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Form Number and Name
OMB Number
Form Edition Date:
Form Expiration Date:
PRA Project:
Form I-765, Application for Employment Authorization
1615-0040
4/1/2024
2/28/2027
I-765-050 T Final Rule
Revision Key
Description
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• All revised (new) text is red.
Example
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column is shown with a strikethrough and in
red.
Original
1. Oranges
2. Bananas
3. Apple
4. Pineapple
Revised
1. Oranges
2. Bananas
3. Apple
4. Pineapple
Copy Deck Version
FILE A FORM: I-765
Column Header Descriptions
Heading
Body Text
Use this form to request employment authorization and an Employment Authorization Document (EAD) if your immigration status allows you to work in the
United States.
Alert
Link
CTA
Notes
https://www.uscis.gov/i-765
Note: You may apply online if your eligibility category is:
• (a)(12) - Temporary Protected Status (You are submitting an initial Form I-821 or you have an approved Form I-821);
• (c)(3)(A) - F-1 student, pre-completion OPT;
• (c)(3)(B) - F-1 student, post-completion OPT;
• (c)(3)(C) - F-1 student, 24-month extension for STEM students (students holding a degree in science, technology, engineering, or mathematics);
• (c)(8) - Applicants for Asylum under the ABC Settlement Agreement;
• (c)(8) – Application for Employment Authorization Based on Pending Form I-589, Application for Asylum or for Withholding of Removal;
• (c)(11) - Parole;
• (c)(19) - Temporary Protected Status (You have a pending Form I-821); or
• (c)(33) - Consideration of Deferred Action for Childhood Arrivals (DACA) (You must have a pending or approved Form I-821D in order to file Form I-765).
All other applicants must submit a paper Form I-765.
Concurrent filing available
You can file Form I-907, Request for Premium Processing Service, if you are filing under one of the eligible categories.
If you request premium processing, we will present Form I-907 for you to complete after you sign Form I-765. This will allow you to pay for and submit both forms
at the same time.
File a Form
APPLICATION OVERVIEW: I-765
Column Header Descriptions
Heading
Sub-Heading
Conditional Logic
I-765, Application for
Employment Authorization
Body Text
Certain foreign nationals who are in the United States may file Form I-765, Application for Employment Authorization, to request employment authorization and an Employment Authorization Document (EAD). Other foreign nationals whose immigration
status authorizes them to work in the United States without restrictions may also use Form I-765 to apply to U.S. Citizenship and Immigration Services (USCIS) for an EAD that shows such authorization.
Alert
Required?
Link
https://www.uscis.gov/i-765
Foreign nationals may also apply for a Social Security number and card on Form I-765.
If you are a lawful permanent resident, a conditional permanent resident, or a nonimmigrant only authorized for employment with a specific employer under 8 CFR 274a.12(b), do not use Form I-765.
Learn more about employment authorization.
Before You Start Your
Application
Eligibility
You may apply online if your eligibility category is:
• (a)(12) - Temporary Protected Status (You are submitting an initial Form I-821 or you have an approved Form I-821);
• (c)(3)(A) - F-1 student, pre-completion OPT;
• (c)(3)(B) - F-1 student, post-completion OPT;
• (c)(3)(C) - F-1 student, 24-month extension for STEM students (students holding a degree in science, technology, engineering, or mathematics);
• (c)(8) - Applicants for Asylum under the ABC Settlement Agreement;
• (c)(8) – Application for Employment Authorization Based on Pending Form I-589, Application for Asylum or for Withholding of Removal;
• (c)(11) - Parole;
• (c)(19) - Temporary Protected Status (You have a pending Form I-821); or
• (c)(33) - Consideration of Deferred Action for Childhood Arrivals (DACA).
link to:
https://www.uscis.gov/humanitarian/
protected-status
www.ucsis.gov/i-765
All other applicants must submit a paper Form I-765.
Note: You can file Form I-907, Request for Premium Processing Service, if you are filing under one of the eligible categories. If you request premium processing, we will present Form I-907 for you to complete after you sign Form I-765. This will allow you
to pay for and submit both forms at the same time.
[accordion]
Please review the specific filing instructions if you are filing Form I-765 under one of the following eligibility categories:
F1 Students Seeking Optional Practical Training (OPT)
https://www.uscis.gov/i-765
(c)(3)(A) eligibility category: Submit Form I-765 up to 90 days before being enrolled as an F-1 foreign student for one full academic year at an educational institution approved by U.S. Immigration and Customs Enforcement (ICE) and Student and Exchange
Visitor Program (SEVP). Your period of employment will not start before you have completed one full academic year. If you completed the one-year requirement while in another valid nonimmigrant status and you are now in valid F-1 status, you are still
eligible to apply for OPT.
(c)(3)(B) eligibility category: Submit Form I-765 up to 90 days before, but no later than 60 days after your program end date. You must submit your application within 30 days of the date that your designated school official (DSO) enters the
recommendation for OPT into your Student and Exchange Visitor Information System (SEVIS) record. If you fail to do so, we will deny your OPT request.
(c)(3)(C) eligibility category: Submit Form I-765 application up to 90 days before your current OPT expires, but you must submit within 60 days of the DSO's approval of STEM OPT.
Note: If you are an F-1 student filing for initial or extension of OPT, your OPT and your employment authorization will be automatically terminated if you change educational program levels or transfer to another school. Working in the United States
without authorization may result in your removal from the United States or denial of re-entry. Consult your DSO for additional details.
[accordion]
Temporary Protected Status (TPS)
[accordion]
(a)(12) and (c)(19) eligibility categories: Submit Form I-765 with your Form I-821 application or with evidence that we accepted or approved your initial Form I-821. You must also follow the instructions for filing your application as described in the most
recent TPS Federal Register notice regarding a TPS designation, re-designation, or extension for your country. For more information, review our instructions for TPS applicants.
