Application for Advance Permission to Enter as Nonimmigrant (Pursuant to 212(d)(3)(A)(ii) of the INA)

Instructions for Application for Advance Permission to
Enter as a Nonimmigrant
Department of Homeland Security
U.S. Citizenship and Immigration Services

USCIS
Form I-192

OMB No. 1615-0017
Expires 10/31/2017

What Is the Purpose of Form I-192?
This application allows inadmissible nonimmigrant aliens to apply for advance permission to temporarily enter the United
States.

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You can find grounds of inadmissibility in the Immigration and Nationality Act (INA) section 212(a). You can find
the statutory and regulatory basis for this application in INA section 212(d)(3)(A)(ii); Title 8 of the Code of Federal
Regulations (CFR), section 212.4; INA section 212(d)(13) and (14); 8 CFR 212.16 and 17; and 8 CFR 214.11 and 214.14
for T nonimmigrant status applicants and U nonimmigrant status petitioners.

Who Should File Form I-192?

File Form I-192 if you are an inadmissible foreign national in one of the following categories:
1. Inadmissible nonimmigrant already in possession of appropriate documents;
2. Applicant for T nonimmigrant status (Form I-914); or
3. Petitioner for U nonimmigrant status (Form I-918).

NOTE: If you are planning to seek admission under the Visa Waiver Program (VWP) under INA section 217, you should
NOT file this application. Aliens from VWP countries who are inadmissible are not eligible for VWP admission. You
must apply instead for a nonimmigrant visa at a U.S. Embassy or U.S. Consulate for authorization to travel. You should
contact the appropriate U.S. Embassy or U.S. Consulate if you have any questions regarding your eligibility for admission
under the VWP or regarding a waiver of inadmissibility in connection with an application for nonimmigrant visa.
NOTE: Do not file this application if you need to obtain a nonimmigrant visa. You should contact the appropriate
U.S. Embassy or U.S. Consulate if you have any questions regarding your eligibility for waiver of inadmissibility in
connection with an application for a nonimmigrant visa.
NOTE: If you are seeking T nonimmigrant status or U nonimmigrant status, and you are only inadmissible under
INA section 212(a)(4) (public charge), you do NOT need to file this application because you are exempt from this ground
of inadmissibility.

General Instructions
U.S. Citizenship and Immigration Services (USCIS) provides forms free of charge through the USCIS Web site. In order
to view, print, or fill out our forms, you should use the latest version of Adobe Reader, which you can download for free
at http://get.adobe.com/reader/. If you do not have Internet access, you may call the USCIS National Customer Service
Center at 1-800-375-5283 and ask that we mail a form to you. For TTY (deaf or hard of hearing) call: 1-800-767-1833.
Signature. Each application must be properly signed and filed. For all signatures on this application, USCIS will not
accept a stamped or typewritten name in place of a signature. If you are under 14 years of age, your parent or legal
guardian may also sign the application on your behalf. A legal guardian may also sign for a mentally incompetent person.
Filing Fee. Each application must be accompanied by the appropriate filing fee and biometric services fee (if applicable).
(See the What Is the Filing Fee section of these Instructions.)

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Biometric Services Fee. If you file this application with USCIS, you do not need to include a biometric services fee
at the time you submit your application. If you are later notified that you must submit biometrics, you will receive a
biometric services appointment notice with instructions on how to submit the additional biometric services fee. If you file
this application with Customs and Border Protection (CBP), please check with CBP to determine if and when you must
submit a biometric services fee.
Evidence. At the time of filing, you must submit all evidence and supporting documentation listed in the Specific
Instructions and What Evidence Must You Submit sections of these Instructions.

