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Item Numbers 7.a. - 8.b. Entry After Removal. Complete this section if you entered or attempted to enter the United

States without being admitted or paroled after having been excluded, deported, or removed from the United States. List

all the dates you were excluded, deported, or removed and when you entered or attempted to reenter into the United

States. (see INA section 212(a)(9)(C)(i)(II)). Provide the dates and locations (city or town and state) for each exclusion,

removal, and entry or attempted reentry. Attach evidence that you have remained outside of the United States for 10 years

since your last departure.

Part 3. Reasons For Your Request For Permission to Reapply

Item Numbers 1.a. - 2. Indicate what immigration status you seek and explain why you would like to reenter the United

States.

Item Numbers 3.a. - 4.b. U.S. Citizen or Lawful Permanent Resident Family Members (if any). Provide the name

and your relationship to the U.S. citizen or lawful permanent resident family members (if any) with close ties to the

United States. Indicate whether each relative is a U.S. citizen or lawful permanent resident or has some other status.

Refer to the What Initial Evidence Should You Submit section of these Instructions for more information about family

members.

Part 4. Biographic Information

Provide the biographic information requested in Part 4., Item Numbers 1. - 6. Providing this information as part of

your application may reduce the time you spend at your USCIS ASC appointment as described in the Biometric Services

Appointment section of these instructions.

Item Numbers 1. - 2. Ethnicity and Race. Select the boxes that best describe your ethnicity and race.

Categories and Definitions for Ethnicity and Race

1. Hispanic or Latino. A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture

or origin, regardless of race. (NOTE: This category is only included under Ethnicity in Part 4., Item Number 1.)

2. White. A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

3. Asian. A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian

subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine

Islands, Thailand, and Vietnam.

4. Black or African American. A person having origins in any of the black racial groups of Africa.

5. American Indian or Alaska Native. A person having origins in any of the original peoples of North and South

America (including Central America), and who maintains tribal affiliation or community attachment.

6. Native Hawaiian or Other Pacific Islander. A person having origins in any of the original peoples of Hawaii,

Guam, Samoa, or other Pacific Islands.

Item Number 3. Height. Select the values that best match your height in feet and inches. For example, if you are five

feet and nine inches, select “5” for feet and “09” for inches. Do not enter your height in meters or centimeters.

Item Number 4. Weight. Enter your weight in pounds. If you do not know your weight, or need to enter a weight under

30 pounds or over 699 pounds, enter “000.” Do not enter your weight in kilograms.

Item Number 5. Eye Color. Select the box that best describes the color of your eyes.

Item Number 6. Hair Color. Select the box that best describes the color of your hair.

Form I-212 Instructions 12/23/16 N

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Instructions For Form I-212 - Application For Permission To Reapply For Admission Into The United States After Deportation Or Removal Page 11