I-765 Form (v053118)

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USCIS Form I-765 - Application For Employment Authorization

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CitizenPath is a private company. We are not a part of U.S. Citizenship and Immigration Services (USCIS) or any other government agency. Your access to and use of this site is subject to additional Terms of Use.

CitizenPath’s self-directed immigration software helps you correctly navigate the immigration process. The service makes the process easy and helps you identify potential problems before you pay. Our Employment Authorization Package costs $53 and includes:

Access to Attorney-Reviewed Software – designed to make the process easy and identify problems
Form I-765, Application for Employment Authorization – official USCIS form will be prepared and ready to sign
Form G-1145 – official USCIS form will be prepared (no signature)
Filing Instructions – detailed instructions customized to your answers in the application to include:
- Specific directions on supporting documents that must be submitted with the application
- Recommendation for organizing your application package
- Mailing address for your application package
Access to customer support
Access to support articles, sample cover letters and affidavits
Money-back guarantee your application will be approved

Upon completion, you have responsibilities:

You must mail your signed form directly to USCIS and
You must pay any USCIS fees related to this form.

I understand and agree. Let's get started.

First, let’s determine your eligibility to file Form I-765.

These questions will help confirm that you may receive employment authorization (work permit).

I am applying for:

Initial permission to accept employmentReplacement (of lost/stolen/damaged employment authorization document)Renewal of my permission to accept employmentIndicate the type of application. Explain more >>

Select the application type that best fits your situation:

Select “Initial” if:

You have never had an EAD and will apply for your first one; or
You currently have an EAD, but you are now applying under a new category.

For example, John already has an EAD because he is an F-1 student with OPT. Recently he married a U.S. citizen and is in the process of adjusting status. John can now apply for an initial EAD as an adjustment of status applicant. It’s an initial application because his category changed from F-1 student to adjustment applicant.

Select “Replacement” if:

You were issued an EAD, but it is lost for any reason;
You were issued an EAD, but was stolen;
You were issued an EAD, but it was damaged, destroyed or mutilated.

For example, Maria is a DACA recipient with an EAD. Somebody recently broke into her car and stole her belongings. She must replace the card so that she has proof of status.

Select “Renewal” if:

You were issued an EAD that is expired/expiring and need to renew it under the same category.

For example, Edward is the spouse of an L-1 intracompany transferee and has an EAD because of this status. However, it will expire in approximately 120 days, so he must renew it now.

When does your Employment Authorization Document (work permit) expire?

It already expiredIt expires before 120 days from todayIt expires after 120 days from today

Sorry, you cannot file for a renewal EAD more than 120 days before your original EAD expires.
You may complete the form now. However, do not mail your application until 120 days before the card expires.

Are you at least 15 years old?

Yes

You must be at least 15 years of age to prepare this application and receive employment authorization.

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Eligibility Category

To determine if you are eligible to file an Application for Employment Authorization, USCIS wants you to identify the category you belong to. Your eligibility category also affects your filing instructions.

Renewal/replacement candidates can find the category on their existing Employment Authorization Cards. How to find this >>

If you already have an Employment Authorization Card (work permit), you can find your eligibility category on the front of your card.

Look for the “Category” on the front of your card. In the example below, the category is “C09”. Find your category and select that code from the drop down list provided.

Which eligibility category do you belong to:

Adjustment of Status(c)(9)Adjustment of Status Applicant(c)(16)Registry Applicant Based on Continuous Residence Since January 1, 1972NIW Physician - Renewal EAD for National Interest Waiver PhysiciansDeferred Action Categories(c)(14)Deferred Action (not including DACA)(c)(33)Consideration of Deferred Action for Childhood Arrivals (DACA)Asylee/Refugee Categories (including spouses and children)(a)(3)Refugee(a)(4)Paroled as a Refugee(a)(5)Asylee (Granted Asylum)(a)(10)Granted Withholding of Deportation or Removal(c)(8)Asylum Applicant (with a pending asylum application)Who Filed for Asylum on or After January 4, 1995Nationality Categories(a)(8)Citizen of Micronesia, the Marshall Islands, or Palau(a)(11)Deferred Enforced Departure (DED)(a)(12)Temporary Protected Status (TPS) under 8CFR 244(c)(19)Temporary Protected Status (TPS) under 8CFR 244.5(c)(10)NACARA Section 203 Applicants Who Are Eligible to Apply for NACARA Relief With USCIS(c)(2)Dependent of TECRO E-1 NonimmigrantForeign Students(c)(3)(A)F-1 Student Seeking Pre-Completion Optional Practical Training(c)(3)(B)F-1 Student Seeking Post-Completion Optional Practical Training(c)(3)(C)F-1 Student Seeking 24-month Extension for STEM Students(c)(3)(ii)F-1 Student Offered Off-Campus Employment by Qualifying Organization(c)(3)(iii)F-1 Student Seeking Off-Campus Employment Due to Economic Hardship(c)(5)J-2 Spouse or Minor Child of an Exchange Visitor(c)(6)M-1 Student Seeking Post-Completion OPT After Completing StudiesEligible Dependents of Diplomatic Missions, International Organizations, or NATO(c)(1)Dependent of A-1 or A-2 Foreign Government Officials(c)(4)Dependent of G-1, G-3 or G-4 Nonimmigrant(c)(7)Dependent of NATO-1 Through NATO-6Employment-Based Nonimmigrant Categories(c)(17)(i)B-1 Nonimmigrant Who Is the Personal or Domestic Servant of a Nonimmigrant Employer(c)(17)(ii)B-1 Nonimmigrant Domestic Servant of a U.S. Citizen(c)(17)(iii)B-1 Nonimmigrant Employed by a Foreign Airline(a)(17)Spouse of an E-1 Treaty Trader, E-2 Treaty Investor, or E-3 Special Occupation(a)(18)Spouse of an L-1 Intracompany Transferee(c)(12)Spouse of an E-2 CNMI Investor(c)(26)Spouse of an H-1B Nonimmigrant (H-4 Dependent)(c)(35)Principal Beneficiary of an Approved Employment Petition Facing Compelling Circumstances(c)(36)Spouse or Unmarried Child of (c)(35) Principal BeneficiaryFamily-Based Nonimmigrant Categories(a)(6)K-1 Nonimmigrant Fiancé(e) of U.S. Citizen or K-2 Dependent(a)(9)K-3 Nonimmigrant Spouse of U.S. Citizen or K-4 Dependent(a)(13)Family Unity Program(a)(14)LIFE Family Unity(a)(15)V-1, V-2 or V-3 NonimmigrantOther Categories(a)(2)Legalization Temporary Resident Pursuant to INA Sections 245A or 210(a)(7)N-8 or N-9 Nonimmigrant(c)(10)Applicant for Cancellation of Removal(c)(20)Applicant for Legalization Pursuant to INA Section 210(c)(22)Applicant for Legalization Pursuant to INA 245A(c)(11)Parole(c)(18)Final Order of Deportation or Removal, including Deferral of Removal under CAT(c)(24)LIFE Legalization Applicant(a)(16)T-1 Nonimmigrant(c)(25)T-2, T-3, T-4, T-5 or T-6 Nonimmigrant(a)(19)U-1 Nonimmigrant(a)(20)U-2, U-3, U-4 or U-5(c)(31)VAWA Self-Petitioners

U-1 Nonimmigrants: If you are currently residing in the United States and your Form I-918, Petition for U Nonimmigrant Status, is approved, you will receive employment authorization incident to status and USCIS will send you an EAD as evidence of that authorization. You do not need to file Form I-765. If you resided outside the United States when your Form I-918 was approved, you must file Form I-765 with USCIS when you enter the United States.

Please select a valid eligibility category above!

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A K-1 or K-2 visa holder cannot renew an EAD (work permit). Instead, you must submit an Adjustment of Status Application and base your new EAD application under the Adjustment of Status applicant (c)(9) category.

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If you are filing for initial or extension of Family Unity benefits, complete and submit Form I-817, Application for Family Unity Benefits. An EAD (work permit) will be issued if your Form I-817 is approved; you do not need to submit Form I-765. Family Unity beneficiaries should only file I-765 to replace a non-expired EAD card that is lost, stolen or damaged.

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If you are filing for initial or extension employment authorization under Family Unity provisions of section 1504 of the LIFE Act Amendments, you should not use this form. Instead, complete and submit Form I-817, Application for Family Unity Benefits. An EAD (work permit) will be issued if your Form I-817 is approved; you do not need to submit Form I-765. LIFE Family Unity beneficiaries should only file I-765 to replace a non-expired EAD card that is lost, stolen or damaged.

