USCIS Form I-90 Application to Replace Permanent Resident Card

USCIS Form I-90 or the "Application To Replace Permanent Resident Card" is a form issued by the U.S. Department of Homeland Security - Citizenship and Immigration Services.

Download a PDF version of the USCIS Form I-90 down below or find it on the U.S. Department of Homeland Security - Citizenship and Immigration Services Forms website.

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Application to Replace Permanent Resident Card
USCIS
Form I-90
Department of Homeland Security
OMB No. 1615-0082
U.S. Citizenship and Immigration Services
Expires 07/31/2019
Applicant Interviewed
Receipt
Action Block
Date:
Class of Admission
For
USCIS
Use
Only
Remarks
START HERE - Type or print in black ink.
Mailing Address
Part 1. Information About You
(USPS ZIP Code Lookup)
1.
Alien Registration Number (A-Number)
6.a. In Care Of Name
A-
6.b.
Street Number
2.
USCIS Online Account Number (if any)
and Name
6.c.
Apt.
Ste.
Flr.
Your Full Name
6.d. City or Town
NOTE: Your card will be issued in this name.
6.e. State
6.f.
ZIP Code
3.a. Family Name
(Last Name)
6.g. Province
3.b. Given Name
(First Name)
6.h. Postal Code
3.c.
Middle Name
6.i.
Country
4.
Has your name legally changed since the issuance of your
Permanent Resident Card?
Yes (Proceed to Item Numbers 5.a. - 5.c.)
Physical Address
No (Proceed to Item Numbers 6.a. - 6.i.)
Provide this information only if different than mailing address.
7.a. Street Number
N/A - I never received my previous card.
and Name
(Proceed to Item Numbers 6.a. - 6.i.)
7.b.
Apt.
Ste.
Flr.
Provide your name exactly as it is printed on your current
Permanent Resident Card.
7.c. City or Town
NOTE: Attach all evidence of your legal name change with
7.d. State
7.e. ZIP Code
this application.
5.a. Family Name
7.f.
Province
(Last Name)
5.b. Given Name
7.g.
Postal Code
(First Name)
7.h.
Country
5.c. Middle Name
Form I-90 02/27/17 N
Page 1 of 7
Application to Replace Permanent Resident Card
USCIS
Form I-90
Department of Homeland Security
OMB No. 1615-0082
U.S. Citizenship and Immigration Services
Expires 07/31/2019
Applicant Interviewed
Receipt
Action Block
Date:
Class of Admission
For
USCIS
Use
Only
Remarks
START HERE - Type or print in black ink.
Mailing Address
Part 1. Information About You
(USPS ZIP Code Lookup)
1.
Alien Registration Number (A-Number)
6.a. In Care Of Name
A-
6.b.
Street Number
2.
USCIS Online Account Number (if any)
and Name
6.c.
Apt.
Ste.
Flr.
Your Full Name
6.d. City or Town
NOTE: Your card will be issued in this name.
6.e. State
6.f.
ZIP Code
3.a. Family Name
(Last Name)
6.g. Province
3.b. Given Name
(First Name)
6.h. Postal Code
3.c.
Middle Name
6.i.
Country
4.
Has your name legally changed since the issuance of your
Permanent Resident Card?
Yes (Proceed to Item Numbers 5.a. - 5.c.)
Physical Address
No (Proceed to Item Numbers 6.a. - 6.i.)
Provide this information only if different than mailing address.
7.a. Street Number
N/A - I never received my previous card.
and Name
(Proceed to Item Numbers 6.a. - 6.i.)
7.b.
Apt.
Ste.
Flr.
Provide your name exactly as it is printed on your current
Permanent Resident Card.
7.c. City or Town
NOTE: Attach all evidence of your legal name change with
7.d. State
7.e. ZIP Code
this application.
5.a. Family Name
7.f.
Province
(Last Name)
5.b. Given Name
7.g.
Postal Code
(First Name)
7.h.
Country
5.c. Middle Name
Form I-90 02/27/17 N
Page 1 of 7
Part 1. Information About You (continued)
Reason for Application (Select only one box)
Section A. (To be used only by a lawful permanent resident or
Additional Information
a permanent resident in commuter status.)
8.
Gender
Male
Female
2.a.
My previous card has been lost, stolen, or destroyed.
9.
Date of Birth
(mm/dd/yyyy)
2.b.
My previous card was issued but never received.
10.
City/Town/Village of Birth
2.c.
