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Get and Sign Form I539 2012
Birth
Daytime Phone Number
Country of Citizenship
U. S. Social Security # (if any)
A-Number (if any)
Reloc Sent
Date
(mm/dd/yyyy)
Date of Last Arrival
Into the U.S.
Current Nonimmigrant Status
I-94 Number
Reloc Rec'd
Expires on
Date
(mm/dd/yyyy)
Part 2. Application Type (See instructions for fee)
1. I am applying for: (Check one)
a.
An extension of stay in my current status.
b.
A change of status. The new status I am requesting is:
c.
Reinstatement to student...
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