Form I-777 Application for Issuance or Replacement of Northern Mari

OMB No. 1615-0042; Expires 06/30/07

I-777, Application for Replacement
of Northern Mariana Card

Department of Homeland Security
U.S. Citizenship and Immigration Services

Instructions
NOTE: Please read these instructions carefully to properly complete this form. If you need more space to complete an answer, use a
separate sheet(s) of paper. Write your name and Alien Registration Number (A#), if you have one, at the top of each sheet and indicate the
number of the item to which the answer refers.

Use Form I-777 to apply for replacement of a Northern
Mariana Identification Card.

My Northern Mariana Card was stolen. Check Box B.
You must submit a certified copy of the police report.

You will need to give us:

My Northern Mariana Card was damaged. Check Box
C. You must return the damaged card with this application.

A completed and signed Form I-777
Evidence of eligibility
Filing fee
See Step 3 for specific filing instructions.

When Should I Use Form I-777?
During the two-year period that ended July 1, 1990,USCIS
issued original Northern Mariana Identification Cards to
individuals who acquired U.S. citizenship through the
Covenant to Establish a Commonwealth of the Northern
Mariana Islands in Political Union with the United States
(Public Law 94-241). These cards remain valid as evidence of
U.S. citizenship. Although USCIS no longer issues these
cards, a citizen to whom a card was previously issued may use
this application to request replacement of a card that was lost,
stolen or damaged.

How Do I File Form I-777?
A separate Form I-777 must be filed for each person seeking
an identification card. Follow the steps below to complete
your application:
Step 1 - Reason for Filing Form I-777
Step 2 - Fill Out the Form I-777
Step 3 - Submit Your Application

Notice
USCIS wants to make sure that you receive the requested
benefit. To do this, we may ask for more evidence, interview
you and/or conduct an investigation. If you give us false
documents, misrepresent facts or otherwise engage in
fraud, USCIS will take appropriate action. This means
we will not only deny your application, you may lose current
and future immigration benefits. You may also face
penalties, including criminal and/or civil prosecution leading
to fines and/or imprisonment.

Step 1. Reason for Filing Form I-777.
Listed below is information on each reason for filing a Form
I-777. Check the box in Part 2 that matches your reason for
filing.
My Northern Mariana Card was lost or destroyed.
Check Box A. You must submit a written statement
explaining to the best of your ability when, how and where
your card was lost or destroyed.

All applications must include a copy of an official identity
document showing a photo of the frontal view of your full
face, and your name and date of birth. (Example: a valid
government issued driver's license, passport identity page or
any other official identity document.) The copy must clearly
show the photo and identity information.

Step 2. Fill Out the Form I-777.
Use black ink. Type or print clearly in black ink, using
capital letters. If an item does not apply to you, write "N/A."
If the answer is none, write "NONE."
This form is divided into Parts 1 through 5. The following
information should help you fill out the form.

Part 1. Information about you. (Person applying to
replace a Northern Mariana Card.)
Family Name (Last name) - Give your legal name. If you
have two last names, include both and use a hyphen (-)
between the names, if appropriate.
Home Address - Give your physical street address. This
must include a street number and name or a rural route
number. Do not put a post office box (P.O. Box) number
here.
Mailing Address - Give your mailing address, if different
from your home address.
Daytime Phone Number - Give a phone number where
you can be reached during the day.
U.S. Social Security # - If you do not have a U.S. Social
Security number, leave this blank.
A # - This is your immigration file number. If you do not
have an A number or do not know it, leave this blank.

Part 2 - Requested Action.
Place a check in the box that corresponds with your reason
for filing.

Part 3 - Additional information.
Numbers 1 and 2 - Give the requested information.

Form I-777 (Rev. 02/28/07) N

Part 4 - Signature.
As the applicant, you must sign and date the application.
If you do not sign the application, the form will be
returned as incomplete.
A parent or legal guardian may sign the application on
behalf of a child under the age of 14 years.