My existing card has been mutilated.
My existing card has incorrect data because of
2.d.
Department of Homeland Security (DHS) error.
11.
Country of Birth
(Attach your existing card with incorrect data along
with this application.)
2.e.
My name or other biographic information has been
Mother's Name
legally changed since issuance of my existing card.
12.
Given Name
2.f.
My existing card has already expired or will expire
(First Name)
within six months.
Father's Name
2.g.1.
I have reached my 14th birthday and am registering
as required. My existing card will expire AFTER my
Given Name
13.
16th birthday. (See NOTE below for additional
(First Name)
information.)
14.
Class of Admission
2.g.2.
I have reached my 14th birthday and am registering
as required. My existing card will expire BEFORE
my 16th birthday. (See NOTE below for additional
15.
Date of Admission
information.)
(mm/dd/yyyy)
NOTE: If you are filing this application before your
16.
U.S. Social Security Number (if any)
14th birthday, or more than 30 days after your 14th
birthday, you must select reason 2.j. However, if
your card has expired, you must select reason 2.f.
2.h.1.
I am a permanent resident who is taking up commuter
Part 2. Application Type
status.
NOTE: If your conditional permanent resident status (for
My Port-of-Entry (POE) into the United States will be:
2.h.1.a.
example: CR1, CR2, CF1, CF2) is expiring within the next 90
City or Town and State
days, then do not file this application. (See the What is the
Purpose of This Application section of the Form I-90
Instructions for further information.)
2.h.2.
I am a commuter who is taking up actual residence in
My status is (Select only one box):
the United States.
2.i.
1.a.
Lawful Permanent Resident (Proceed to Section A.)
I have been automatically converted to lawful
permanent resident status.
1.b.
Permanent Resident - In Commuter Status
2.j.
(Proceed to Section A.)
I have a prior edition of the Alien Registration Card,
or I am applying to replace my current Permanent
1.c.
Conditional Permanent Resident
Resident Card for a reason that is not specified above.
(Proceed to Section B.)
Form I-90 02/27/17 N
Page 2 of 7
Part 2. Application Type (continued)
Biographic Information
Section B. (To be used only by a conditional permanent resident.)
6.
Ethnicity (Select only one box)
Hispanic or Latino
3.a.
My previous card has been lost, stolen, or destroyed.
Not Hispanic or Latino
3.b.
My previous card was issued but never received.
7.
Race (Select all applicable boxes)
3.c.
My existing card has been mutilated.
White
3.d.
My existing card has incorrect data because of DHS
Asian
error. (Attach your existing permanent resident card
Black or African American
with incorrect data along with this application.)
American Indian or Alaska Native
3.e.
My name or other biographic information has legally
Native Hawaiian or Other Pacific Islander
changed since the issuance of my existing card.
8.
Height
Feet
Inches
Part 3. Processing Information
9.
Weight
Pounds
1.
Location where you applied for an immigrant visa or
adjustment of status:
10.
Eye Color (Select only one box)
Black
Blue
Brown
Gray
Green
Hazel
2.
Location where your immigrant visa was issued or USCIS
office where you were granted adjustment of status:
Maroon
Pink
Unknown/Other
11.
Hair Color (Select only one box)
Complete Item Numbers 3.a. and 3.a1. if you entered the
Bald (No hair)
Black
Blond
United States with an immigrant visa. (If you were granted
Brown
Gray
Red
adjustment of status, proceed to Item Number 4.)
Sandy
White
Unknown/Other
3.a. Destination in the United States at time of admission
Part 4. Accommodations for Individuals with
Disabilities and/or Impairments (Read the
3.a.1.
Port-of-Entry where admitted to the United States:
information in the Form I-90 Instructions before
City or Town and State
completing this part.)
NOTE: If you need extra space to complete this section, use
4.
Have you ever been in exclusion, deportation, or removal
the space provided in Part 8. Additional Information.
proceedings or ordered removed from the United States?
1.
Are you requesting an accommodation because of your
Yes
No
disabilities and/or impairments?
Yes
No
5.
Since you were granted permanent residence, have you
If you answered "Yes," select any applicable boxes:
ever filed Form I-407, Abandonment by Alien of Status as
Lawful Permanent Resident, or otherwise been determined
1.a.
I am deaf or hard of hearing and request the
to have abandoned your status?
Yes
No
following accommodation (If you are requesting a
sign-language interpreter, indicate for which
NOTE: If you answered "Yes" to Item Numbers 4. or 5.
language (for example, American Sign Language)):
above, provide a detailed explanation in the space provided in
Part 8. Additional Information.
