Form I-94, Arrival Departure Card for non-immigrants to the US
PROVIDED BY IMMIHELP.COM FOR ILLUSTRATION PURPOSE ONLY
YOU CAN USE THIS FORM TO HELP TRAVELERS REGARDING HOW TO FILL THIS FORM.
YOU CAN NOT SUBMIT THIS FORM AT PORT OF ENTRY.
YOU MUST USE THE FORM PROVIDED BY AIRLINE.
DEPARTMENT OF HOMELAND SECURITY
U.S. Customs and Border Protection
App lic a nt's
This Side For Government Use Only
Referred Time lnsp. #
□ 212A D D□ PP □ Visa □ Parole □ SLB □ TWOV
Time Insp. #
20. CIS A Number
21. CIS FCO
22. Petition Number
23. Program Number
24. D Bond
25. D Prospective Student
TWOV Ticket Numb er
Warning A nonimmigrant who accepts unauthori zed employment is subject to deportat ion .
Important - Retain this permit in your possession; you must surrender it when you leave the U.S. Failur e to do so may de lay 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 vio lation 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 "Arri val- Departure" on page 2 of Form 1-20 prior to surrendering this permit.