Purpose of Form:
This form is for a permanent resident alien who must leave the United States for certain employment purposes and wishes to preserve his/her status as an immigrant in order to pursue naturalization.
Number of Pages: 7
11/01/06. Prior versions acceptable.
Where to File:
File this application with the USCIS Local Office with jurisdiction over your place of residence.
Filing Fee: $305.00
Please note: This is a large file (816 KB). We recommend that it not be filled out in your web browser, but that you download it to your computer (by "right-clicking" on the link below and selecting "Save Target At". Then launch the file from Adobe Reader.
Note on Filing Fee:
Checks should be made payable to Department of Homeland Security or U.S. Citizenship and Immigration Services