I-821-015 Final Fee Rule Mocks

Application for Temporary Protected Status

I-821-015 Final Fee Rule Mocks

OMB: 1615-0043

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Select the form you want to file online. Once you start your form, we will automatically save your
information for 30 days, or from the last time you worked on the form.

Fee waiver: If you are requesting a fee waiver, you cannot file online. You must file a paper version of
both the Form I-912, Request for Fee Waiver and the form for the specific benefit you are requesting.
You can review the fee waiver guidance at www.uscis.gov/feewaiver.

Select the form you want to file online.
I-821, Application For Temporary Protected Status (TPS)
Use this form to apply or re-register for Temporary Protected Status (TPS) if you are an eligible
national of a designated country. Review our website for more information on countries designated
for TPS and registration dates.


Concurrent filing available

We will present Form I-765 for you to complete if you request an Employment Authorization
Document (EAD) when completing Form I-821. This will allow you to submit both forms at the same
time.

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I-821, Application For Temporary
Protected Status (TPS)
If you are an eligible national of certain countries that the Secretary of Homeland Security (Secretary)
has designated for Temporary Protected Status (TPS) or a person without nationality who last
habitually resided in the designated country, then you may apply for TPS by filing Form I-821,
Application for Temporary Protected Status. This form is also used if you have TPS and are filing for
TPS re-registration.
Do not use Form I-821 to request Consideration Of Deferred Action for Childhood Arrivals (DACA).
Form I-821D must be used to request DACA.
Review our website for more information on countries currently designated for TPS and registration
dates.



Before You Start Your Application


Eligibility

To be eligible for TPS, you must be admissible to the United States as an immigrant
under the applicable grounds in INA section 212(a), with certain exceptions.
We may grant discretionary waivers of certain inadmissibility grounds for humanitarian
purposes, to assure family unity, or because it is otherwise in the public interest.
However, we cannot waive some inadmissibility grounds, by law, including certain
criminal grounds in INA sections 212(a)(2)(A-C) and national security, terrorism-related,
and persecution grounds in INA sections 212(a)(3)(A-C, E). If you are inadmissible on
grounds that can be waived, you may be able to obtain a discretionary waiver. If you are
re-registering for TPS and you were already granted a waiver of a ground of
inadmissibility in conjunction with your prior TPS application, you do not need to seek
another waiver for the same action, incident, or circumstance. For example, if on a prior
TPS application, USCIS previously granted you a waiver of the health ground of
inadmissibility because you had tuberculosis that was treated, you do not need to apply
for another waiver for that same health incident. However, you will need to file for a
waiver if you have contracted another communicable disease for which a waiver is
necessary.
Each person seeking TPS must apply for themselves on a separate Form I-821. There is
no derivative TPS status, meaning that your spouse, children or parents cannot obtain
TPS as a result of your approval for TPS. They must each qualify for TPS individually.
However, we may accept late initial TPS applications from certain individuals who had a
qualifying relationship to a spouse or child during the initial registration period for the
TPS-designated country and that relative is also currently eligible for TPS. Even where
such a relationship exists, the applicant must still meet all other TPS eligibility
requirements before we may grant TPS.
You may submit this form with Form I-765 online if you also want to request an
Employment Authorization Document (EAD). If you request an EAD in Form I-821, we will
add Form I-765 for you to complete a er you sign your Form I-821.

Note: If you were ever convicted of or ever committed a “particularly serious crime” that

constitutes a “danger to the community of the United States,” or there are serious
reasons for believing that you have committed “serious nonpolitical crimes” outside of
the United States before your arrival in this country, you cannot be granted TPS. We will
make the determination as to whether your crimes fall into either of these categories.
You must, however, provide information and, if available, any supporting documentation
on all crimes which you have committed or were convicted of in the United States or
outside of this country so that we can make an appropriate decision. If you believe that
any of your arrests or convictions were politically motivated, describe why in your
supplemental statements.
 Fee

We will automatically calculate the cost for you before you submit your application. For
specific information about fees applicable to this form, see Form G-1055.

Refund policy: USCIS does not refund fees, regardless of any action we take on your

application, petition or request, or how long USCIS takes to reach a decision. By
continuing this transaction, you acknowledge that you must submit fees in the exact
amount and that you are paying the fees for a government service.
Please refer to the instructions for the form(s) you are filing for additional information or
you may call the USCIS Contact Center at 800-375-5283. For TTY (deaf or hard of hearing)
800-767-1833.


Documents you may need
We will automatically determine which documents you should provide us as you fill out
your application. At the time of filing, you must submit all evidence and supporting
documentation listed.



Biometric services appointment
USCIS may require that you appear for an interview or provide fingerprints, photograph,
and/or signature at any time to verify your identity, obtain additional information, and
conduct background and security checks, including a check of criminal history records
maintained by the Federal Bureau of Investigation (FBI), before making a decision on
your application, petition, or request. A er USCIS receives your application and ensures
it is complete, we will inform you in writing or by email notice if you e-file your
application, if you need to attend a biometric services appointment. If an appointment is
necessary, the notice will provide you the location of your local or designated USCIS
Application Support Center (ASC) and the date and time of your appointment or, if you
are currently overseas, instruct you to contact a U.S. Embassy, U.S. Consulate, or USCIS
office outside the United States to set up an appointment.



A er You Submit Your Application


Track your case online

A er you submit your form, you can track its status through your USCIS account. Sign in
to your account o en to check your case status and read any important messages from
USCIS.


Respond to requests for information

If we need more information from you, we will send you a Request for Evidence (RFE) or
Request for Information (RFI). You can respond to our request and upload your
documents through your USCIS account.


Receive your decision

The decision on Form I-821 involves a determination of whether you have established
eligibility for the immigration benefit you are seeking. USCIS will notify you of the
decision in writing.

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Completing Your Form Online
Filing online



Submitting your application online is the same as mailing in a completed paper form.
They both gather the same information and cost the same.


Complete the Getting Started section first

You should answer all questions in the Getting Started section first so we can best
customize the rest of your online form experience.


Provide as many responses as you can

You should provide as many responses as you can. Incomplete fields or sections and
missing information can slow down the process a er you submit your form.


We will automatically save your responses

We will automatically save your information when you select next to go to a new page or
navigate to another section of the form. We will save your information for 30 days from
today, or from the last time you worked on the form.


How to continue filling out your form

A er you start your form, you can sign in to your account to continue your form.

DHS Privacy Notice
AUTHORITIES: The information requested on this application, and the associated evidence,
is collected under INA sections 101 and 244.

PURPOSE: The primary purpose for obtaining the requested information on this application
is to determine whether you have established eligibility for TPS, if you have not yet been
granted TPS. DHS will use the information you provide to grant or deny the benefit you are
seeking.

DISCLOSURE: The information you provide is voluntary. However, failure to provide the
requested information, including your Social Security number (if applicable), and any
requested evidence, may delay a final decision or result in denial of your application.

ROUTINE USES: DHS may, where allowable under relevant confidentiality provisions, share

the information you provide on this application and any additional requested evidence 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, DHS/USCIS-007
- Benefits Information System, and DHS/USCIS-018 Immigration Biometric and Background
Check System] and the published privacy impact assessment [DHS/USCIS/PIA-056 USCIS
Electronic Immigration System] which you can find at www.dhs.gov/privacy. DHS may also
share the information, as appropriate, for law enforcement purposes or in the interest of
national security.

Paperwork Reduction Act
An agency may not conduct or sponsor an information collection, and a person is not
required to respond to a collection of information, unless it displays a currently valid Office of
Management and Budget (OMB) control number. The public reporting burden for this
collection of information is estimated at 2.227 hours per response, including the time for
reviewing instructions, gathering the required documentation and information, completing
the application, attaching necessary documentation, and submitting the application. The
collection of biometrics, where required, is estimated to require 1 hour and 10 minutes. Send
comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden to:
U.S. Citizenship and Immigration Services
Office of Policy and Strategy, Regulatory Coordination Division
5900 Capital Gateway Drive, Mail Stop #2140
Camp Springs, MD 20588-0009
Do not mail your completed Form I-821 to this address.
OMB No. 1615-0043
Expires: 8/31/2025



Security Reminder

If you do not work on your application for more than 30 days, we will delete your
data in order to prevent storing personal information indefinitely.