Pending Asylum and Withholding of Removal Applicants and Applicants for Asylum under the ABC Settlement Agreement
(c)(8) eligibility category: File Form I-765 if you have a pending Form I-589, Application for Asylum and Withholding of Removal. Please review the Special Filing Instructions for those with Pending Asylum Applications before submitting Form I-765.
www.uscis.gov/tps
https://www.uscis.gov/sites/default/f
ent/forms/i-765instr.pdf
Pending Asylum Applications
(c)(8) eligibility category: You are subject to a 150-day waiting period before you can apply for an EAD, and an additional 30-day period before we can issue you an EAD, for a total of 180 days. The number of days a completed asylum application is
considered pending does not include any delays requested or caused by you while your application is pending with the USCIS asylum office or with an EOIR IJ. (See 8 CFR 208.7.) This time period during which your asylum application is pending before we
may grant you an EAD is called the “180-day asylum EAD clock.” We may reject your Form I-765 if you file it before the 150-day waiting period has elapsed. Some examples of delays that may be caused by you while your application is pending with the
USCIS Asylum Office include, but are not limited to:
• Failure to appear at your interview or fingerprint appointment;
• Failure to receive and acknowledge your asylum decision in person (if required);
• A request to reschedule your interview for a later date;
• A request to transfer your case to a new asylum office or interview location, including when the transfer is based on a new address;
• A request to provide additional evidence after your interview; and
• Failure to provide a competent interpreter at your interview.
Additionally, if you fail to appear for your interview with a USCIS asylum office or for a hearing before an EOIR IJ, you may be ineligible for an EAD.
If you have received a Recommended Approval notice from the USCIS asylum office recommending a grant of asylum, you do not need to wait 150 days and may apply for an EAD immediately upon receipt of this notice. Provide a copy of your notice as
evidence of your recommended approval with your Form I-765.
Asylum application under the ABC Settlement Agreement
(c)(8) eligibility category: If you are a Salvadoran or Guatemalan national eligible for benefits under the ABC settlement agreement, American Baptist Churches v. Thornburgh, 760 F. Supp. 976 (N.D. Cal. 1991), you are entitled to an EAD under the ABC
settlement agreement. Follow the instructions contained in this section when filing your Form I-765.
If you are requesting an initial EAD under this category, you do not need to pay the filing fee. If you are requesting a renewal or replacement EAD, you must pay the filing fee. Mark your application as follows:
1. Type “ABC” in the top right corner of your EAD application. You must identify yourself as an ABC class member if you are applying for an EAD under the ABC settlement agreement.
2. Type “(c)(8)” in the Eligibility Category of the application.
3. Select the “Salvadoran or Guatemalan national eligible for benefits under the ABC settlement agreement” box of this application.
You are entitled to an EAD without regard to the merits of your asylum claim.
Your Form I-765 will be decided within 60 days if:
• You pay the filing fee;
• You have a complete pending asylum application on file; and
• You correctly mark your application as described above. You must pay the filing fee for an initial EAD request. If you cannot pay the filing fee for an EAD, you may apply for a fee waiver under 8 CFR.
Application Overview
APPLICATION OVERVIEW: I-765
Column Header Descriptions
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Sub-Heading
Conditional Logic
Body Text
[accordion]
Parole
Alert
Required?
Link
(c)(11) eligibility category: File Form I-765 with a copy of your Form I-94, passport, or other travel document showing you were paroled into the United States for urgent humanitarian reasons or reasons of significant public benefit pursuant to INA
212(d)(5) (such as Cuban Family and Haitian Family Reunification Parole programs).
Note: For individuals paroled into the United States after a positive credible fear determination — On Feb. 7, 2022, in Asylumworks et al. v. Mayorkas et al., the U.S. District Court for the District of Columbia vacated several rules that affected applications
for employment authorization filed by individuals who received positive credible fear determinations and were subsequently paroled into the United States. Credible fear parolees may file an EAD application at any time after being paroled into the
United States, and may seek employment authorization under the (c)(11) category at the time of filing.
[accordion]
Fee
Consideration of Deferred Action for Childhood Arrivals
(c)(33) eligibility category: You must submit Form I-765 with Form I-821D or with proof that you previously filed Form I-821D.
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. There is an additional fee for Premium Processing Service.
https://www.uscis.gov/g-1055
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 Form I-765, Application for Employment Authorization. You can review the fee waiver guidance at
www.uscis.gov/feewaiver.
https://www.uscis.gov/forms/filingfees/additional-information-on-filing-a
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.
Documents you may need
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.
Most applicants must upload:
• A copy of your Form I-94, Nonimmigrant Arrival-Departure Record (front and back), a printout of your electronic Form I-94 from www.cbp.gov/i94, passport, or other travel document.
• A copy of your last EAD (front and back). If you were not previously issued an EAD, you must submit a copy of a government-issued identity document (such as a passport) showing your picture, name, and date of birth; a birth certificate with photo ID;
a visa issued by a foreign consulate; or a national ID document with photo and/or fingerprint. The identity document photocopy must clearly show your facial features and contain your biographical information.
• A color passport-style photograph of yourself taken recently.
We will automatically inform you which documents and additional evidence you may need to provide as you fill out your application. These recommendations for additional information will be based on the information you provide in the application,
such as your personal history and circumstances.
Biometric services appointment
Any document containing foreign language submitted to USCIS must be accompanied by a full English language translation that the translator has certified as complete and accurate, and by the translator's certification that he or she is competent to
translate from the foreign language into English.
USCIS may require that you appear for an interview or provide biometrics (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. After USCIS receives your application and ensures it is complete, we will inform you in writing 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.
If you are required to provide biometrics, at your appointment you must sign an oath reaffirming that:
1. You provided or authorized all information in the application;
2. You reviewed and understood all of the information contained in, and submitted with, your application; and
3. All of the declared information was complete, true, and correct at the time of filing.
After You Submit Your
Application
Completing Your Form
Online
Track your case online
If you fail to attend your biometric services appointment, USCIS may deny your application.
After you submit your form, you can track its status through your USCIS account. Sign in to your account often 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-765 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. If your application is approved, we will either mail
your EAD to you or we may require you to visit your local USCIS office to pick it up. If USCIS cannot approve your application, you will receive a written notice explaining the basis of your denial.
Filing online
Submitting your application online is the same as mailing in a completed paper form. They both gather the same information.
Complete the Getting Started section first
Provide as many responses as you can
We will automatically save your responses
You should answer all questions in the Getting Started section first so we can best customize the rest of your online form experience.
You should provide as many responses as you can. Incomplete fields or sections and missing information can slow down the process after you submit your form.
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
DHS Privacy Notice
After you start your form, you can sign in to your account to continue where you left off.
AUTHORITIES: The information requested on this application, and the associated evidence, is collected under the Immigration and Nationality Act, 8 U.S.C. section 1324a, and 8 CFR 274a.13.
