I192-016-INS-REV-OMBReview-10312023

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 10/31/2023

What Is the Purpose of Form I-192?
Use this application if you are inadmissible and are seeking advance permission to temporarily enter the United States as
a nonimmigrant, or you are in the United States as a T nonimmigrant status applicant or U nonimmigrant status petitioner
seeking to waive your inadmissibility.

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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) and 212(d)(13), 8 CFR section 212.4,
212.16, 212.17, 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. Applicant for principal or derivative T nonimmigrant status (Form I-914 or I-914, Supplement A);
2. Petitioner for principal or derivative U nonimmigrant status (Form I-918 or I-918, Supplement A);
or

3. Inadmissible nonimmigrant already possessing appropriate documents.

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.
NOTE: If you need a visa to come to the United States as a nonimmigrant (other than as a T or U nonimmigrant) do
not file this application. 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.

General Instructions
We provide free forms through the USCIS website. To view, print, or complete 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 Contact Center at 800-375-5283 (TTY 800-767-1833) and ask that we mail a form to you.
Signature. You (or your signing authority) must properly complete your application. USCIS will not accept a stamped
or typewritten name in place of any signature on this application. If you are under 14 years of age, your parent or
legal guardian may sign the application on your behalf. A legal guardian may also sign for a mentally incompetent
person. If your application is not signed, or if the signature is not valid, we will reject your application. See
8 CFR 103.2(a)(7)(ii)(A). If USCIS accepts an application for adjudication and determines that it has a deficient signature,
USCIS will deny the application.
Validity of Signatures. USCIS will consider a photocopied, faxed, or scanned copy of an original handwritten signature
as valid for filing purposes. The photocopy, fax, or scan must be of the original document containing the handwritten, ink
signature.

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Filing Fee. You must pay the appropriate filing fee for each application you submit. (See the What Is the Filing Fee
section of these Instructions for more information, including eligibility for fee waivers).
Evidence. When you file your application, you must submit all evidence and supporting documentation listed in the
What Evidence Must You Submit and/or Specific Instructions sections of these Instructions.
Biometric Services Appointment
We recommend that you review your copy of your completed application before you go to your biometric services
appointment at a USCIS ASC.

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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.
For Applicants Filing Form I-192 with CBP. Contact CBP to determine where and when to attend a biometric services
appointment for the purpose of filing your Form I-192.
Copies. You should submit legible photocopies of requested documents unless the Instructions specifically instruct you
to submit an original document. USCIS or CBP may request an original document at any time during the adjudication
process. If we request an original document from you, we will return it to you after USCIS determines it no longer needs
the original.
NOTE: If you submit original documents when they are not required or requested, USCIS may destroy them after we
receive them.
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 they are competent to translate from the foreign language into English. The certification must also include the their
signature, printed name, the signature date, and their contact information.
USCIS Contact Center. For additional information on the form and instructions about where to file, change of
address, and other questions, visit the USCIS Contact Center at www.uscis.gov/contactcenter or call at 800-375-5283
(TTY 800-767-1833). The USCIS Contact Center provides information in English and Spanish.
How To Complete 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 6. 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.
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.
4. USCIS Online Account Number. Providing the applicant’s unique USCIS Online Account Number (OAN) helps
them manage their online account. You have an Online Account Number if you previously filed an application,
petition, or request online or filed a benefit request by mail and received a receipt number that begins with IOE. If
you filed a form online, you can find your OAN in your USCIS Online Account profile. If you filed a form by mail
and received a receipt number that begins with IOE, you can find your OAN at the top of the USCIS Account Access
Notice we sent you. The OAN is not the same as an A-Number. If you do not have a receipt number beginning with
IOE, you do not have an OAN.
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Specific Instructions
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.

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Item Number 2. Other Names Used. Provide all other names you have ever used, including aliases, maiden name, and
nicknames. If you need extra space to complete this section, use the space provided in Part 6. Additional Information.
Item Number 3. Alien Registration Number (A-Number) (if any). Provide your A-Number. We use your A-Number
to identify your immigration records. It begins with an “A” and can be found on correspondence you have received from
the Department of Homeland Security (DHS) or USCIS. If you do not have an A-Number, type or print “N/A.”
Item Number 4. USCIS Online Account Number (if any). If you have previously filed an application or petition using
the myUSCIS online filing system (previously called USCIS Electronic Immigration System (USCIS ELIS)), provide the
USCIS OAN you were issued by the system. You can find your USCIS OAN by logging in to your account and going
to the profile page. If you previously filed certain applications or petitions on a paper form through a USCIS Lockbox
facility, you may have received a USCIS Online Account Access Notice issuing you a USCIS OAN. You may find your
USCIS OAN at the top of the notice. If you were issued a USCIS OAN, enter it in the space provided. The USCIS OAN
is not the same as an A-Number.
Item Number 5. Date of Birth. Provide your date of birth in mm/dd/yyyy format.

