- Have you previously filed Form I-765?
- ✓✓ Check No if you have not previously applied for work authorization with an I-765
- ✓✓ Check Yes if you have previously filed an I-765 (provide evidence)
- Is someone assisting you with completing this application?
- ✓✓ Check No
Your Information
- ➢ Your Name
- ✓✓ What is your current legal name?
- ✓✓ Have you used any other names since birth?
- ➢ Your contact information
- ✓✓ How may we contact you?
- Daytime telephone number
- Email address
- ■ What is your current U.S. mailing address?
- ■ Is your current mailing address the same as your physical address?
- ➢ Describe yourself
- ✓✓ What is your gender?
- ✓✓ What is your marital status?
- ➢ When and where you were born
- ✓✓ What is your city, town or village of birth?
- ✓✓ What is your state or province of birth?
- ✓✓ What is your country of birth?
- ✓✓ What is your date of birth?
- ➢ Your immigration information
- ✓✓ What is your country of citizenship or nationality?
- ✓✓ What is your Form I-94 Arrival-Departure Record Number?
- ✓When did you last arrive in the United States?
- Date of Arrival
- Place of arrival (airport)
- Status at last arrival
- oSelect F-1 unless you changed your status after your most recent arrival
- ✓✓ What is the passport number of your most recently issued passport?
- ✓What is your travel document number (if any)? In most cases, leave this section blank. Likely you don't have one.
- ✓✓ What is the expiration date of your passport or travel document?
- ✓✓ What country issued your passport or travel document?