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I-821, Application for
Temporary Protected
Status (TPS)
Getting Started

Resources





Sign Out

What is your reason for applying?
Initial application for Temporary Protected Status (TPS)
- applicant has not been previously granted TPS
Re-registration application for Temporary Protected
Status (TPS) - applicant has previously been granted
TPS



Reason for request
Preparer and interpreter
information

About You



Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



What is the name of the designated TPS country
under which you are applying?


Are you also filing a request for employment
authorization?
Yes, I am requesting an Employment Authorization
Document (EAD), and I am filing form I-765, Application
for Employment Authorization, together with my form
I-821.
No, I am not currently requesting an EAD.

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My Account

I-821, Application for
Temporary Protected
Status (TPS)
Getting Started

Resources





Sign Out

What is your reason for applying?
Initial application for Temporary Protected Status (TPS)
- applicant has not been previously granted TPS
Re-registration application for Temporary Protected
Status (TPS) - applicant has previously been granted
TPS



Reason for request
Preparer and interpreter
information

About You



Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



What is the name of the designated TPS country
under which you are applying?


Who granted you TPS?
USCIS
Immigration Judge/Board of Immigration Appeals

Are you also filing a request for employment
authorization?
Yes, I am requesting an Employment Authorization
Document (EAD), and I am filing form I-765, Application
for Employment Authorization, together with my form
I-821.
No, I am not currently requesting an EAD.

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An official website of the United States government Hereʼs how you know



My Account

I-821, Application for
Temporary Protected
Status (TPS)
Getting Started

Resources





Sign Out

What is your reason for applying?
Initial application for Temporary Protected Status (TPS)
- applicant has not been previously granted TPS
Re-registration application for Temporary Protected
Status (TPS) - applicant has previously been granted
TPS



Reason for request
Preparer and interpreter
information

About You



Your Family



Basis of Eligibility



Additional Information



Evidenceand Submit
Review



What is the name of the designated TPS country
under which you are applying?


Who granted you TPS?
USCIS
Immigration Judge/Board of Immigration Appeals

Are you also filing a request for employment
authorization?
Yes, I am requesting an Employment Authorization
Document (EAD), and I am filing form I-765, Application
for Employment Authorization, together with my form
I-821.
No, I am not currently requesting an EAD.
 We will add Form I-765 for you to complete a er you sign your
Form I-821. A er your Form I-821 is signed, it will be locked and
no further changes can be made. Once both forms are complete,
you can pay for and submit the forms at the same time.

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I-821, Application for
Temporary Protected
Status (TPS)



Resources



Sign Out

Is someone assisting you with completing this
application?
Yes
No

Getting Started
Reason for request

Preparer and interpreter
information

About You



Your Family



Basis of Eligibility



Evidence
Additional Information



Review and Submit

Back

Next




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I-821, Application for
Temporary Protected
Status (TPS)



Resources



Sign Out

Is someone assisting you with completing this
application?
Yes
No

Getting Started
Reason for request

Preparer and interpreter
information
Preparer information
Interpreter information

About You



Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



Is a preparer assisting you with completing this
application?
A preparer is anyone who completes or helps you complete all or part of
your application using information and answers that you provide.

Yes
No

Is an interpreter assisting you with completing
this application?
An interpreter is anyone who translates or helps you translate all or part of
your application using information and answers that you provide.

Yes
No

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I-821, Application for
Temporary Protected
Status (TPS)

Resources





Sign Out

What is your preparerʼs full name?
Given name (first name)

Family name (last name)

Getting Started
Reason for request
Preparer and interpreter
information

Preparer information

What is your preparerʼs business or organization
name?

Interpreter information

About You



Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



My preparer is not part of a business or organization.

What is your preparerʼs mailing address?
Country


Address line 1

Street number and name

Address line 2

Apartment, suite, unit, or floor

City or town

State

ZIP code


Provide a 5 or 9-digit
ZIP code.

What is your preparerʼs contact information?
Daytime telephone number

Provide a 10-digit phone number.

Mobile telephone number
My preparer does not have a mobile telephone number.

Provide a 10-digit phone number.

Email address
My preparer does not have an email address.

Example: user@domain.com

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An official website of the United States government Hereʼs how you know

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My Account

I-821, Application for
Temporary Protected
Status (TPS)



Resources



Sign Out

What is your interpreterʼs full name?
Given name (first name)

Family name (last name)

Getting Started
Reason for request
Preparer and interpreter
information
Preparer information

What is your interpreterʼs business or organization
name?

Interpreter information

About You



Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



My interpreter is not part of a business or organization.

What is your interpreterʼs mailing address?
Country


Address line 1

Street number and name

Address line 2

Apartment, suite, unit, or floor

City or town

State

ZIP code


Provide a 5 or 9-digit
ZIP code.

What is your interpreterʼs contact information?
Daytime telephone number

Provide a 10-digit phone number.

Mobile telephone number
My interpreter does not have a mobile telephone number.

Provide a 10-digit phone number.

Email address
My preparer does not have an email address.

Example: user@domain.com

What language is your interpreter using to
interpret this application for you?

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My Account

I-821, Application for
Temporary Protected
Status (TPS)



Resources



Sign Out

What is your current legal name?

Getting Started



Your current legal name is the name on your birth certificate, unless it
changed a er birth by a legal action such as marriage or court order. Do not
provide any nicknames here.

About you



Given name (first name)

Middle name

Your Name
Your contact information
When and where you were born

Family name (last name)

Describe yourself
Where you have lived
Your immigration
information



Your immigration
information page 2

Have you used any other names since birth?

Immigration status

Other names used may include nicknames, aliases, and maiden names.

Other information

Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



Yes
No

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An official website of the United States government Hereʼs how you know

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My Account

I-821, Application for
Temporary Protected
Status (TPS)



Resources



Sign Out

What is your current legal name?

Getting Started



Your current legal name is the name on your birth certificate, unless it
changed a er birth by a legal action such as marriage or court order. Do not
provide any nicknames here.

About you



Given name (first name)

Middle name

Your Name
Your contact information
When and where you were born

Family name (last name)

Describe yourself
Where you have lived
Your immigration
information



Your immigration
information page 2

Have you used any other names since birth?

Immigration status

Other names used may include nicknames, aliases, and maiden names.

Other information

Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



Yes
No

Back

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Contact USCIS
USCIS.gov
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

My Account

I-821, Application for
Temporary Protected
Status (TPS)



Resources



Sign Out

How may we contact you?

Getting Started



About you



Daytime telephone number

Provide a 10-digit phone number.

Your Name

Mobile telephone number (if any)
This is the same as my daytime telephone number.

Your contact information
When and where you were born
Describe yourself
Where you have lived
Your immigration
information

Provide a 10-digit phone number.


Email address

Your immigration
information page 2

Example: user@domain.com

Immigration status
Other information

Your Family



Basis of Eligibility



Evidence

What is your current mailing address?



Additional Information



We will use your current mailing address to contact you throughout the
application process. We may not be able to contact you if you do not
provide a complete and valid address. Please provide a U.S. address only.

Review and Submit



In care of name (if any)

Address line 1

Street number and name

Address line 2

Apartment, suite, unit, or floor

City or town

State

ZIP code


Provide a 5 or 9-digit
ZIP code.

Is your current mailing address the same as your
physical address?
Yes
No

Where in the United States do you live?
Address line 1

Street number and name

Address line 2

Apartment, suite, unit, or floor

City or town

State

ZIP code


Provide a 5 or 9-digit
ZIP code.

Back

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Citizenship

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An official website of the United States government Hereʼs how you know



My Account

I-821, Application for
Temporary Protected
Status (TPS)



Resources



Sign Out

What is your date of birth?

Getting Started



About you



The provided date of birth automatically completes the same question on
your concurrent Form I-765. Once you finish your Form I-821 and lock it,
you will not be able to alter your date of birth when filling out Form I-765.
Please ensure you enter accurate information before proceeding.