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You may only request a renewal of your EAD with this eligibility category. If you wish to apply for a renewal EAD as a National Interest Waiver Physician, please go to the intial question on this page and change it to "renewal."

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If you are filing an initial application for Consideration of Deferred Action for Childhood Arrivals, we encourage you to consult with an immigration attorney.
Help me find an immigration attorney

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If you are filing a renewal application for Consideration of Deferred Action for Childhood Arrivals (DACA), we encourage you to use our DACA Application. This includes the Form I-765 and Form I-821D.
Start DACA Application

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If you are filing an initial application for Temporary Protected Status, we encourage you to use our TPS Application. This includes the Form I-765 and Form I-765, Application for Temporary Protected Status.
Start TPS Application

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Sorry. You cannot continue. Although this is a valid eligibility category, CitizenPath does support the category at this time. Due to the complexities of obtaining employment authorization for this category, we recommend that you use an experienced immigration attorney.
Help me find an immigration attorney

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Are you filing Form I-485 on the basis of asylum or refugee status?

Yes

Asylees and refugees file under a different eligibility category. Explain more >>

We found a problem. Based on your answer, you cannot continue. If you were admitted as a refugee or granted asylum and are now filing Form I-485 to adjust status to permanent resident on that basis, do not file Form I-765 under eligibility category (c)(9) as an adjustment of status applicant. Instead, go back and select your relevant category:
Use (a)(5) for asylum
Use (a)(3) for refugee status

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If you were admitted as a refugee or granted asylum and are now filing Form I-485 to adjust status to permanent resident on that basis, do not file Form I-765 under eligibility category (c)(9) as an adjustment of status applicant.

Asylum Status
If you are an asylee and have applied under INA section 209 to adjust to lawful permanent resident status using Form I-485, file Form I-765 under category (a)(5) as an asylee. Do not file Form I-765 under eligibility category (c)(9) as an INA section 245 adjustment applicant.

Refugee Status
If you were admitted as a refugee and have applied under the Immigration and Nationality Act (INA) section 209 to adjust to lawful permanent resident status using Form I-485, Application to Register Permanent Residence or Adjust Status, file Form I-765 under category (a)(3) as a refugee. Do not file Form I-765 under eligibility category (c)(9) as an INA section 245 adjustment applicant.

Source: USCIS

Are you an A-3 or G-5 nonimmigrant who has filed a pending civil action against your employer because your employer violated the terms of your employment contract?

Yes

Have you EVER been arrested or charged with any misdemeanor or felony crime in the United States?

Yes

Traffic violations do not need to be included unless they are alcohol or drug related. Explain more >>

Certain criminal offenses (some misdemeanor crimes and most felony crimes) can affect the success of your application. Even if you have been arrested for a DUI (driving under the influence) or minor crime, you should truthfully answer this question.

If you have ever been charged with a crime, please contact an experienced immigration attorney before filing any USCIS forms. If your attorney says you may safely proceed on your own, come back and complete your application.

Your answer to this question suggests that you have a history which may require the assistance of a legal professional. We want the best result for you, and therefore CitizenPath suggests that you consult with an experienced immigration attorney that can provide you with additional guidance and representation.
Help me find an immigration attorney

I acknowledge that I have spoken to an attorney and / or want to continue anyway

Have you EVER given false or misleading information to any U.S. government official while applying for any immigration benefit or to prevent deportation, exclusion, or removal?

Yes

Your answer to this question suggests that you have a history which may require the assistance of a legal professional. We want the best result for you, and therefore CitizenPath suggests that you consult with an experienced immigration attorney that can provide you with additional guidance and representation.
Help me find an immigration attorney

I acknowledge that I have spoken to an attorney and / or want to continue anyway

Congratulations, you're likely eligible to apply for employment authorization.
Please click on "Next Page" below to continue your application.

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Applicant Information

Let's get started with some information about you, the applicant.

Applicant's Full Name

Provide your full legal name. Spell out middle names completely. If you do not have a middle name, you may leave this field blank. Explain more >>

Full Name
Your legal name is your current legal name. It’s generally the name on your birth certificate or passport unless it has been changed by a legal action such as a marriage or court order. Spell out middle names completely and do not use just the initial. If you do not have a middle name, you may leave this field blank.