Item Number 6. Place of Birth. Provide the city or town, state or province, and country where you were born in the
spaces provided.
Item Number 7. Country of Citizenship or Nationality. Provide the name of the country where you are a citizen and/
or national. 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 Part 6. Additional Information.
Item Number 8. Gender. Indicate how you identify. Your selection will be reflected on secure documents if we approve
your application.
Item Number 9. Mailing Address (Safe Address, if applicable). You must provide a valid mailing address in the United
States in Part 2. You may list a valid U.S. residence, APO, or commercial address. You may also list a U.S. Post Office
address (P.O. Box) if that is how you receive your mail. If your mail is sent to someone other than yourself, please
include an “In Care Of Name” as part of your mailing address. If your U.S. mailing address is in a U.S. territory and it
contains an urbanization name, list the urbanization name in the “In Care Of Name” space provided.
NOTE: If you have a pending or approved application as a victim of trafficking (T nonimmigrant), or petition as a victim
of qualifying criminal activity (U nonimmigrant), and you do not feel safe receiving mail about this application at your
physical address, provide a safe mailing address. The safe address may be a P.O. Box or the address of a friend, your
attorney or accredited representative, a community-based organization that is helping you, or any other address where you
can safely and timely receive mail.
Item Numbers 10. - 11. Address History. Provide physical addresses for everywhere you have lived during the last five
years, whether inside or outside the United States. Provide your current address first. If you need extra space to complete
this section, use the space provided in Part 6. Additional Information.
Item Numbers 12. - 25. Information About Your Marital History. If you have ever been married, provide information
about your current marriage and any previous marriages. If you have had more than one previous marriage, use the space
provided in Part 6. Additional Information to provide the information requested.

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Item Numbers 26. - 36. 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 6. Additional Information.
Item Numbers 37. - 43. 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.
NOTE: If you are an applicant for T nonimmigrant status or a petitioner for U nonimmigrant status and are in the United
States, you do not need to answer Item Numbers 37. - 43.
Item Numbers 44. - 45. Employment History. Provide your employment history for the last five years, whether inside
or outside the United States. Provide the most recent employment first. If you need extra space to complete this section,
use the space provided in Part 6. Additional Information.

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Part 3. Applicant’s Statement, Contact Information, Certification, and Signature

You must sign and date your application and, if applicable, provide your daytime telephone number, mobile telephone
number, and email address. The signature of a parent or legal guardian, if applicable, is acceptable. A stamped or
typewritten name in place of a signature is not acceptable. This certification does not affect the confidentiality protections
you are entitled to under 8 U.S.C. section 1367(a)(2).
NOTE: Special protections (described at 8 U.S.C. section 1367) apply to applicants for T nonimmigrant status and
petitioners for U nonimmigrant status, including any qualifying family members. The first form of protection under this
statute is a prohibition on adverse determinations based on information provided solely by the trafficker or perpetrator
of the qualifying criminal activity and other prohibited sources. The second form of protection under this statute is a
prohibition on disclosure of any information about the applicant or petitioner to third parties, except in certain very limited
circumstances.
Part 4. Interpreter’s Contact Information, Certification, and Signature

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 their, the name and address of their business or
organization (if any), their daytime telephone number, their mobile telephone number (if any), and their email address (if
any). The interpreter must sign and date the application.
Part 5. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than
the Applicant
The person who completed your application, if other than the applicant must sign this section and complete both Part 4.
and Part 5. A stamped or typewritten name in place of a signature is not acceptable.
Part 6. Additional Information
If you need extra space to provide any additional information within this application, use the space provided in Part 6.
Additional Information. If you need more space than what is provided in Part 6., you may make copies of Part 6. 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.

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We recommend that you print or save a copy of your completed application for your records. We
recommend that you review your copy of your completed application before you go to your biometric
services appointment at a USCIS ASC. At your appointment, USCIS will allow 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, we will require you to return for another appointment.