MM/DD/YYYY

Your Name
Your contact information

When and where you were born
Describe yourself

List all other dates of birth you have ever used.

Where you have lived
Your immigration
information



MM/DD/YYYY

Your immigration
information page 2
Immigration status



Add another date of birth

Other information

Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



What is your city, town, or village of birth?

What is your country of birth?


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

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Temporary Protected
Status (TPS)



Resources



Sign Out

What is your gender?

Getting Started



About you



Male
Female

Your Name
Your contact information

What is your ethnicity?

When and where you were born

Hispanic or Latino refers to a person of Cuban, Mexican, Puerto Rican,
South or Central American, or other Spanish culture or origin, regardless of
race.

Describe yourself
Where you have lived
Your immigration
information



Hispanic or Latino
Not Hispanic or Latino

Your immigration
information page 2
Immigration status
Other information

Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



What is your race?
Select all that apply. Your race is different from your ethnicity and should
reflect your geographical origins.


White



Asian



Black or African American 
American Indian or Alaska Native



Native Hawaiian or Other Pacific Islander



What is your height?
Feet

Inches




What is your weight?
Pounds

Provide a weight between 30 and 699 pounds.

What is the color of your eyes?


What is the color of your hair?


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

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

Resources



Sign Out

What countries did you live in before coming to
the United States?

Getting Started



About you





Your Name



Your contact information

Add another country

When and where you were born
Describe yourself

Where you have lived
Your immigration
information

Back



Next

Your immigration
information page 2
Immigration status
Other information

Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



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

My Account

I-821, Application for
Temporary Protected
Status (TPS)

Resources





Sign Out

What is your country of citizenship or nationality?

Getting Started



About you



List all countries where you are currently a citizen or national. If you are
stateless, choose “Stateless.”


Your Name
Your contact information



When and where you were born

Add country

Describe yourself
Where you have lived

Your immigration
information



When did you last enter the United States?

Your immigration
information page 2

MM/DD/YYYY

Immigration status
Other information

Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



Where did you last enter the United States?
Port of entry


City or town

State


What was your immigration status when you last
entered the United States?


What is your Form I-94 Arrival-Departure Record
Number (if any)?

Provide an 11-character I-94 Number.

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I-821, Application for
Temporary Protected
Status (TPS)



Resources



Sign Out

What is the expiration date of the authorized stay
shown on your Form I-94 or Form I-95?

Getting Started



About you



Duration of Status

MM/DD/YYYY

Your Name
Your contact information
When and where you were born

What is the passport number of your most
recently issued passport (if any)?

Describe yourself
Where you have lived
Your immigration
information



Your immigration
information page 2
Immigration status
Other information

Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



What is your travel document number (if any)?

What country issued your most recent passport or
travel document?


What is the expiration date of your most recent
passport or travel document?
MM/DD/YYYY

What other passport or travel document numbers
do you have (if any)?
List the passport or travel document numbers for all additional documents
you have.



Add another number

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Temporary Protected
Status (TPS)



Resources



Sign Out

What is your current immigration status or lack of
status?

Getting Started



About you





Your Name
Your contact information
When and where you were born

Are you now or were you ever in immigration
proceedings?

Describe yourself
Where you have lived
Your immigration
information

Yes
No



Your immigration
information page 2

Immigration status
Other information

Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



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

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Status (TPS)

Resources





Sign Out

What is your current immigration status or lack of
status?

Getting Started



About you





Your Name
Your contact information
When and where you were born

Are you now or were you ever in immigration
proceedings?

Describe yourself
Where you have lived
Your immigration
information

Yes
No



Your immigration
information page 2

Your immigration information
Other information

Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



What type of proceedings were you in or are you
currently in? Select all that apply.
If your proceedings are ongoing, leave the “To” date blank. List any other
immigration proceedings in the “Additional Information” section. Include
the type of proceedings you were in, the dates, and the location.

Immigration court (before an immigration judge)
Board of Immigration Appeals (BIA)
I am no longer in Department of Justice (DOJ) or
Department of Homeland Security (DHS) immigration
proceedings, but I am or was in Federal court
proceedings regarding immigration issues.

Where were your DOJ and/or DHS proceedings
held, or are currently being held (if applicable)?

When did the proceedings take place?
Present

From (MM/DD/YYYY)

To (MM/DD/YYYY)

MM/DD/YYYY

MM/DD/YYYY

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

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Status (TPS)

Resources





Sign Out

What is your current immigration status or lack of
status?

Getting Started



About you





Your Name
Your contact information
When and where you were born

Are you now or were you ever in immigration
proceedings?

Describe yourself
Where you have lived
Your immigration
information

Yes
No



Your immigration
information page 2
Your immigration information
Other information

Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



What type of proceedings were you in or are you
currently in? Select all that apply.
If your proceedings are ongoing, leave the “To” date blank. List any other
immigration proceedings in the “Additional Information” section. Include
the type of proceedings you were in, the dates, and the location.

Immigration court (before an immigration judge)
Board of Immigration Appeals (BIA)


I am no longer in Department of Justice (DOJ) or
Department of Homeland Security (DHS) immigration
proceedings, but I am or was in Federal court
proceedings regarding immigration issues.

Where were your DOJ and/or DHS proceedings
held, or are currently being held (if applicable)?

Where were your federal court proceedings
regarding immigration issues held, or are
currently being held (if applicable)?

When did the proceedings take place?
Present

From (MM/DD/YYYY)

To (MM/DD/YYYY)

MM/DD/YYYY

MM/DD/YYYY

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Status (TPS)



Resources



Sign Out

What is your A-Number?
I do not have or know their A-Number.

Getting Started



About you



AProvide a 7, 8, or 9-digit number. If your A-Number is fewer than 9 digits,
the system will automatically add zero(s) a er the “A” and before the first
digit so there is a total of 9 digits, for example: A-001234567.

Your Name
Your contact information
When and where you were born
Describe yourself
Where you have lived
Your immigration
information

What is your U.S. Social Security number?



I do not have or know my U.S. Social Security number.

Your immigration
information page 2
Immigration status

Provide a 9-digit Social Security number.

Other information

Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



What is your USCIS Online Account Number?
Providing your unique USCIS Online Account Number (OAN) helps us
manage your account. You may already have an OAN if you previously filed
certain paper forms and received an Account Access Notice in the mail. You
can find the OAN at the top of the notice; it is not the same as an A-Number.
I do not have or know my USCIS Online Account Number.

Provide a 12-digit Online Account Number.

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

Resources



Sign Out

What is your current marital status?

Getting Started



About you



Your Family



Single, never married
Married
Divorced
Widowed
Separated
Marriage annulled
Other

Marital status
Your spouse
Your former spouses
Your children

Basis of Eligibility



Evidence



Additional Information



Review and Submit



Back

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Status (TPS)



Resources



Sign Out

What is your current marital status?

Getting Started



About you



Your Family



Single, never married
Married
Divorced
Widowed
Separated
Marriage annulled
Other

Marital status
Your spouse
Your former spouses
Your children

Basis of Eligibility



Evidence



Additional Information



Review and Submit



On what date did you marry your spouse?
MM/DD/YYYY

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Resources





Sign Out

 Complete this section only if you are filing a late initial

Getting Started



About you



Your Family



application for TPS. To determine if this applies to you, review
our instructions for filing late.

What is your spouseʼs legal name?
Your spouseʼs legal name is the name on their birth certificate, unless it
changed a er birth by a legal action such as marriage or court order. Do not
provide a nickname here.

Marital status

Your spouse

Given name (first name)

Your former spouses

Middle name

Your children

Basis of Eligibility



Evidence



Additional Information



Review and Submit



Family name (last name)

What is your spouseʼs current mailing address?
My spouseʼs current mailing address is the same as my
mailing address.

Country

Address line 1

Street number and name

Address line 2

Apartment, suite, unit, or floor

City or town

State

ZIP code


Provide a 5 or 9-digit
ZIP code.

What is your spouseʼs A-Number?
My spouse does not have or know their A-Number.

