Toolkit v.1.

0 Step 4

Step-by-Step Instructions for the Application for Employment Authorization Form I-765 and I-765WS
Why am I filling out these forms? At this point, you should have completed your I-821D application for Deferred Action. Filling out the I-821D is just the first step to obtaining a valid social security number to work legally in the United States. To obtain a valid social security number, you must also complete the I-765 and I765WS. Again, YOU MAY ONLY USE BLACK INK WHEN COMPLETING THE FORM. In the alternative, you may download electronic version of Forms I-765 and I765WS from USCIS. Go to http://www.uscis.gov and search for I-765 and I-765WS. The direct web address is: http://www.uscis.gov/portal/site/uscis/menuitem.5af9bb95919f35e66f614176543f6d1a/?vgnextoi d=73ddd59cb7a5d010VgnVCM10000048f3d6a1RCRD&vgnextchannel=7d316c0b4c3bf110Vgn VCM1000004718190aRCRD You must complete the entire form. If a question does not pertain to you, leave it blank. You must not use N/A or Not Applicable. Do not intentionally omit information, as this would constitute fraud and will make you ineligible for Deferred Action. Moreover, any attempt to defraud the government to qualify for Deferred Action may subject you to removal proceedings. Do not write in this block Please follow directions closely and do not write in the area encapsulated by the box. This area is for USCIS to complete. I am applying for You are applying for PERMISSION TO ACCEPT EMPLOYMENT. Do not mark the other boxes.

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Toolkit v.1.0 Step 4

Questions

1. Name (Family Name in CAPS) (First) (Middle). Your legal name is the name found in your birth certificate or passport. You must enter your legal last name in all uppercase letters. Ex. For someone named, Jane Elizabeth Doe, she would write, DOE Jane Elizabeth on the proceeding line. 2. Other Names Used (include Maiden Name). This is where you list all the other names you have ever used and should match Question 12 from the I-812d. Your maiden name is the last name you used before you married or entered into a civil partnership. If you need extra space, please attach a new sheet of paper, with your name on top, with your last name in capital letters, followed by your first and middle name. Be sure to include your date of birth, address, and telephone number to all added sheets. 3. Address in the United States (Street Number and Name). Enter your building number and the name of the street on which you live. (Apt. Number). If you are currently residing inside an apartment, please enter the number and/or letter of your apartment. (Town or City). Enter the name of the town or city in which you live. To find this, please locate a letter addressed to you. On the letter, there should be a mailing label where your city is listed to the left of the state in which you reside. (State/Country). You must be in the United States when you complete this form and the I-812d. Therefore, you must choose the state you are currently living in, and may not choose another country. (Zipcode). If you look at mail addressed to you, the zip code is the row of numbers that appears after the state. Enter all five digits onto this line. 4. Country of Citizenship/Nationality 2 of 6
Prepared by the Asian Pacific American Legal Center, Member of Asian American Center for Advancing Justice. Created Aug. 15, 2010.

Toolkit v.1.0 Step 4 This question must match Part 1, Question 10 of Form I-821D. For most people, this is the country of birth. If you are uncertain about your nationality because you legally received a passport from a country that is not your birth country, enter the country in which you hold citizenship. Some people may hold dual citizenships. If you have more that one citizenship, then please list the countries in which you hold citizenship. WARNING: A legal passport issued to you from a country must have your legal name. If the passport from an issuing country contains a name that is clearly not yours, then you must contact an immigration attorney to consider whether you should apply for Deferred Action. 5. Place of Birth. Please enter the Town or City, State or Province, and Country of your birth. This must match Part 1, Questions 8.a and 8.b of Form 821d. 6. Date of Birth. Please enter your date of birth as found on your legal birth certificate. While you may have a different birth date on your passport, your legal birth certificate is what you must use to answer this question. This answer must match Part 1, Question 6 of Form 821d. If you do not have your legal birth certificate, then you may rely on the birth date listed on your passport. What if my birth certificate has my Lunar birth date that isnt used by the United States? You might have two birth dates, one based on the solar calendar and the other on the lunar calendar. Here, please rely on the birth date shown on your birth certificate even if it is based on the lunar calendar. 7. Gender Mark the box that corresponds to the sex assigned to you on your birth certificate. If you do not have your birth certificate, then you must mark the sex that appears on your passport. This must match Part 1, Question 7 of form I-821D. If you have undergone gender reassignment, and your legal documents issued by a government body reflects that, then you may mark the box that corresponds with your gender. However, if you have had gender reassignment surgery, and have not had that change reflected on your legal documents, then you must mark the box that corresponds to the sex listed on your birth certificate (or passport if you cannot find your birth certificate). 8. Martial Status. Mark the box that applies to you. Marriages that occurred outside of the United States count as much as marriages that occurred in the United States. This must match Part 1, Question 11.

