Form I-102 - Application For Replacement/initial Nonimmigrant Arrival-Departure Document - U.s. Citizenship And Immigration Services Page 3

Download a blank fillable Form I-102 - Application For Replacement/initial Nonimmigrant Arrival-Departure Document - U.s. Citizenship And Immigration Services in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form I-102 - Application For Replacement/initial Nonimmigrant Arrival-Departure Document - U.s. Citizenship And Immigration Services with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

Part 4. Statement, Certification, Signature, and
Part 5. Contact Information, Certification, and
Contact Information of the Applicant
Signature of the Interpreter
NOTE: Select the box for either Item Number 1.a. or 1.b. If
Interpreter's Full Name
applicable, select the box for Item Number 2.
Provide the following information concerning the interpreter:
1.a.
I can read and understand English, and have read and
understand every question and instruction on this
1.a.
Interpreter's Family Name (Last Name)
form, as well as my answer to every question.
1.b.
The interpreter named below has read to me every
1.b.
Interpreter's Given Name (First Name)
question and instruction on this form, as well as my
answer to every question, in
,
2.
Interpreter's Business or Organization Name (if any)
a language in which I am fluent. I understand every
question and instruction on this form as translated
to me by my interpreter, and have provided true
Interpreter's Mailing Address
and correct responses in the language indicated
above.
3.a.
Street Number
and Name
2.
I have requested the services of and consented to
3.b. Apt.
Ste.
Flr.
,
who is
is not
an attorney or accredited
3.c. City or Town
representative, preparing this form for me.
3.d. State
3.e. ZIP Code
Applicant Certification
3.f.
Province
I certify, under penalty of perjury, that the foregoing is true
and correct. Copies of documents submitted are exact
3.g. Postal Code
photocopies of unaltered original documents, and I
understand that I may be required to submit original
3.h.
Country
documents to U.S. Citizenship and Immigration Services
(USCIS) at a later date. Furthermore, I authorize the release
of any information from my records that USCIS may need to
Interpreter's Contact Information
determine my eligibility for the benefit that I seek. I
furthermore authorize release of information contained in this
4.
Interpreter's Daytime Telephone Number
form, in supporting documents, and in my USCIS records, to
other entities and persons where necessary for the
administration of U.S. immigration laws.
5.
Interpreter's E-mail Address
3.a. Applicant's Signature
3.b. Date of Signature (mm/dd/yyyy) ►
Applicant's Contact Information
4.
Applicant's Daytime Telephone Number
5.
Applicant's Mobile Telephone Number
6.
Applicant's E-mail Address
Form I-102 12/23/16 N
Page 3 of 4

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go
Page of 4