Form I-131 Application for Travel Document

Application for Travel Document

USCIS
Form I-131

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

Action Block

Receipt
For
USCIS
Use
Only

OMB No. 1615-0013
Expires 04/30/2022

DRAFT
Not for
Production
05/13/2020

To Be Completed
by an Attorney/
Representative,
if any.
Fill in box if G-28 is
attached to represent
the applicant.

Document Hand Delivered
By:

Date:

/

/

/

Document Issued
Re-entry Permit (Update
"Mail To" Section)

Refugee Travel Document
(Update "Mail To" Section)

Single Advance Parole

Multiple Advance Parole
Valid Until:
/
/

/

Mail To

Address in Part 1

(Re-entry &
Refugee
Only)

US Consulate at:

Attorney State
License Number:

Intl DHS Ofc at:

► Start Here. Type or Print in Black Ink

Part 1. Information About You
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)

Other Information

3.

► A-

1.c. Middle Name

Physical Address
2.a. In Care of Name

2.b. Street Number
and Name
2.c. Apt.

Ste.

2.g. Postal Code

4.

Country of Birth

5.

Country of Citizenship

6.

Class of Admission

7.

Gender

8.

Date of Birth

9.

U.S. Social Security Number (if any)

Flr.

2.d. City or Town
2.e. State

Alien Registration Number (A-Number)

2.f.

ZIP Code

Male

Female
(mm/dd/yyyy) ►

►

2.h. Province
2.i.

Country

Form I-131 04/24/19

Page 1 of 6

Part 2. Application Type
1.a.

I am a permanent resident or conditional resident of
the United States, and I am applying for a reentry
permit.

1.b.

I now hold U.S. refugee or asylee status, and I am
applying for a Refugee Travel Document.

1.c.

I am a permanent resident as a direct result of refugee
or asylee status, and I am applying for a Refugee
Travel Document.

1.d.

1.e.
1.f.

2.e. Country of Birth

2.f.

Country of Citizenship

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2.g. Daytime Phone Number

2.h. In Care of Name

I am outside the United States, and I am applying for
an Advance Parole Document.

2.i.

I am applying for an Advance Parole Document for a
person who is outside the United States.

Street Number
and Name

2.j.

Apt.

2.a. Family Name
(Last Name)
2.b. Given Name
(First Name)
2.c. Middle Name
2.d. Date of Birth

)

-

Physical Address (If you checked box 1.f.)

I am applying for an Advance Parole Document to
allow me to return to the United States after
temporary foreign travel.

If you checked box "1.f." provide the following information
about that person in 2.a. through 2.p.

(

Ste.

Flr.

2.k. City or Town
2.l.

State

2.m. ZIP Code

2.n. Postal Code
2.o. Province

(mm/dd/yyyy) ►

2.p. Country

Part 3. Processing Information
1.

Date of Intended Departure
(mm/dd/yyyy) ►

2.

4.a. Have you ever before been issued a reentry permit or
Refugee Travel Document? (If "Yes" give the following
information for the last document issued to you):
Yes

Expected Length of Trip (in days)

3.a. Are you, or any person included in this application, now
in exclusion, deportation, removal, or rescission
proceedings?
Yes
No

4.b. Date Issued

No

(mm/dd/yyyy) ►

4.c. Disposition (attached, lost, etc.):

3.b. If "Yes", Name of DHS office:

If you are applying for a non-DACA related Advance Parole Document, skip to Part 7; DACA recipients must complete Part 4
before skipping to Part 7.

Form I-131 04/24/19

Page 2 of 6

Part 3. Processing Information (continued)
Where do you want this travel document sent? (Check one)
5.
6.

To the U.S. address shown in Part 1 (2.a through
2.i.) of this form.

6.b. Country
7.

10.c. Apt.

7.b. Country

Ste.

Flr.

10.d. City or Town
10.e. State

To a DHS office overseas at:

7.a. City or Town

10.b. Street Number
and Name

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To a U.S. Embassy or consulate at:

6.a. City or Town

10.a. In Care of Name

10.f. ZIP Code

10.g. Postal Code
10.h. Province

If you checked "6" or "7", where should the notice to pick up
the travel document be sent?

10.i. Country

8.

To the address shown in Part 2 (2.h. through 2.p.)
of this form.

10.j. Daytime Phone Number

9.

To the address shown in Part 3 (10.a. through 10.i.)
of this form.:

(

)

-

Part 4. Information About Your Proposed Travel
1.a. Purpose of trip. (If you need more space, continue on a
separate sheet of paper.)

1.b. List the countries you intend to visit. (If you need more
space, continue on a separate sheet of paper.)

Part 5. Complete Only If Applying for a Re-entry Permit
Since becoming a permanent resident of the United States (or
during the past 5 years, whichever is less) how much total time
have you spent outside the United States?
1.a.
1.b.
1.c.

less than 6 months
6 months to 1 year
1 to 2 years

Form I-131 04/24/19

1.d.
1.e.
1.f.

