Printable I 94 Form Details

If you're looking to travel within the United States, the I 94 Blank Form is something you'll need. This form is used to document your entry and exit from the country, and can be useful for a variety of purposes. Here's what you need to know about this form, and how to fill it out correctly.

You will find information regarding the type of form you intend to submit in the table. It will tell you how much time it should take to complete i 94 blank, exactly what fields you will need to fill in, and so forth.

QuestionAnswer
Form NameI 94 Blank
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesi 94 form pdf no download needed, how to fill in the i94, i 94 form pdf print, blank i 94

Form Preview Example

DEPARTMENT OF HOMELAND SECURITY

OMB No. 1651-0111

U.S. Customs and Border Protection

 

Welcome to the United States

I-94 Arrival/Departure Record

Instructions

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 17) and the Departure Record (Items 18 through 21).

When all items are completed, present this form to the CBP Officer.

Item 9 - 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.

5 U.S.C. § 552a(e)(3) Privacy Act Notice: Information collected on this form is required by Title 8 of the U.S. Code, including the INA (8 U.S.C. 1103, 1187), and 8 CFR 235.1, 264, and 1235.1. The purposes for this collection are to give the terms of admission and document the arrival and departure of nonimmigrant aliens to the U.S. The information solicited on this form may be made available to other government agencies for law enforcement purposes or to assist DHS in determining your admissibility. All nonimmigrant aliens seeking admission to the U.S., unless otherwise exempted, must provide this information. Failure to provide this information may deny you entry to the United States and result in your removal.

CBP Form I-94 (05/08)

OMB No. 1651-0111

Arrival Record

Admission Number

000000000

00

1. Family Name

2. First (Given) Name

3. Birth Date (DD/MM/YY)

4. Country of Citizenship

5. Sex (Male or Female)

6. Passport Issue Date (DD/MM/YY)

7. Passport Expiration Date (DD/MM/YY)

8. Passport Number

9. Airline and Flight Number

10. Country Where You Live

11. Country Where You Boarded

12. City Where Visa Was Issued

13. Date Issued (DD/MM/YY)

14.Address While in the United States (Number and Street)

15.City and State

16.Telephone Number in the U.S. Where You Can be Reached

17.Email Address

CBP Form I-94 (05/08)

DEPARTMENT OF HOMELAND SECURITY

U.S. Customs and Border Protection

OMB No. 1651-0111

Departure Record

Admission Number

000000000

00

18. Family Name

19. First (Given) Name

20. Birth Date (DD/MM/YY)

21. Country of Citizenship

CBP Form I-94 (05/08)

See Other Side

STAPLE HERE

This Side For Government Use Only

I-94 Back 11” h x 4.5”w Fonts:

Applicant’s Name

Date

Referred

212A

Primary Inspection

 

Time

 

 

 

 

Insp. #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reason Referred

 

 

 

 

 

 

 

PP

 

 

 

Visa

 

Parole

 

 

L/O

 

TWOV

 

 

 

 

 

 

 

Arial, Times

Other

 

 

 

 

Secondary Inspection

End Secondary

 

 

 

 

 

Time

 

 

 

 

Insp. #

 

 

 

 

 

Disposition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

22.

Occupation

 

23.

Waivers

 

 

 

 

24. CIS A Number

 

 

25. CIS FCO

A-

 

 

 

 

 

 

 

 

 

 

26.

Petition Number

 

27.

Program Number

 

 

 

 

 

 

 

28.

 

Bond

 

29.

 

Prospective Student

 

 

 

 

 

 

 

30.

Itinerary/Comments

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

31. TWOV Ticket Number

Paperwork Reduction Act Statement: An agency may not conduct or sponsor an information collection and a person is not required to respond to this information unless it displays a current valid OMB control number. The control number for this collection is 1651-0111. The estimated average time to complete this application is 8 minutes per respondent. If you have any comments regarding the burden estimate you can write to U.S. Customs and Border Protection, Asset Management, 1300 Pennsylvania Avenue, NW, Washington DC 20229

Warning A nonimmigrant who accepts unauthorized employment is subject to deportation.

Important Retain this permit in your possession; you must surrender it when you leave the U.S.

Failure to do so may delay your entry into the U.S. in the future.

You are authorized to stay in the U.S. only until the date written on this form. To remain past this date, without permission from Department of Homeland Security authorities, is a violation of the law.

Surrender this permit when you leave the U.S.:

-By sea or air, to the transportation line;

-Across the Canadian border, to a Canadian Official;

-Across the Mexican border, to a U.S. Official

Students planning to reenter the U.S. within 30 days to return to the same school, see

“Arrival-

Departure” on page 2 of Form I-20 prior to surrendering this permit.

Record of Changes

Departure Record

Port:

Date:

Carrier:

Flight No./ Ship Name:

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