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Get 1615-0056 Expires 103109 Department Of Homeland Security U

Ease type or print in black ink. Part 1. For USCIS Use Only Returned Information about you. (Person filing this application) Family Name Given Name A # (if any) Middle Name U.S. Social Security # (if any) Home Address - Street Number and Name Apt. # City Date Date Resubmitted Date Date Reloc Sent State/Province Zip/Postal Code Receipt Country Date Mailing Address - Street Number and Name Apt. # Date Reloc Rec'd Date C/O (in care of): Date Remarks City State/Province Zip/.

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