AProvide a 7, 8, or 9-digit number. If your A-Number is fewer than 9 digits,
the system will automatically add zero(s) a er the “A” and before the first
digit so there is a total of 9 digits, for example: A-001234567.

What is your spouseʼs date of birth?
MM/DD/YYYY

On what date did you marry your spouse?
MM/DD/YYYY

Where were you and your spouse married?
Place of marriage

Country

City or town

State/Province


If you know, has your spouse ever had TPS?
Yes
No

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

Resources



Sign Out

 Complete this section only if you are filing a late initial

Getting Started



About you



Your Family



application for TPS. To determine if this applies to you, review
our instructions for filing late.

Former Spouses
Provide information about your former spouses (if any).

Marital status


Your spouse

Add former spouse

Your former spouses
Your children

Basis of Eligibility



Evidence



Additional Information



Review and Submit



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

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Status (TPS)



Resources



Sign Out

 Complete this section only if you are filing a late initial

Getting Started



About you



Your Family



application for TPS. To determine if this applies to you, review
our instructions for filing late.

Former Spouses
Provide information about your former spouses (if any).

Marital status

Your spouse
Your former spouses

What is your former spouseʼs legal name?

Your children

Basis of Eligibility



Evidence



Additional Information



Review and Submit



Your former spouseʼs legal name is the name on their birth certificate,
unless it changed a er birth by legal action such as marriage or court order.
Do not provide a nickname here.

Given name (first name)

Middle name

Family name (last name)

What are your former spouseʼs nationalities?

Provide your former spouseʼs nationality or nationalities, if more than one.

What is your former spouseʼs A-Number?
My former spouse does not have or know their A-Number.

AProvide a 7, 8, or 9-digit number. If your A-Number is fewer than 9 digits,
the system will automatically add zero(s) a er the “A” and before the first
digit so there is a total of 9 digits, for example: A-001234567.

What is your former spouseʼs date of birth?
MM/DD/YYYY

What is the date of your former spouseʼs death (if
deceased)?
MM/DD/YYYY

When were you married to your former spouse?
From (MM/DD/YYYY)

To (MM/DD/YYYY)

MM/DD/YYYY

MM/DD/YYYY

How did this marriage end?
Annulled
Divorced
Widowed
Other

Did your former spouse have TPS or do they
currently have TPS?
Yes
No
I do not know

Is your former spouse currently applying for TPS
or re-registering for TPS?
Yes
No
I do not know

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

Resources



Sign Out

 Complete this section only if you are filing a late initial

Getting Started



About you



Your Family



application for TPS. To determine if this applies to you, review
our instructions for filing late.

Children Information
Provide information about your children (if any).

Marital status


Your spouse

Add a child

Your former spouses

Your children

Basis of Eligibility



Evidence



Additional Information



Review and Submit



Back

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

Resources



Sign Out

 Complete this section only if you are filing a late initial

Getting Started



About you



Your Family



application for TPS. To determine if this applies to you, review
our instructions for filing late.

Children Information
Provide information about your children (if any).

Marital status
Your spouse
Your former spouses

What is your childʼs current legal name?

Your children

Basis of Eligibility



Evidence



Additional Information



Review and Submit



Your childʼs legal name is the name on their birth certificate, unless it
changed a er birth by legal action such as marriage or court order. Do not
provide a nickname here.

Given name (first name)

Middle name

Family name (last name)

What is your childʼs date of birth?
MM/DD/YYYY

What is your childʼs current mailing address?
My spouseʼs current mailing address is the same as my
mailing address.

Country

Address line 1

Street number and name

Address line 2

Apartment, suite, unit, or floor

City or town

State

ZIP code


Provide a 5 or 9-digit
ZIP code.

What is your childʼs USCIS Online Account
Number?
My child does not have or know their USCIS Online Account Number.

What is your childʼs A-Number?
My child does not have or know their A-Number.

AProvide a 7, 8, or 9-digit number. If your A-Number is fewer than 9 digits,
the system will automatically add zero(s) a er the “A” and before the first
digit so there is a total of 9 digits, for example: A-001234567.

If your child had TPS or currently has TPS, enter
the dates of their TPS, if known.
From (MM/DD/YYYY)

To (MM/DD/YYYY)

MM/DD/YYYY

MM/DD/YYYY

Is your child currently applying for TPS or reregistering for TPS, if known?
Yes
No

Save entry

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

About you



Your Family



Basis of Eligibility




Immigration eligibility
page 2
Immigration violations



Immigration violations
page 2


Affiliations

Resources



Sign Out

To be eligible for TPS, you must be admissible as an immigrant to the
United States, with certain exceptions. The questions below and your
responses to these questions will help USCIS determine if you are eligible
for TPS.

Getting Started

Immigration eligibility



Affiliations page 2

If any of the questions apply to you, please provide information about the
events, including the places and dates of occurrence. Provide a full
explanation of the circumstances related to the specific event. If you need
additional space to respond to a question, use the “Additional Information”
section.

Are you now the guardian of, and are you
accompanying, another individual who has been
found to be inadmissible and who has been
certified by a medical examiner to be helpless due
to sickness, physical or mental disability, or
infancy?
Yes
No

Affiliations page 3
Crime and offenses



Crime and offenses
page 2

Do you now have a communicable disease of
public health significance?

Crime and offenses
page 3
Moral character



Moral character page 2

Evidence



Additional Information



Review and Submit



Yes
No

Do you now have or have you ever had a physical
or mental disorder and behavior (or a history of
behavior that is likely to recur) associated with the
disorder which has posed or may pose a threat to
the property, safety, or welfare of yourself or
others?
Yes
No

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

Your Family



Basis of Eligibility







I entered the United States on the following date,
and have resided in the United States since that
time.

Immigration eligibility
page 2


Immigration violations
page 2

MM/DD/YYYY



Affiliations

Sign Out

If you have no nationality, enter the country where you last habitually
resided.


Immigration violations



What is your country of nationality?

Getting Started

Immigration eligibility

Resources



Affiliations page 2
Affiliations page 3
Crime and offenses



Have you ever traveled to and entered a country
other than your country of nationality or last
habitual residence before you last entered the
United States?

Crime and offenses
page 2
Crime and offenses
page 3
Moral character



Yes
No

Moral character page 2

Evidence



Additional Information



Review and Submit



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

Immigration violations



Sign Out

Provide information for each country you traveled to and entered prior to
entering the United States.


Add country



Immigration eligibility
page 2

Immigration eligibility
page 3

Resources

Countries You Traveled To

Getting Started

Immigration eligibility



Back

Next



Immigration violations
page 2


Affiliations
Affiliations page 2
Affiliations page 3
Crime and offenses



Crime and offenses
page 2
Crime and offenses
page 3
Moral character
Moral character page 2




Evidence
Additional Information



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

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

About you



Your Family



Basis of Eligibility



Immigration eligibility



Provide information for each country you traveled to and entered prior to
entering the United States.

What country did you travel to and enter?




Immigration eligibility
page 2

Immigration eligibility
page 3
Immigration violations

When were you in this country?



Immigration violations
page 2

From (MM/DD/YYYY)


Affiliations

To (MM/DD/YYYY)

MM/DD/YYYY

MM/DD/YYYY

Affiliations page 2
Affiliations page 3
Crime and offenses



Crime and offenses
page 2

What was your immigration status in this country,
if any?

Crime and offenses
page 3
Moral character



Moral character page 2

Evidence



Additional Information



Review and Submit



Ex: citizen, legal permanent resident, refugee, asylee, visitor, student,
temporary resident, or no status.

Have you ever been offered any immigration
status by another country that you did not accept?
Yes
No

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

About you



Your Family



Basis of Eligibility



Immigration eligibility



Provide information for each country you traveled to and entered prior to
entering the United States.

What country did you travel to and enter?




Immigration eligibility
page 2

Immigration eligibility
page 3
Immigration violations

When were you in this country?



Immigration violations
page 2

From (MM/DD/YYYY)


Affiliations

To (MM/DD/YYYY)

MM/DD/YYYY

MM/DD/YYYY

Affiliations page 2
Affiliations page 3
Crime and offenses



Crime and offenses
page 2

What was your immigration status in this country,
if any?

