquite, TX 75185-1182

If you are currently Arizona, California, Guam, Hawaii or Nevada, mail the application to:

USCIS – California Service Center P.O. Box 10102 Laguna Niguel, CA 92607-0040

If you are currently anywhere else in the United States, mail the application to:

USCIS – Nebraska Service Center P.O. Box 87102 Lincoln, NE 68501-7102

Processing Information.

Our goal at USCIS is to process all applications fairly. The processing time will vary, depending on the specific circumstances of each case. We may deny an application if you do not give us the requested information or do not go to a scheduled interview. Every application must be properly signed with the correct fee. If you are under 14 years of age, your parent or guardian may sign the application.

Acceptance. Any application that is not signed or is not accompanied by the proper fee, if required, will be rejected with a notice that the application is deficient. You may correct the deficiency and resubmit the application. However, an application is not considered properly filed until it is accepted by USCIS.

Initial Processing. Once the application has been accepted, it will be checked for completeness, including submission of the required initial evidence. If you do not completely fill out the form or file it without the required initial evidence, you will not establish a basis for eligibility and we may deny your application.

Decision. You will be notified in writing of the decision on your application. If the application is approved, a new Form I-94 or Form I-95 will be issued to you.

Address Changes. If you change your address, you must fill out a Form AR-11, Alien’s Change of Address Card, and mail it to the address noted in the form’s instructions.

USCIS Forms and Information. To request USCIS forms, call our toll-free forms line at 1-800-870-3676. You may also get forms and information about immigration laws and regulations by calling our National Customer Service Center at 1-800-375-5283 or visiting our internet website at www.uscis.gov.

Use InfoPass to Make an Appointment. As an alternative to waiting in line for assistance at your local USCIS office, you can now schedule an appointment through our internet-based system, InfoPass. To access the system, visit our website at www.uscis.gov. Use the InfoPass appointment scheduler and follow the screen prompts to set up your appointment. InfoPass generates an electronic appointment notice that appears on the screen. Print the notice and take it with you to your appointment. The notice gives the time and date of your appointment, along with the address of the USCIS office.

Privacy Act Notice. USCIS will use the information on your Form I-102 to determine eligibility for the requested immigration benefit. We may provide information on your application to other government agencies. If you do not provide us with the information or any requested evidence, such action may delay a final decision or result in denial of your application.

Paperwork Reduction Act Notice. An agency may not conduct or sponsor an information collection and you are not required to respond to a collection of information unless it displays a currently valid OMB control number.
We try to create forms and instructions that are accurate, can be easily understood and that impose the least possible burden on you to provide us with information. Often this is difficult because some immigration laws are very complex.

The estimated average time to complete and file this application is as follows: (1) 5 minutes to learn about the law and form; (2) 5 minutes to complete the form; (3) 15 minutes to assemble and file the application; for a total estimated average of 25 minutes per response.

If you have comments regarding the accuracy of this estimate or suggestions for making this form simpler, you may write to the U.S. Bureau of Citizenship and Immigration Services, Regulatory Management Division, 111 Massachusetts Avenue, N.W., Washington, DC 20529. Do not mail your completed application to this address.

Check List

  • Did you completely fill out and sign the form?
  • Did you attach all required evidence?
  • Did you attach a check or money order for the appropriate fee?

You should keep copies of your application and retain your original supporting documents for your records.