Part 5 - Signature of person preparing form, if
other than applicant.
If you, the applicant, did not fill out the Form I-777, the
preparer must also sign, date and give his or her address.

Step 3. Submit Your Form I-777.
Your must include the following items.

Your signed and completed Form I-777.
Filing fee. The filing fee for a Form I-777 is $15.00.
Use the following guidelines when you prepare your check
or money order:
-- The check or money order must be drawn on a bank or
other financial institution located in the United States
and must be payable in U.S. currency; and
-- Make the check or money order payable to the U.S.
Department of Homeland Security, unless:
If you live in Guam and are filing your application
there, make it payable to the Treasurer, Guam.
If you live in the U.S. Virgin Islands and are filing
your application there, make it payable to the
Commissioner of Finance of the Virgin Islands.

NOTE: Spell out U.S. Citizenship and Immigration
Services. Do not use the initials "USCIS".
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 charge you a fee and your application and any
document issued to you will not be valid.

Evidence. Attach copies showing the front and back of
the documents you need to support your application. See
Step 1, Reason for Filing, for information on document
requirements. Do not send original documents unless
instructed to do so.
All applications must include a copy of an official photo
identity document showing a photo of the frontal view
of your full face, and your name and date of birth.
(Example: a valid government issued driver's license,
passport identity page or any other official identity
document.) The copy must clearly show the photo and
identity information.

Translations. If you send us a document in a foreign
language, it must have a full English translation that the
translator has certified as complete and correct. The
translator must also certify that he or she is competent to
translate the foreign language into English.

Photos. You must submit two identical natural color
photographs of yourself taken within 30 days of this
application. The photos must have a white background, be
unmounted, printed on thin paper and be glossy and
unretouched. The photo should be a full frontal passport
style photograph. The photos should be no larger than 2 x
2 inches, with the distance from the top of the head to just
below the chin about 1 and 1/4 inches. Using a pencil,
lightly print your A# on the back of each photo.

Submit your application.
Where you submit your form depends on where you live.
If you currently live in the Commonwealth of the Northern
Mariana Islands, Guam or elsewhere outside the United
States, you must mail this application to:
USCIS - Guam
Sirena Plaza, Suite 100
108 Hernan Cortez Avenue
Hagatna, GU 96910
If you currently live in Connecticut, Delaware, District of
Columbia, Maine, Maryland, Massachusetts, New Jersey,
New Hampshire, New York, Pennsylvania, Puerto Rico,
Rhode Island, Vermont, Virginia, West Virginia or the US
Virgin Islands, mail the application to:
USCIS - Vermont Service Center
75 Lower Welden Street
St. Albans, VT 05479-0001
If you currently live in Alabama, Arkansas, Florida,
Georgia, Kentucky, Louisiana, Mississippi, New Mexico,
North Carolina, Oklahoma, South Carolina, Tennessee or
Texas, mail the application to:
USCIS - Texas Service Center
P.O. Box 851041
Mesquite, TX 75185-1041
If you currently live in Arizona, California, Hawaii or
Nevada, mail the application to:
USCIS - California Service Center
P.O. Box 10765
Laguna Niguel, CA 92607-1076
If you currently live anywhere else in the United States, mail
the application to:
USCIS - Nebraska Service Center
P.O. Box 87765
Lincoln, NE 68501-7765

Form I-777 (Rev. 02/28/07) N Page 2

Processing Information.

Paperwork Reduction Act.

Our goal at USCIS is to process all applications fairly. The
processing time will vary, depending on the specific
circumstances of each case. We may reject an incomplete
application. We may deny your application if you do not give
us the requested information or do not go to a scheduled
interview.