Crime and offenses
page 3
Moral character



Moral character page 2

Evidence



Additional Information



Review and Submit



Ex: citizen, legal permanent resident, refugee, asylee, visitor, student,
temporary resident, or no status.

Have you ever been offered any immigration
status by another country that you did not accept?
Yes
No

Provide the country or countries, the nature of the
immigration status you were offered, and the
dates when it was offered.

Describe why you chose not to accept the
immigration status offered to you.

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Basis of Eligibility



Sign Out



Have you ever claimed to be a U.S. citizen (in
writing or in any other way)?



Yes
No

Immigration violations
page 2


Affiliations



Yes
No

Immigration eligibility
page 2

Immigration violations

Resources

Have you ever unlawfully voted in a United States
Federal, state, or local election?

Getting Started

Immigration eligibility



Affiliations page 2
Affiliations page 3
Crime and offenses



Have you ever been ordered removed, and been
deported from the United States?

Crime and offenses
page 2
Crime and offenses
page 3
Moral character

Yes
No



Moral character page 2

Evidence



Additional Information



Review and Submit



Have you ever voluntarily departed the United
States under an order of removal?
Yes
No

Have you re-entered the United States unlawfully
at any time a er you were deported or you
voluntarily departed?
Yes
No

Has DHS reinstated your prior order of removal?
Yes
No

Have you ever failed to attend or remain in
attendance at any immigration proceedings to
determine your admissibility or deportability?
Yes
No

Has an immigration judge or the Board of
Immigration Appeals ever determined that you
filed a frivolous asylum application in the past?
Yes
No

Have you ever, by fraud or willfully
misrepresenting a material fact, sought to obtain
a visa or other documentation, admission to the
United States, or any other immigration benefit?
Yes
No

Have you ever assisted any other person to enter
the United States in violation of the law?
Yes
No

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

Sign Out

Yes
No



Did the former Immigration and Naturalization
Service (INS) ever impose, or has DHS ever
imposed, civil monetary penalties on you for
producing or using false documentation to obtain
an immigration benefit?

Immigration eligibility
page 2
Immigration violations

Resources

Have you ever entered the United States as a
stowaway?

Getting Started

Immigration eligibility





Immigration violations
page 2


Affiliations

Yes
No

Affiliations page 2
Affiliations page 3
Crime and offenses



Crime and offenses
page 2

Are you now subject to a final order for violation
of section 274C (producing and/or using false
documentation to unlawfully satisfy a
requirement of the Immigration and Nationality
Act)?

Crime and offenses
page 3
Moral character



Moral character page 2

Evidence



Additional Information



Review and Submit



Yes
No

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

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

Basis of Eligibility



Immigration eligibility



Sign Out

Yes
No



Have you ever participated in Nazi persecution or
genocide?



Immigration violations
page 2

Affiliations

Resources

Have you ever been or are you now a member of
the Communist or other totalitarian party, except
when membership was involuntary?

Immigration eligibility
page 2
Immigration violations



Yes
No



Affiliations page 2
Affiliations page 3
Crime and offenses



Have you ever ordered, incited, assisted, or
otherwise participated in the persecution of any
person on account of race, religion, nationality,
membership in a particular social group, or
political opinion?

Crime and offenses
page 2
Crime and offenses
page 3
Moral character



Moral character page 2

Evidence



Additional Information



Review and Submit



Yes
No

Have you ever ordered, incited, called for,
committed, helped with, or otherwise
participated in acts involving torture or genocide?
Yes
No

Have you ever ordered, incited, called for,
committed, helped with, or otherwise
participated in killing any person?
Yes
No

Have you ever ordered, incited, called for,
committed, helped with, or otherwise
participated in intentionally and severely injuring
any person?
Yes
No

Have you ever or are you now engaged in terrorist
activities?
Yes
No

Have you ever ordered, incited, called for,
committed, helped with, or otherwise
participated in any kind of sexual contact or
relations with any person who was being forced or
threatened?
Yes
No

Have you ever ordered, incited, called for,
committed, helped with, or otherwise
participated in limiting or denying any personʼs
ability to exercise religious beliefs?
Yes
No

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

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

Basis of Eligibility



Immigration eligibility



Resources



Sign Out

Have you ever served in, been a member of,
assisted in, or participated in any military unit,
paramilitary unit, police unit, self- defense unit,
vigilante unit, rebel group, guerrilla group, militia,
or insurgent organization?
Yes
No



Immigration eligibility
page 2
Immigration violations



Have you ever served or worked in any prison, jail,
prison camp, detention facility, labor camp, or any
other situation that involved detaining persons?

Immigration violations
page 2


Affiliations

Affiliations page 2

Yes
No

Affiliations page 3
Crime and offenses



Crime and offenses
page 2
Crime and offenses
page 3
Moral character

Have you ever been a member of, assisted in, or
participated in any group, unit, or organization of
any kind in which you or other persons used any
type of weapon against any person or threatened
to do so?



Moral character page 2

Evidence



Additional Information



Review and Submit



Yes
No

Have you ever assisted with or participated in
selling or providing weapons to any person who
to your knowledge used them against another
person, or in transporting weapons to any person
who to your knowledge used them against
another person?
Yes
No

Have you ever received any type of military,
paramilitary, or weapons training?
Yes
No

Have you ever recruited, enlisted, conscripted, or
used any person under 15 years of age to serve in
or help an armed force or group?
Yes
No

Have you ever used any person under 15 years of
age to take part in hostilities or to help or provide
services to people in combat?
Yes
No

Have you ever been responsible for or directly
carried out particularly severe violations of
religious freedom, as defined in section 3 of the
International Religious Freedom Act of 1998 (22
U.S.C. section 6402) while serving as a foreign
government official?
Yes
No

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

Basis of Eligibility



Sign Out



Are you the spouse or child of an alien who
assisted, abetted, conspired, or colluded with
others in the unlawful trafficking of any controlled
substance?



Immigration violations
page 2

Yes
No



Affiliations



Yes
No

Immigration eligibility
page 2
Immigration violations

Resources

Are you the spouse or child of an alien who
unlawfully trafficked in any controlled substance?

Getting Started

Immigration eligibility



Affiliations page 2

Affiliations page 3
Crime and offenses



Crime and offenses
page 2

Are you now the spouse or child of an alien who
committed or conspired to commit human
trafficking offenses?

Crime and offenses
page 3
Moral character



Yes
No

Moral character page 2

Evidence



Additional Information



Review and Submit



Are you now the spouse or child of, or are you
yourself, an alien who knowingly aided, abetted,
assisted, conspired, or colluded with a human
trafficker?
Yes
No

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Your Family



Basis of Eligibility



Sign Out



Have you ever been convicted of any
misdemeanor committed in the United States?


Yes
No

Immigration violations
page 2


Affiliations



Yes
No

Immigration eligibility
page 2
Immigration violations

Resources

Have you ever been convicted of any felony
committed in the United States?

Getting Started

Immigration eligibility



Affiliations page 2
Affiliations page 3

Crime and offenses



Have you ever been convicted of any particularly
serious crime committed either in or outside the
United States?

Crime and offenses
page 2
Crime and offenses
page 3
Moral character

Yes
No



Moral character page 2

Evidence



Additional Information



Review and Submit



Have you ever been convicted of or have you ever
committed acts which constitute the essential
elements of a crime (other than a purely political
offense)?
Yes
No

Have you ever been convicted of or have you ever
committed acts which constitute the essential
elements of a violation of any law relating to a
controlled substance as defined in section 102 of
the Controlled Substances Act?
Yes
No

Have you ever been convicted of or have you ever
committed acts which constitute the essential
elements of a conspiracy to violate any law
relating to a controlled substance as defined in
section 102 of the Controlled Substances Act?
Yes
No

Have you ever been convicted of two or more
criminal offenses (other than purely political
offenses) for which you received sentences to
confinement that, when combined, total five years
or more?
Yes
No

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

Immigration eligibility

Sign Out



Have you ever, whether in the United States or any
other country been cited, charged, or indicted, for
breaking or violating any law or ordinance,
excluding minor traffic violations?