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Prepared by the Asian Pacific American Legal Center, Member of Asian American Center for Advancing Justice. Created Aug. 15, 2010.

Toolkit v.1.0 Step 4 Social Security Number (include all numbers you have ever used) (if any). You must list all social security numbers that you may have used, either assigned to or not assigned to you. WARNING: If you have used a fake social security number or someone elses social security number you should speak to an immigration attorney to assess the risks of disclosing this information and whether you should apply for deferred action. 9. Alien Registration Number (A-Number) or I-94 Number (if any). If you have an Alien Registration Number (a.k.a. A-Number), then please enter it here. If you received an I-94 number along with a visa issued by the United States, please enter all 11-digits here. WARNING: If you received a visa and an I-94 under an identity that did not belong to you, do not enter this information. Please contact an immigration attorney to determine whether you should apply for deferred action. This must match Part 1, Question 4 or Question 16.b of Form I-821D. 10. Have you ever before applied for employment authorization from USCIS? Mark the applicable box. If Yes, you must answer the sub-questions that follow. 11. Date of Last Entry into the U.S. This must match Part 1, Question 13 of Form I-821D. 12. Place of Last Entry into the U.S. This must match Part 1, Question 14 of Form I-821D. 13. Manner of Last Entry (Visitor, Student, etc.). If you came on a visa that has expired, please look at visa to see the manner in which you entered. If you did not enter the United States lawfully, please enter No Lawful Entry on this line. 15. Current Immigration Status (Visitor, Student, etc.) Enter No Lawful Status on this line. 16. Place the letter and number of eligibility category selected from the instruction. You MUST put the letter c in the first bracket, and the number 33 in the second. It should look like this: (c)(33). 4 of 6
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Toolkit v.1.0 Step 4 17. Leave blank.

Certification Remember, you are signing this form under penalty of perjury to the United States government. If you answered everything truthfully without omission to the best of your knowledge, without an intent to deceive the United States government, then sign the form. Also, include your telephone number and do not forget the date. If someone else helped you prepare this form, have him or her complete the area beneath Signature of Person Preparing Form, If Other Than Above. You have now completed your I-765. We shall now move onto I-765WS. Unlike the I-821D, you will not need to supply supporting documentation to prove that the information you provide is true. Still, because this form is a part of your I-821D and I-765, you must answer truthfully and without omissions. Part 1. Full Name. 1.a 1.c These answers must match Part 1, Questions 1.a 1.c of Form I-821D and Question 1 of Form I-795. Part. 2. Financial Information 2. My current annual income is: Your current annual income is everything you earned within the last 12 months. This includes money earned off the books or under the table in cash. If your parents help support you, please also include this in your calculations. Academic stipends given to you by a university would count as income if it is received on a monthly basis. On the other hand, if the money is given to you in a lump sum that you keep in your savings account, then that is an asset (See #4 below). 3. My current annual expenses are: Your annual expenses are what you spend per year to support your career while you earn an income. For example, if you tutor, things such as: gasoline, car insurance, oil changes, papers, books, etc. would count as expenses. 4. The current value of my assets is: 5 of 6
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Toolkit v.1.0 Step 4 Assets are resources you can hold over each month and sell/use at when you need to use it. For example, if you have a checking and savings account, money held in your savings account would count as an asset, but cash in your checking account would not. If you own a car or property with equity, these are also assets. If you owe more on an item than its fair market value, the asset has zero value and would not factor into this calculation. Part. 3. Additional Information This is where you write a brief account of your life in the United States, starting with your education and how this relates to your career goals. Explain how you earn your income and any financial hardships faced by you and/or your family. If you are receiving any scholarships (public and/or private) or state grants, please also note it in this section. You have now completed Forms I-765 and I-765WS. Now What? Now that you have completed Forms I-765 and I-765WS, do not forget to make a photocopy of these forms for yourself. These forms must be included in with your I-821D application for deferred action. Please refer to the last section of Toolkit Part 1 for instructions.

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Prepared by the Asian Pacific American Legal Center, Member of Asian American Center for Advancing Justice. Created Aug. 15, 2010.