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Application for Travel Document
USCIS
Form I-131

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

OMB No. 1615-0013
Expires 03/31/2016

Action Block

Receipt

To Be Completed by an Attorney/
Representative,
if any.

For
USCIS
Use
Only

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
(Re-entry &
Refugee
Only)
/

Attorney State
License Number:

Address in Part 1
US Consulate at:
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.

Alien Registration Number (A-Number)
► A-

1.c. Middle Name
4.

2.c. Apt.

Ste.

2.g. Postal Code

Gender

8.

Date of Birth

9.

U.S. Social Security Number (if any)

Flr.

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

Class of Admission

7.

2.b. Street Number and Name

Country of Citizenship

6.

2.a. In Care of Name

Country of Birth

5.

Physical Address

2.f.

Zip Code

Male

Female
(mm/dd/yyyy) ►

►
2.h. Province
2.i.

Country

Form I-131 03/22/13 N

Page 1 of 5

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

2.g. Daytime Phone Number

(

)

-

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

I am applying