Form I-90 Green Card Replacement
A-Number
*
USCIS Online Account Number
Last Name
*
First Name
*
Middle Name
Has your name changed?
*
Yes
No
New Legal Last Name
New Legal First Name
New Legal Middle Name
In Care Of
Mailing Street
*
Mailing Apartment/Suite
Mailing City
*
Mailing State
*
Mailing ZIP
*
Mailing Country
*
Physical Address (if different from mailing)
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
City of Birth
*
Country of Birth
*
Social Security Number (SSN)
Class of Admission
Date of Admission
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Mother First Name
Father First Name
Gender
*
Please Select
Male
Female
Immigration Status
*
Please Select
Lawful Permanent Resident
Commuter
Conditional Resident
Reason for Application
*
Please Select
Lost / Stolen
Never received
Damaged
DHS error
Name change
Expired / expiring
Turning 14
Status change
Other
Other Reason (explain)
Commuter Status Details
Conversion to LPR Details
Port of Entry Information
Where you applied for visa or AOS
Where visa was issued / USCIS office
Have you ever been in removal or deportation proceedings?
Yes
No
Have you filed Form I-407 (abandon status)?
Yes
No
Height
Weight (in pounds)
Ethnicity
Please Select
Hispanic
Not Hispanic
Race
Please Select
White
Black
Asian
Other
Eye Color
Please Select
Black
Blue
Brown
Gray
Green
Other
Hair Color
Please Select
Bald
Black
Blond
Brown
Gray
Other
Do you need a disability accommodation?
Yes
No
Accommodation Type - Deaf / Interpreter
Deaf / Interpreter
Accommodation Type - Blind
Blind
Accommodation Type - Other disability (describe)
Signature
*
Signature Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Submit
Should be Empty: