Form I-131 - Application For Travel Document - Citizenship And Immigration Services Page 3
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5Part 3. Processing Information (continued)
Where do you want this travel document sent? (Check one)
10.a.
In Care of Name
5.
To the U.S. address shown in Part 1 (2.a through
2.i.) of this form.
10.b.
Street Number
and Name
6.
To a U.S. Embassy or consulate at:
10.c. Apt.
Ste.
Flr.
6.a.
City or Town
10.d.
City or Town
6.b.
Country
10.e.
State
10.f.
ZIP Code
7.
To a DHS office overseas at:
7.a. City or Town
10.g. Postal Code
7.b. Country
10.h.
Province
If you checked "6" or "7", where should the notice to pick up
10.i.
Country
the travel document be sent?
(
)
10.j.
Daytime Phone Number
-
8.
To the address shown in Part 2 (2.h. through 2.p.)
of this form.
9.
To the address shown in Part 3 (10.a. through 10.i.)
of this form.:
Part 4. Information About Your Proposed Travel
Purpose of trip. (If you need more space, continue on a
1.b.
List the countries you intend to visit. (If you need more
1.a.
separate sheet of paper.)
space, continue on a separate sheet of paper.)
Part 5. Complete Only If Applying for a Re-entry Permit
Since becoming a permanent resident of the United States (or
2.
Since you became a permanent resident of the United
during the past 5 years, whichever is less) how much total time
States, have you ever filed a Federal income tax return as
have you spent outside the United States?
a nonresident or failed to file a Federal income tax return
because you considered yourself to be a nonresident? (If
1.a.
less than 6 months
1.d.
2 to 3 years
"Yes" give details on a separate sheet of paper.)
1.b.
6 months to 1 year
1.e.
3 to 4 years
Yes
No
1.c.
1 to 2 years
1.f.
more than 4 years
Form I-131 12/23/16 N
Page 3 of 5
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