Form I-90 02/27/17 N
Page 3 of 7
Part 4. Accommodations for Individuals with
Applicant's Contact Information
Disabilities and/or Impairments (continued)
3.
Applicant's Daytime Telephone Number
1.b.
I am blind or have low vision and request the
following accommodation:
4.
Applicant's Mobile Telephone Number (if any)
5.
Applicant's Email Address (if any)
Applicant's Certification
1.c.
I have another type of disability and/or impairment
(Describe the nature of your disability and/or
Copies of any documents I have submitted are exact
impairment and the accommodation you are
photocopies of unaltered, original documents, and I understand
requesting):
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 of my records that USCIS may need
to determine my eligibility for the immigration benefit I seek.
I further 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
Part 5. Applicant's Statement, Contact
administration and enforcement of U.S. immigration laws.
Information, Certification, and Signature
I understand that USCIS will require me to appear for an
NOTE: Read the Penalties section of the Form I-90
appointment to take my biometrics (fingerprints, photograph,
Instructions before completing this part.
and/or signature) and, at that time, I will be required to sign an
oath reaffirming that:
Applicant's Statement
1) I reviewed and provided or authorized all of the
NOTE: Select the box for either Item Number 1.a. or 1.b. If
information in my application;
applicable, select the box for Item Number 2.
2) I understood all of the information contained in, and
submitted with, my application; and
1.a.
I can read and understand English, and I have read
3) All of this information was complete, true, and correct
and understand every question and instruction on this
at the time of filing.
application and my answer to every question.
I certify, under penalty of perjury, that I provided or authorized
1.b.
The interpreter named in Part 6. read to me every
all of the information in my application, I understand all of the
question and instruction on this application and my
information contained in, and submitted with, my application,
answer to every question in
and that all of this information is complete, true, and correct.
,
Applicant's Signature
a language in which I am fluent and I understood
everything.
6.a.
Applicant's Signature (sign in ink)
2.
At my request, the preparer named in Part 7.,
,
6.b.
Date of Signature
(mm/dd/yyyy)
prepared this application for me based only upon
information I provided or authorized.
NOTE TO ALL APPLICANTS: If you do not completely fill
out this application or fail to submit required documents listed
in the Instructions, USCIS may deny your application.
Form I-90 02/27/17 N
Page 4 of 7
Part 6. Interpreter's Contact Information,
Interpreter's Signature
Certification, and Signature
7.a.
Interpreter's Signature (sign in ink)
Provide the following information about the interpreter.
Interpreter's Full Name
7.b.
Date of Signature
(mm/dd/yyyy)
1.a.
Interpreter's Family Name (Last Name)
Part 7. Contact Information, Declaration, and
Signature of the Person Preparing this
1.b.
Interpreter's Given Name (First Name)
Application, if Other Than the Applicant
Provide the following information about the preparer.
2.
Interpreter's Business or Organization Name (if any)
Preparer's Full Name
Interpreter's Mailing Address
1.a. Preparer's Family Name (Last Name)
3.a.
Street Number
and Name
1.b.
Preparer's Given Name (First Name)
3.b.
Apt.
Ste.
Flr.
2.
Preparer's Business or Organization Name (if any)
3.c. City or Town
3.d. State
3.e. ZIP Code
Preparer's Mailing Address
3.f.
Province
3.a.
Street Number
and Name
3.g. Postal Code
3.b.
Apt.
Ste.
Flr.
3.h.
Country
3.c. City or Town
Interpreter's Contact Information
3.d. State
3.e. ZIP Code
4.
Interpreter's Daytime Telephone Number
3.f.
Province
3.g. Postal Code
5.
Interpreter's Mobile Telephone Number (if any)
3.h.
Country
6.
Interpreter's Email Address (if any)
Preparer's Contact Information
Interpreter's Certification
4.
Preparer's Daytime Telephone Number
I certify, under penalty of perjury, that:
5.
Preparer's Mobile Telephone Number (if any)
I am fluent in English and
,
which is the same language provided in Part 5., Item Number
1.b., and I have read to this applicant in the identified language
6.
Preparer's Email Address (if any)
every question and instruction on this application and his or her
answer to every question. The applicant informed me that he or
she understands every instruction, question, and answer on the
application, including the Applicant's Certification, and has
verified the accuracy of every answer.
Form I-90 02/27/17 N
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