U.S. Department of Justice
Immigration and Naturalization Service

This form must be completed by all persons except U.S. citizens, returning resident aliens, aliens with immigrant visas, and Canadian citizens visiting or in transit.

Type or print legibly with pen in ALL CAPITAL LETTERS. Use English. Do not write on the back of this form.

This form is in two parts. Please complete both the Arrival Record (Items 1 through 13) and the Departure Record (Items 14 through 17).

When all items are completed, present this form to the U.S. Immigration and Naturalization Service Inspector.

Item 7 - If you are entering the United States by land, enter LAND in this space. If you are entering the United States by ship, enter SEA in this space.

I-94
Arrival Record

1. Family Name
   
   
2. First (Given) Name
   
   
3. Birth Date (Day/Mo/Yr)
   
   
4. Country of Citizenship
   
   
5. Sex (Male or Female)
   
   
6. Passport Number
   
   
7. Airline and Flight Number
   
   
8. Country Where You Live
   
   
9. City Where you Boarded
   
   
10. City Where Visa Was Issued
    
    
11. Date Issued (Day/Mo/Yr)
    
    
12. Address while in the United States (Number and Street)
    
    
13. City and State
    
    

I-94
Departure Record

14. Family Name

15. First (Given) Name

16. Birth Date (Day/Mo/Yr)

17. Country of Citizenship