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Biometric Services Appointment

1. For Applicants Filing Form I-192 with USCIS. USCIS may require that you appear for an interview or provide
fingerprints, photograph, and/or signature at any time to verify your identity, obtain additional information, and
conduct background and security checks, including a check of criminal history records maintained by the Federal
Bureau of Investigation (FBI), before making a decision on your application, petition, or request. After USCIS
receives your application and ensures it is complete, we will inform you in writing if you need to attend a biometric
services appointment. If an appointment is necessary, the notice will provide you the location of your local or
designated USCIS Application Support Center (ASC) and the date and time of your appointment or, if you are
currently overseas, instruct you to contact a U.S. Embassy, U.S. Consulate, or USCIS office outside the United States
to set up an appointment.
If you are required to provide biometrics, at your appointment you must sign an oath reaffirming that:
(1) You provided or authorized all information in the application;

(2) You reviewed and understood all of the information contained in, and submitted with, your application; and
(3) All of this information was complete, true, and correct at the time of filing.

If you fail to attend your biometric services appointment, USCIS may deny your application.

2. For Applicants Filing Form I-192 with CBP. Contact CBP to determine whether you have to attend a biometric
services appointment for purpose of filing your Form I-192.
Copies. You may submit legible photocopies of documents requested, unless the Instructions specifically state that
you must submit an original document. USCIS or CBP may request an original document at the time of filing or at any
time during processing of an application, petition, or request. If you submit original documents when not required, the
documents may remain a part of the record, and USCIS or CBP will not automatically return them to you.
Translations. If you submit a document with information in a foreign language, you must also submit a full English
translation. The translator must sign a certification that the English language translation is complete and accurate, and that
he or she is competent to translate from the foreign language into English. The certification must include the translator’s
signature. DHS recommends the certification contain the translator’s printed name and the date and the translator’s contact
information.
How To Fill Out Form I-192
1. Type or print legibly in black ink.
2. If you need extra space to complete any item within this application, use the space provided in Part 7. Additional
Information or attach a separate sheet of paper; type or print your name and Alien Registration Number (A-Number)
(if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer
refers; and sign and date each sheet.

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3. Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been
married and the question asks, “Provide the name of your current spouse”), type or print “N/A,” unless otherwise
directed. If your answer to a question which requires a numeric response is zero or none (for example, “How many
children do you have” or “How many times have you departed the United States”), type or print “None,” unless
otherwise directed.

Specific Instructions

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Part 1. Application Type

Item Number 1. Indicate the basis for your application by selecting the box next to the appropriate category.
Part 2. Information About You

In this section, provide the following information about yourself.

Item Number 1. Your Full Name. Provide your full legal name in the spaces provided.

Item Number 2. Alien Registration Number (A-Number) (if any). Provide your A-Number. Your A-Number is the
number used to identify your immigration records. You can find this number on documents you received from USCIS,
U.S. Immigration and Customs Enforcement (ICE), or DOJ Executive Office for Immigration Review (EOIR) during
immigration proceedings in court.
Item Number 3. USCIS Online Account Number (if any). If you have previously filed an application, petition, or
request using the USCIS online filing system (previously called USCIS Electronic Immigration System (USCIS ELIS)),
provide the USCIS Online Account Number you were issued by the system. You can find your USCIS Online Account
Number by logging in to your account and going to the profile page. If you previously filed certain applications, petitions,
or requests on a paper form via a USCIS Lockbox facility, you may have received a USCIS Online Account Access Notice
issuing you a USCIS Online Account Number. If you received such a notice, your USCIS Online Account Number can be
found at the top of the notice. If you were issued a USCIS Online Account Number, enter it in the space provided. The
USCIS Online Account Number is not the same as an A-Number.
Item Number 4. Date of Birth (mm/dd/yyyy). Provide your date of birth in month/day/year format.