Affiliations page 2

Yes
No

Affiliations page 3
Crime and offenses



Yes
No

Immigration violations
page 2
Affiliations

Resources

Have you ever, whether in the United States or any
other country been arrested, for breaking or
violating any law or ordinance, excluding minor
traffic violations?

Immigration eligibility
page 2
Immigration violations





Crime and offenses
page 2
Crime and offenses
page 3
Moral character

Have you ever, whether in the United States or any
other country been convicted, fined, imprisoned,
placed on probation, received a suspended
sentence or deferral of adjudication for breaking
or violating any law or ordinance, excluding minor
traffic violations?



Moral character page 2

Evidence



Additional Information



Review and Submit



Yes
No

Have you ever been the beneficiary of a pardon,
amnesty, rehabilitation decree, other act of
clemency, or similar action?
Yes
No

Have you ever committed a serious criminal
offense in the United States and asserted
immunity from prosecution?
Yes
No

Have you ever committed serious nonpolitical
crimes outside of the United States prior to your
arrival in the United States?
Yes
No

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

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Sign Out



Have you ever engaged, or do you plan to engage,
solely, principally, or incidentally, in any activity
to violate or evade any law prohibiting the export
from the United States of goods, technology, or
sensitive information?





Affiliations page 2
Affiliations page 3
Crime and offenses



Yes
No

Immigration violations
page 2
Affiliations

Resources

Have you ever engaged, or do you plan to engage,
solely, principally, or incidentally, in any activity
to violate any law of the United States relating to
espionage or sabotage?

Immigration eligibility
page 2
Immigration violations



Yes
No



Crime and offenses
page 2

Crime and offenses
page 3
Moral character



Have you ever engaged, or do you plan to engage,
solely, principally, or incidentally, in any other
unlawful activity in the United States?

Moral character page 2

Evidence



Additional Information



Review and Submit



Yes
No

Have you ever engaged, or do you plan to engage,
solely, principally, or incidentally, in any activity in
which a purpose is to oppose, control, or
overthrow the Government of the United States
by force, violence, or other unlawful means,
including but not limited to participating in such
activities, giving support to others involved in
such activities, or being a member or
representative of a terrorist organization?
Yes
No

Have you ever or are you now engaged in or plan
to engage in activities in the United States that
would have potentially serious adverse foreign
policy consequences for the United States?
Yes
No

Have you ever or are you now engaged in
activities that could be reasonable grounds for
concluding that you are a danger to the security of
the United States?
Yes
No

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

Basis of Eligibility



Sign Out



Are you now or have you ever knowingly assisted,
abetted, conspired, or colluded with others in the
unlawful trafficking of any controlled substance?



Immigration violations
page 2

Yes
No



Affiliations



Yes
No

Immigration eligibility
page 2
Immigration violations

Resources

Have you ever trafficked in or are you now
trafficking in any controlled substance?

Getting Started

Immigration eligibility



Affiliations page 2
Affiliations page 3
Crime and offenses



Within the previous five years, have you ever
obtained any financial or other benefit from the
unlawful activity of your spouse (including former
spouses) or parents, and you knew, or reasonably
should have known, that the financial or other
benefit was the product of such illicit activity?

Crime and offenses
page 2
Crime and offenses
page 3

Moral character



Moral character page 2

Evidence



Additional Information



Review and Submit



Yes
No

Have you ever, within the past 10 years, or are you
now engaged in prostitution or procurement of
prostitution?
Yes
No

Have you ever, within the past 10 years (either
directly or indirectly) procured or attempted to
procure or import prostitutes or persons for the
purpose of prostitution?
Yes
No

Have you ever, within the past 10 years, received,
in whole or in part, the proceeds of prostitution?
Yes
No

Have you ever been or do you intend to be
involved in any other commercial vice?
Yes
No

Are you now or have you ever been a drug abuser
or drug addict?
Yes
No

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My Account

I-821, Application for
Temporary Protected
Status (TPS)


About you



Your Family



Basis of Eligibility



Sign Out

Have you ever detained, retained, or withheld the
custody of a child having a lawful claim to U.S.
citizenship, outside the United States, from a U.S.
citizen granted custody?





Immigration violations
page 2

Yes
No



Affiliations



Yes
No

Immigration eligibility
page 2
Immigration violations

Resources

Do you now practice polygamy?

Getting Started

Immigration eligibility



Affiliations page 2
Affiliations page 3
Crime and offenses



Have you ever committed or conspired to commit
human trafficking offenses, as defined in the
section 103 of the Victims of Trafficking and
Violence Protection Act of 2000, in the United
States or outside the United States?

Crime and offenses
page 2
Crime and offenses
page 3
Moral character



Moral character page 2

Evidence



Additional Information



Review and Submit



Yes
No

Have you ever knowingly aided, abetted, assisted,
conspired, or colluded with a human trafficker?
Yes
No

Within the previous five years, have you ever
obtained any financial or other benefit from the
human trafficking activity of your spouse
(including former spouses) or parents, and you
knew, or reasonably should have known, that the
financial or other benefit that you received
resulted from such human trafficking?
Yes
No

Are you now or have you ever engaged in money
laundering as described in section 1956 or 1957 of
Title 18, United States Code?
Yes
No

Are you now or have you ever been a knowing
aider, abettor, assister, conspirator, or colluder
with others in money laundering?
Yes
No

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Getting Started



About you



Your Family



Evidence



Clear and readable
Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
No encrypted or password-protected files
If your documents are in a foreign language, upload a full English
translation and the translatorʼs certification with each original
document.
• Upload no more than five documents at a time
Accepted file name characters: English letters, numbers, spaces,
• periods, hyphens, underscores, and parentheses
• Maximum size: 12MB per file
•
•
•
•

Proof of entry



Sign Out

File requirements

Proof of Residence

Review and Submit



If you are submitting a first-time re-registration with USCIS following an
Immigration Judge or Board of Immigration Appeals decision granting
your TPS application, upload a copy of the TPS decision order.

Proof of identity and nationality



Resources

Proof of Temporary Protected Status Granted by
EOIR Immigration Judge or Board of
Immigration Appeals

EOIR or BIA order

Criminal history
Additional
Information



Choose or drop files here to upload

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

Resources



Sign Out

Proof Of Identity And Nationality

Getting Started



About you



Your Family



Evidence



Upload proof of your identity and nationality. Examples of documents you
may submit include copies of your:
Passport (cover to cover);
Birth certificate accompanied by photo identification; or
Any national identity document from your country of origin that
includes your photo and/or fingerprint.

File requirements

EOIR or BIA order

Clear and readable
Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
No encrypted or password-protected files
If your documents are in a foreign language, upload a full English
translation and the translatorʼs certification with each original
document.
Upload no more than five documents at a time
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
Maximum size: 12MB per file

Proof of identity and
nationality
Proof of Residence
Proof of entry
Criminal history
Additional
Information



Review and Submit



Choose or drop files here to upload

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

Resources



Sign Out

Proof Of Residence

Getting Started



About you



Your Family



Evidence



Upload proof of your continuous residence in the United States. Examples
of documents you may submit include copies of your:
Employment records (for example, pay stubs; Form W-2, Wage and Tax
Statement; certification of the filing of Federal income tax returns;
state verification of the filing of state income tax returns; letters from
employers; or, if you are self-employed, letters from banks and other
firms with which you have done business.)
NOTE: In all of these documents, your name and the name of the
employer or other interested organization must appear on the form or
letter, as well as relevant dates. Letters from employers must be in
affidavit form and the employer must also sign and attest to the
affidavit under penalty of perjury. Such letters must include:
Your address at the time of employment;
Exact periods of employment;
Periods of layoff; and
Duties with the company.

