Form I-90 Edition 04/01/24 Page 1 of 7

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 02/28/2027

► 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. Ste. Flr.

6.d. City or Town

6.h. Postal Code 

6.i. Country 

6.e. State 6.f. ZIP Code

Class of Admission

Applicant Interviewed Receipt Action Block

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

2. USCIS Online Account Number (if any)

►

6.g. Province

A-

 Physical Address 

7.a. Street Number 

and Name

7.c. City or Town

7.d. State 7.e. ZIP Code

7.b. Apt. Ste. Flr.

Provide this information only if different than mailing address.

7.h. Country 

7.g. Postal Code 

7.f. Province

(USPS ZIP Code Lookup)
Form I-90 Edition 04/01/24 Page 2 of 7

9.

10.

Part 1. Information About You (continued)

8.

Date of Birth (mm/dd/yyyy)

City/Town/Village of Birth 

Country of Birth 

►

14.

13.

Class of Admission

Date of Admission 

(mm/dd/yyyy)

U.S. Social Security Number (if any)

15.

2.e. My name or other biographic information has been 

legally changed since issuance of my existing card.

2.f. My existing card has already expired or will expire 

within six months. 

2.g.1. I have reached my 14th birthday and am registering 

as required. My existing card will expire AFTER my 

16th birthday. (See NOTE below for additional 

information.)

I have reached my 14th birthday and am registering 

as required. My existing card will expire BEFORE 

my 16th birthday. (See NOTE below for additional 

information.)

2.g.2.

2.d. My existing card has incorrect data because of 

Department of Homeland Security (DHS) error. 

(Attach your existing card with incorrect data along 

with this application.) 

Mother's Name

Father's Name

11. 

Given Name 

(First Name) 

12. 

Given Name 

(First Name) 

 Reason for Application (Select only one box)

Section A. (To be used only by a lawful permanent resident or 

a permanent resident in commuter status.)

2.a. My previous card has been lost, stolen, or destroyed.

2.b. My previous card was issued but never received. 

2.c. My existing card has been mutilated. 

 Additional Information

16.

Gender Male Female

Part 2. Application Type

NOTE: If you are filing this application before your 

14th birthday, or more than 30 days after your 14th 

birthday, you must select reason 2.j. However, if 

your card has expired, you must select reason 2.f.

NOTE: If your conditional permanent resident status (for 

example: CR1, CR2, CF1, CF2) is expiring within the next 90 

days, then do not file this application. (See the What is the 

Purpose of This Application section of the Form I-90 

Instructions for further information.)

My status is (Select only one box):

1.a. Lawful Permanent Resident (Proceed to Section A.)

1.b. Permanent Resident - In Commuter Status 

(Proceed to Section A.)

1.c. Conditional Permanent Resident 

(Proceed to Section B.)

2.j. I have a prior edition of the Alien Registration Card, 

or I am applying to replace my current Permanent 

Resident Card for a reason that is not specified above.

2.h.1.a. 

2.h.2. I am a commuter who is taking up actual residence in 

the United States. 

2.i. I have been automatically converted to lawful 

permanent resident status.

My Port-of-Entry (POE) into the United States will be:

2.h.1. I am a permanent resident who is taking up commuter 

status. 

City or Town and State
Form I-90 Edition 04/01/24 Page 3 of 7

1.

2.

Location where you applied for an immigrant visa or 

adjustment of status:

Location where your immigrant visa was issued or USCIS 

office where you were granted adjustment of status:

4.

5.

Have you ever been in exclusion, deportation, or removal 

proceedings or ordered removed from the United States?

Yes No

Since you were granted permanent residence, have you 

ever filed Form I-407, Abandonment by Alien of Status as 

Lawful Permanent Resident, or otherwise been determined 

to have abandoned your status? Yes No

NOTE: If you answered "Yes" to Item Numbers 4. or 5. 

above, provide a detailed explanation in the space provided in 

Part 8. Additional Information.

6.

7.

Height

9. Weight 

8. Feet Inches

Pounds

3.b. My previous card was issued but never received.

3.c. My existing card has been mutilated. 

3.d. My existing card has incorrect data because of DHS 

error. (Attach your existing permanent resident card 

with incorrect data along with this application.)

