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Ar 11

This document is an AR-11 form used by aliens in the United States to report a change of address within 10 days. It requires information such as name, country of citizenship, date of birth, present and last addresses, and port of entry. The form advises that failure to report an address change is punishable by fine or imprisonment and that it is not evidence of identity, age, or status. It also provides instructions for submitting the form and notes that the collection of information is required by law and used for statistical and law enforcement purposes.

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90 views1 page

Ar 11

This document is an AR-11 form used by aliens in the United States to report a change of address within 10 days. It requires information such as name, country of citizenship, date of birth, present and last addresses, and port of entry. The form advises that failure to report an address change is punishable by fine or imprisonment and that it is not evidence of identity, age, or status. It also provides instructions for submitting the form and notes that the collection of information is required by law and used for statistical and law enforcement purposes.

Uploaded by

tussh_rocks
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Department of Homeland Security OMB No.

1615-0007; Expires 09/30/11


U.S. Citizenship and Immigration Services AR-11, Alien's Change of Address Card
Name (Last in CAPS) (First Name) (Middle Name) I am in the United States as a:
Visitor Permanent Resident
Student Other (Specify)
Country of Citizenship Date of Birth (mm/dd/yyyy) Copy Number From Alien Card
A
Present Address (Street or Rural Route) (City or Post Office) (State) (Zip Code)

(If the above address is temporary) I expect to remain there Years Months

Last Address (Street or Rural Route) (City or Post Office) (State) (Zip Code)

I work for or attend school at: (Employer's Name or Name of School)

(Street Address or Rural Route) (City or Post Office) (State) (Zip Code)

Port of Entry Into U.S. Date of Entry Into U.S. If not a Permanent Resident,
(mm/dd/yyyy) my stay in the U.S. expires on:
(Date - mm/dd/yyyy)

Signature Date (mm/dd/yyyy)

Form AR-11 (Rev. 10/06/08) Y

AR-11, Alien's Change of Address Card


This card is to be used by all aliens to report a change of address within ten days of such change.
The collection of this information is required by Section 265 of the Immigration and Nationality Act (8 U.S.C. 1305). The data is
used by U.S. Citizenship and Immigration Services for statistical and record purposes and may be furnished to Federal, State, local
and foreign law enforcement officials. Failure to report a change of address is punishable by fine or imprisonment and/or removal.

ADVISORY: This card is not evidence of identity, age, or status claimed.

Paperwork Reduction Act


An agency may not conduct or sponsor an information collection and a person is not required to respond to a collection of information
unless it displays a currently valid OMB control number. The public reporting burden for this collection of information is estimated at
five minutes per response, including the time for reviewing instructions and completing and submitting the form. Send comments
regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to:
U.S. Citizenship and Immigration Services, Regulatory Management Division, 111 Massachusetts Avenue, N.W., 3rd Floor, Suite
3008, Washington, DC 20529. OMB No. 1615-0007. Do not mail your application to this address.
Mail Your Form to the Address Shown Below:
For commercial overnight or fast freight
Department of Homeland Security Department of Homeland Security
U.S. Citizenship and Immigration Services U.S. Citizenship and Immigration Services
Change of Address Change of Address
P.O. Box 7134 1084-I South Laurel Road
London, KY 40742-7134 London, KY 40742-7134

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