EOIR or BIA order
Proof of identity and nationality

Proof of Residence
Proof of entry
Criminal history
Additional
Information



Review and Submit



If the employment records are unavailable, submit an affidavit
explaining why you cannot obtain these records. Your employer must
sign and attest to the affidavit under penalty of perjury.
Rent receipts, utility bills (for example, gas, electric and phone), and
receipts or letters from companies showing the dates during which you
received service.
School records (for example, letters, and report cards) from the
schools that you or your children have attended in the United States,
showing the names of the schools and periods of school attendance.
Hospital or medical records concerning treatment or hospitalization of
you or your children, showing the name of the medical facility or
physician, and the dates of the treatment or hospitalization.
Attestations by churches, unions, or other organizations to your
residence, identifying you by name. The attestation must be signed by
an official (whose title is shown); show inclusive dates of membership;
state the address where you resided during membership periods;
include the seal of the organization impressed on the letter or the
letterhead of the organization, if the organization has letterhead
stationery; establish how the author knows you; and establish the
origin of the information being attested to.
Additional documents may include copies of money order receipts for
money sent in or out of the country; passport entries; birth certificates
of children born in the United States; dated bank transactions;
correspondence between you and another person or organization; U.S.
Social Security card; Selective Service card; automobile license
receipts, title, vehicle registration; deeds, mortgages, contracts to
which you have been a party; tax receipts; insurance policies; receipts;
and letters.
Any other relevant documents.

File requirements
Clear and readable
Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
No encrypted or password-protected files
If your documents are in a foreign language, upload a full English
translation and the translatorʼs certification with each original
document.
Upload no more than five documents at a time
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
Maximum size: 12MB per file

Choose or drop files here to upload

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I-821, Application for
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

Resources



Sign Out

Proof Of Entry

Getting Started



About you



Your Family



Evidence



Upload proof of your date of entry into the United States. Examples of
documents you may submit include copies of your:
Passport (cover to cover);
Form I-94, Arrival-Departure Record; or
Any documents outlined under Proof of residence on the previous
page.

File requirements

EOIR or BIA order

Clear and readable
Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
No encrypted or password-protected files
If your documents are in a foreign language, upload a full English
translation and the translatorʼs certification with each original
document.
Upload no more than five documents at a time
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
Maximum size: 12MB per file

Proof of identity and nationality
Proof of Residence

Proof of entry

Additional Information



Review and Submit



Choose or drop files here to upload

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Resources



Sign Out

Criminal History

I-821, Application for
Temporary Protected
Status (TPS)
Getting Started



About you



Your Family



Evidence



If you were ever arrested, charged, and/or convicted for a criminal offense,
you will need to provide court disposition records. Upload a certified copy
of all arrest reports, court dispositions, sentencing documents, and any
other relevant documents. You may also include any mitigating evidence
concerning the circumstances of your arrests or convictions that you would
like USCIS to consider if you have been arrested or convicted of a crime. If
you were placed on probation, you must provide evidence to show that you
completed your probationary period.
You do not need to submit documentation for traffic fines and incidents
(unless the traffic fines or incidents were alcohol- or drug-related) that did
not involve an actual arrest if the penalty was only a fine of less than $500
or points on your driverʼs license. However, if you were arrested for any
traffic offense, provide disposition documentation, so USCIS can properly
assess whether your conviction may relate to your TPS eligibility.



EOIR or BIA order
Proof of identity and nationality
Proof of Residence

If official documents are not available to you, you must establish that
the documents are not available to you or your designated
representative. If you claim that a record is not available because of a
“confidentiality” law or other reason, please submit:
(1) A copy of your petition or motion to the court or other custodian of the
record seeking permission to obtain a copy to submit with your
application; and
(2) A copy of the courtʼs or custodianʼs order denying permission, if
possible.

Proof of entry

Criminal history

Additional Information



Review and Submit



If you show that you cannot obtain a copy of the official record, you
can submit any secondary evidence that might be available, such as
copies that you or your attorney may have retained.
If you cannot obtain primary or secondary evidence, you must provide
at least one written statement. Each written statement must:
(1) Be from a named individual who has personal knowledge to the
proceeding;
(2) Explain the source of the individualʼs personal knowledge;
(3) Describe the nature of the proceeding, the underlying charges, and the
disposition; and
(4) Be signed by the individual under oath, affirmation, or penalty of
perjury.

File requirements
Clear and readable
Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
No encrypted or password-protected files
If your documents are in a foreign language, upload a full English
translation and the translatorʼs certification with each original
document.
Upload no more than five documents at a time
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
Maximum size: 12MB per file

Choose or drop files here to upload

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

Resources



Sign Out

Additional Information

Getting Started



About you



Your Family



Evidence



Additional Information



If you need to provide any additional information for any of your answers to
the questions in this form, enter it into the space below. You should include
the questions that you are referencing.
If you do not need to provide any additional information, you may leave
this section blank.


Add a response

Additional information

Review and Submit



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Resources



Sign Out

Additional Information

Getting Started



About you



Your Family



Evidence



Additional Information



If you need to provide any additional information for any of your answers to
the questions in this form, enter it into the space below. You should include
the questions that you are referencing.
If you do not need to provide any additional information, you may leave
this section blank.

Section

Additional information

Review and Submit



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



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

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Additional Information

Getting Started



About you



Your Family



Evidence



Additional Information



If you need to provide any additional information for any of your answers to
the questions in this form, enter it into the space below. You should include
the questions that you are referencing.
If you do not need to provide any additional information, you may leave
this section blank.


Additional information

Review and Submit

Resources





Add a response

Name

Action

On whose behalf are you filing this
form



Edit



Delete

Additional information.

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

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Sign Out

Check your application before you submit

Getting Started



About you



Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



We will review your application to check for accuracy and completeness
before you submit it.
We encourage you to provide as many responses as you can throughout the
application, to the best of your knowledge. Missing information can slow
down the review process a er you submit your application.
You can return to this page to review your application as many times as you
want before you submit it.

Your fee
 Your form filing fee is: $85

Review your application

Refund policy: USCIS does not refund fees, regardless of any action we

Your application summary

take on your application, petition or request, or how long USCIS takes to
reach a decision. By continuing this transaction, you acknowledge that you
must submit fees in the exact amount and that you are paying the fees for a
government service.

Preparer signature
Interpreter signature
Your statement

Alerts and warning

Your signature

A green alert means you have completed all required fields and responses.


We found no alerts or warnings in your declaration.

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Resources



Sign Out

Review the I-821 form information
Here is a summary of all the information you provided in your application.

Getting Started



About you



Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



Make sure you have provided responses for everything that applies to you
before you submit your application. You can edit your responses by going
to each application section using the site navigation.
We also prepared a dra case snapshot with your responses, which you can
download below.


View dra snapshot



Print

Getting Started



Preparer or interpreter information

Review your application

Your application summary

Is someone assisting you with completing
this application?

Preparer statement
Preparer signature
Interpreter certification
Interpreter signature
Your statement
Your signature

Yes

Is a preparer assisting you with
completing this application?

Yes

Is an interpreter assisting you
with completing this application?

Yes

Preparer or interpreter information
Is someone assisting you with completing
this application?

Yes

Is a preparer assisting you with
completing this application?

Yes

Is an interpreter assisting you
with completing this application?

Yes

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

Resources



Sign Out

Preparerʼs statement

Your preparer must read the statements below and select the statement
that applies to him or her.

Getting Started



About you



Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



If your preparer is an attorney or accredited representative whose
representation extends beyond preparation of this application, he or she
may be obliged to submit a completed Notice of Entry of Appearance as
Attorney or Accredited Representative (G-28) with your application.

I am not an attorney or accredited representative but
have prepared this application on behalf of the applicant
and with the applicantʼs consent.
I am an attorney or accredited representative and my
representation of the applicant in this case does not
extend beyond the preparation of this application.
I am an attorney or accredited representative and my
representation of the applicant in this case extends
beyond the preparation of this application.

Review your application
Your application summary

Preparer statement
Preparer signature
Interpreter certification
Interpreter signature
Your statement

Preparerʼs certification and signature

Your signature

Your preparer must read and agree to the certification below.

By my signature, I certify, under penalty of perjury, that I
prepared this application at the request of the applicant.
The applicant then reviewed this completed application
and informed me that the applicant understands all of the
information contained in, and submitted with, the
application, including the Applicantʼs Certification, and
that all of this information is complete, true, and correct. I
completed this application based only on the information
that applicant provided to me or authorized me to obtain
or use.