Other Names
Your other names include any other names that you have used in the past. Usually this includes maiden names or a name that you used before a legal name change. However, it includes any name (including nick names) that you have used in various legal documents, bank accounts, ID cards (e.g. driver’s license, work permit), criminal records, and school records. If you have been publicly known by another name, you should include it here.

Given Name (First Name)

Middle Name

Family Name (Last Name)

Have you used any other names since birth?

Yes

Provide any other names that you have ever used, including maiden names, names from previous marriages, aliases and nicknames. Explain more >>

Other Name

Given Name (First Name)

Middle Name

Family Name (Last Name)

Birth Information

Enter your place of birth and date of birth.

City or Town

Province or State

Country

Enter other country

Date of Birth

You entered an invalid date. Please enter a valid date in the past.

Other Information

Sex

Male

Female

Select your current marital status:

SingleMarriedDivorcedWidowedSelect the marital status you have on the date you are filing this application. If you are currently unmarried, but had a prior marriage that was annulled or otherwise legally terminated, select "Divorced."

USCIS Online Account Number

If you have a USCIS Online Account Number, enter it here. If you don't have one or you're not sure, leave the field empty. Explain more >>

USCIS will process your application in the USCIS online filing system. The USCIS online account number is not the same as an A-Number. If you were issued a USCIS online account number, enter it in the space provided. If you do not have an account number (or do not know), you may leave it empty.

If you do not have an existing USCIS online account, an online account will be automatically created for you. You will receive a “Welcome” letter with instructions on how to access your USCIS online account. A USCIS online account allows you to:

Check the status of your application;
Receive notifications and case updates; and
Manage your contact information.

If you choose not to access your USCIS online account, USCIS will still process your application in the USCIS online filing system. You will also receive notifications and updates about your application by mail through the U.S. Postal Service.

Source: USCIS

Alien Registration Number (A-Number)

A-

If you have an A-Number, enter it here. If you don't have an A-Number, you may leave this field empty. How to find this >>

Also known as an A-Number or USCIS#, your Alien Registration Number is an 8- or 9-digit number that can be found on your Employment Authorization Document (work permit) if you have one. In the example below, the A-Number is listed as “000-000-773” next to USCIS#. If your card is lost or missing, you may be able to find your A-Number on other documents. Only list a valid A-Number that was issued to you.

Social Security Number

Has the Social Security Administration (SSA) ever officially issued a Social Security card to you?

Yes

Social Security Number

Enter the 9-digit Social Security number. If you lost the card or otherwise do not know your SSN, you may select "I don't know my Social Security number" below. How to find this >>

I don't know my Social Security number

Do you want the SSA to issue you a Social Security card?

Yes

If your request for employment authorization is approved, the SSA may assign you an SSN and issue you a Social Security card.

Do you want the SSA to issue you a replacement Social Security card?

Yes

If your request for employment authorization is approved, the SSA can issue a replacement Social Security card.

Do you authorize the disclosure of information from this application to the SSA as required for the purpose of assigning you an SSN (if necessary) and issuing you a Social Security card?

Yes

If you do not consent to the disclosure of your information to SSA, you must go back and answer "No" to the question above

If you do not consent to the disclosure of your information to SSA, you must go back and answer "No" to the question above.

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Father's Name

Enter your father's birth name. Applicants who do not know may enter "Unknown" for both names.

Given Name (First Name)

Family Name (Last Name)

Mother's Name

Enter your mother's birth name. Applicants who do not know may enter "Unknown" for both names.

Given Name (First Name)

Family Name (Last Name)

If you have a social security number, you can find it on your social security card. Some other places that you can find your SSN are on tax returns, pay statements, and bank statements. However if you do not have a social security number, leave this field blank. Using a false SSN will result in your application being rejected.

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Applicant's Immigration History

Tell us about your immigration history.

Country of Citizenship or Nationality

List all countries where you are currently a citizen or national. If you are a citizen or national of more than one country, click the "Add Another Country" button to add another record. If you are stateless, select the name of the country where you were last a citizen or national.

I am a citizen or national of...

Are you eligible for benefits under the ABC settlement agreement?