Item Number 5. Place of Birth. Provide the city or town, state or province, and country where you were born in the
spaces provided.
Item Number 6. Country of Citizenship or Nationality. Provide the name of the country of which you are a citizen
or which is your country of nationality. This is not necessarily the country where you were born. If you do not have
citizenship in any country, type or print “stateless” and provide an explanation in the space provided in Part 7. Additional
Information.
Item Number 7. Physical Address. If your current mailing address is not the same as your physical address, provide
your physical street address. You must include a street number and name or a rural route number. Do not provide a post
office box (PO Box) number here.
Item Number 8. Prior Residences. Provide a list of addresses for every place you have resided during the past five
years. Start with your last residence prior to the place you currently reside.
Item Number 9. - 14. Travel Information. Indicate where you intend to enter the United States. Provide your planned
port-of-entry (POE) and the city and U.S. state where the POE is located. Also describe the purpose for your trip to the
United States and how long you intend to remain in the United States.
Item Numbers 15. - 21. Immigration and Criminal History. Provide answers for all the questions in this section. If an
answer requires an explanation or you would like to provide USCIS additional information that you believe is relevant to
the response, use the space provided in Part 7. Additional Information.

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Part 3. Biographic Information
Provide the biographic information requested in Part 3., Item Numbers 1. - 6. Providing this information as part of
your application may reduce the time you spend at your USCIS ASC appointment as described in the Biometric Services
Appointment section of these instructions.
Item Numbers 1. - 2. Ethnicity and Race. Select the boxes that describe your ethnicity and race.
Categories and Definitions for Ethnicity and Race
1. Hispanic or Latino. A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture
or origin, regardless of race. (NOTE: This category is only included under Ethnicity in Part 3., Item Number 1.)

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2. White. A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
3. Asian. A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian
subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine
Islands, Thailand, and Vietnam.
4. Black or African American. A person having origins in any of the black racial groups of Africa.

5. American Indian or Alaska Native. A person having origins in any of the original peoples of North and South
America (including Central America), and who maintains tribal affiliation or community attachment.
6. Native Hawaiian or Other Pacific Islander. A person having origins in any of the original peoples of Hawaii,
Guam, Samoa, or other Pacific Islands.
Item Number 3. Height. Select the values that best match your height in feet and inches. For example, if you are five
feet and nine inches, select “5” for feet and “09” for inches. Do not enter your height in meters or centimeters.
Item Number 4. Weight. Enter your weight in pounds. If you do not know your weight, or need to enter a weight under
30 pounds or over 699 pounds, enter “000.” Do not enter your weight in kilograms.
Item Number 5. Eye Color. Select the box that best describes the color of your eyes.

Item Number 6. Hair Color. Select the box that best describes the color of your hair.
Part 4. Applicant’s Statement, Contact Information, Certification, and Signature

Item Numbers 1. - 6. Select the appropriate box to indicate whether you read this application yourself or whether you
had an interpreter assist you. If someone assisted you in completing the application, select the box indicating that you
used a preparer. Further, you must sign and date your application and provide your daytime telephone number, mobile
telephone number (if any), and email address (if any). Every application MUST contain the signature of the applicant (or
parent or legal guardian, if applicable). A stamped or typewritten name in place of a signature is not acceptable.
Part 5. Interpreter’s Contact Information, Certification, and Signature
Item Numbers 1. - 7. If you used anyone as an interpreter to read the Instructions and questions on this application to
you in a language in which you are fluent, the interpreter must fill out this section, provide his or her name, the name and
address of his or her business or organization (if any), his or her daytime telephone number, his or her mobile telephone
number (if any), and his or her email address (if any). The interpreter must sign and date the application.

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Part 6. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than
the Applicant
Item Numbers 1. - 8. This section must contain the signature of the person who completed your application, if other
than you, the applicant. If the same individual acted as your interpreter and your preparer, that person should complete
both Part 5. and Part 6. If the person who completed this application is associated with a business or organization, that
person should complete the business or organization name and address information. Anyone who helped you complete
this application MUST sign and date the application. A stamped or typewritten name in place of a signature is not
acceptable. If the person who helped you prepare your application is an attorney or accredited representative whose
representation extends beyond preparation of this application, he or she may be obliged to also submit a completed Form
G-28, Notice of Entry of Appearance as Attorney or Accredited Representative, or G-28I, Notice of Entry of Appearance
as Attorney In Matters Outside the Geographical Confines of the United States, along with your application.

