Form DS-117 at a glance
What it is: The Application to Determine Returning Resident Status is an application for Special Immigrant Status under Section 101(a)(27)(A) of the Immigration and Nationality Act.
Who signs: By typing your name in the field, you swear or affirm.
It is for lawfully admitted permanent residents who are returning from a temporary visit abroad.
To qualify, submit with the application evidence that: (1) You had the status of an alien lawfully admitted for permanent residence at the time of departure from the United States; (2) You departed from the United States with the intention of returning and you have not abandoned this intention; and (3) You are returning to the United States from a temporary visit abroad and, if the stay abroad was protracted, this was caused by reasons beyond your control and for which you are not responsible.
The information on the form will be used to determine your eligibility for returning resident status.
What to bring and attach to Form DS-117
Submit evidence with the application to support the requirements, including proof of lawful permanent residence (Examples: Form I-151, I-551, Reentry Permit, etc.), dates of travel outside of the United States (Examples: airline tickets, passport stamps, etc.), proof of ties to the United States and intention to return (Examples: tax returns, and evidence of economic, family and social ties to the United States), and proof a protracted stay was for reasons beyond the applicant's control (Examples: medical incapacitation, employment with a U.S. company, accompanying a U.S. citizen spouse, etc.). All documents will be returned to you.
A filled-in Form DS-117 example: a returning resident fills out the form
How to fill out Form DS-117, box by box
Your names, Current Home Address and Place of Birth
In box 1, enter the Family Name, First Name and Middle Name.
In box 2, enter Other Names Used, Aliases (If Married Woman, Give Maiden Name).
In box 3, enter the Current Home Address and Telephone Number.
In box 4, enter the Place of Birth (City, Province, Country); in box 5, enter the Date of Birth (mm-dd-yyyy).
Marital Status and information about spouse
In box 6, check one of Married, Single (Never Married), Widowed or Divorced.
If married, enter information about your spouse: a. Name (Last, First, MI), b. Address, c. Place of Birth, d. Date of Birth (mm-dd-yyyy), e. U.S. Residence Status, if any (U.S. Citizen, Legal Permanent Resident, Etc.) and f. Date of Marriage to You (mm-dd-yyyy).
Close Family Members in the United States
In box 7, list All Close Family Members in the United States with Full Name, Relationship, Resident Status and Place of Residence (Continue on Separate Page if Necessary.).
Previous Immigration Record
In box 8, enter the Previous Immigration Record: a. DHS "A" Number, b. Immigration Category, c. Previous Immigrant Visa Date of Issue (mm-dd-yyyy) and Place of Issue, and d. Adjustment of Status Date of Adjustment of Status with DHS (IF ANY) (mm-dd-yyyy) and Place of Adjustment of Status with DHS (IF ANY).
For e. Initial Entry into the United States as Lawful Permanent Resident and f. Last Entry into the United States as Lawful Permanent Resident, enter the Date of Entry (mm-dd-yyyy) and the Port of Entry.
Most Recent Departure from the United States
In box 9, enter the Date of Departure (mm-dd-yyyy), the Destination and the Reason for the Most Recent Departure from the United States.
Continuing ties with the United States
In box 10: What continuing ties have you maintained with the United States? What efforts have you made to avoid abandoning your permanent resident status in the United States?
Reasons for not returning to the United States
In box 11, enter the Reasons for not returning to the United States until time of this application.
Periods lived outside of the United States
In box 12, list all periods that you have lived outside of the United States for six months or longer since your initial entry into the United States as a permanent resident, with Dates (mm-dd-yyyy) From, To and Country.
Employed outside of the United States
In box 13, check Yes or No: Have you been employed outside of the United States since your most recent departure?
If "Yes", complete the following.
Enter the Name of Employer, Address, From (mm-dd-yyyy) and To (mm-dd-yyyy).
Date you wish to return to the United States
In box 14, enter the Date (mm-dd-yyyy) on or about which you wish to return to the United States.
Typing your name to swear or affirm
You swear or affirm that all statements which appear on this application are true and complete to the best of your knowledge and belief.
Enter the Date (mm-dd-yyyy) and the Name of Applicant.
Any false or misleading statement or willful concealment of a material fact may subject you to permanent exclusion from the United States.
More rules for Form DS-117
Providing the information is mandatory; failure to provide the information requested on the form may result in the applicant's inability to receive returning resident status.
Common questions about Form DS-117
Is there a deadline?
If the application for special immigrant status is approved, you must apply for an immigrant visa within six months from the date of approval.
Sources
[1] Form DS-117 (10-2019), Application to Determine Returning Resident Status, U.S. Department of State (the Official source link on this page).