Instructions For Application For Replacement/initial Nonimmigrant Arrival-Departure Document (Form I-102) (Page 3 of 7) in pdf

Item Number 14. Date Status Expires. Provide the date (mm/dd/yyyy) your authorized period of stay in the United

States expires or expired.

Item Number 15.a. Form I-94, I-94W, or I-95 Arrival-Departure Number. Provide your Form I-94, I-94W, or I-95

Arrival-Departure Number, if you have one. Otherwise, leave this field blank. The I-94 number is on the Form I-94

Arrival-Departure Record, which may be noted as the Departure Number on some versions. If CBP did not provide you

with a Form I-94 upon arrival/admission to the United States, you may print out a paper version of the Form I-94 from the

CBP website at

according to the instructions provided by CBP at the time of admission.

Item Number 15.b. Passport Number. Enter the passport number of the passport you used at your last entry into the

United States, even if that passport has expired. Skip Item Number 15.c. if you provided your passport number in this

box.

Item Number 15.c. Travel Document Number. If you do not have your passport number, enter the travel document

number of the travel document you used at your last entry into the United States, even if that travel document has expired.

Item Number 15.d. Country of Issuance for Passport or Travel Document. Enter the country that issued the passport

or travel document number you provided in Item Numbers 15.b. or 15.c.

Item Number 15.e. Expiration Date for Passport or Travel Document. Enter the expiration date (mm/dd/yyyy) of the

passport or travel document number you provided in Item Numbers 15.b. or 15.c.

Part 2. Reason for Application

The following is a brief description of eligibility categories. Select only one 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 the Submit Your Application section of these instructions for

information on what evidence is required.

You should use Form I-102 to:

1. Replace your lost, stolen, or mutilated Form I-94, I-94W, or I-95. Select box "1.a.," "1.b.," "1.c.," or "1.d." in Part 2.

NOTE: If you were issued an electronic Form I-94 by CBP at a POE at an airport or seaport, you may not need to file

Form I-102 to receive your Form I-94 in paper format. Instead, you may be able to obtain your Form I-94 in paper

format by going to the CBP website at

and following the instructions on the website. No fee is

charged for this service. See the NOTE in the When Should I Use This Form section of these instructions for more

information.

2. Receive an initial Form I-94 or I-94W if you were admitted to the United States at a POE (whether at a land border,

airport, or seaport) and you were not issued an initial Form I-94 or I-94W at admission. Select box “1.e.” in Part 2.

NOTE: If you were issued an electronic Form I-94 by CBP at a POE at an airport or seaport, you may not need to file

Form I-102 to receive your Form I-94 in paper format. Instead, you may be able to obtain your Form I-94 in paper

format by going to the CBP website at

and following the instructions on the website. No fee is

charged for this service. See the NOTE in the When Should I Use This Form section of these instructions for more

information.

3. Receive a corrected Form I-94, I-94W, or I-95 if you were issued one by USCIS with incorrect information. Select

box "1.f." in Part 2.

NOTE: If CBP issued you Form I-94, I-94W, or I-95 with incorrect information (for example: misspelled name,

incorrect date of birth, visa classification, or date of admission), you should not file Form I-102. You will need to go

to the nearest CBP POE or the nearest CBP deferred inspection office, in person, to have the information corrected.

For locations and hours of operation visit the CBP's website at

Form I-102 Instructions 10/19/17 N

Page 3 of 7

Instructions For Application For Replacement/initial Nonimmigrant Arrival-Departure Document (Form I-102) Page 3

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