Yes

Answer "Yes" only if you are sure you are eligible. Explain more >>

The American Baptist Churches v. Thornburgh (ABC) Settlement Agreement was a class action settlement between a class of Guatemalan and Salvadoran nationals and the U.S. government rendered in American Baptist Churches v. Thornburgh, 760 F. Supp. 796 (N.D. Cal. 1991) on January 31, 1991.

Eligibility
To be eligible for ABC benefits, an applicant must meet three requirements:

The applicant must be a class member; and
The applicant must have registered for ABC benefits by the agreed upon date; and
The applicant must have applied for asylum by the required date.

A class member who meets these three requirements may nonetheless be ineligible for benefits if he or she has been convicted of an aggravated felony or was apprehended at the time of entry after December 19, 1990.

Most people preparing Form I-765 are not eligible for benefits. If you believe you may be eligible for benefits under the ABC settlement agreement, confirm you have met all requirements before answering “Yes.”

Source: USCIS

Passport/Travel Document

Enter your passport (or travel document) details below from your most recent entry to the United States.

On your most recent entry to the United States, did you have a passport or travel document?

PassportTravel documentNeither

Passport Number

Travel Document Number

Country of Issuance

Enter name of country:

Expiration Date

Enter the expiration date for your passport or travel document, even if it has already expired.

I-94 Arrival/Departure Record

You most likely have an I-94 Arrival/Departure Record if you entered the U.S. lawfully. The information to answer the next few questions can be found in the I-94 record from your most recent arrival to the United States. If you do not have Form I-94, please refer to your passport.

How to Find an I-94 Record >>

How to Read an I-94 Record >>

An I-94 is the Arrival/Departure Record issued by U.S. Customs and Border Protection (CBP) when foreign nationals enter the United States with a non-immigrant visa or some other status. The I-94 record confirms that the immigrant is legally entering the United States in a specific status and period of time.

Electronic I-94 Record
Modern I-94 Arrival/Departure Records are available electronically if the foreigner traveled by air or sea. An electronic I-94 can be obtained by going to the CBP I-94 Website. If you are unable to find an electronic I-94, check your passport for a stamp. In some cases, CBP may provide an I-94 stamp instead.

Paper I-94 Record
CBP still issues a paper I-94 at land border ports of entry. Also, if the foreigner arrived to the United States via air or sea before May 2013, CBP probably issued a paper I-94. The I-94 is a paper card like the sample below. The I-94 number (also labeled as a departure number) is an 11-digit number generally found in the upper/left corner.

Arrival/Departure Record

Advance Parole
If your most recent entry was done with an advance parole document (common for asylees, DACA, TPS and some other statuses), your I-94 may be stamped or attached to the advance parole document.

Canadian Temporary Visitors
Canadian visitors may not receive an I-94 at land border crossings. This is a lawful entry as long as the visitor had a valid visa or parole (including the Visa Waiver Program) at the time of entry.

If you are having trouble retrieving an I-94 from the CBP website, visit our knowledge base article on How to Find an Electronic I-94 Record for additional tips.

You can find the following items on an electronic or paper I-94 record. A sample electronic I-94 record is pictured below.

Arrival/Departure Record

I-94 Number
The Admission (I-94) Record Number is a unique 11-digit number that is assigned to each specific entry into the United States.

Date of Arrival
This is the date of entry when the visitor arrived in the United States.

Admit Until Date
The Admit Until Date is the date the visitor is authorized to stay in the United States. For students, the date may be labeled “D/S” for Duration of Status.

Class of Admission
This is the immigration status that was used for entering the United States.

Source: CBP

DACA Applicants: If you "entered without inspection," you probably do not have an I-94 Arrival/Departure Record or stamped passport. That's okay. You may skip to the next question.

I-94 Number

Enter the I-94 number from your Arrival/Departure Record (I-94). If you do not have an I-94 record, leave this field empty.

Information About Your Last Arrival

Select the visa category you held when you most recently entered the U.S. and were admitted by a U.S. Customs and Border Protection (CBP) officer. The visa category will be listed on your I-94 record or visa which is located inside your passport. If you do not remember your visa category, please select "Other," and enter the written word for a broad category such as Visitor or Student.

DACA Applicants: There are generally three possibilities for answering this question:

If an individual most recently "entered without inspection," the immigration status at last entry was No Status.
If an individual entered with a valid visa that later expired, enter the visa type that was used during the last entry.
In some rare cases, an individual may have been granted DACA and then re-entered the U.S. with advance parole. In this case, the immigration status at last entry was Deferred Action.

