I-693 Applicant Information Autofill

Printable-copy workflow: This page writes applicant information onto pages 1–3 and repeats the patient’s name and A-Number through page 14. It does not unlock or modify the protected interactive XFA form. Verify every generated page before using it.

Applicant information

Enter the information once, then download a completed printable PDF copy.

Page 1 - Applicant information Name, address, sex, birth information, and A-Number

Family name (last name)

Given name (first name)

Middle name

A-Number, if any Enter up to nine digits. The existing “A-” on the form is preserved.

Street number and name

Unit type

Apartment, suite, or floor number

City or town

State

ZIP code

Country

Sex

Date of birth

City, town, or village of birth

Country of birth

Page 2 - Applicant contact information Daytime telephone number and email address

Daytime telephone number

Email address

Page 3 - Identification document The form of identification will be entered as “Passport”

Passport number

Repeated PDF header preview

Family Name

Given Name

Middle Name

A-Number

Download original blank PDF

The PDF is created inside the browser. This page does not upload or retain patient information.

How to use the result

Verify the applicant’s name, address, sex, birth information, and A-Number on page 1.
Verify the daytime telephone number and email on page 2 and the passport number on page 3.
Confirm the name and A-Number repeat correctly in the headers on pages 2–14.
Complete the remaining information using your normal I-693 workflow.
Confirm that all 14 pages, edition date, page numbers, and barcodes remain visible before printing.