PURPOSE: The primary purpose for providing the requested information on this application is to determine eligibility for certain aliens who are temporarily in the United States requesting an Employment Authorization Document. DHS uses the
information you provide to grant or deny the benefit you are seeking.
Paperwork Reduction Act
DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, including your Social Security number, and any requested evidence may delay a final decision or result in a rejection or 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, as described in the associated published system of records notices [DHS/USCIS-001 – Alien File, Index, and National File Tracking System; DHS/USCIS-007 – Benefit Information System;
DHS/USCIS-010 – Asylum Information and Pre-Screening; and DHS/USCIS-017 Refugee Case Processing and Security Screening Information System] and the published privacy impact assessments [DHS/USCIS/PIA-016(a) Computer Linked Application
Information Management System and Associated Systems; DHS/USCIS/PIA-027 Asylum Division; DHS/USCIS/PIA-056 USCIS Electronic Immigration System; and DHS/USCIS/PIA-068 Refugee Case Processing and Security Vetting], which you can find at
www.dhs.gov/privacy. DHS may also share this information as appropriate for law enforcement purposes or in the interest of national security.
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 4 hours and 30 minutes per response, including the time for reviewing instructions, gathering the required documentation and information, completing the application, preparing statements,
attaching necessary documentation, and submitting the application. The collection of biometrics is estimated to require 1 hour and 10 minutes. The public reporting burden for the collection of information for Form I-765WS is estimated at 30 minutes
per response, including the time for reviewing instructions, gathering the required documentation and information, completing the application, preparing statements, attaching necessary documentation, and submitting the application. 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 I-765 application to this address.
Security reminder
OMB No. 1615-0040
Expires: 02/28/2027
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.
Application Overview
GETTING STARTED: I-765
Column Header Descriptions
Primary Nav
Secondary Nav
Getting Started
Basis of eligibility
Tertiary Nav
Conditional Logic
Paper Form
Question
Question
2.27
What is your eligibility category?
Sub-Question
Field Type
(a)(12) Temporary Protected Status Granted
(c)(3)(A) Student Pre-Completion OPT
(c)(3)(B) Student Post-Completion OPT
(c)(3)(C) STEM Extension
(c)(8) Pending Asylum and Withholding of Removal
Applicants and Applicants for Asylum under the ABC
Settlement Agreement
(c)(11) Parole
(c)(11) Afghan Parole
(c)(11) Ukraine Parole
(c)(19) Temporary Protected Status Pending
(c)(33) Consideration of Deferred Action for Childhood
Arrivals
Dropdown
Instructional Text
Alert
Required?
Notes
[yellow alert]
[Header:] Important information regarding your Form
I-20
2.28.a
2.28.b
2.28.c
[yellow alert]
(if (c)(8))
What is your degree?
What is your employer's name as listed in E-Verify?
What is your employer's E-Verify company identification
number or a valid E-Verify client company identification
number?
[Body:] Do NOT submit this form until you receive a
Form I-20 recommendation from your DSO. We will
deny your application if you do not include your Form
I-20 recommendation when you submit Form I-765. If
you need to provide Form I-765 to your DSO, print or
download this draft before you submit.
Text
Text
Text
[yellow alert]
[h] Special filing instructions for pending asylum
applications
https://www.us
cis.gov/sites/de
fault/files/docu
ment/forms/i765instr.pdf
[b] You are subject to a 150-day waiting period after
the filing of your asylum application, before you can
apply for an EAD, and an additional 30-day period
before we can issue you an EAD, for a total of 180
days. Learn more about special filing instructions for
asylum applications.
[If 2.27 = (c)(8)]
Links
Yes
[yellow alert]
(if c3a)
(if c3c)
(if c3c)
(if c3c)
Help Text
3.6
(if c3a, c3b, or c3c)
Are you a Salvadoran or Guatemalan national eligible for
benefits under the ABC settlement agreement?
Would you like to request Premium Processing Service?
Yes/No
Radio
Yes/No
Radio
Premium Processing Service guarantees that USCIS will take one of several
possible actions (issue an approval notice, a denial notice, a notice of intent to
deny, or a request for evidence or open an investigation for fraud or
misrepresentation) on your Form I-765 within 30 days.
If you request premium processing, you will be asked to complete Form I-907
after you sign your Form I-765. You will then be able to pay for and submit both
forms at the same time.
[blue alert]
[If user selects c3a, c3b, or c3c]
[blue alert]
Form I-765 and Form I-907 will be submitted
together. After you sign Form I-765, the form will be
locked. You will not be able to make any changes to
the form once it is locked. You will immediately be
directed to Form I-907 and will be able to pay for and
submit both forms after you provide your signatures.
AND
[if yes to premium processing]
Reason for applying
Preparer and interpreter
information
1.1.a
What is your reason for applying?
(if a12/c3a/c3b/c3c/c8/c11/c19/c33)
1.1.b
Radio
(if a12/c3a/c3b/c3c/c8/c11/c19)
1.1.c
2.12
Replacement of lost, stolen, or damaged employment
authorization document, or correction of my
employment authorization document NOT DUE to U.S.
Citizenship and Immigration Services error
Renewal of permission to accept employment
Have you previously filed Form I-765?
Yes/No
Is someone assisting you with completing this application? Yes/No
Is a preparer assisting you with completing this
application?
Is an interpreter assisting you with completing this
application?
What is your preparer's full name?
Yes/No
Radio
Yes/No
Radio
Given name (first name)
Family name (last name)
Text
Text
Text
Checkbox
Dropdown/Text
Text
Text
Text
Dropdown/Text
Text
(IF YES)
(IF YES)
Preparer information
(IF YES TO PREPARER QUESTION)
5.1.b
5.1.a
5.2
What is your preparer's business or organization name?
5.3.a.-5.3.h. What is your preparer's mailing address?
(If non-USA use Province and text field)
(If non-USA use Postal code and remove
help text)
5.4
5.5
What is your preparer's contact information?
5.6
Interpreter information
(IF YES TO INTERPRETER)
(If non-USA use Province and text field)
(If non-USA use Postal code and remove
help text)
4.1.b
4.1.a
4.2
What is your interpreter's full name?
4.3
What is your interpreter's mailing address?
4.4
4.5
What is your interpreter's business or organization name?