3.e. My name or other biographic information has legally 

changed since the issuance of my existing card. 

Part 3. Processing Information

Part 2. Application Type (continued)

Section B. (To be used only by a conditional permanent resident.)

3.a. My previous card has been lost, stolen, or destroyed.

3.a.1.Port-of-Entry where admitted to the United States:

 Biographic Information

Not Hispanic or Latino

Hispanic or Latino

Ethnicity (Select only one box)

Race (Select all applicable boxes)

Native Hawaiian or Other Pacific Islander

American Indian or Alaska Native

White

Asian

Black or African American

Black Brown

Maroon Pink

Green Hazel

Blue

10. Eye Color (Select only one box) 

Unknown/Other

Gray

Complete Item Numbers 3.a. and 3.a1. if you entered the 

United States with an immigrant visa. (If you were granted 

adjustment of status, proceed to Item Number 4.)

City or Town and State

3.a. Destination in the United States at time of admission

White

11. Hair Color (Select only one box) 

Black

Brown Red

Sandy Unknown/Other

Gray

Bald (No hair) Blond

Part 4. Accommodations for Individuals with 

Disabilities and/or Impairments (Read the 

information in the Form I-90 Instructions before 

completing this part.) 

1. Are you requesting an accommodation because of your 

disabilities and/or impairments? Yes No

1.a. I am deaf or hard of hearing and request the 

following accommodation (If you are requesting a 

sign-language interpreter, indicate for which 

language (for example, American Sign Language)): 

If you answered "Yes," select any applicable boxes:

NOTE: If you need extra space to complete this section, use 

the space provided in Part 8. Additional Information.
Form I-90 Edition 04/01/24 Page 4 of 7

1.b. I am blind or have low vision and request the 

following accommodation:

1.c. I have another type of disability and/or impairment 

(Describe the nature of your disability and/or 

impairment and the accommodation you are 

requesting): 

Part 5. Applicant's Statement, Contact 

Information, Certification, and Signature 

NOTE: Select the box for either Item Number 1.a. or 1.b. If 

applicable, select the box for Item Number 2.

1.a. I can read and understand English, and I have read 

and understand every question and instruction on this 

application and my answer to every question.

NOTE: Read the Penalties section of the Form I-90 

Instructions before completing this part. 

 Applicant's Statement

1.b. The interpreter named in Part 6. read to me every 

question and instruction on this application and my 

answer to every question in

a language in which I am fluent and I understood 

everything.

,

2. At my request, the preparer named in Part 7., 

prepared this application for me based only upon 

information I provided or authorized.

,

 Applicant's Contact Information

3. Applicant's Daytime Telephone Number

5. Applicant's Email Address (if any)

4. Applicant's Mobile Telephone Number (if any)

Part 4. Accommodations for Individuals with 

Disabilities and/or Impairments (continued)

 Applicant's Certification

Copies of any documents I have submitted are exact 

photocopies of unaltered, original documents, and I understand 

that USCIS may require that I submit original documents to 

USCIS at a later date. Furthermore, I authorize the release of 

any information from any of my records that USCIS may need 

to determine my eligibility for the immigration benefit I seek.

I certify, under penalty of perjury, that I provided or authorized 

all of the information in my application, I understand all of the 

information contained in, and submitted with, my application, 

and that all of this information is complete, true, and correct.

I further authorize release of information contained in this 

application, in supporting documents, and in my USCIS records 

to other entities and persons where necessary for the 

administration and enforcement of U.S. immigration laws.

I understand that USCIS will require me to appear for an 

appointment to take my biometrics (fingerprints, photograph, 

and/or signature) and, at that time, I will be required to sign an 

oath reaffirming that:

1) I reviewed and provided or authorized all of the 

information in my application; 

2) I understood all of the information contained in, and 

submitted with, my application; and 

3) All of this information was complete, true, and correct 

at the time of filing.

6.b. Date of Signature (mm/dd/yyyy)

6.a. Applicant's Signature (sign in ink)

 Applicant's Signature

NOTE TO ALL APPLICANTS: If you do not completely fill 

out this application or fail to submit required documents listed 

in the Instructions, USCIS may deny your application.
Form I-90 Edition 04/01/24 Page 5 of 7

1.b. Interpreter's Given Name (First Name)

1.a. Interpreter's Family Name (Last Name)

2. Interpreter's Business or Organization Name (if any)

Interpreter's Full Name

Provide the following information about the interpreter.

