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Get USCIS I-765 2020

- 9. in the Who May File Form I-765 section of the Form I-765 Instructions for information about providing court dispositions. NOTE Read the Penalties section of the Form I-765 Instructions before completing this section. You must file Form I-765 while in the United States. Additional Information. 18. a. Country Married Divorced Widowed Have you previously filed Form I-765 13. Refer to Replacement for Card Error in the What is the Filing Fee section of the Form I-765 Instructions for further details. Information About You Your Full Legal Name Form I-765 05/31/18 Page 1 of 7 13. b. Provide your Social Security number SSN if known. Refer to the Who May File Form I-765 section of the Form I-765 Instructions to determine the appropriate eligibility category for this application. Enter the appropriate letter and number for your eligibility category below for example a 8 c 17 iii. 1. c. 2. a. Family Name Last Name 2. b. Given Name First Name NOTE Replacement correction of an employment require a new Form I-765 and filing fee. USCIS Form I-765 Application For Employment Authorization Department of Homeland Security U.S. Citizenship and Immigration Services Authorization/Extension Valid From For Use Only Fee Stamp OMB No. 1615-0040 Expires 05/31/2020 Action Block Valid Through Alien Registration Number A- Remarks To be completed by an attorney or Board of Immigration Appeals BIA accredited representative if any. Select this box if Form G-28 is attached* Attorney or Accredited Representative USCIS Online Account Number if any START HERE - Type or print in black ink. Part 1. Reason for Applying Other Names Used I am applying for select only one box Provide all other names you have ever used including aliases maiden name and nicknames. If you need extra space to complete this section use the space provided in Part 6. Additional Information* 1. a* Initial permission to accept employment. 1. b. Replacement of lost stolen or damaged employment authorization document or correction of my employment authorization document NOT DUE to error. 2. c* Middle Name Renewal of my permission to accept employment. Attach a copy of your previous employment Part 2. Your U*S* Mailing Address 5. a* In Care Of Name if any Do you want the SSA to issue you a Social Security card You must also answer Yes to Item Number 15. Consent for Disclosure to receive a card. Yes 5. b. Street Number and Name 5. c* Apt. Ste. NOTE If you answered No to Item Number 14. skip to Part 2. Item Number 18. a* If you answered Yes to Item Number 14. you must also answer Yes to Item Number 15. Flr. 5. d. City or Town 5. e. State 5. f* ZIP Code USPS ZIP Code Lookup Is your current mailing address the same as your physical address No provide your physical address below. Mother s Name 7. c* City or Town 7. d. State Provide your mother s birth name. 7. e. ZIP Code Other Information Gender Marital Status Single Your Country or Countries of Citizenship or Nationality 14. - 15. provide the information requested in Item Numbers 16. a* - 17. b. 7. a* Street Number information from this application to the SSA as required for the purpose of assigning me an SSN and issuing me a Social Security card.

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