Form DS-5507, Affidavit of Physical Presence Instructions

Provide additional details as required before the specified event.

Enter the full name of the affiant.

Enter the name of the country relevant to the affiant's information.

Enter the full name of the affiant.

Enter the city or town and state in the United States where the affiant resides or has resided.

Enter the city and state where the event or stay took place.

Enter the start date of the event or stay in the format mm-dd-yyyy.

Enter the end date of the event or stay in the format mm-dd-yyyy.

Indicate the purpose of the stay, such as vacation, family visit, business trip, studies, employment, or residence.

Enter the city and state where the event or stay took place.

Enter the start date of the event or stay in the format mm-dd-yyyy.

Enter the end date of the event or stay in the format mm-dd-yyyy.

Indicate the purpose of the stay, such as vacation, family visit, business trip, studies, employment, or residence.

Enter the place of birth.

Enter the date of birth.

Enter the date of birth abroad.

Specify the location where the birth occurred to U.S. citizen(s) or U.S. non-citizen national(s).

Enter the full name of the child.

Enter the date of birth of the child in the format mm-dd-yyyy.

Enter the place of birth of the child.

Enter the full name of the child.

Enter the date of birth of the child in the format mm-dd-yyyy.

Enter the place of birth of the child.

Enter the full name of the child.

Enter the date of birth of the child in the format mm-dd-yyyy.

Enter the place of birth of the child.

Enter the full name of the child for whom the affidavit is being completed.

Enter the date of birth of the child in the format mm-dd-yyyy.

Enter the place of birth of the child, including city and country.

Enter the full name of the child for whom the affidavit is being completed.

Enter the date of birth of the child in the format mm-dd-yyyy.

Enter the place of birth of the child, including city and country.

Enter the full name of the child for whom the affidavit is being completed.

Enter the date of birth of the child in the format mm-dd-yyyy.

Enter the place of birth of the child, including city and country.

Enter the full name of the child for whom the affidavit is being completed.

Enter the date of birth of the child in the format mm-dd-yyyy.

Enter the place of birth of the child, including city and country.

Check this box if the individual is a citizen or national of the U.S.

Check this box if the individual is not a citizen of the U.S.

Enter the start date of the event or stay for the second entry.

Enter the end date of the event or stay for the second entry.

Enter the start date of the event or stay for the third entry.

Enter the end date of the event or stay for the third entry.

Enter the start date of the event or stay for the fourth entry.

Enter the end date of the event or stay for the fourth entry.

Enter the start date of the event or stay for the first entry on page 2.

Enter the end date of the event or stay for the first entry on page 2.

Enter the start date for the third entry of your stay or event in the format MM/DD/YYYY.

Enter the end date for the third entry of your stay or event in the format MM/DD/YYYY.

Enter the start date for the fourth entry of your stay or event in the format MM/DD/YYYY.

Enter the end date for the fourth entry of your stay or event in the format MM/DD/YYYY.

Enter the start date for the fifth entry of your stay or event in the format MM/DD/YYYY.

Enter the end date for the fifth entry of your stay or event in the format MM/DD/YYYY.

Enter the date for the specified event or action.

Enter the date for the specified event or action.

Enter the date for the specified event or action.

Enter the date for the specified event or action.

Button to reset the form to its default state.

Enter the name of the country relevant to the affiant's information.

Enter the date in the format mm-dd-yyyy.

Enter the date in the format mm-dd-yyyy.

Enter the date in the format mm-dd-yyyy.

Enter the date in the format mm-dd-yyyy.

Enter the name of the court or USCIS office and the U.S. state where relevant proceedings took place.

Enter the city and state where the event or stay took place for the third entry.

Enter the city and state where the event or stay took place for the fourth entry.

Enter the city and state where the event or stay took place for the fifth entry.

Enter the city and state where the event or stay took place for the first entry on page 2.

Enter the city and state where the event or stay took place for the second entry on page 2.

Enter the city and state where you were present during the specified dates.

Enter the city and state where you were present during the specified dates.

Enter the city and state where you were present during the specified dates.

Enter the city and state of the specified place.

Enter the city and state of the specified place.

Enter the city and state where the event or stay took place for the third entry.

Enter the city and state where the event or stay took place for the fourth entry.

Enter the city and state where the event or stay took place for the fifth entry.

Check this box if the affiant is currently married.

Check this box if the affiant has been previously married.

Check this box if the affiant is currently single.

Enter the date of naturalization.

Indicate whether the U.S. passport is being filed abroad or in the U.S.

Specify the purpose of your stay, such as vacation, family visit, business trip, studies, employment, or residence, for the third entry.

Specify the purpose of your stay, such as vacation, family visit, business trip, studies, employment, or residence, for the fourth entry.

Specify the purpose of your stay, such as vacation, family visit, business trip, studies, employment, or residence, for the fifth entry.

Specify the purpose of your stay, such as vacation, family visit, business trip, studies, employment, or residence. If working abroad, provide the name of the employer and specify if in U.S. government employment, military service, or on orders as a dependent.

Specify the purpose of your stay, such as vacation, family visit, business trip, studies, employment, or residence. If working abroad, include the name of your employer and indicate if you were in U.S. government employment, military service, or on orders as a dependent.

Specify the purpose of your stay, such as vacation, family visit, business trip, studies, employment, or residence. If working abroad, include the name of your employer and indicate if you were in U.S. government employment, military service, or on orders as a dependent.

Specify the purpose of your stay, such as vacation, family visit, business trip, studies, employment, or residence. If working abroad, include the name of your employer and indicate if you were in U.S. government employment, military service, or on orders as a dependent.

Specify the purpose of your stay for the third entry, such as vacation, family visit, business trip, studies, employment, or residence.

Specify the purpose of your stay for the fourth entry, such as vacation, family visit, business trip, studies, employment, or residence.

Specify the purpose of your stay for the fifth entry, such as vacation, family visit, business trip, studies, employment, or residence.

Specify the purpose(s) of your stay, such as vacation, family visit, business trip, studies, employment, or residence. If you worked abroad, provide the name of your employer and indicate if you were in U.S. government employment, military service, or on orders as a dependent.

Specify the purpose(s) of your stay, such as vacation, family visit, business trip, studies, employment, or residence.

Specify the purpose(s) of your stay, such as vacation, family visit, business trip, studies, employment, or residence.

Enter the start date of your stay or presence in the specified location.

Enter the end date of your stay or presence in the specified location.

Enter the start date of your stay or presence in the specified location.

Enter the end date of your stay or presence in the specified location.

Enter the start date of your stay or presence in the specified location.

Enter the end date of your stay or presence in the specified location.

Enter the start date of your stay or presence in the specified location.

Enter the end date of your stay or presence in the specified location.