Part 6. Interpreter's Contact Information, 

Certification, and Signature

3.h.

Interpreter's Mailing Address

3.c. City or Town

3.d. State 3.e. ZIP Code

3.f. Province 

Street Number 

and Name

3.a.

Country 

3.b. Apt. Ste. Flr.

3.g. Postal Code 

 Interpreter's Contact Information

4. Interpreter's Daytime Telephone Number

6. Interpreter's Email Address (if any)

5. Interpreter's Mobile Telephone Number (if any)

Interpreter's Certification

I certify, under penalty of perjury, that:

which is the same language provided in Part 5., Item Number 

1.b., and I have read to this applicant in the identified language 

every question and instruction on this application and his or her 

answer to every question. The applicant informed me that he or 

she understands every instruction, question, and answer on the 

application, including the Applicant's Certification, and has 

verified the accuracy of every answer.

I am fluent in English and ,

7.b. Date of Signature (mm/dd/yyyy)

7.a. Interpreter's Signature (sign in ink)

Interpreter's Signature

Part 7. Contact Information, Declaration, and 

Signature of the Person Preparing this 

Application, if Other Than the Applicant

Preparer's Full Name

1.a. Preparer's Family Name (Last Name)

1.b. Preparer's Given Name (First Name)

Provide the following information about the preparer.

2. Preparer's Business or Organization Name (if any)

 Preparer's Mailing Address

3.h.

3.c. City or Town

3.d. State 3.e. ZIP Code

3.f. Province 

Street Number 

and Name

3.a.

Country 

3.b. Apt. Ste. Flr.

3.g. Postal Code 

 Preparer's Contact Information

4. Preparer's Daytime Telephone Number

6. Preparer's Email Address (if any)

5. Preparer's Mobile Telephone Number (if any)
Form I-90 Edition 04/01/24 Page 6 of 7

Preparer's Certification

I am not an attorney or accredited representative but 

have prepared this application on behalf of the 

applicant and with the applicant's consent.

7.a.

7.b.

preparation of this application.

I am an attorney or accredited representative and my 

representation of the applicant in this case

extends does not extend beyond the 

 Preparer's Statement

NOTE: If you are an attorney or accredited 

representative whose representation extends beyond 

preparation of this application, you may be obliged to 

submit a completed Form G-28, Notice of Entry of 

Appearance as Attorney or Accredited 

Representative, with this application. 

8.a. Preparer's Signature (sign in ink)

8.b. Date of Signature (mm/dd/yyyy)

By my signature, I certify, under penalty of perjury, that I 

prepared this application at the request of the applicant. The 

applicant then reviewed this completed application and 

informed me that he or she understands all of the information 

contained in, and submitted with, his or her application, 

including the Applicant's Certification, and that all of this 

information is complete, true, and correct. I completed this 

application based only on information that the applicant 

provided to me or authorized me to obtain or use.

Preparer's Signature

Part 7. Contact Information, Declaration, and 

Signature of the Person Preparing this 

Application, if Other Than the Applicant 

(continued)
Form I-90 Edition 04/01/24 Page 7 of 7

3.d.

6.a. Page Number 6.b. Part Number 6.c. Item Number

6.d.

5.d.

Part 8. Additional Information 

If you need extra space to provide any additional information 

within this application, use the space below. If you need more 

space than what is provided, you may make copies of this page 

to complete and file with this application or attach a separate 

sheet of paper. Include your name and A -Number (if any) at 

the top of each sheet; indicate the Page Number, Part 

Number, and Item Number to which your answer refers; and 

sign and date each sheet.

 Your Full Name

1.a. Family Name 

(Last Name) 

1.b. Given Name 

(First Name) 

1.c. Middle Name

2. A-Number (if any) 

3.a. Page Number 3.b. Part Number 3.c. Item Number

5.a. Page Number 5.b. Part Number 5.c. Item Number

4.a. Page Number 4.b. Part Number 4.c. Item Number

4.d.

7.a. Page Number 7.b. Part Number 7.c. Item Number

7.d.

A-