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USCIS Alien Change of Address Form

This document is an Alien's Change of Address Card (Form AR-11) from the Department of Homeland Security. The form collects an alien's name, date of birth, alien registration number, present and previous physical addresses, and mailing address. It instructs aliens subject to registration requirements to use the form to report an address change within 10 days. It notes that failure to report a change of address is punishable by fine or imprisonment and/or removal from the United States.

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0% found this document useful (0 votes)
216 views2 pages

USCIS Alien Change of Address Form

This document is an Alien's Change of Address Card (Form AR-11) from the Department of Homeland Security. The form collects an alien's name, date of birth, alien registration number, present and previous physical addresses, and mailing address. It instructs aliens subject to registration requirements to use the form to report an address change within 10 days. It notes that failure to report a change of address is punishable by fine or imprisonment and/or removal from the United States.

Uploaded by

Daniela Arenas
Copyright
© © All Rights Reserved
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

Alien's Change of Address Card

Department of Homeland Security USCIS


U.S. Citizenship and Immigration Services Form AR-11

NOTE: An asterisk (*) indicates a mandatory field that must be completed.

Information About You


*Family Name (Last Name) *Given Name (First Name) Middle Name (if applicable)

*Date of Birth (mm/dd/yyyy) Alien Registration Number (A-Number) (if any)


► A-

Information About Your Address


*Present Physical Address (No PO Boxes)
*Street Number and Name Apt. Ste. Flr. Number

*City or Town *State *ZIP Code

(USPS ZIP Code Lookup)


Previous Physical Address
Street Number and Name Apt. Ste. Flr. Number

City or Town State ZIP Code

Mailing Address (optional)


Street Number and Name Apt. Ste. Flr. Number

City or Town State ZIP Code

(USPS ZIP Code Lookup)

Your Signature
*Your Signature Date of Signature (mm/dd/yyyy)

Form AR-11 Edition 11/02/22 Page 1 of 2


Address Change Information and Instructions
All aliens subject to registration requirements may use this form to report a change of address within 10 days of such change. For
detailed instructions on how to update your address, please visit [Link]/addresschange. The collection of this information is
required by Immigration and Nationality Act (INA) section 265 (8 U.S.C. 1305). U.S. Citizenship and Immigration Services (USCIS)
uses the data collected on this form for statistical and record-keeping purposes, and may share this information with other Federal,
state, local, and law enforcement officials. Failure to report a change of address is punishable by fine or imprisonment and/or removal
from the United States.
NOTE: This form is not evidence of identity, age, or status claimed.
IMPORTANT: If you are in immigration proceedings, you must separately notify the Immigration Court of any address
changes. Filing Form AR-11 with USCIS does not update your address with the Immigration Court.

Instructions
Complete all fields on this form, sign and date the form, and mail it to:

U.S. Department of Homeland Security


Citizenship and Immigration Services
Attn: Change of Address
1344 Pleasants Drive
Harrisonburg, VA 22801

DHS Privacy Notice


AUTHORITIES: The information requested on this form is collected under the Immigration and Nationality Act (INA) section 265.
PURPOSE: The primary purpose for providing the requested information on this form is to report a change of address. Except for
those exempted, all aliens in the U.S. are required to report any change of address or new address. DHS uses the information you
provide to contact you about the immigration benefit you are seeking.
DISCLOSURE: The information you provide is mandatory. Failure to report a change of address may result in a fine, imprisonment
and/or removal (8 U.S.C. sections 1227(a)(3) and1306). Failure to comply could also jeopardize your ability to obtain a future visa or
other immigration benefits.
ROUTINE USES: DHS may share the information you provide on this form with other Federal, state, local, and foreign government
agencies and authorized organizations. DHS follows approved routine uses described in the associated published system of records
notices [DHS/USCIS-001 - Alien File, Index, and National File Tracking System and DHS/USCIS-007 - Benefits Information
System] and the published privacy impact assessments [DHS/USCIS/PIA-018 Alien Change of Address Card (AR-11)] which you can
find at [Link]/privacy. DHS may also share this information, as appropriate, for law enforcement purposes or in the interest
of national security.

Form AR-11 Edition 11/02/22 Page 2 of 2

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