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Part 7. Additional Information

Item Numbers 1. - 6. If you need extra space to provide any additional information within this application, use the space
provided in Part 7. Additional Information. If you need more space than what is provided in Part 7., you may make
copies of Part 7. to complete and file with your application, or attach a separate sheet of paper. Type or print your name
and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which
your answer refers; and sign and date each sheet.
We recommend that you print or save a copy of your completed application to review in the future and for
your records. We recommend that you review your copy of your completed application before you come to
your biometric services appointment at a USCIS ASC. At your appointment, USCIS will permit you to complete
the application process only if you are able to confirm, under penalty of perjury, that all of the information in your
application is complete, true, and correct. If you are not able to make that attestation in good faith at that time,
USCIS will require you to return for another appointment.

What Evidence Must You Submit?

Read the instructions carefully. Depending on whether you submit the application with USCIS or with CBP, you may
have to submit additional information.
You must submit all evidence requested in these Instructions with your application. If you fail to submit required
evidence, USCIS or CBP may reject or deny your application for failure to submit requested evidence or supporting
documents in accordance with 8 CFR 103.2(b)(1) and these Instructions.
1. General Information Required to Complete Form I-192
If you are filing this application with CBP, submit the additional documentation listed in Item Number 2. below.
A. Inadmissible on Foreign Policy or National Security Grounds under INA section 212(a)(3)
If you are inadmissible under any provision of INA section 212(a)(3)(A)(i)(II), (B), (E)(iii), or (F), submit a
written statement with your application, signed under penalty of perjury under U.S. law. The written statement
should explain in detail why you are inadmissible and why you believe you should be admitted.
NOTE: Do not file this application if you are inadmissible under INA section 212(a)(3)(A)(i)(I), INA section
212(a)(3)(A)(ii), INA section 212(a)(3)(A)(iii), INA section 212(a)(3)(C), INA section 212(a)(3)(E)(i), or INA
section 212(a)(3)(E)(ii). INA section 212(d)(3)(A) does not permit the nonimmigrant admission of a foreign
national inadmissible on one of these grounds.
NOTE: Do not file this application if you are inadmissible only under INA section 212(a)(3)(D) for being a
member of a Communist or other totalitarian party, since this inadmissibility ground applies to immigrants, and
not nonimmigrants.

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NOTE: If you are inadmissible under INA section 212(a)(9)(A) or 212(a)(9)(C)(i)(II), you may also need to file
Form I-212, Application for Permission to Reapply for Admission into the United States After Deportation or
Removal.
B. Inadmissible Because of Health-Related Grounds of Inadmissibility Under INA section 212(a)(1)
If you file this application because you are inadmissible because of health-related grounds of inadmissibility, you
must describe the health-related grounds in detail.
If you are seeking admission to the United States for the treatment of a medical condition, you must attach a
written statement establishing:

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(1) That satisfactory treatment cannot be obtained outside the United States;

(2) That arrangements for treatment have been made, including where and from whom or what institution
treatment will be received;
(3) What financial arrangements for payment of expenses (incurred in connection with the treatment) have been
made; and
(4) That a bond will be available, if required by the Secretary of Homeland Security.

C. Inadmissible Because of Criminal Convictions and Related Grounds under INA section 212(a)(2)
If the application is made because you have been convicted of one or more crimes anywhere in the world, your
application must include a statement, signed by you under penalty of perjury under U.S. law, specifying the:
(1) Name of the crimes for which you were convicted, and the country in which you were convicted;
(2) Dates and places of the commission of the crimes;

(3) Dates and places of conviction (including the name of the court); and

(4) Sentences you received, or any other judgments from the court related to the crimes.
List each crime separately.

