Application to Replace Permanent Resident Card (Green Card)File Online

• Legal Form Number: I-90
• Section: Citizenship and Immigration Services (United States of America)
• Issuer: Citizenship and Immigration Services (United States of America)

Form I-90 02/27/17 N

For

USCIS

Use

Only

Application to Replace Permanent Resident Card

Department of Homeland Security

U.S. Citizenship and Immigration Services

USCIS

Form I-90

OMB No. 1615-0082

Expires 07/31/2019

START HERE - Type or print in black ink.►

Part 1. Information About You

Alien Registration Number (A-Number)

Your Full Name

NOTE: Your card will be issued in this name.

3.a. Family Name

(Last Name)

3.b. Given Name

(First Name)

3.c.

4.

Middle Name

Has your name legally changed since the issuance of your

Permanent Resident Card?

Yes (Proceed to Item Numbers 5.a. - 5.c.)

No (Proceed to Item Numbers 6.a. - 6.i.)

N/A - I never received my previous card.

(Proceed to Item Numbers 6.a. - 6.i.)

1.

Street Number

and Name

Mailing Address

6.a.

In Care Of Name

6.b.

6.c. Apt. Flr.Ste.

6.d. City or Town

6.h. Postal Code

6.i. Country

6.e. State 6.f. ZIP Code

Class of Admission

Applicant Interviewed

Action BlockReceipt

Date:

Remarks

Provide your name exactly as it is printed on your current

Permanent Resident Card.

NOTE: Attach all evidence of your legal name change with

this application.

5.a. Family Name

(Last Name)

5.b. Given Name

(First Name)

5.c. Middle Name

USCIS Online Account Number (if any)2.

►

6.g. Province

Page 1 of 7

A-

Physical Address

7.a. Street Number

and Name

7.c. City or Town

7.d. State 7.e. ZIP Code

7.b. Apt. Flr.Ste.

Provide this information only if different than mailing address.

Country 7.h.

Postal Code

7.g.

Province

7.f.

(USPS ZIP Code Lookup)