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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 in accordance with 8 CFR 103.2(b)(1) and these
Instructions.
1. General Information Required to Complete Form I-192

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 seeking advance permission under INA section 212(d)(3)(A),
but are inadmissible under INA sections 212(a)(3)(A)(i)(I), 212(a)(3)(A)(ii), 212(a)(3)(A)(iii), 212(a)(3)(C),
212(a)(3)(E)(i), or 212(a)(3)(E)(ii). INA section 212(d)(3)(A) does not permit the nonimmigrant admission of
a foreign national who is inadmissible on one of these grounds.
NOTE: Do not file this application if you are an applicant for T nonimmigrant status seeking a waiver under INA
section 212(d)(13) and you are inadmissible under INA sections 212(a)(3), 212(a)(10)(C), or 212(a)(10)(E). INA
section 212(d)(13)(B)(ii) does not permit the waiver of these grounds of inadmissibility for T nonimmigrants.
NOTE: Do not file this application if you are seeking U nonimmigrant status and you are inadmissible under
INA section 212(a)(3)(E). INA section 212(d)(14) does not permit the waiver of this ground of inadmissibility.
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 as, this inadmissibility ground does not apply to
nonimmigrants.
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:
(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;

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(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.
NOTE: Do not file this application if you are inadmissible only under INA section 212(a)(1)(A)(ii) for failure to
present documentation of having received vaccination against vaccine-preventable disease, as this inadmissibility
ground does not apply to nonimmigrants.
C. Inadmissible Because of Criminal Convictions and Related Grounds under INA section 212(a)(2)
If you are filing this application 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:

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(1) Name each of the crimes and criminal statutes 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 an official
record is not available.
These records must be in English, or an English translation must be included. The translator must certify that they
are competent to translate from the foreign language to English 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 a waiver or 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. If you have ever used a name other than your full legal name as provided on this application, you must list it in
Part 2., Item Number 2. Include any names from previous marriages. Evidence of any legal name changes,
such as marriage certificates, or divorce decrees must be included. Copies are acceptable.
C. 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.
D. 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 website at: www.rcmp-grc.gc.ca/.
E. 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 or Form G-28I, Notice of Entry of Appearance as
Attorney In Matters Outside the Geographical Confines of the United States.
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F. 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; and
(2) A copy of any previously issued Form I-192 decisions (favorable or otherwise).

What Is the Filing Fee?

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The filing fee for Form I-192 depends on the agency that makes the decision on your application.
1. If filing with USCIS, the filing fee for Form I-192 is $930.
2. If filing with CBP, the filing fee for Form I-192 is $585.

A fee waiver request will be considered 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.
If you are applying to USCIS, use the following guidelines when you prepare your check or money order for the Form
I-192 filing fee:
•

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 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 are seeking T or U nonimmigrant status and are located outside of the United States, you must pay the filing fee
or submit the fee waiver to the appropriate address as listed in “Where to File”.
For all other matters: 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 Paying by Check. If you send USCIS a check, we 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.
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 your check is returned as unpayable, we will
re-submit the payment to the financial institution one time. If the check is returned as unpayable a second time, we will
reject your application and charge you a returned check fee.
If you are applying to CBP, use the following guidelines when you prepare your check or money order for the Form
I-192 filing fee:
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 may accept payment in the form of cash or credit cards.

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We recommend that you contact the CBP Port of Entry where you intend to be processed for payment instructions.
Please visit the CBP website at www.cbp.gov (go to the search box and type “Form I-192,” “I-192,” “192,” or
“waiver”).
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/Admissibility Review Office (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 fee is correct by following one of the steps below.

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1. Visit the USCIS website at www.uscis.gov, select “FORMS,” and check the appropriate fee; or
2. Visit www.uscis.gov/contactcenter or call the USCIS Contact Center to get answers to your questions and connect
with a live USCIS representative.
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 website at www.uscis.gov/I-192 for the most current
information about where to file this application.
If you are filing your application with CBP, see the CBP website 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
If you are not a U.S. citizen, you must notify USCIS of your new address within 10 days of moving from your previous
residence. For information on changing your address, go to our website at www.uscis.gov/addresschange, or call the
USCIS Contact Center.
NOTE: Do not submit a change of address request to the USCIS Lockbox.
If You Have an Application Pending With CBP
You may notify CBP of your change of address in writing through regular mail or email to:
U.S. Customs and Border Protection
Admissibility Review Office
Mail Stop 1234
22685 Holiday Park Drive Suite 10
Sterling, 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 properly
complete this application, you will not establish a basis for your eligibility and we may reject or deny your application.

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Requests for More Information. USCIS 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. If we request an original
document from you, we will return it to you after USCIS determines it is no longer needed.
Requests for Interview. We may request that you appear at a USCIS office for an interview based on your application.
During your interview, USCIS may require you to provide your biometrics 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 our decision in writing.
For additional information on how to make customer service inquires for protected persons T and U related filings, visit
the USCIS Contact Us webpage at www.uscis.gov/about-us/contact-us, utilizing the available case inquiry options for
“Inquiries for VAWA, T, and U Filings.”
Prohibition on Disclosure of Information. Information concerning U nonimmigrant status petitioners, T nonimmigrant
applicants and their qualifying family members is protected under 8 U.S.C. 1367 from unauthorized disclosure to anyone
other than an officer or employee of the Department of Homeland Security (DHS), the Department of Justice (DOJ),
or the Department of State (DOS) who has a need to know the information. The disclosure of any information relating
to a protected individual beyond DHS, DOJ, or DOS to anyone other than that protected individual or their authorized
representative is prohibited except in certain limited circumstances as provided by law.

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 150 days have passed from submission of your application before making a status inquiry.
If you have a question about the status of your application, email the following address: [email protected].
Attorneys should send their questions to: [email protected].
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 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 www.uscis.gov.

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 application and may deny any other immigration benefit. In addition, you will face severe penalties provided
by law and may be subject to criminal prosecution.

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USCIS Compliance Review and Monitoring

By signing this application, you have stated under penalty of perjury (28 U.S.C. section 1746) that all information and
documentation submitted with this application are complete, true, and correct. You also authorize the release of any
information from your records that USCIS may need to determine your eligibility for the immigration benefit you are
seeking and consent to USCIS verifying such information.
The Department of Homeland Security (DHS) has the authority to verify any information you submit to establish
eligibility for the immigration benefit you are seeking at any time. Our legal authority to verify this information is in 8
U.S.C. sections 1103, 1155, and 1184, and 8 CFR parts 103, 204, 205, and 214. To ensure compliance with applicable
laws and authorities, we may verify information before or after your case is decided.
Agency verification methods may include, but are not limited to: reviewing public records and information; contacting
through written correspondence; using the internet, fax, other electronic transmission, or telephone; making unannounced
physical site inspections of residences and locations of employment; and interviewing people. USCIS will use the
information we obtain to assess your compliance with the laws and to determine your eligibility for an immigration
benefit.
Subject to the restrictions under 8 CFR 103.2(b)(16), USCIS will provide you with an opportunity to address any adverse
or derogatory information that may result from a compliance review, verification, or site visit before a decision is made
on your request. For a visit after your request is approved, USCIS will provide you with an opportunity to address any
adverse or derogatory information which may result in revocation or termination of an approval.

DHS Privacy Notice
AUTHORITIES: The information requested on this application, and the associated evidence, is collected under INA
sections 212(d)(3)(A)(ii), 212(d)(13), and 212(d)(14) and Title 8 Code of Federal Regulations sections 212.4, 212.16,
212.17, 214.11, and 214.14.
PURPOSE: The primary purpose for providing the requested information on this application is for USCIS and CBP to
grant advance permission for certain inadmissible nonimmigrants to temporarily enter the United States. DHS uses 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,
including your Social Security number (if applicable), and any requested evidence, may delay a final decision or result in
denial of your request to temporarily enter the United States.

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ROUTINE USES: DHS may share the information you provide on this application and any additional requested
evidence 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/ICE/CBP- 001
Alien File, Index, and National File Tracking System of Records, DHS/USCIS-007 Benefits Information System,
and DHS/CBP-006 Automated Targeting System] and the published privacy impact assessments [DHS/USCIS/PIA016(a) Computer Linked Application Information Management System and Associated Systems and DHS/CBP/PIA006(b) Automated Targeting System Update], which can be found at www.dhs.gov/privacy. DHS may also share this
information, as appropriate, for law enforcement purposes or in the interest of national security.
FBI Privacy Notice

Draft
Not for
Production
10/31/2023

USCIS may use your biometrics to obtain the criminal history records of the Federal Bureau of Investigation (FBI),
for identity verification, to determine eligibility, to create immigration documents (for example, Permanent Resident
Card, Employment Authorization Document), or any purpose authorized by the Immigration and Nationality Act.
You may obtain a copy of your own FBI record using the procedures outlined at 28 CFR 16.30-16.34. For more
information, please visit:
https://www.fbi.gov/services/cjis/compact-council/guiding-principles-noncriminal-justice-applicants-privacy-rights.
For information regarding how the FBI will use your fingerprints, please visit
https://www.fbi.gov/services/cjis/compact-council/privacy-act-statement.

Paperwork Reduction Act

USCIS 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 Office of Management and Budget (OMB) control number. The public
reporting burden for this collection of information is estimated at 1 hour and 11 minutes per response, including the time
for reviewing instructions, gathering the required documentation and information, completing the application, preparing
statements, attaching necessary documentation, and submitting the application. 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, Office of Policy and Strategy, Regulatory Coordination Division, 5900 Capital
Gateway Drive, Mail Stop #2140, Camp Springs, MD 20588-0009; OMB No. 1615-0017. Do not mail your completed
Form I-192 to this address.

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