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To: Immigration & Naturalization Service
______________________________
______________________________ ______________________________ CHANGE OF ADDRESS FORM Please change my address information in my immigration
file. The information is as
follows: Name:
__________________________________
Alien or File No. _______________ Date of Birth: ______________
Place of Birth: _____________________________ Old Address:
____________________________________________________________ New Address:
___________________________________________________________ I may be contacted at the
following telephone number(s): _________________________ I hereby
certify that a true copy of this document was mailed / hand delivered to the
Immigration and Naturalization Service office listed above on the date stated
below. Signature: _______________________________ Date: _____________ |