For each conviction, you must submit the official record of each conviction and all court dispositions, as well as
any other documents relating to the commutation of sentence, parole, probation, or pardon. If an official record is
not available then you may submit an official letter from the court of jurisdiction stating the reason why an official
record is not available.
These records must be in English, or an English translation must be included. The translator must certify that he
or she is competent to translate and that the translation is accurate.
D. For All Other Grounds of Inadmissibility under INA section 212(a)

If you are inadmissible under any ground not listed above, you must provide a statement signed by you under
penalty of perjury that specifies the applicable ground of inadmissibility, the factual basis for your inadmissibility,
and reasons for claiming that you should be granted advance permission to enter the United States.
2. Required Additional Information When Filing Form I-192 With CBP
If you file this application with CBP, you must submit the following additional documentation.
A. Proof of citizenship and identity, such as a passport, citizenship card with photograph, naturalization certificate, or
birth certificate. Note that a driver’s license is not considered proof of citizenship but may accompany a copy of
another document. Copies of these documents are acceptable.
B. Completed Form G-325A, Biographic Information, signed and dated by you.
C. If you have ever used a name other than your full legal name as provided on this application, you must list it
on the application. Include any names from previous marriages. Evidence of any legal name changes, such as
marriage certificates, divorce decrees, etc. must be included. Copies are acceptable.

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D. Ensure that in Part 1., Item Number 7., you list a current and complete address, including a postal code. You
may use a PO Box for mailing purposes. You must also list your complete and current address on all forms and
correspondence you send to CBP.
E. Each application must contain your official police record or evidence that no record exists from your country of
residence or nationality. This record is valid for 15 months from the date of issuance for submission with your
Form I-192.
NOTE to Canadian applicants: You can obtain the information noted above from the Royal Canadian
Mounted Police (RCMP) by submitting your fingerprints on Form C-216C. The returned Civil Product and any
accompanying records must be dated and endorsed by the RCMP within 15 months of submission with your Form
I-192. For instructions, addresses, and payment information, visit the RCMP Web site at: www.rcmp-grc.ca/.

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F. If you retained an attorney to file the application, counsel may be obliged to complete Form G-28, Notice of Entry
of Appearance as Attorney or Accredited Representative.
G. Recommended Supporting Documentation:

(1) Evidence and/or a written account demonstrating rehabilitation and character reformation related to your
being inadmissible. The focus of such evidence should include, but is not limited to, targeted counseling,
rehabilitation programs attended/completed, achievements in community service, or other relevant, credible
information showing rehabilitation and character reformation.
(2) A copy of any previously issued Form I-192 decisions (favorable or otherwise).

What Is the Filing Fee?

The filing fee for Form I-192 is $585.

A fee waiver request will be accepted in accordance with 8 CFR 103.7(c) for the following individuals:
1. An applicant for T nonimmigrant status; and
2. A petitioner for U nonimmigrant status.

NOTE: The filing fee is not refundable, regardless of any action USCIS takes on this application. DO NOT MAIL
CASH. You must submit all fees in the exact amount.
Use the following guidelines when you prepare your check or money order for the Form I-192 filing fee, if you are
applying to USCIS:
1. 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
2. Make the check or money order payable to U.S. Department of Homeland Security.
NOTE: Spell out U.S. Department of Homeland Security; do not use the initials “USDHS” or “DHS.”
3. If you live outside the United States, contact the nearest U.S. Embassy or U.S. Consulate for instructions on the
method of payment.
Notice to Those Making Payment by Check. If you send us a check, USCIS will convert it into an electronic funds
transfer (EFT). This means we will copy your check and use the account information on it to electronically debit your
account for the amount of the check. The debit from your account will usually take 24 hours and your bank will show it
on your regular account statement.
You will not receive your original check back. We will destroy your original check, but will keep a copy of it. If USCIS
cannot process the EFT for technical reasons, you authorize us to process the copy in place of your original check. If
USCIS cannot complete the EFT because of insufficient funds, we may try to make the transfer two additional times.

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Use the following guidelines when you prepare your check or money order for the Form I-192 filing fee, if you are
applying to CBP:
1. The check or money order must be made payable to Customs and Border Protection. 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.
Certain CBP-designated ports-of- entry and certain CBP-designated preclearance offices may accept payment in the
form of cash or credit cards.
We recommend that you contact the CBP preclearance office or CBP port-of-entry where you intend to be processed
for payment instructions. Please visit the CBP Web site at www.cbp.gov (go to the search box and type “Form I-192,”
“I-192,” “192,” or “waiver”).

