Instructions For Application For Replacement/initial Nonimmigrant Arrival-Departure Document (Form I-102) (Page 4 of 7) in pdf

4. 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 (Select box "1.g." in Part 2.):

A. Nonimmigrant member of the U.S. Armed Forces;

B. Nonimmigrant member of the North Atlantic Treaty Organization (NATO) armed forces or civilian component; or

C. Nonimmigrant member of the Partnership for Peace military program under the Status of Forces Agreement (SOFA).

Part 3. Processing Information

Item Numbers 1.a. - 5. Provide all information requested in the spaces provided.

Part 4. Statement, Certification, Signature and Contact Information of the Applicant

Select the box that indicates if you filled out this form or if someone interpreted this form for you. If applicable, select the

box that indicates if someone filled out this form for you. Every application must contain the original signature of the

applicant. A photocopy of a signed application or a typewritten name in place of a signature is not acceptable. If you are

under 14 years of age, your parent or legal guardian may sign the application on your behalf. Sign and date the form and

provide your daytime telephone number, mobile telephone number, and e-mail address.

Part 5. Contact Information, Certification, and Signature of Interpreter

If you used an interpreter to read the instructions and complete the questions on this form, the interpreter must fill out this

section, provide the name of his or her business/organization, the business/organization's address, his or her daytime

telephone number, and his or her e-mail address. The interpreter must also sign and date the form.

Part 6. Contact Information, Declaration, and Signature of the Person Preparing This Application, If Other than

Applicant

This section must contain the original signature of the person who completed this form, if other than the person named in

Part 4. If the person who completed this form is associated with a business or organization, the prepare should provide

the name of his or her business/organization name and address. If the person completing this form is an attorney or

accredited representative, he or she must submit a completed Form G-28, Notice of Entry of Appearance as Attorney or

Accredited Representative, along with this application.

Submit Your Application

Your application must include the following items:

1. Your Signed and Completed Form I-102

Each application must be properly signed and filed with the correct fee. If you are under 14 years of age, your parent

or legal guardian may sign the application.

2. General Requirements

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 I-94, I-94W, or I-95. If you are applying to replace a lost or stolen Form I-94, I-94W, or

I-95, 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 Form I-94, I-94W, or I-95 was stolen,

submit a copy of the police report relating to the theft, if available. If a police report is unavailable or was not

made, submit an explanation describing the circumstances of the theft and why the police report is unavailable or

was not made.

Form I-102 Instructions 10/19/17 N

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