Application for Travel Document USCIS

Form I-131 03/22/13 N Page 1 of 5
For
USCIS
Use
Only
USCIS
Form I-131
OMB No. 1615-0013
Expires 03/31/2016
Application for Travel Document
Department of Homeland Security
U.S. Citizenship and Immigration Services
Part 1. Information About You
Start Here. Type or Print in Black Ink
3.
A-
Alien Registration Number (A-Number)
1.b.
1.c.
2.a.
1.a. Family Name
(Last Name)
Given Name
(First Name)
Middle Name
Physical Address
In Care of Name
Zip Code
2.f.
State
2.e.
City or Town2.d.
2.h.
2.i.
Province
Country
2.g.
Postal Code
8. (mm/dd/yyyy)Date of Birth
Other Information
5. Country of Citizenship
4. Country of Birth
9. U.S. Social Security Number (if any)
Class of Admission6.
FemaleMaleGender7.
Street Number
and Name
2.b.
2.c.
Apt.
Flr.Ste.
Address in Part 1
US Consulate at:
Intl DHS Ofc at:
Action Block
Receipt
To Be Completed
by an Attorney/
Representative,
if any.
Fill in box if G-28 is
attached to represent
the applicant.
Attorney State
License Number:
By: Date: / / /
Document Hand Delivered
Document Issued
Re-entry Permit (Update
"Mail To" Section)
Multiple Advance Parole
Valid Until: / / /
Single Advance Parole
Refugee Travel Document
(Update "Mail To" Section)
Mail To
(Re-entry &
Refugee
Only)
Page 1/5
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Application for Travel Document USCIS PDF

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