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2. Special Instructions for Citizens of Palau, the Federated States of Micronesia, or the Marshall Islands. You
may contact the nearest U.S. Embassy or U.S. Consulate to receive payment instructions. You may also receive
instructions by emailing the CBP/ARO at: [email protected].
How To Check If The Fees Are Correct

Form I-192’s filing fee is current as of the edition date in the lower left corner of this page. However, because USCIS fees
change periodically, you can verify that the fees are correct by following one of the steps below.
1. Visit the USCIS Web site at www.uscis.gov, select “FORMS,” and check the appropriate fee; or

2. Call the USCIS National Customer Service Center at 1-800-375-5283 and ask for fee information. For TTY (deaf or
hard of hearing) call: 1-800-767-1833.
Fee Waiver - USCIS Applications Only

You may be eligible for a fee waiver under 8 CFR 103.7(c). If you believe you are eligible for a fee waiver, complete
Form I-912, Request for Fee Waiver (or a written request) and submit it and any required evidence of your inability to pay
the filing fee with this application. You can review the fee waiver guidance at www.uscis.gov/feewaiver.

Where to File?

You may file this application with USCIS only if you are applying for T nonimmigrant status (Form I-914) or petitioning
for U nonimmigrant status (Form I-918). In all other cases, you must file this application with CBP.
If you are filing your application with USCIS, please see our Web site at www.uscis.gov/I-192 or call our National
Customer Service Center at 1-800-375-5283 for the most current information about where to file this application. For
TTY (deaf or hard of hearing) call: 1-800-767-1833.
If you are filing your application with CBP, see the CBP Web site at www.cbp.gov for the most current information about
where to file this application. For TTY (deaf or hard of hearing) call: 1-800-767-1833.

Address Change
If You Have an Application Pending With USCIS
An applicant who is not a U.S. citizen must notify USCIS of his or her new address within 10 days of moving from his or
her previous residence. For information on filing a change of address, go to the USCIS Web site at
www.uscis.gov/addresschange or contact the USCIS National Customer Service Center at 1-800-375-5283. For TTY
(deaf or hard of hearing) call: 1-800-767-1833.
NOTE: Do not submit a change of address request to USCIS Lockbox facilities because USCIS Lockbox facilities do not
process change of address requests.

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If You Have an Application Pending With CBP
You may notify CBP of your change of address by writing via regular mail or via email to:
U.S. Customs and Border Protection
Admissibility Review Office
7799 Leesburg Pike, 6th Floor
Falls Church, VA 20598-1234
Email address: [email protected]

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Processing Information

NOTE: It is important to fully disclose all grounds of inadmissibility that apply or may apply to you. If the
application is approved, the approval is only valid for the grounds of inadmissibility that were listed on the
application.

USCIS Processing

Initial Processing. Once USCIS accepts your application we will check it for completeness. If you do not completely fill
out this application, you will not establish a basis for your eligibility and USCIS may reject or deny your application.
Requests for More Information. We may request that you provide more information or evidence to support your
application. We may also request that you provide the originals of any copies you submit. USCIS will return any
requested originals when they are no longer needed.
Requests for Interview. We may request that you appear at a USCIS office for an interview based on your application.
At the time of any interview or other appearance at a USCIS office, we may require that you provide your fingerprints,
photograph, and/or signature to verify your identity and/or update background and security checks.
Decision. The decision on Form I-192 involves a determination of whether you have established eligibility for the
immigration benefit you are seeking. USCIS will notify you of the decision in writing.
If you have any questions about your case, call the USCIS National Customer Service Center at 1-800-375-5283 or visit
the USCIS Web site at www.uscis.gov. For TTY (deaf or hard of hearing) call: 1-800-767-1833. You can also write to
the Vermont Service Center at:
USCIS-Vermont Service Center
75 Lower Welden Street
St. Albans, VT 05479-0001

CBP Processing
The Admissibility Review Office (ARO) will make a decision on your application. You will be notified in writing of the
decision. The decision will be mailed to the address provided on the application. It is recommended that you wait until
after more than 90 days have passed from submission of your application before making a status inquiry. Status inquiries
are made via email at the following address: [email protected]. Attorneys should address their inquiries to:
[email protected].

