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OMB No. 1615-0042; Expires 04/30/2014 Instructions for Form I-777, Application for Replacement of Northern Mariana Card Department of Homeland Security U.S. Citizenship and Immigration Services Instructions NOTE: Read these instructions carefully to properly complete this form. If you need more space to complete an answer, use a separate sheet of paper. Write your name and Alien Registration Number (A-Number), if any, at the top of each sheet and indicate the number of the item to which the answer refers. What Is the Purpose of This Form? Step 1. Reason for Filing Form I-777 Form I-777 is used to apply for replacement of a Northern Mariana Identification Card. Listed below is information on each reason for filing Form I-777. Check the box in Part 2 that matches your reason for filing. You will need to give us: 1. A completed and signed Form I-777; and 2. Evidence of eligibility Filing fee. 1. My Northern Mariana Card was lost or destroyed. Check Box A. You must submit a written statement explaining to the best of your ability when, how, and where your card was lost or destroyed. See Step 3 for specific filing instructions. 2. My Northern Mariana Card was stolen. Check Box B. You must submit a certified copy of the police report. When Should I Use This Form? 3. My Northern Mariana Card was damaged. Check Box C. You must return the damaged card with this application. During the 2-year period that ended July 1, 1990, USCIS issued original Northern Mariana Identification Cards to individuals who acquired U.S. citizenship through the Covenant to Establish a Commonwealth of the Northern Mariana Islands in Political Union with the United States (Public Law 94-241). These cards remain valid as evidence of U.S. citizenship. Although USCIS no longer issues these cards, a citizen to whom a card was previously issued may use this application to request replacement of a card that was lost, stolen, or damaged. How Do I File Form I-777? A separate Form I-777 must be filed for each person seeking an identification card. Follow the steps below to complete your application: Step 1 - Reason for Filing Form I-777 Step 2 - Fill Out Form I-777 Step 3 - Submit Your Application Notice USCIS wants to make sure that you receive the requested benefit. To do this, we may ask for more evidence, interview you, and/or conduct an investigation. If you give us false documents, misrepresent facts, or otherwise engage in fraud, USCIS will take appropriate action. This means we will not only deny your application, you may lose current and future immigration benefits. You may also face penalties, including criminal and/or civil prosecution leading to fines and/or imprisonment. All applications must include a copy of an official identity document showing a photo of the frontal view of your full face, name, and date of birth. (Example: a valid government issued driver's license, passport identity page, or any other official identity document.) The copy must clearly show the photo and identity information. Step 2. Fill Out Form I-777 Type or print clearly in black ink, using capital letters. If an item does not apply to you, write "N/A." If the answer is none, write "NONE." This form is divided into Parts 1 through 5. The following information should help you fill out the form. Part 1. Information About You (Person applying to replace a Northern Mariana Card) 1. Family Name (Last name) - Give your legal name. If you have two last names, include both and use a hyphen (-) between the names, if appropriate. 2. Home Address - Give your physical street address. This must include a street number and name or a rural route number. Do not put a post office box (P.O. Box) number here. 3. Mailing Address - Give your mailing address, if different from your home address. Form I-777 (Rev. 04/26/12) Y 4. Daytime Phone Number - Give a phone number where you can be reached during the day. B. If you live in the U.S. Virgin Islands, make it payable to Commissioner of Finance of the Virgin Islands. 5. U.S. Social Security Number - If you do not have a U.S. Social Security Number, leave this blank. NOTE: Please spell out U.S. Department of Homeland Security; do not use the initials "USDHS" or "DHS." 6. A Number - This is your immigration file number. If you do not have an A-Number or do not know it, leave this blank. Notice to Those Making Payment by Check. If you send us a check, it will be converted into an electronic funds transfer (EFT). This means we will copy your check and use the account information on it to electronically debit your account for the amount of the check. The debit from your account will usually take 24 hours, and will be shown on your regular account statement. Part 2. Requested Action Place a check in the box that corresponds with your reason for filing. Part 3. Additional Information Numbers 1 and 2 - Give the requested information. Part 4. Signature 1. As the applicant, you must sign and date the application. If you do not sign the application, the form will be returned as incomplete. 