Form I-131 - Application For Travel Document (Page 3 of 3) in pdf

Form I-131 - Application For Travel Document Page 3

Part 7. Complete Only If Applying for Advance Parole

On a separate sheet of paper, explain how you qualify for an Advance Parole Document, and what circumstances warrant issuance of

advance parole. Include copies of any documents you wish considered. (See instructions.)

One Trip

More than one trip

1. How many trips do you intend to use this document?

2. If the person intended to receive an Advance Parole Document is outside the United States, provide the location (city and country)

of the U.S. Embassy or consulate or the DHS overseas office that you want us to notify.

City

Country

3. If the travel document will be delivered to an overseas office, where should the notice to pick up the document be sent?:

To the address shown in Part 2 on the first page of this form.

To the address shown below:

Address (Number and Street)

Apt. #

Daytime Telephone #

(area/country code)

City

State or Province

Zip/Postal Code

Country

Read the information on penalties in the instructions before completing this section. If you are filing

Part 8. Signature

for a reentry permit or Refugee Travel Document, you must be in the United States to file this application.

I certify, under penalty of perjury under the laws of the United States of America, that this application and the evidence submitted with

it are 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.

Date (mm/dd/yyyy)

Daytime Telephone Number (with area code)

Signature

Note: If you do not completely fill out this form or fail to submit required documents listed in the instructions, you may not be

found eligible for the requested document and this application may be denied.

Part 9. Signature of Person Preparing Form, If Other Than the Applicant

(Sign below)

I declare that I prepared this application at the request of the applicant, and it is based on all information of which I have knowledge.

Signature

Print or Type Your Name

Firm Name and Address

Daytime Telephone Number (with area code)

Fax Number (if any)

Date (mm/dd/yyyy)

Form I-131 (Rev. 11/23/10)Y Page 3

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Form I-131 - Application For Travel Document Page 3