2 to 3 years
3 to 4 years
more than 4 years

2.

Since you became a permanent resident of the United
States, have you ever filed a Federal income tax return as
a nonresident or failed to file a Federal income tax return
because you considered yourself to be a nonresident? (If
"Yes" give details on a separate sheet of paper.)
Yes

No

Page 3 of 6

Part 6. Complete Only If Applying for a Refugee Travel Document
1.

3.c. Applied for and/or received any benefit from such country
(for example, health insurance benefits)?

Country from which you are a refugee or asylee:

Yes
If you answer "Yes" to any of the following questions, you
must explain on a separate sheet of paper. Include your
Name and A-Number on the top of each sheet.
2.

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Do you plan to travel to the country
named above?

Yes

No

No

Since you were accorded refugee/asylee status, have you, by
any legal procedure or voluntary act:
4.a. Reacquired the nationality of the
country named above?

Yes

No

Since you were accorded refugee/asylee status, have you ever:

4.b. Acquired a new nationality?

Yes

No

3.a. Returned to the country named
above?

4.c. Been granted refugee or asylee status
in any other country?

Yes

No

Yes

No

3.b. Applied for and/or obtained a national passport, passport
renewal, or entry permit of that country?
Yes

No

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.)
1.

How many trips do you intend to use this document?
One Trip
More than one trip

If the person intended to receive an Advance Parole Document
is outside the United States, provide the location (City or Town
and Country) of the U.S. Embassy or consulate or the DHS
overseas office that you want us to notify.
2.a. City or Town

4.a. In Care of Name

4.b. Street Number
and Name

4.c. Apt.

Ste.

Flr.

4.d. City or Town
4.e. State

4.f.

ZIP Code

4.g. Postal Code
4.h. Province

2.b. Country

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

To the address shown in Part 2 (2.h. through 2.p.)
of this form.

4.

To the address shown in Part 7 (4.a. through 4.i.)
of this form.

Form I-131 04/24/19

4.i.

Country

4.j.

Daytime Phone Number

(

)

-

Page 4 of 6

Part 8. Biographic Information for the Person Who Will Receive the Document
1.

2.

Ethnicity (Select only one box)

4.

Weight

Hispanic or Latino
Not Hispanic or Latino

5.

Eye Color (Select only one box)

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Black
Gray
Maroon

Race (Select all applicable boxes)
White
Asian
Black or African American

6.

Height

Feet

Blue
Green
Pink

Brown
Hazel
Unknown/Other

Hair Color (Select only one box)
Bald (No hair)
Brown
Sandy

American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
3.

Pounds

Black
Gray
White

Blond
Red
Unknown/Other

Inches

Part 9. Signature of Applicant (Read the information on penalties in the Form instructions before completing
this Part.) If you are filing for a Re-entry Permit or Refugee Travel Document, you must be in the United States
to file this application.
Copies of any documents I have submitted are exact
photocopies of unaltered, original documents, and I understand
that USCIS may require that I submit original documents to
USCIS at a later date. Furthermore, I authorize the release of
any information from any and all of my records that USCIS
may need to determine my eligibility for the immigration
benefit I seek.

1.

Date of Signature (mm/dd/yyyy)

2.

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.

I furthermore authorize release of information contained in this
application, in supporting documents, and in my USCIS
records, to other entities and persons where necessary for the
administration and enforcement of U.S. immigration laws.

I certify, under penalty of perjury, that all of the information in
my application and any document submitted with it were
provided or authorized by me, that I reviewed and understand
all of the information contained in, and submitted with, my
application and that all of this information is complete, true, and
correct.
Signature of Applicant

Form I-131 04/24/19

Page 5 of 6

Part 10. Information About Person Who Prepared This Application, If Other Than the Applicant
NOTE: If you are an attorney or representative, you must
submit a completed Form G-28, Notice of Entry of Appearance
as Attorney or Accredited Representative, along with this
application.

Preparer's Contact Information
4.

Preparer's Daytime Phone Number

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(

Preparer's Full Name

5.

)

Extension

-

Preparer's E-mail Address (if any)

Provide the following information concerning the preparer:
1.a. Preparer's Family Name (Last Name)

Declaration

1.b. Preparer's Given Name (First Name)

2.

Preparer's Business or Organization Name

To be completed by all preparers, including attorneys and
authorized representatives: I declare that I prepared this benefit
request at the request of the applicant, that it is based on all the
information of which I have knowledge, and that the
information is true to the best of my knowledge.

6.a. Signature
of Preparer

Preparer's Mailing Address
3.a. Street Number
and Name
3.b. Apt.

Ste.

3.c. City or Town
3.d. State
3.f.

Postal Code

Flr.

6.b. Date of Signature (mm/dd/yyyy) ►
NOTE: If you require more space to provide any additional
information, use a separate sheet of paper. You must include
your Name and A-Number on the top of each sheet.

3.e. ZIP Code

3.g. Province
3.h. Country

Form I-131 04/24/19

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