Form I-102 - Application For Replacement/initial Nonimmigrant Arrival - Departure Document Page 2
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6-- Make the check or money order payable to the
Date of Last Admission - Give the day of your last actual
Department of Homeland Security, unless:
entry into the United States.
f you live in Guam and are filing your application there,
Current Nonimmigrant Status - Give your current status.
I
If you were granted a change of status, provide the status
make it payable to the Treasurer, Guam.
noting the change.
you live in the U.S. Virgin Islands and are filing your
If
Expires on - Give the day your authorized stay in the
application there, make it payable to the Commissioner
United States ends.
of Finance of the Virgin Islands.
Numbers on Forms I-94, I-94W or I-95 Arrival-Departure
NOTE: Please spell out Department of Homeland Security.
Document - Give the number that is at the top of the
Do not use the initials "USDHS" or "DHS."
document you originally received at the time of entry. If
you did not receive a Form I-94 at entry, write N/A.
Your check or money order must be honored by the bank or
financial institution on which it is drawn. If it is not, we will
Part 2 - Reason for application.
charge you a fee and invalidate your application and any
Place a check in the box that corresponds with your reason
document we have issued to you.
for filing.
How to check if the fee is correct.
Part 3 - Processing information.
The fee on this form is current as of the edition date
Numbers 1 - 3 - Give all information requested.
appearing in the lower right hand corner of this page.
Part 4 - Signature.
However, because USCIS fees change periodically, you can
verify if the fee is correct by following one of the steps
As the applicant, you must sign and date the application. If
below:
you do not sign the form, it will be returned as incomplete.
Daytime Telephone Number - Give a phone number with
Visit our website at and scroll down to
the area code where you can be reached during the day.
"Forms and E-Filing" to check the appropriate fee, or
Part 5 -
Signature of person preparing form,
Review the Fee Schedule included in your form package, if
if other than applicant.
you called us to request the form, or
If you, the applicant, did not fill out the Form I-102, the
Telephone our National Customer Service Center at
preparer must also sign, date and give his or her address,
1-800-375-5283 and ask for the fee information.
daytime phone number and fax number.
NOTE: If your petition or application requires a biometric
services fee for USCIS to take your fingerprints, photograph
Step 3. Submit Your Application.
or signature, you can use the same procedure above to
Your application must include the following items.
confirm the biometrics fee.
Your signed and completed Form I-102.
Every
Initial Evidence.
application must be properly signed and filed with the
You must file your application with the
required initial evidence. Attach copies, showing the front
correct fee. If you are under 14 years of age, your parent or
and back of the documents you need to support your
guardian may sign the application.
application. Do not send original documents unless
Filing Fee.
The fee for filing Form I-102 is $160.00.
instructed to do so.
Lost or Stolen Form.
The fee must be submitted in the exact amount. It cannot be
If you are applying to replace a lost
or stolen Form I-94, I-94W or I-95, submit a copy of the
refunded. Do not mail cash.
original or submit a copy of the biographic page from your
You do not need to pay the fee to request USCIS to correct
passport and a copy of the page indicating admission as
your Forms I-94, I-94W or Form I-95 if the error(s) on your
claimed, or other evidence of your admission. If you are
document was made by USCIS, through no fault of you own.
unable to provide this evidence, submit a full explanation
If, however, the error(s) was made because of information
stating why you cannot give any of the above evidence, along
you provided or failed to provide to USCIS or the U.S.
with a copy of evidence of your identity and copies of any
Department of State, you must pay the fee.
evidence in your possession to substantiate your claim. If
your card was stolen, submit a copy of the police report
You do not need to pay the fee if you are a nonimmigrant
relating to the theft.
military member in the U.S. armed forces or you are
participating in a NATO or Partnership for Peace military
Mutilated Form.
If you are applying to replace a
program under the SOFA and you are requesting an initial or
mutilated Form I-94, I-94W or I-95, attach the original,
replacement Form I-94.
damaged form.
Use the following guidelines when you prepare your check or
First Form I-94.
If you were not issued a Form I-94 at
money order:
admission and have not since been issued a Form I-94, but
now require a Form I-94 for another application you are
--
The check or money order must be drawn on a bank or
filing, submit a copy of any evidence in your possession to
other financial institution located in the United States
substantiate your claimed admission.
and must be payable in U.S. currency; and
Instructions I-102 (Rev. 10/26/05)Y Page 2
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