What is your interpreter's contact information?
4.6
What language is your interpreter using to interpret this
application for you?
Initial permission to accept employment
Radio
(if a12/c3a/c3b/c3c/c8/c11)
My preparer is not part of a business or organization.
Country
Address line 1
Address line 2
City or town
State/Province
ZIP code/Postal code
Daytime phone number
Mobile telephone number
My preparer does not have a mobile telephone number
Email address
My preparer does not have an email address.
Given name (first name)
Family name (last name)
My interpreter is not part of a business or organization.
Country
Address line 1
Address line 2
City or town
State/Province
ZIP code/Postal code
Daytime telephone number
Mobile telephone number
My interpreter does not have a mobile telephone
number
Email address
My interpreter does not have an email address.
Yes
Radio
Radio
Radio
Text
Text
Checkbox
Text
Checkbox
Text
Text
Text
Checkbox
Dropdown/Text
Text
Text
Text
Dropdown/Text
Text
A preparer is anyone who completes or helps you complete all or part of your
application using information and answers that you provide.
An interpreter is anyone who translates or helps you translate all or part of your
application using information and answers that you provide.
Street number and name
Apartment, suite, unit, or floor
Provide a 5 or 9-digit ZIP code.
Provide a 10-digit phone number.
Provide a 10-digit phone number.
Example: user@domain.com
Street number and name
Apartment, suite, unit, or floor
Provide a 5 or 9-digit ZIP code.
Text
Text
Checkbox
Provide a 10-digit phone number.
Provide a 10-digit phone number.
Text
Checkbox
Text
Example: user@domain.com
Getting Started
ABOUT YOU: I-765
Column Header Descriptions
Primary Nav
Secondary Nav
About You
Your name
Tertiary Nav
Conditional Logic
Paper Form
Question
Question
2.1.b
2.1.c
2.1a
(if yes)
Your contact
information
2.2b
2.2c
2.2a
3.3
Have you used any other names since
birth?
How may we contact you?
3.4
3.5
2.5.a
2.5.b
2.5.c
2.5.d
2.5.e
2.5.f
2.6
(if no)
Describe yourself
When and where
you were born
Your immigration
information
2.7.a
2.7.b
2.7.c
2.7.d
2.7.e
2.10
2.12
What is your state or province of birth?
What is your country of birth?
What is your date of birth?
What is your country of citizenship or
nationality?
2.21.a
What is your Form I-94 Arrival-Departure
Record Number (if any)?
When did you last arrive in the United States?
2.21.d
2.25
2.26
2.8
2.9
2.13a
(If yes to 2.13a)
2.13b
2.14
(If yes to 2.14)
2.15
(If yes to 2.15)
2.16b
2.16a
2.17b
2.17a
2.3
(If yes to 2.15)
[If 2.27 = (c)(8)]
What is your gender?
What is your marital status?
2.19b
2.19c
2.20
2.18
2.21.e
(if c11 hide this
checkbox)
Is your current mailing address the same
as your physical address?
Where in the United States do you live?
What is your city, town, or village of birth?
2.21c
(if c11 this
question is
required)
What is your current U.S. mailing
address?
2.19a
2.22
2.23
2.24
2.21.b
Other information
What is your current legal name?
What is the passport number of your most
recently issued passport?
What is your travel document number (if
any)?
What is the expiration date of your passport
or travel document?
What country issued your passport or travel
document?
What is your current immigration status or
category?
What is your Student and Exchange Visitor
Information System (SEVIS) Number (if any) ?
What is your A-Number?
Sub-Question
Field Type
Middle name
Family name (last name)
Yes/No
Given name (first name)
Middle name
Family name (last name)
Daytime telephone number
Text
Provide a 10-digit phone number.
Mobile telephone number (if any)
This is the same as my daytime
telephone number.
Email address
In care of name (if any)
Text
Checkbox
Provide a 10-digit phone number.
Text
Text
Example: user@domain.com
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.
Address line 1
Address line 2
City or town
State
ZIP code
Yes/No
Text
Text
Text
Dropdown/Text
Text
Radio
Street number and name
Apartment, suite, unit, or floor
Address line 1
Address line 2
City or town
State
ZIP code
Male/Female
Single
Married
Divorced
Widowed
Text
Text
Text
Dropdown/Text
Text
Radio
Radio
MM/DD/YYYY
Alert
Tooltip
Required?
Notes
Yes
Other names used may include nicknames, aliases,
and maiden names.
Provide the other names you have used.
Yes
Yes
Yes
Yes
Provide a 5 or 9-digit ZIP code.
Street number and name
Apartment, suite, unit, or floor
Provide a 5 or 9-digit ZIP code.
Text
Text
Dropdown/Text
Date
Dropdown
List all countries where you are currently a citizen or
national.
Yes
Required field
User will be able to input multiple countries (at least
two based on paper form). It will be a table or list.
Provide an 11 character I-94 Number.
Text
List your arrival date, place of arrival, and status at arrival.
Date of arrival (on or about)
Place of arrival
Status at last arrival
Date
Dropdown/Text
Dropdown/Text
Text
Text
MM/DD/YYYY
Date
Country
Dropdown/Text
Dropdown/Text
N-
Text
A-
Text
Checkbox
What is your USCIS Online Account
Number?
Text
I do not have or know my USCIS Online
Account Number.
Has the Social Security Administration
(SSA) ever officially issued a Social
Security card to you?
What is your Social Security number (if
known)?
Do you want the SSA to issue you a Social
Security card?
Consent for Disclosure: I authorize
disclosure of information from this
application to the SSA as required for the
purpose of assigning me an SSN and
issuing me a Social Security card.
What is your father's birth name?
Checkbox
Have you EVER been arrested for and/or
convicted of any crime?
Help Text
Your current legal name is the name on your birth
certificate, unless it changed after birth by a legal
action such as marriage or court order. Do not provide
any nicknames here.
Given name (first name)
I do not have or know my A-Number.
What is your mother's birth name?
Instructional Text
Yes/No
Use the "Additional Information" section to include all
previously used SEVIS numbers.
Provide a 10, 11, or 12-digit SEVIS number.
Conditionally
required for c11
Provide a 7, 8, or 9-digit number. If your A-Number is
fewer than 9 digits, the system will automatically add
zero(s) after the "A" and before the first digit so there is a
total of 9 digits, for example: A-001234567.
Providing your unique USCIS Online Account Number (OAN) Provide a 12-digit Online Account Number.
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 ANumber.
Certain paper forms:
I-90, I-130, I-485, I-821, I-821D, N-336,
N-400, N-565, N-600, N-600K
Radio
Text
Yes/No
Radio
Yes/No
Radio
Given name (first name)
Family name (last name)
Given name (first name)
Family name (last name)
Yes/No
Text
Text
Text
Text
Radio
Provide a 9-digit Social Security number.
USCIS will make the determination as to whether your
convictions meet the definition of aggravated felony. Learn
more about arrests and convictions for Application for
Employment Authorization.
https://www.uscis.gov/sites/default/files/document
/forms/i-765instr.pdf
About You
EVIDENCE: I-765
Column Header Descriptions
Primary Nav
Secondary Nav
Evidence
2 x 2 photo of you
Tertiary Nav
Conditional Logic
(if all)
Paper Form
Form I-765 instructions, "Required
Documentation" - pages 25-26
Evidence Title
2 x 2 Photo Of You
Field Type
Upload
Instructional Text
Upload a recent color photograph of yourself that measures 2 inches by 2 inches, with your face measuring 1 inch to 1 3/8 inch from your chin to the top of your head.
Your eyes should be between 1 1/8 inch and 1 3/8 inch from the bottom of the photo.
Make sure your whole face is visible, you are facing the camera directly, and the background is white or off-white. Your head must be bare, unless contrary to your
religious beliefs.
If you need help understanding the photo requirements or want to resize, rotate, or crop your photo, you can use the Department of State's photo composition tools.
Please note that we cannot approve your application without your photo.
Form I-94 or passport
(if all)
Form I-765 instructions, "Required
Documentation" - page 25
Form I-94, Arrival And Departure
Record Or Passport
Upload
Upload a copy of one of the following:
• Your Form I-94, Arrival-Departure Record (front and back);
• A printout of your electronic Form I-94 ; or
• Your passport or other travel document.
If you were admitted to the United States by CBP at an airport or seaport after April 30, 2013, CBP may have issued you an electronic Form I-94 instead of a paper Form I94. You may visit the CBP website to obtain a paper version of an electronic Form I-94. CBP does not charge a fee for this service. Some travelers admitted to the United
States at a land border, airport, or seaport, after April 30, 2013, with a passport or travel document, who were issued a paper Form I-94 by CBP, may also be able to
obtain a replacement Form I-94 from the CBP website without charge.
If your Form I-94 cannot be obtained from the CBP website, it may be obtained by filing Form I-102, Application for Replacement/Initial Nonimmigrant Arrival-Departure
Record, with USCIS. USCIS does charge a fee for this service. For specific information about fees applicable to this form, see Form G-1055.
Document type
File Requirements
• Clear and readable
• Accepted file formats: JPG, JPEG, or PNG
• No encrypted or password-protected files
• If your documents are in a foreign language, upload a full
English translation and the translator's certification with
each original document.
• Upload no more than one document at a time
• Accepted file name characters: English letters, numbers,
spaces, periods, hyphens, underscores, and parentheses
• Maximum size: 12MB per file
Alerts
Required?
Links
https://travel.state.gov/conte
nt/travel/en/us-visas/visainformationresources/photos.html
Notes
https://www.cbp.gov/travel/in
ternational-visitors/i-94
• 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 translator's 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
www.uscis.gov/i-102
https://www.uscis.gov/forms/
all-forms
https://www.uscis.gov/sites/d
efault/files/document/forms/i765instr.pdf
If you do not have and cannot get a required document, you must demonstrate this and provide secondary evidence. If secondary evidence does not exist or is
unavailable, you must demonstrate both the unavailability of the required document and the relevant secondary evidence and submit two or more sworn affidavits by
people not named on this application who have direct knowledge of the event and circumstances.
Learn more about Primary and Secondary evidences.
Employment Authorization Document
(if all)
Form I-765 instructions, "Required
Documentation" - page 25
Proof of enrollment
(if c3a)
Form I-765 instructions, "Who May File Proof Of Enrollment
Form I-765"- page 7
Previously authorized CPT or OPT
(if c3a or c3b)
Form I-20
(if c3a, c3b, c3c)
Employment Authorization Document Upload
Or Government ID
Upload a copy of your last Employment Authorization document (EAD) (front and back). If you were not previously issued an EAD, you must upload a copy of a
government-issued identity document (such as a passport) showing your picture, name, and date of birth; a birth certificate with photo ID; a visa issued by a foreign
consulate; or a national ID document with photo and/or fingerprint. The identity document photocopy must clearly show your facial features and contain your
biographical information.
• 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 translator's 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
Upload
Upload evidence of having been lawfully enrolled on a full-time basis for one full academic year at a college, university, conservatory, or seminary approved by the U.S.
Immigration and Customs Enforcement (ICE) Student and Exchange Visitor Program (SEVP) for attendance by F-1 foreign students.
• 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 translator's 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
Form I-765 instructions, "Who May File Previously Authorized CPT Or OPT
Form I-765"- pages 7-8
Upload
Upload evidence of any previously authorized CPT or OPT and the academic level at which it was authorized.
• 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 translator's 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
Form I-765 instructions, "Who May File I-20, Certificate Of Eligibility For
Form I-765"- pages 7-8
Nonimmigrant Student Status
Upload
Upload a copy of the Form I-20, Certificate of Eligibility for Nonimmigrant Student Status endorsed by the Designated School Official (DSO). For the (c)(3)(B) eligibility
category, your DSO must have entered the recommendation for OPT into your SEVIS record within 30 days of you submitting Form I-765. If you fail to do so, we will deny
your OPT request. For the (c)(3)(C) eligibility category, the Form I-20 must have been endorsed by the DSO within 60 days of submitting Form I-765.
• 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 translator's 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
(if c3a show alert)
[yellow alert]
[Header:] Important information regarding your Form I20
[Body:] Do NOT submit this form until you receive a
Form I-20 recommendation from your DSO. We will
deny your application if you do not include your Form I20 recommendation when you submit Form I-765. If
you need to provide Form I-765 to your DSO, print or
download this draft before you submit.
College degree
(if c3c)
Form I-765 instructions, "Who May File College Degree
Form I-765"- page 8
Upload
Upload evidence that the degree that is the basis for the STEM OPT extension is in one of the degree programs currently listed on the STEM Designated Degree Program
List or a copy of your prior STEM degree.
• 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 translator's 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
Institution accreditation
(if c3c)
Form I-765 instructions, "Who May File Institution Accreditation
Form I-765"- page 8
Upload
Upload evidence that the institution that granted your STEM degree is currently accredited by the U.S. Department of Education and certified by the Student Exchange
and Visitor Program (SEVP), if this STEM OPT extension is based on a previously earned STEM degree.
• 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 translator's 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
EOIR or BIA order
(if a12/c19)
Form I-765 instructions, "Who May File Proof of Temporary Protected Status Upload
Form I-765" page 6
Granted By EOIR Immigration Judge
Or Board Of Immigration Appeals
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.
• 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 translator's 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
(if a12/c19)
Form I-765 instructions, "Who May File Proof Of Identity And Nationality
Form I-765" page 6
Upload
Upload proof of your identity and nationality. Examples of documents you may submit include copies of your:
• 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 translator's 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
Form I-765 instructions, "Who May File I-821, Application For Temporary
Form I-765" page 6
Protect Status
Upload
Form I-821
(if a12/c19)
•
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.
If you previously filed Form I-821, upload evidence that we accepted or approved your initial Form I-821.
https://studyinthestates.dhs.g
ov/stem-opt-hub/eligible-cipcodes-for-the-stem-optextension
• 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 translator's 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
Evidence
EVIDENCE: I-765
Column Header Descriptions
Primary Nav
Secondary Nav
Form I-821D
Tertiary Nav
Conditional Logic
(if c33)
Form I-765WS
(if c33)
Form I-589
(if c8)
Paper Form
Evidence Title
I-821D, Consideration Of Deferred
Action For Childhood Arrivals
(DACA)
Field Type
Upload
I-765WS, Worksheet
Form I-765 instructions, "Additional
Evidence requirement for category
(c)(8) applicants" page 4
I-589, Application For Asylum And
Withholding Of Removal
Upload
Instructional Text
If you previously filed Form I-821D, upload evidence that you have a pending or approved Form I-821D.
Document type
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 translator's 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
USCIS uses the evidence you submit with your application to determine your eligibility for employment authorization. You are not required to submit this evidence, but
it will help us process your request more efficiently.
• 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 translator's 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
NOTE: USCIS may, in its discretion, deny your application if you have been arrested and/or convicted of any crime.
Required?
Links
Notes
• 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 translator's 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
Download, complete, and upload Form I-765WS so that we can determine whether you have an economic need for work.
If you are a category (c)(8) applicant who has met the requisite 150-day waiting period to file Form I-765, not including delays caused or requested by you, file your Form
I-765 with the following evidence, where applicable.
• If you filed your Form I-589 with USCIS, a copy of the following: the USCIS Acknowledgement of Receipt that was mailed to you and your USCIS Asylum Interview Notice
(scheduling, re-scheduling, or cancelling your asylum interview); your Form I-797C Notice (ASC appointment notice) (for a biometrics appointment for your Form I-589);
or other evidence that you filed your Form I-589 with USCIS.
• If you lodged or filed your Form I-589 with EOIR, acknowledgement of receipt of your application or other available evidence.
Alerts
Asylum and Withholding of Deportation Applicants (with a pending Form I-589) who filed before January 4, 1995
You may file Form I-765 at any time; however, we will only grant your employment authorization if we find that your asylum application is not frivolous. File Form I-765
with a copy of the following documents, where applicable:
• Your date-stamped previously filed Form I-589;
• If you filed your Form I-589 with the former Immigration and Naturalization Service (INS), an INS Acknowledgement of Receipt;
• A USCIS Asylum Interview Notice (scheduling, re-scheduling, or cancelling your asylum interview);
• Form I-797 Notice, Fingerprint Notification (for a fingerprint appointment for your Form I-589);
• If you filed your Form I-589 in exclusion or deportation proceedings, evidence that your Form I-589 was filed with EOIR;
• If you are currently in exclusion or deportation proceedings, a copy of Form I-221, Order to Show Cause and Notice of Hearing, or Form I-122, Notice to Applicant for
Admission Detained for Hearing Before Immigration Judge; or
• Evidence that your Form I-589 remains under administrative or judicial review.
Asylum application under the ABC Settlement Agreement--(c)(8). If you are a Salvadoran or Guatemalan national eligible for benefits under the ABC settlement
agreement, American Baptist Churches v. Thornburgh, 760 F. Supp. 976 (N.D. Cal. 1991), you are entitled to an EAD under the ABC settlement agreement. Follow the
instructions contained in this section when filing your Form I-765.
You must have filed your asylum application (Form I-589) with us (INS or USCIS) or with an EOIR IJ to receive an EAD. Therefore, submit evidence that you have
previously filed a complete asylum application when you submit Form I-765. You are not required to submit this evidence when you apply, but it will help us process
your request more efficiently.
Proof of appeal
(if c8) and (if renewal)
Form I-765 instructions, "Additional
Evidence requirement for category
(c)(8) applicants" page 4
Proof Of Appeal
Upload
If an EOIR IJ has denied your asylum and withholding of removal relief, but you met the requisite 180-day waiting period prior to the EOIR IJ’s decision in your case,
evidence that you:
• Timely appealed the EOIR IJ’s decision on your Form I-589 to the BIA and the appeal remains pending; and
• If applicable, evidence that you timely appealed the BIA decision on your Form I-589 to a U.S. Court of Appeals and that decision remains pending.
• 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 translator's 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
BIA remand order
(if c8)
Form I-765 instructions, "Additional
Evidence requirement for category
(c)(8) applicants" page 4
Board Of Immigration Appeals
Remand Order
Upload
If your Form I-589 has been remanded to an EOIR IJ for further adjudication of your underlying asylum claim, upload:
• A copy of the BIA decision and order remanding your case to the EOIR IJ; and
• Evidence that your asylum claim remains under review by the EOIR IJ.
• 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 translator's 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
Criminal history
(if c8) and (if yes to convicted of
crime)
Form I-765 instructions, "Additional
Evidence requirement for category
(c)(8) applicants" page 4-5
Criminal History
Upload
For initial and renewal applications, you are required to submit evidence of any arrests and/or convictions. If you have been convicted of an aggravated felony, you
cannot be granted employment authorization under this eligibility category. USCIS will make the determination as to whether your convictions meet the definition of
aggravated felony. You must, however, provide information and any supporting documentation on all crimes which you were convicted of so USCIS can make an
appropriate decision. Provide a certified copy of all arrest reports, court dispositions, sentencing documents, and any other relevant documents.
• 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 translator's 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
NOTE: USCIS may, in its discretion, deny your application if you have been arrested and/or convicted of any crime.
Evidence
ADDITIONAL INFORMATION: I-765
Column Header Descriptions
Primary Nav
Secondary Nav
Additional
Information
Additional information
Tertiary Nav
Conditional Logic
Paper Form Question
Question
Sub-Question
Field Type
Instructional Text
You may provide additional information for your application.
Add additional
information
Large table
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.
Help Text
Alert
Required?
Notes
No
Large Table
Pattern
Ghost Sub Nav
If you do not need to provide any additional
information, you may leave this section blank.
Additional Information
REVIEW AND SUBMIT: I-765
Column Header Descriptions
Primary Nav
Secondary Nav
Review and Submit
Tertiary Nav
Conditional Logic
Paper form question
Review your application
Question
Sub-Question
Field Type
Check your application before you submit
Instructional Text
Help Text
Alert
Required?
CTA
Notes
Please review your ${formType} and check it for accuracy and completeness before you
submit it.
We encourage you to provide as many responses as you can throughout the
${formType}. Missing or incomplete information may slow down the review process after
you submit your ${formType}.
You can return to this page to review your ${formType} as many times as you want
before you submit it.
Your form filing fee is: [$XXX}
Your fee
Exact fee will be pulled from ELIS
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.
Alerts and warnings
You have one or more alerts and warnings based on the information you provided in
your application.
A red alert means you have incomplete responses or inconsistent data. You cannot
submit your application with any alerts.
A yellow warning means you may be missing information or may need to follow-up with
us about your responses. You can still submit your application, but some warnings may
slow down the review process after you submit your application.
A green alert means you have completed all required fields and responses.
Your application summary
Here is a summary of all the information you provided in your application.
Review the I-765 form information
Next
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 draft case snapshot with your responses, which you can
download below.
Preparer statement
(IF PREPARER)
5.7a
Preparer's statement
I am not an attorney or accredited representative but have prepared this application on behalf of the applicant and with the
applicant's consent.
Radio
Your preparer must read the statements below and select the statement that applies to
him or her.
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.
5.7b
5.7b
5.8a
Preparer's certification and signature
I am an attorney or accredited representative and my representation of the applicant in this case does not extend beyond
Radio
the preparation of this application.
I am an attorney or accredited representative and my representation of the applicant in this case extends beyond the
Radio
preparation of this application.
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 he or she understands all of the information
contained in, and submitted with, his or her application, including the Applicant's Declaration and Certification, and that all
of this information is complete, true, and correct. I completed this application based only on information that the applicant
provided to me or authorized me to obtain or use.
Your preparer must read and agree to the certification below.
As the applicant's 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.
Preparer signature
Interpreter certification
(IF PREPARER)
(IF INTERPRETER)
4.7a
Preparer's signature upload
Interpreter's certification and signature
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 Applicant's Declaration and Certification, and has verified the accuracy of every
answer.
Upload
Scan and upload your preparer's completed signature page below.
Your interpreter must read and agree to the certification below.
As the applicant's interpreter, you must sign on paper and provide your signature page to the applicant. Follow these steps:
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
The applicant will need to scan and upload your completed signature page on the next screen.
Interpreter signature
Your statement
Your signature
(IF INTERPRETER)
(IF NO INTERPRETER)
3.1a
Interpreter's signature upload
Applicant's statement
(IF PREPARER)
3.2
Applicant's statement regarding the preparer
(IF INTERPRETER)
3.1b
Applicant's statement regarding the interpreter
(If "Your statement" is
complete)
Form I-765, "Applicant's
Declaration and
Certification" - pages 4-5
Applicant's Declaration and Certification
Upload
I can read and understand English, and have read and understand every question and instruction on this application, as well Checkbox
as my answer to every question.
At my request, the preparer named in the Getting Started section of this application prepared this application for me based Checkbox
only upon the information I provided or authorized.
The interpreter named in the Getting Started section of this application read to me every question and instruction on this
Checkbox
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.
Scan and upload your interpreter's completed signature page below.
You must read and agree to the statement below.
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 and all of my records that USCIS may need to determine my eligibility for the immigration benefit that I seek.
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.
You must read and agree to the statement below.
You must read and agree to the statement below.
I furthermore 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 law.
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, if I am required to provide biometrics, I will be required to sign an oath reaffirming that:
1. I reviewed and understood all of the information contained in, and submitted with, my application; and
2. All of this information was complete, true, and correct at the time of filing.
I certify, under penalty of perjury, that all of the information in my application and any document submitted with it were
provided or authorized by me, that I reviewed and understand all of the information contained in, and submitted with, my
application and that all of this information is complete, true, and correct.
3.7a
Pay and submit
(If "Your Statement" and
"Your signature" pages
are complete)
AND
(if standalone filing)
Your signature
I have read and agree to the applicant's statement
Pay for and submit your application
Checkbox
You must provide your digital signature below by typing your full legal name. If you do
not completely fill out this application, or if you do not submit the required documents
listed in the Instructions, we may deny your application. We will record the date of your
signature with your application.
The final step to submit your Form I-765, Application for Employment Authorization is
to pay the required fee.
Yes
Required field
Exact fee will be pulled from ELIS
Your application fee is: [$XXX]
Refund policy: By continuing this transaction, you agree that you are 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 & Submit
REVIEW AND SUBMIT: I-765
Column Header Descriptions
Primary Nav
Secondary Nav
Tertiary Nav
Conditional Logic
Paper form question
Question
Sub-Question
Field Type
Instructional Text
We will send you to Pay.gov — our safe, secure payment website — to pay your fees
and submit your application online.
Help Text
Alert
Required?
CTA
Notes
Pay and submit
Here are the steps in the payment and submission process:
1. Provide your billing information on Pay.gov
2. Provide your credit card or U.S. bank account information
3. Submit your payment
When you have paid your fee, your application 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.
