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I-20 Request Form to Remove F-2 Dependents

This form is to be used by continuing U-M students to request that a dependent be removed from your I-20.

A new I-20 form will be printed for you.
I-20 processing time is 5-10 business days.
If you have International Center health insurance plan, please remember to remove your dependent(s) from your health insurance coverage. This is a separate procedure, please see International Health Insurance Change Form. Updating your I-20 will NOT automatically remove your dependent(s) from your health insurance.

Tags:

F-1 Students

Personal Information

First Name: *

Last Name: *

UMID: *

Current Email: *

Phone: *

Number of Dependents: *

Number of Dependents to be removed: *

Delivery Method

Delivery Method: *

I will pick it up

Someone will pick it up for me

Express Mail

U.S. Mail (only for U.S. addresses)

His/Her name is: *

US Address

(Street) *

(City) *

(State) *

(Zip Code) *

Dependent 1 to be removed from your I-20

Last Name: *

First Name: *

Birthdate: *

Month

Day

Year

Dependent is *

in U.S.

out of U.S.

If in US, dependent’s current US visa status: *

If available, copy documenting your dependent’s current immigration status *

Files must be less than 2 MB.
Allowed file types: gif jpg png bmp tif txt rtf html odf pdf doc docx ppt pptx xls xlsx xml.

Reason for Removal (Document Required): *

Copy of documentation demonstrating the reason for dependent’s removal: proof of departure from U.S. (e.g., airline boarding pass), proof of new immigration status, divorce certificate, death certificate, etc. *

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf.

Dependent 2 to be removed from your I-20

Last Name: *

First Name: *

Birthdate: *

Month

Day

Year

Dependent is *

in U.S.

out of U.S.

If in US, dependent’s current US visa status: *

If available, copy documenting your dependent’s current immigration status *

Files must be less than 2 MB.
Allowed file types: gif jpg png bmp tif txt rtf html odf pdf doc docx ppt pptx xls xlsx xml.

Reason for Removal (Document Required): *

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf.

Dependent 3 to be removed from your I-20

Last Name: *

First Name: *

Birthdate: *

Month

Day

Year

Dependent is *

in U.S.

out of U.S.

If in US, dependent’s current US visa status *

If available, copy documenting your dependent’s current immigration status *

Files must be less than 2 MB.
Allowed file types: gif jpg png bmp tif txt rtf html odf pdf doc docx ppt pptx xls xlsx xml.

Reason for Removal (Document Required): *

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf.

Please attach the following documents

Copy of paper or print-out of electronic Most Recent I-94 *

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf.

Copy of your current I-20, page 1 *

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf.

Copy of your current I-20, page 2 *

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf.

An unofficial transcript downloaded from Wolverine Access *

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf.

Comments

Certify *

I certify that I have read the request form instructions and information in full and the information I have provided is, to the best of my knowledge, accurate. I understand that I (and any F-2 dependents) must have U-M approved health insurance for the duration of my F-1 status. I understand that I must report any address changes, current (U.S.) or permanent (out of U.S.), through Wolverine Access within 10 days of the change.

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I-20 Request Form to Remove F-2 Dependents