Form I-90 - Application To Replace Permanent Resident Card Page 3
Download a blank fillable Form I-90 - Application To Replace Permanent Resident Card in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form I-90 - Application To Replace Permanent Resident Card with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5Part 3. Processing Information
1. Mother's First Name
2. Father's First Name
3. City of residence where you applied for an
4. Consulate where immigrant visa or USCIS office
immigrant visa or adjustment of status
where adjustment of status was granted
5. If you entered the United States with an immigrant visa, also complete the following:
(If you were granted adjustment of status, skip this question and proceed to Question 6.)
a. Destination in United States at time of admission
b. Port of entry where admitted to United States
6. Have you ever been ordered removed from the United States?
No
Yes
7. Since you were granted permanent residence, have you ever filed Form I-407,
Abandonment by Alien of Status as Lawful Permanent Resident, or otherwise been
No
Yes
judged to have abandoned your status?
NOTE: If you answered "Yes" to Question 6 or Question 7 above, provide detailed explanation in Part 7.
Part 4. Accommodations for Individuals With Disabilities and Impairments (Read the information in the
instructions before completing this section.)
Are you requesting an accommodation because of your disability and/or impairment?
Yes
No
If you answered "Yes," check any applicable box:
1. I am deaf or hard of hearing and request the following accommodation(s) (if requesting a sign-language interpreter, indicate
which language (e.g., American Sign Language)):
2. I am blind or sight-impaired and request the following accommodation(s):
3. I have another type of disability and/or impairment (describe the nature of your disability(ies) and/or impairment(s) and
accommodation(s) you are requesting):
Part 5. Signature
(Read the information on penalties in the instructions before completing this section. You must file this
application while in the United States.)
I certify, under penalty of perjury under the laws of the United States of America, that this application and the evidence submitted with
it is all true and correct. I authorize the release of any information from my records that U.S. Citizenship and Immigration Services
needs to determine eligibility for the benefit I am seeking.
Signature
Date
Daytime Phone Number
NOTE: If you do not completely fill out this form or fail to submit required documents listed in the instructions, your application may
be denied.
Form I-90 (Rev. 11/23/10)Y Page 3
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal