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Get Form I 407

Ermanent Address in United States (Number and Street) "A" File Number (City) 3. Date of Birth (mm/dd/yyyy) Country of Birth 4. Date of Last Departure From the United States (mm/dd/yyyy) (State) Name of Vessel, Airline or Other Means of Departure (Zip Code) Country of Citizenship Port of Departure From the United States 5. Intended or Actual Permanent Address Abroad 6(a). I voluntarily, willingly and affirmatively am abandoning have abandoned my status as a lawful permanent resident.

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