Finish and continue to I907
(If "Your Statement" and
"Your signature" are
complete)
Finish the I-765 and continue to the I-907
AND
By finishing this form, your Form I-765 will be locked and no further changes can be
made. Please make sure that the information on your Form I-765 is complete and
accurate before continuing. If you need to make any edits after finishing, you will need to
create a new Form I-765.
Finish and continue
Next, you will continue to Form I-907. Once you complete Form I-907, you can pay for and
submit both forms at the same time.
(if user concurrently filed)
You have successfully submitted your Application for Employment Authorization (I-765)
(Successful submission)
(No nav)
We will contact you if we have any questions or need additional information. You can
track the status of your application through your USCIS online account.
Go to my cases
Your payment failed because your credit or debit card was declined.
(Unsuccessful card
declined) (No nav)
You did not submit your Application for Employment Authorization (I-765)
(Unsuccessful submission)
(No nav)
You did not submit your Application for Employment Authorization (I-765)
You can try again now to sign and submit your applications or save and exit.
Your payment failed or was canceled before it could be processed on Pay.gov.
You can try again now to sign and submit your application or save your application and
exit. We will save your application for 30 days from when you started it.
Sign and submit
Sign and submit
Review & Submit
WARNINGS, ALERTS, NOTICES, AND ERRORS: I-765
Column Header Descriptions
Section: The primary nav where the alert can be found.
Page: The secondary nav where the alert can be found
Conditional Logic
Section
Page
Type
Getting Started
Getting Started
Basis of eligibility
Basis of eligibility
Message
Link
Yellow alert Always displays
h2. You can file your request online only for certain eligibility categories
https://www.uscis.gov/sites/default/file
s/document/forms/i-765.pdf
Yellow alert If user selects a12 or c19
If your eligibility category does not appear on the drop-down list, you must file a paper Form I-765. If you submit online and are not eligible for one of the listed categories, your application may be
denied.
h2. You must file Form I-821
Notes
Based on the eligibility category you selected and your A-number, you may be a TPS applicant or recipient and must file Form I-821 before you file Form I-765. If you are not a TPS recipient, amend your eligibility
category before proceeding.
Getting Started
Getting Started
Getting Started
Getting Started
Basis of eligibility
Basis of eligibility
Basis of eligibility
Basis of eligibility
Yellow
alert
If user select c8
Blue Alert
If user selects c3a, c3b, or c3c
Blue alert
If you are a TPS applicant or recipient, upload evidence that we accepted or approved your Form I-821, otherwise, we will reject your application and you will not receive a refund.
[h] Special filing instructions for pending asylum applications
AND
[b] You are subject to a 150-day waiting period after the filing of your asylum application, before you can apply for an EAD, and an additional 30-day period before we can issue you an EAD, for a
total of 180 days. Learn more about special filing instructions for asylum applications.
[Blue alert]
Form I-765 and Form I-907 will be submitted together. After you sign Form I-765, the form will be locked. You will not be able to make any changes to the form once it is locked. You will immediately be directed to
Form I-907 and will be able to pay for and submit both forms after you provide your signatures.
if yes to premium processing
if users selects c11
h2. You can now file an EAD application after being paroled into the United States
Yellow alert if users selects c33
https://www.uscis.gov/sites/default/fil
es/document/forms/i-765instr.pdf
Pursuant to the Feb. 7, 2022 ruling in Asylumworks et al. v. Mayorkas et al., credible fear parolees may file an EAD application at any time after being paroled into the United States, and may seek employment
authorization under the (c)(11) category at the time of filing.
h2. You must file Form I-821D or currently have DACA
Based on the EAD eligibility category you selected and your A-number, you cannot submit a Form I-765, Application for Employment Authorization until you have filed an initial or renewal Form I-821D, Consideration
for Deferred Action for Childhood Arrivals (DACA), or your request for DACA (initial or renewal) has been approved.
If you have not yet filed Form I-821D, return to the "File a Form" page and select "Form I-821D, Consideration of Deferred Action for Childhood Arrivals." from the drop-down menu to file your request for DACA first.
After you complete and pay for your Form I-821D, you will then be able to file Form I-765 online. If you already have a Form I-821D pending or were recently approved for DACA, please upload your receipt notice for
your pending Form I-821D or the decision notice USCIS issued approving your request for DACA.
If you continue to file the Form I-765 and fail to provide evidence of a pending or approved Form I-821D, we will reject your application and you will not receive a refund of the filing fee.
Getting Started
About You
About You
Additional information
Other information
Other information
Yellow alert User selects "Yes" to "Do you want
the SSA to issue you a Social
Security card"
Yellow alert User selects "No" to consent
statement regarding SSN
Yellow alert
h2. You must agree to the Consent for Disclosure
f you answer “Yes”, you must also answer “Yes” to the Consent for Disclosure.
h2. You must agree to the Consent for Disclosure
To receive a Social Security card, you must select "Yes" to the Consent for Disclosure.
h2. You must file Form I-821
Based on the eligibility category you selected and your A-number, you may be a TPS applicant or recipient and must file Form I-821 before you file Form I-765. If you are not a TPS recipient, amend your eligibility
category before proceeding.
Evidence, I-821D
Review and Submit
Review and Submit
Yellow alert if no evidence uploaded
If you are a TPS applicant or recipient, upload evidence that we accepted or approved your Form I-821, otherwise, we will reject your application and you will not receive a refund.
h2. Provide proof of your pending or approved Form I-821D
Yellow alert If c3a
Please upload a copy of your receipt notice for your pending Form I-821D or the decision notice USCIS issued approving your request for DACA. If you continue to file Form I-765 and fail to provide evidence of a
pending or approved Form I-821D, we will reject your application and you will not receive a refund of the filing fee.
[Header:] Important information regarding your Form I-20
Red alert
[Body:] Do NOT submit this form until you receive a Form I-20 recommendation from your DSO. We will deny your application if you do not include your Form I-20 recommendation when you submit Form I-765. If
you need to provide Form I-765 to your DSO, print or download this draft before you submit.
h2. There are errors in (Section): (Sub section)
If user has not answered required
field
Edit my response
Alerts
File Type | application/pdf |
File Title | Copy of I-130 Form Copydeck 6.18.19- acaOCC 062719 |
Author | Microsoft Office User |
File Modified | 2024-04-05 |
File Created | 2024-04-05 |