Form I-193, Application for Waiver Completed Form Examples and Samples

Discover a sample filled Form I-193, showcasing a waiver application for a tourist visa. This example includes all necessary fields like applicant details, reason for request, and proper signature for submission in 2025, aiding in understanding form completion for waiver requests.
Form I-193, Application for Waiver has a basic Form Complexity Index of 45/100 — Instafill’s AI completes it in under a minute.
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Completed Form I-193 for a Tourist Visa Waiver Application

Form I-193 Example – Waiver for Tourist Visa Applicant

How this form was filled:

This example demonstrates a filled Form I-193 for a tourist visa applicant. It covers essential fields like the applicant's personal details, reason for the waiver request, and includes a signature and date for submission in 2025.

Information used to fill out the document:

  • Applicant Name: Jane Smith
  • Date of Birth: 01/15/1990
  • Nationality: Canadian
  • U.S. Address: 456 Park Avenue, New York, NY, USA
  • Passport Number: CA987654321
  • Reason for Waiver: Inability to present a valid passport due to unforeseen circumstances
  • Intended Length of Stay: 2 weeks
  • Signature: Jane Smith
  • Date: 03/10/2025

What this filled form sample shows:

  • Accurate personal information including name, date of birth, and nationality
  • Clear reason for waiver request due to unforeseen circumstances
  • Specified U.S. address and length of stay
  • Properly formatted signature and date for 2025 submission

Form specifications and details:

Use Case: Tourist visa applicant seeking waiver for documentary requirements
Completed Form I-193 for a Tourist Visa Waiver Application