Form I-131

Form I-131
Check box if G-28 is attached.
On By
5. Name (
Family name in capital letters)
City Zip/Postal Code
State or Province
6. Address (Number and Street)
DO NOT WRITE IN THIS BLOCK FOR USCIS USE ONLY (except G-28 block below)
Part 1. Information About You (Type or print in black ink)
Receipt
Document Issued
Valid to:
Reentry Permit
Refugee Travel Document
Single Advance Parole
Multiple Advance Parole
If Reentry Permit or Refugee Travel
Document, mail to:
U.S. Embassy/consulate
at:
Overseas DHS office
Address in Part 1
at:
Document Hand Delivered
To be completed by Attorney/Representative, if any.
Attorney State License #
(First)
Country
I am a permanent resident or conditional resident of the United States, and I am applying for a reentry permit.
a.
I now hold U.S. refugee or asylee status, and I am applying for a Refugee Travel Document.
I am a permanent resident as a direct result of refugee or asylee status, and I am applying for a Refugee Travel Document.
b.
c.
d.
e.
f.
I am applying for an advance parole document to allow me to return to the United States after temporary foreign travel.
I am applying for an Advance Parole Document for a person who is outside the United States. If you checked box "f,"
provide the following information about that person:
Part 2. Application Type (Check one)
1. Name (Family name in capital letters)
City Zip/Postal Code
State or Province
5. Address (Number and Street)
(First) (Middle)
Apt. #
Country
2. Date of Birth (mm/dd/yyyy) 3. Country of Birth
Form I-131 (11/05/11) Y
Apt. Number
1. A Number 2. Date of Birth (mm/dd/yyyy) 3. Class of Admission 4. Gender
7. Country of Birth 9. Social Security # (if any)
(Middle)
Action Block
I-131, Application for Travel Document
8. Country of Citizenship
4. Country of Citizenship
OMB No. 1615-0013; Expires 03/31/2012
Daytime Telephone # (area/country code)
I am outside the United States, and I am applying for an Advance Parole Document.
Department of Homeland Security
U. S. Citizenship and Immigration Services
Male
Female
Form I-131

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