If possible, refer to the Form I-765 in your initial DACA application. It's important to keep your answers consistent. If you did not keep a copy of your initial DACA application, contact the lawyer or organization that helped you. They should be willing to give you a copy.

Select your immigration status when you most recently entered the United States:

Enter your immigration status when you most recently entered the U.S.:

Date of Your Last Arrival

The date of last arrival is the date you most recently entered the U.S. which may be more recent than your I-94 record.

You entered an invalid date. Please enter a valid date in the past.

Location of Last Arrival

Select the port of entry where you physically entered the United States. If you did not enter the country through an official port of entry, select “Other” and type the name of the area you entered.

Enter the location of last arrival:

Describe the general region you entered. Type the city and state if possible.

Current Immigration Status or Category

Now, select your current immigration status. For most people, their current immigration status will be the same. However, other people have changed status since entering the United States.

Select your current immigration status:

Enter your current immigration status:

Your answer to this question suggests that you have a history which may require the assistance of a legal professional. We want the best result for you, and therefore CitizenPath suggests that you consult with an experienced immigration attorney that can provide you with additional guidance and representation.
Help me find an immigration attorney

I acknowledge that I have spoken to an attorney and / or want to continue anyway

SEVIS Number

N-

Enter your Student and Exchange Visitor Information System (SEVIS) Number. How to find this >>

SEVIS ID numbers start with the letter N and are generally followed by 10 digits. You can find your SEVIS number on various documents like Form I-20 and DS-2019.

On the sample Form I-20 below, the SEVIS number is on the top left-hand side of page above the student’s surname.

On the sample DS-2019 below, the SEVIS number is on the top right-hand side of the page in the box above the barcode.

Source: ICE

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Address Information

Provide your current mailing address and contact information.

U.S. Mailing Address

Enter a safe address where USCIS may contact you by mail. You may list a valid residence, APO, or commercial address. This may be a Post Office address (P.O. Box) if that is how you receive your mail.

In Care Of

Street Number and Name

Is there an apartment, suite or floor?

Enter the number here:

Town or City

State

ZIP Code

Is the above mailing address also your current physical address?

Yes

Your physical address is the residence where you live.

U.S. Physical Address

Enter the address where you live inside the United States.

Street Number and Name

Is there an apartment, suite or floor?

Enter the number here:

Town or City

State

ZIP Code

Contact Information

This contact information is so that USCIS can reach you. Your mobile phone number and/or email address will also be used so that CitizenPath can create a complimentary Form G-1145 for you. By filing G-1145 with your adjustment of status application, USCIS will text and/or email when they have accepted the application for processing.

Daytime Phone Number

Mobile Phone Number (if any)

Email Address (if any)

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Final Details

You're almost finished. This is the final page.

Previous Application

Have you previously filed Form I-765?

Yes

If you have ever applied for employment authorization, you should indicate “Yes."

STEM OPT Applicants

Because you are applying for employment authorization card on the basis of a 24-Month Extension for STEM Students (c)(3)(C), the application requires some additional details about your employment situation.

Your degree

Employer's Name as listed in E-Verify

Your Employer's E-Verify Company Identification Number or a valid E-Verify Client Company Identification Number

H-4 Applicants

Because you are applying for employment authorization card on the basis of an H-4 Spouse of an H1-B Spouse (c)(26), the application requires you to enter the receipt number of your H-1B spouse's most recent Form I-797 Notice for Form I-129, Petition for a Nonimmigrant Worker.

Receipt Number

A receipt number is a unique 13-character identifier that consists of three letters and 10 numbers. Omit dashes ("-") when entering a receipt number. However, you can include all other characters, including asterisks ("*"), if they are listed on your notice as part of the receipt number.

Deferred Action Applicants

Because you are applying for a replacement employment authorization card on the basis of Deferred Action or DACA, the following four questions will help us produce the Form I-765 Worksheet for you. The I-765 worksheet is required. Explain more >>

USCIS wants to determine whether you have an economic need in order to warrant the issuance of a work permit, also known as an Employment Authorization Document (EAD). People work for many reasons so there are many valid answers. It isn’t necessary to prove that you are going into poverty – you only need to demonstrate that you have a need.