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How Long Is an Approved Form I-192 Valid?
If your application for advance permission to enter as a nonimmigrant is granted, the permission will be valid for the
duration stated on the approval (8 CFR 212.4(c)(3)(iii)), subject to the conditions imposed on your admission. Advance
permission to enter as a nonimmigrant is granted at the discretion of the Department of Homeland Security (DHS), and
may be revoked at any time. See 8 CFR 212.4(c)(1)(viii).
If you leave the United States, and if the approval is no longer valid, you will need to file a new application for any future
entries. A prior approval of Form I-192 cannot be revalidated. See 8 CFR 212.4(c)(3)(vi).

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USCIS Forms and Information

To ensure you are using the latest version of this application, visit the USCIS Web site at www.uscis.gov where you can
obtain the latest USCIS forms and immigration-related information. If you do not have Internet access, you may order
USCIS forms by calling our toll-free number at 1-800-870-3676. You may also obtain forms and information by calling
the USCIS National Customer Service Center at 1-800-375-5283. For TTY (deaf or hard of hearing) call:
1-800-767-1833.
Instead of waiting in line for assistance at your local USCIS office, you can schedule an appointment online at
www.uscis.gov. Select “Schedule an appointment online” and follow the screen prompts to set up your appointment.
Once you finish scheduling an appointment, the system will generate an appointment notice for you.

Penalties

If you knowingly and willfully falsify or conceal a material fact or submit a false document with your Form I-192, we will
deny your Form I-192 and may deny any other immigration benefit. In addition, you will face severe penalties provided
by law and may be subject to criminal prosecution.

USCIS Privacy Act Statement

AUTHORITIES: The information requested on this application, and the associated evidence, is collected under the
Immigration and Nationality Act, sections 212(d)(3)(A)(ii), 212(d)(13), and 14 and 8 CFR parts 212.4(b), 212.16 and 17,
214.11, and 214.14.
PURPOSE: The primary purpose for providing the requested information on this application is for USCIS and CBP
to grant temporary permission for certain inadmissible nonimmigrants to enter the United States. DHS will use the
information you provide to grant or deny the immigration benefit you are seeking.
DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and
any requested evidence, may delay a final decision in your case or result in denial of your application.
ROUTINE USES: DHS may share the information you provide on this application with other Federal, state, local,
and foreign government agencies and authorized organizations. DHS follows approved routine uses described in the
associated published system of records notices [DHS/USCIS-007 - Benefits Information System, DHS/CBP-006 Automated Targeting System, and DHS/USCIS-ICE/CBP-001 - Alien File, Index, and National File Tracking System
of Records] which you can find at www.dhs.gov/privacy. DHS may also share the information, as appropriate, for law
enforcement purposes or in the interest of national security. Disclosure of information will also be in compliance with
provisions of 8 U.S.C. section 1367.

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Paperwork Reduction Act
An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection
of information, unless it displays a currently valid Office of Management and Budget (OMB) control number. The
public reporting burden for this collection of information is estimated at 30 minutes per response, including the time
for reviewing instructions, gathering the required documentation and information, completing the application, attaching
necessary documentation, and submitting the application. The collection of biometrics is estimated to require 1 hour and
10 minutes. Send comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services, Regulatory Coordination Division,
Office of Policy and Strategy, 20 Massachusetts Ave NW, Washington, DC 20529-2140; OMB No. 1615-0017. Do not
mail your completed Form I-192 to this address.

DRAFT
Not for
Reproduction
05/10/2016

Form I-192 Instructions 10/21/15 N

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