I-212 Application for Permission to Reapply for Admission After Deportation or Removal Template

I-212 Application for Permission to Reapply for Admission After Deportation or Removal Template

[Your Full Name]
[Your A-Number (if any)]
[Your Street Address]
[City, State/Province, ZIP/Postal Code]
[Country]
[Phone Number]
[Email Address]

[Date]

To: [U.S. Department of Homeland Security / USCIS Office / U.S. Consulate or Embassy]
Attn: [Office/Section, if known]
[Office or Consulate Address]
[City, Country]

Re: I-212 Application for Permission to Reapply for Admission After Deportation or Removal
Applicant: [Your Full Name], A-Number: [A-Number, if any]

1. Introduction and Purpose of This Statement

I, [Your Full Name], respectfully submit this written statement in support of my I-212 Application for Permission to Reapply for Admission After Deportation or Removal. The purpose of this statement is to:

• Explain my immigration history and the circumstances that led to my removal or departure;

• Accept responsibility for my past actions where appropriate;

• Describe my family, personal, and community ties;

• Demonstrate my rehabilitation and positive conduct since my removal; and

• Present the reasons why I respectfully request that my application for permission to reapply be granted as a matter of discretion.

2. Personal Background

I was born on [Date of Birth] in [City, Country of Birth]. I am currently [your age] years old. I am [marital status, e.g., married/single/divorced] and have [number] children: [list children’s names and ages, especially if they are U.S. citizens or lawful permanent residents, if you choose to include this].

Before my removal, I lived in [City, State, Country] from approximately [Year] to [Year]. During that time, I [briefly describe your work, education, or family responsibilities, for example: “worked as a [Job Title] and supported my family,” or “was studying at [School Name]”].

[Optional: Provide any relevant background about your upbringing, family situation, or responsibilities, but avoid using this as an excuse. Focus on context that helps the officer understand your circumstances.]

3. Immigration History

My immigration history is as follows (to the best of my knowledge and memory):

• I first entered the United States on or about [Date of First Entry], at [Port of Entry], with [type of status, if any, e.g., visitor visa, border crossing, or without inspection].

• I [describe your immigration path: for example, “overstayed my authorized period of stay,” “worked without authorization,” or “failed to depart on time”].

• On [Date], I was placed in immigration proceedings in [City, State] and was ordered removed on [Date of Removal Order] by an Immigration Judge.

• On [Date of Removal or Departure], I was [removed/deported] from the United States through [Port of Departure] to [Country].

[Example: “On [Date], I tried to reenter the United States without inspection and was apprehended near [Location]. I was returned to [Country] on [Date].”]

4. Circumstances Leading to My Removal or Departure

The circumstances that led to my removal are as follows:

On or about [Date], I [briefly describe what happened: overstayed, entered without permission, violated a condition, or had a criminal incident]. As a result, immigration authorities began removal proceedings against me.

During my immigration case, I [describe cooperation or lack thereof, if appropriate: “appeared at my hearings,” “failed to appear,” “did not fully understand my options,” etc.]. Ultimately, on [Date], an Immigration Judge ordered me removed from the United States.

I understand now that my actions and decisions at that time were serious and had significant consequences. I regret any violations of immigration law and any misunderstanding or lack of responsibility on my part. I accept that my own decisions and actions led to my removal.

5. Acceptance of Responsibility and Remorse

I fully understand that my past immigration violations were wrong and that the United States has the right to enforce its immigration laws. I do not blame anyone else for my situation.

I take responsibility for:

• [Specify: overstaying a visa, entering without permission, failing to attend a hearing, or other conduct];

• The hardship caused to my family and myself; and

• The time and resources that the government had to spend on my case.

Since my removal, I have had time to reflect on my choices and their impact. I deeply regret my past mistakes and any lack of respect that my actions may have shown toward U.S. laws. I am committed to following all immigration laws and procedures in the future and to only seek legal and honest ways to enter or reside in the United States.

6. Family, Community, and Hardship Factors

I respectfully ask that you consider the following family and hardship factors in reviewing my I-212 application:

• My spouse: [Name], who is a [U.S. citizen / lawful permanent resident / other status], currently lives in [Location] and depends on my emotional and/or financial support.

• My children: [List names, ages, and status, especially if they are U.S. citizens or lawful permanent residents], who would suffer hardship if I am unable to return or remain lawfully with them.

• Other family members: [Parents, siblings, or other relatives] who are [elderly, ill, or otherwise dependent on your support], if applicable.

In addition to family hardship, I also ask you to consider:

• Economic hardship: [Describe loss of income, job opportunities, or ability to provide for your family due to your removal].

• Emotional and psychological hardship: [Describe the emotional impact on you and your close family members].

• Educational or medical hardship: [Explain any special educational needs or medical conditions affecting you or family members that are made worse by your separation].

7. Rehabilitation, Good Conduct, and Positive Factors

Since my removal from the United States on [Date], I have made every effort to live a responsible and law-abiding life. I respectfully ask you to consider the following positive factors:

• I have [maintained steady employment / started a small business / supported my family] in [Country] since [Year].

• I have not been convicted of any new crimes or serious offenses since my removal.

• I have [participated in community, church, volunteer, or charitable activities], which show my commitment to being a positive and contributing member of society.

• I have taken steps to improve myself through [education, training, language classes, counseling, or other programs], demonstrating my commitment to personal growth and responsibility.

8. Reasons for Granting Permission to Reapply

I respectfully request that my I-212 application be granted because:

• My close family ties to the United States (especially U.S. citizen or lawful permanent resident family members) are strong, and our separation causes genuine hardship.

• I have shown rehabilitation and good moral character since my removal.

• I am committed to following all U.S. laws and procedures, and I am seeking to return through a lawful and appropriate process.

• Allowing me to reapply for admission will promote family unity and stability, and will allow me to contribute positively through [employment, supporting my family, paying taxes, community involvement, etc.].

I understand that this application is discretionary, and I respectfully ask you to exercise your discretion favorably in my case after considering both my past mistakes and my positive actions since then.

9. Supporting Documents

I am including the following documents in support of my I-212 application, where available:

• Copy of my removal order and/or immigration court documents;

• Evidence of my prior entries and departures (passports, travel records, etc.);

• Birth and/or marriage certificates showing family relationships;

• Evidence of family hardship (medical records, school records, financial records, letters from family);

• Evidence of my rehabilitation and good conduct (employment letters, certificates, community or church letters, police clearance records, etc.);

• Any other documents that help explain my situation and support my request.

[Adjust this list to match the documents you are actually providing.]

10. Closing Statement

I respectfully submit this statement as part of my I-212 Application for Permission to Reapply for Admission After Deportation or Removal. I understand that my past immigration violations were serious, and I deeply regret my mistakes.

I hope that this explanation, together with the supporting evidence, shows that I have taken responsibility, changed my behavior, and am now seeking to follow the law and do things correctly. I ask that you please consider my family ties, hardship factors, positive conduct, and rehabilitation, and grant my request for permission to reapply for admission to the United States.

Thank you for taking the time to review my statement and my application.

Sincerely,

[Your Full Name]
[Signature, if printed]
[Date]