2. A parent or legal guardian may sign the application on behalf of a child under the age of 14 years. Part 5. Signature of Person Preparing Form, if Other Than Applicant 1. If you, the applicant, did not fill out Form I-777, the preparer must also sign, date, and give his or her address. Step 3. Submit Your Application Your must include the following items: 1. Your signed and completed Form I-777; and 2. Filing fee. The filing fee for Form I-777 is $15. Use the following guidelines when you prepare your check or money order: 1. The check or money order must be drawn on a bank or other financial institution located in the United States and must be payable in U.S. currency; and 2. Make the check or money order payable to U.S. Department of Homeland Security, unless: You will not receive your original check back. We will destroy your original check, but we will keep a copy of it. If the EFT cannot be processed for technical reasons, you authorize us to process the copy in place of your original check. If the EFT cannot be completed because of insufficient funds, we may try to make the transfer up to two times. 3. Evidence. Attach copies showing the front and back of the documents you need to support your application. See Step 1, Reason for Filing, for information on document requirements. Do not send original documents unless instructed to do so. All applications must include a copy of an official photo identity document showing a photo of the frontal view of your full face, name, and date of birth. (Example: a valid government issued driver's license, passport identity page, or any other official identity document.) The copy must clearly show the photo and identity information. 4. Translations. If you send us a document in a foreign language, it must have a full English translation that the translator has certified as complete and correct. The translator must also certify that he or she is competent to translate the foreign language into English. 5. Photos. You must submit two identical natural color photographs of yourself taken within 30 days of this application. The photos must have a white background, be unmounted, printed on thin paper, and be glossy and unretouched. The photo should be a full frontal passport style photograph. The photos should be no larger than 2 x 2 inches, with the distance from the top of the head to just below the chin about 1 and 1/4 inches. Using a pencil, lightly print your A-Number on the back of each photo. 6. Submit your Form I-777 A. If you live in Guam, make it payable to Treasurer, Guam. Where you submit your form depends on where you live. Form I-777 (Rev. 04/26/12) Y Page 2 If you currently live in the Commonwealth of the Northern Mariana Islands, Guam, or elsewhere outside the United States, you must mail this application to: USCIS - Guam Sirena Plaza, Suite 100 108 Hernan Cortez Avenue Hagatna, GU 96910 If you currently live in Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Jersey, New Hampshire, New York, Pennsylvania, Puerto Rico, Rhode Island, Vermont, Virginia, West Virginia, or the U.S. Virgin Islands, mail the application to: USCIS - Vermont Service Center 75 Lower Welden Street St. Albans, VT 05479-0001 If you currently live in Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, or Texas, mail the application to: USCIS - Texas Service Center P.O. Box 851041 Mesquite, TX 75185-1041 If you currently live in Arizona, California, Hawaii, or Nevada, mail the application to: USCIS - California Service Center P.O. Box 10765 Laguna Niguel, CA 92607-1076 If you currently live anywhere else in the United States, mail the application to: USCIS - Nebraska Service Center P.O. Box 87765 Lincoln, NE 68501-7765 Processing Information Our goal at USCIS is to process all applications fairly. The processing time will vary, depending on the specific circumstances of each case. We may reject an incomplete application. We may deny your application if you do not give us the requested information or you do not appear at your scheduled interview. Privacy Act Notice USCIS will use the information on Form I-777 to determine eligibility for the requested immigration benefit. We may provide information on your application to other government agencies. Address Changes If you have changed your address, you must inform USCIS of your new address. For information on filing a change of address go to the USCIS Web site at www.uscis.gov/ addresschange or contact the USCIS National Customer Service Center at 1-800-375-5283. USCIS Forms and Information To order USCIS forms, call our toll-free number at 1-800-870-3676. You can also get USCIS forms and information on immigration laws, regulations and procedures by telephoning our National Customer Service Center at 1-800-375-5283 or visiting our Internet Web site at www.uscis.gov. As an alternative to waiting in line for assistance at your local USCIS office, you can now schedule an appointment through our Internet-based system, InfoPass. To access the system, visit our Web site. Use the InfoPass appointment scheduler and follow the screen prompts to set up your appointment. InfoPass generates an electronic appointment notice that appears on the screen. Paperwork Reduction Act An agency may not conduct or sponsor an information collection and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The public reporting burden for this collection of information is estimated at 30 minutes per response, including the time for reviewing instructions and completing and submitting the form. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services, Regulatory Products Division, Office of Policy and Strategy, 20 Massachusetts Avenue, N.W., Washington, DC 20529-2020. OMB No. 1615-0042. Do not mail your Form I-777 to this address. Form I-777 (Rev. 04/26/12) Y Page 3