Form I-193, Application for Waiver Instructions
This form contains 34 fields organized into 12 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Application Details | ||
| File Number | Text |
Enter the file number associated with your application.
|
| Application Information | ||
| DATE OF THIS APPLICATION Enter 2-digit month, 2-digit day and 4-digit year | Text |
Enter the date when you are filling out this application. Use the format MM/DD/YYYY.
|
| Application Status | ||
| APPLICATION APPROVED. WAIVER GRANTED | CheckBox |
Check this box if your application has been approved and the waiver has been granted.
|
| Application Disapproved | CheckBox |
Check this box if your application has been disapproved.
|
| Application Type | ||
| PASSPORT | CheckBox |
Check this box if you are applying for a waiver of the passport fee.
|
| VISA | CheckBox |
Check this box if you are applying for a waiver of the visa fee.
|
| Arrival Information | ||
| PORT OF ARRIVAL | Text |
Enter the port of arrival in the United States.
|
| MANNER OF ARRIVAL (NAME OF VESSEL, AIRLINE, ETCETERA) | Text |
Enter the name of the vessel, airline, or other means of transportation you used to arrive in the U.S.
|
| DATE OF ARRIVAL Enter 2-digit month, 2-digit day and 4-digit year | Text |
Enter the date you arrived in the U.S. in the format MM/DD/YYYY.
|
| Citizenship Details | ||
| THE COUNTRY OF WHICH I AM A CITIZEN, SUBJECT OR NATIONAL IS | Text |
Enter the country of which you are a citizen, subject, or national.
|
| Contact Information | ||
| MY UNITED STATES DESTINATION IS: (NUMBER AND STREET, APARTMENT NUMBER, CITY, STATE, ZIP CODE) | Text |
Enter your U.S. destination, including number and street, apartment number, city, state, and ZIP code.
|
| MY PERMANENT ADDRESS ABROAD IS | Text |
Enter your permanent address abroad.
|
| Legal Authority | ||
| UNDER SECTION 211(b) by authority of | CheckBox |
Check this box if the waiver is granted under Section 211(b) by the authority specified.
|
| UNDER SECTION 212(d) (4) by authority of | CheckBox |
Check this box if the waiver is granted under Section 212(d)(4) by the authority specified.
|
| Passport Information | ||
| PLACE PASSPORT ISSUED | Text |
Provide the location where your passport was issued.
|
| PASSPORT ISSUE DATE Enter 2-digit month, 2-digit day and 4-digit year | Text |
Enter the date your passport was issued in the format MM/DD/YYYY.
|
| PASSPORT NUMBER | Text |
Enter your passport number.
|
| PASSPORT VALID TO Enter 2-digit month, 2-digit day and 4-digit year | Text |
Enter the expiration date of your passport. Use the format MM/DD/YYYY.
|
| Personal Information | ||
| LAST NAME | Text |
Enter your last name.
|
| FIRST NAME | Text |
Enter your first name.
|
| MIDDLE NAME | Text |
Enter your middle name.
|
| DATE OF BIRTH (MM/DD/YYYY) Enter 2-digit month, 2-digit day and 4-digit year | Text |
Enter your date of birth in the format MM/DD/YYYY.
|
| CITY AND STATE | Text |
Enter the city and state of your permanent address abroad.
|
| PLACE OF BIRTH | Text |
Enter your place of birth.
|
| THE REASON I AM NOT IN POSSESSION OF PASSPORT / VISA IS AS FOLLOWS | Text |
Provide the reason why you do not have a passport or visa.
|
| Signatures | ||
| SIGNATURE OF APPLICANT This is a protected field | Text |
Sign the form. This field is protected and cannot be edited.
|
| Signature of Preparer. This is a protected field | Text |
Signature of the person who prepared the form. This field is protected and cannot be edited.
|
| Address of Preparer | Text |
Enter the address of the person who prepared the form.
|
| Date Document Prepared Enter 2-digit month, 2-digit day and 4-digit year | Text |
Enter the date the document was prepared in the format MM/DD/YYYY.
|
| Visa Information | ||
| PLACE VISA PREVIOUSLY ISSUED | Text |
Provide the location where your visa was previously issued.
|
| DATE VISA ISSUED Enter 2-digit month, 2-digit day and 4-digit year | Text |
Enter the date your visa was issued in the format MM/DD/YYYY.
|
| VISA NUMBER | Text |
Enter the number of your previous visa.
|
| VISA CLASSIFICATION | Text |
Specify the classification of your previous visa (e.g., B1, B2, etc.).
|
| VISA VALID TO Enter 2-digit month, 2-digit day and 4-digit year | Text |
Enter the expiration date of your visa. Use the format MM/DD/YYYY.
|