I-765 Info Sheet For Dependents

Instructions For Questions

Use this table to find instructions to specific questions
Question No.Information RequestedInstructions
5a-6U.S. Mailing AddressEnter the U.S. address to which your receipt notice and EAD card will be sent. If you move before your receipt notice or EAD card are delivered, mail from USCIS will not be forwarded.
12Previously Filed I-765If you have ever previously applied for H-4 work authorization, J-2 work authorization, F-1 OPT, Severe Economic Hardship, or submitted an I-765 as part of a Permanent Residency application, check “Yes.”
8Alien Registration Number (A-Number)If you have ever obtained an Employment Authorization Document (also known as an EAD card) from USCIS, you should copy the number from your EAD card in this space. Similarly, if you have ever filed an I-140 Immigrant Petition for Alien Worker or I-485 Application to Register Permanent Residence or Adjust Status, you should copy the number from your I‑797 receipt notice in this space. If you do not have an A # mark the space “N/A” for not applicable.
13a - 15Social Security Administration

The Form I-765 allows you to apply for a Social Security number (SSN) when you apply for an EAD. You are not required to apply for the SSN on this form, but it may save time in the work authorization process.

  • If you do want to apply for the SSN, you will answer “Yes” for number 14
    • If you answer “Yes”, you must also answer number 15 that you authorize the information to be provided to the Social Security Administration
    • If you answer “Yes” to numbers 14 and 15 then you must answer number 16a-17b
  • If you do not want to apply for the SSN, you will answer “No” for number 14
21aForm I-94 Arrival-Departure Record Number

Enter information from your most recent I-94 document.

  • If you have a paper I-94 card, enter all 11 digits of the Departure Number at the top left corner of the card.
  • If you have an electronic I-94 document, enter all 11 digits of the Admission (I-94) Record Number.
  • If you extended/changed immigration status within the US and have only an I-797 Approval Notice confirming your status, enter all 11 digits of the I-94# found at the bottom left of the I-797.
23Place of Last Arrival Into the United StatesEnter the name of the city or airport code for the place you last entered the United States.
24Immigration Status at Last ArrivalEnter the immigration status you held when you last entered the US
25Current Immigration Status or CategoryEnter the immigration status you currently hold
26Student and Exchange Visitor Information System (SEVIS) NumberPersons in H-4 status will not have a current SEVIS Number. Leave this question blank.
27Eligibility CategoryEnter ( c ) ( 26 ) ( )
Note: This is the eligibility category for H-4 work authorization

Next Steps

Step 1: Assemble items on checklist below in the order below
Step 2: Mail your packet to the appropriate lockbox
Step 3: Wait 7-10 days for your I-765 Receipt Notice & 2-4 months for employment authorization card
Step 4: Follow your case status through the “Check Your Case Status” link at www.uscis.gov
Step 5: If requested, your SSN will be processed after the EAD is issued

Checklist

Optional

  • Form G-1145 to receive a text or e-mail with your case number from USCIS when your case is received

Required

  • Form I-765, completed and signed
  • Two color, passport-style photos with your full name and date of birth written on the back in pen. Put your photos in a small plastic bag and staple this bag to the top right corner of the I-765. Photos can be purchased at OIS.
  • Check or money order for $410.00 (U.S. dollars) made payable to “U.S. Department of Homeland Security”. Staple your check/money order to the top center of the I-765.
  • Copy of your most recent I-94 document. This should be one of the following:
    • paper I-94 card (front and back)
    • print-out of an electronic I-94
    • your I-797 Approval Notice, if you changed your immigration status inside the US and have not departed
  • Copy of any previous employment authorization cards (front and back)
  • Copy of any current immigration document (I-797 approval notice, I-20, DS-2019, etc.)
  • Copy of the name & photo page of your passport (including expiration date and any extension pages)
  • Copy of the H-1B’s I-797 approval notice
  • Copies of the H-1B’s 3 months’ recent pay stubs to show maintenance of H-1B status
  • Copy of the H-1B’s I-140 receipt or approval notice
  • Copy of proof of relationship to the H-1B in English (marriage certificate, visa stamp, etc.)
Mailing Information
If address you use on the I-765 is in:Mail your application to:
Alaska, Arizona, California, Colorado, Guam, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, North Dakota, Ohio, Oregon, South Dakota, Utah, Washington, Wisconsin, Wyoming, or Commonwealth of the Northern
Marina Islands
USCIS PHOENIX LOCKBOX
  • If you want to use the US Postal Service (USPS)*

USCIS
PO Box 20400
Phoenix, AZ 85036

  • If you want to use a private company (FedEx, UPS, DHL, etc.)‡
USCIS
Attn: H4
1820 E. Skyharbor Circle S
Suite 100
Phoenix, AZ 85034


Important! Visit http://www.uscis.gov/i-765 to verify the filing address.

Note:

* In general, the US Postal Service is the less expensive option, but their service can be somewhat slower. If you choose the USPS, we advise purchasing a tracking number for your package.


‡ Private companies are often the more expensive option, but their shipments are usually faster.