Even if you are getting by (income is greater than expenses), you may need to work because:

Your parents currently provide for most/all of your expenses, and you would like to begin contributing toward your own costs.
You would like to save for college or want to earn additional income so that you can study full-time.
You are saving for a used car.
You want to save for an emergency fund for healthcare.
You expect to graduate someday and want to become self-sufficient.

These are just some examples of valid answers. Use the space provided to describe your situation and economic need.

Current Annual Income

Report your individual income (not your household income) truthfully.

My current annual income is:

Current Annual Expenses

This is a total of all your expenses. If you live with your family, you can report your share of the household's total expenses (rent, food, auto, etc.) Your personal expenses (like education, transportation, phone, books, etc.) should be included.

My current annual expenses are:

Current Value of Assets

This is the total of value of money you might have in a bank account plus any other valuables that you might own. Include your car, home, stocks/bonds, land, jewelry, etc. Owning assets will not disqualify you from a work permit.

The total current value of my assets is:

If you would like to provide an explanation regarding your current financial information or your economic need for employment authorization, please use space below:

Interpreter

Did you receive help from an interpreter to prepare this application?

Yes

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

Interpreter's Information

Which language was used?

Given Name (First Name)

Family Name (Last Name)

Business or Organization (if any)

Interpreter's Address

Street Number and Name

Is there an apartment, suite or floor?

Enter the number here:

Town or City

Country

Other Country

State

ZIP Code

Province

Postal Code

Interpreter's Contact Information

Daytime Phone Number

Mobile Phone Number (if any)

Email Address (if any)

The interpreter named above read to me every question and instruction on this application and my answer to every question in a language in which I am fluent. I understood all of this information as interpreted.

Preparer

If the applicant received help from another person to prepare this application, indicate here.

Who prepared this application?

I am the applicant, and I prepared this application.I am not an attorney or accredited representative but have prepared this application on behalf of the applicant and with the applicant's consent.I am an attorney or accredited representative of the applicant that prepared this application.

My representation of the applicant in this case:

Extends beyond the preparation of this application.Does not extend beyond the preparation of this application.

Preparer's Information

Given Name (First Name)

Family Name (Last Name)

Business or Organization (if any)

USCIS Online Account Number

Will you attach Form G-28 to the application?

YesNo

Preparer's Address

Street Number and Name

Is there an apartment, suite or floor?

Enter the number here:

Town or City

Country

Other Country

State

ZIP Code

Province

Postal Code

Preparer's Contact Information

Daytime Phone Number

Mobile Phone Number (if any)

Email Address (if any)

Secure Checkout

Delivery Information

Electronic Delivery

Immediately after payment, you will be forwarded to a confirmation page to download your files. You will also receive a confirmation email that includes a link to the download page so that you may return later.

E-mail

Confirm E-mail

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Mail To Me

For an additional $15, we will print a copy of your completed form and filing instructions and mail them directly to you. The documents will arrive in 3-5 business days via U.S. Postal Service.

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First Name On Card

Last Name On Card

Does your credit card have a US billing address?

Yes

Billing ZIP Code

Card Number

Expiration

Security Code (learn more)

The security code is the last 3 digits on the back of your Visa, MasterCard, or Discover card.

The security code on American Express cards is the 4-digit number on the front of your card above your account number.

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Your Purchase

Form I-765 prepared for you
Amount

Form G-1145 prepared for you
Amount

Included

Filing Instructions customized for you
Amount

Included

First Class Mail to you
Amount

Coupon Code
Amount

Total

We guarantee USCIS will approve your form. (Read the details).

If USCIS denies your immigration application, CitizenPath will refund our fee and reimburse your USCIS fees.

If USCIS issues a final denial of a USCIS application that you created via CitizenPath’s software, we will refund the fee you paid to CitizenPath for use of the service and reimburse any fee you paid to the government in direct connection to the same application. For the complete policy, refer to our guarantees page.

If you’re not 100% satisfied using CitizenPath’s immigration services, we’ll refund your money.

If you’re not satisfied with our service, give us the opportunity to resolve your problem. Contact us during our normal business hours. If your problem cannot be resolved within forty-eight (48) hours of contacting us, we will provide a refund of your purchase. For the complete policy, refer to our guarantees page.

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