An agency may not conduct or sponsor an information
collection and you are not required to respond to a collection
of information unless it displays a currently valid OMB
control number. We try to create forms and instructions that
are accurate, can be easily understood and that impose the
least possible burden on you to provide us with information.
Often this is difficult because some immigration laws are very
complex. The estimated average time to complete and file this
application is as follows: (1) 15 minutes to learn about the
law and form; (2) 10 minutes to complete the form; (3) 5
minutes to assemble and file the petition; for a total estimated
average of 30 minutes per response. If you have comments
regarding the accuracy of this estimate, or suggestions for
making this form simpler, you may write to the U.S.
Citizenship and Immigration Services, Regulatory
Management Division,111 Massachusetts Avenue, 3rd Floor,
Suite 3008, Washington, DC 20529; OMB No. 1615-0042.
Do not mail your completed application to this address.

Privacy Act Notice. USCIS will use the information on Form
I-777 to determine eligibility for the requested immigration
benefit. We may provide information on your application to
other government agencies.
Address Changes. If you change your address, you must fill
out a Form AR-11, Alien's Change of Address Card, and mail
it to the office where the Form I-777 was originally filed.
Write "Form I-777" in the lower left hand corner of the
address side of the AR-11.
USCIS Forms and Information. To request USCIS forms,
call our toll-free forms line at 1-800-870-3676. You may also
get USCIS forms and information about immigration laws and
regulations by calling our National Customer Service Center
at 1-800-375-5283 or from our internet website at www.uscis.
gov.

Form I-777 (Rev. 02/28/07) N Page 3

OMB No. 1615-0042; Expires 06/30/07

I-777, Application for Replacement
of Northern Mariana Card

U.S. Department of Homeland Security
U.S. Citizenship and Immigration Services

START HERE - Please Type or Print (Use black ink.)

Part 1.

Information about you. (Person applying for a Northern Mariana Card)

Family Name

Given Name

Middle Name

FOR CIS USE ONLY
Returned
Receipt
Date
Date
Resubmitted

Home Address - Street Number and Name

Apt. #
Date

City

State or Province

Date
Reloc Sent

Zip/Postal Code

Country

Date

Mailing Address - Street Number and Name

Apt./Suite #

Date
Reloc Rec'd
Date

C/O (In care of):

Date
Applicant

City

State or Province

Zip/Postal Code

Country

Interviewed
on
A Number
Remarks

Gender

Daytime Phone # (Area/Country Code)

Male

Female

Date of Birth (mm/dd/yyyy)

Place of Birth (City/Town and Country)

A # (If any)

U.S. Social Security # (If any)

Father's First Name

Mother's First Name

Action

Part 2.

Requested action. (Check one)

Check the classification that best describes your eligibility. (Check one box.)
A.

My Northern Mariana Card was lost or destroyed.

B.

My Northern Mariana Card was stolen. (You must attach a copy of the police
report.)

C.

My Northern Mariana Card was damaged. (You must attach the damaged
card.)

To Be Completed by
Attorney or Representative, if any.
Fill in box if G-28 is attached
to represent the applicant.
ATTY State License #

Form I-777 (Rev. 02/28/07) N

Part 3.

Additional information.

1. List all absences from the Commonwealth of the Northern Mariana Islands or the United States. (List absences from the last
to the present.)
From
To
From
To
Present

Present

2. At what address(es) have you lived for the last ten years? (List present address first.)
Street Address (Number and Name)

Town or City

From (mm/dd/yyyy) To (mm/dd/yyyy)
Present

Part 4. Signature Read the information on penalties in the instructions before completing this part.
I certify, under penalty of perjury of the laws of the United States of America, that my 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 my eligibility for the benefit I am seeking.
Date (mm/dd/yyyy)
Signature
Daytime Phone Number (with area code)

NOTE: If you do not completely fill out this form or fail to submit the required documents listed in the instructions, you may not be found
eligible for the requested document and this application may be denied.

Part 5.

Signature of person preparing form, if other than above. (Sign below.)

I declare that I prepared this application at the request of the person named above and it is based on all information of which I have
knowledge.
Signature
Print or Type Your Name

Firm Name and Address

Fax Number or Email

Date (mm/dd/yyyy)

Daytime Phone Number (with area code)

Form I-777 (Rev. 02/28/07) N Page 2