As the applicantʼs preparer, you must sign on paper and
provide your signature page to the applicant. Follow these
steps:


1. Download the Preparer Signature page



2. Print the Preparer Signature page



3. Read and sign the Preparer Signature page



4. Give the signed Preparer Signature page to
the applicant

The applicant will need to scan and upload your
completed signature page on the next screen.

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Preparerʼs Signature Upload

Scan and upload your preparerʼs completed signature page below.

Getting Started



About you



Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



File requirements
Clear and readable
Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
No encrypted or password-protected files
If your documents are in a foreign language, upload a full English
translation and the translatorʼs certification with each original
document.
Upload no more than five documents at a time
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
Maximum size: 12MB per file

Review your application
Your application summary
Preparer statement

Choose or drop files here to upload

Preparer signature
Interpreter certification
Interpreter signature
Your statement
Your signature

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Interpreterʼs certification and signature

Your interpreter must read and agree to the certification below.

Getting Started



About you



Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



I certify, under penalty of perjury, that: I am fluent in
English and the language provided in the Getting Started
section of this application, and I have read to this
applicant in the identified language every question and
instruction on this application and his or her answer to
every question. The applicant informed me that he or she
understands every instruction, question, and answer on
the application, including the Applicantʼs Certification,
and has verified the accuracy of every answer.

Review your application
Your application summary
Preparer statement

As the applicantʼs interpreter, you must sign on paper and
provide your signature page to the applicant. Follow these
steps:

Preparer signature

Interpreter certification
Interpreter signature
Your statement



1. Download the Interpreter Signature page



2. Print the Interpreter Signature page



3. Read and sign the Interpreter Signature page



4. Give the signed Interpreter Signature page to
the applicant

Your signature

The applicant will need to scan and upload your
completed signature page on the next screen.

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I-821, Application for
Temporary Protected
Status (TPS)



Resources



Sign Out

Interpreterʼs signature upload

Scan and upload your interpreterʼs completed signature page below.

Getting Started



About you



Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



File requirements
Clear and readable
Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
No encrypted or password-protected files
If your documents are in a foreign language, upload a full English
translation and the translatorʼs certification with each original
document.
Upload no more than five documents at a time
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
Maximum size: 12MB per file

Review your application
Your application summary
Preparer statement

Choose or drop files here to upload

Preparer signature
Interpreter certification

Interpreter signature
Your statement
Your signature

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

My Account

I-821, Application for
Temporary Protected
Status (TPS)



Resources



Sign Out

Applicantʼs statement

You must read and agree to the statement below.

Getting Started



About you



Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit





I can read and understand English, and have read and understand
every question and instruction on this application, as well as my
answer to every question.

Back

Next

Review your application
Your application summary
Preparer statement
Preparer signature
Interpreter certification
Interpreter signature

Your statement
Your signature

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

My Account

I-821, Application for
Temporary Protected
Status (TPS)

Resources



Sign Out

Applicantʼs statement regarding the preparer
You must read and agree to the statement below.

Getting Started



About you



Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit





At my request, the preparer named in the Getting Started section of this
application prepared this application for me based only upon
information I provided or authorized.

Applicantʼs statement regarding the interpreter
You must read and agree to the statement below.




Review your application
Your application summary
Preparer statement
Preparer signature

The interpreter named in the Getting Started section of this application
to me every question and instruction on this application and my
answer to every question in the language I specified in the Getting
Started section, a language in which I am fluent, and I understood
everything.

Interpreter certification
Interpreter signature

Your statement

Back

Your signature

Next

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

My Account

I-821, Application for
Temporary Protected
Status (TPS)



Resources



Sign Out

Applicantʼs certification

Getting Started



About you



Your Family



Basis of Eligibility



Evidence



Additional Information



Review and Submit



You must read and agree to the certification below. If you knowingly and
willfully falsify or conceal a material fact or submit a false document with
your application, we can deny your application and may deny any other
immigration benefit. You may also face criminal prosecution and penalties
provided by the law.

Copies of any documents I have submitted are exact
photocopies of unaltered, original documents, and I
understand that USCIS may require that I submit original
documents to USCIS at a later date. Furthermore, I
authorize the release of any information from any of my
records that USCIS may need to determine my eligibility
for the immigration benefit I seek.

Review your application
Your application summary
Preparer statement
Preparer signature
Interpreter certification

I further authorize release of information contained in this
application, in supporting documents, and in my USCIS
records to other entities and persons where necessary for
the administration and enforcement of U.S. immigration
laws.

Interpreter signature
Your statement

Your signature

I understand that USCIS may require me to appear for an
appointment to take my biometrics (fingerprints,
photograph, and/or signature) and, at that time, I will be
required to sign an oath reaffirming that:
1. I reviewed and provided or authorized all of the
information in my application;
2. I understood all of the information contained in, and
submitted with, my application; and
3. All of this information was complete, true, and
correct at the time of filing.

I certify, under penalty of perjury, that I provided or
authorized all of the information in my application, I
understand all of the information contained in, and
submitted with, my application, and that all of this
information is complete, true, and correct.



I have read and agree to the applicantʼs statement

You must provide your digital signature below by typing
your full legal name. We may deny your application if you
do not completely fill out this application or fail to submit
required documents. We will record the date of your
signature with your application.

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

My Account

I-821, Application for
Temporary Protected
Status (TPS)



Resources



Sign Out

Pay for and submit your application

The final step to submit your Form I-821, Application for Temporary
Protected Status is to pay the required fee.

Getting Started



About you

Your application fee is: [$XXX]



Your Family

Refund policy: By continuing this transaction, you agree that you are



Basis of Eligibility



Evidence



Additional Information



Review and Submit



paying for a government service and that the filing fee, biometric services
fee and all related financial transactions are final and not refundable,
regardless of any action USCIS takes on an application, petition or request,
or how long USCIS takes to reach a decision. You must submit all fees in the
exact amounts.

Review your application
Your application summary

We will send you to Pay.gov — our safe and secure
payment website — to pay your fees and submit your form
online.

Preparer statement
Preparer signature
Interpreter certification
Interpreter signature

Here are the steps in the payment and submission
process:
1. Provide your billing information on Pay.gov

Your statement
Your signature

2. Provide your credit card or U.S. bank account
information

Pay and Submit

3. Submit your payment

When you have paid your fee, your form will be submitted.
Pay.gov will redirect you to a uscis.gov confirmation
screen, which will include your receipt number. Please
keep a copy of your receipt number for your records. You
can track the status of your application through your
USCIS online account.

Pay and submit

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Resources

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Sign Out

You have successfully submitted your I-821, Application for
Temporary Protected Status (TPS)

We will contact you if we have any questions or need additional information. You can track the status
of your request through your USCIS online account.

Go to my cases

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Resources

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Sign Out

You did not submit your Application for Temporary Protected Status
(I-821)
Your payment failed because your credit or debit card was declined.

You can try again now to sign and submit your requests or save and exit.

Sign and submit

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Citizenship

Schedule An Appointment

Find A Doctor

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Contact USCIS
USCIS.gov
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You did not submit your Application for Temporary Protected Status
(I-821)
Your payment failed or was canceled before it could be processed on Pay.gov.

You can try again now to sign and submit your request or save your request and exit. We will save your
request for 30 days from when you started it.

Sign and submit

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Resources



Sign Out

Finish the I-821 and continue to the I-765
By finishing this form, your Form I-821 will be locked and no further changes can be made.

Please make sure that the information on your Form I-821 is complete and accurate before continuing.
If you need to make any edits a er finishing, you will need to create a new Form I-821.
Next, you will continue to Form I-765. Once you complete Form I-765, you can pay for and submit both
forms at the same time.

Finish and continue

Return to top

Topics

Contact Us

Citizenship

Schedule An Appointment

Find A Doctor

Find A Class

Contact USCIS
USCIS.gov
An official website of the U.S. Department of Homeland Security
About USCIS

Freedom of Information Act

Office of the Inspector General

Accessibility

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USA.gov


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