Application for Benefits Under the Family Unity Program

OMB No. 1615-0005: Expires 07/31/07

Instructions for I-817, Application
for Family Unity Benefits

Department of Homeland Security
U.S Citizenship and Immigration Services

Instructions
Please read these instructions carefully to properly complete this form. If you need more space to complete an answer, use a separate
sheet(s) of paper. Write your name and Alien Registration Number (A#), if you have one, at the top of each sheet and indicate the
number of the item to which the answer refers.

What is the Purpose of This Form.
For requesting initial benefits under the Family Unity
Program, or to request an extension of such benefits.

When Should I Use Form I-817.
You should use Form I-817 to request initial benefits under
the Family Unity Program as well as to request an extension
of such benefits.
1.

2.

Form I-817 should be used if you are applying for Family
Unity Program benefits pursuant to section 301 of the
Immigration Act of 1990 (IMMACT 90), or if you are
applying pursuant to section 1504 of the Legal
Immigration Family Equity Act (LIFE Act) Amendments.
If you are granted family unity benefits under IMMACT
90, you are authorized to remain in the United States for
two years and you will receive an Employment
Authorization Document (EAD) valid for the same
period.

3. If you are granted family unity benefits pursuant to the
LIFE Act Amendments, you are authorized to remain in
the United States for two years (or one year if your spouse
or parent has not adjusted to lawful permanent resident
status). You will receive an EAD valid for the same
period. You should file only this Form I-817 application
with supporting documents to request authorization to
remain in the United States and an EAD.
4.

If after granted family unity benefits under either
IMMACT 90 or the LIFE Act Amendments, you intend to
travel outside the United States temporarily, you must
apply for advance authorization by completing Form
I-131, Application for Travel Document. Upon approval
of the Form I-131, you will be issued a Form I-512,
Authorization of Parole Into the United States. Advance
parole allows you to leave the United States and be
paroled back into the United States when you return.

General Instructions.
You must fill out a separate Form I-817 for each person who
needs to apply for family unity benefits. Follow the steps to
complete the application process:

Step 1 - Reason for Filing Form I-817
Step 2 - Fill Out the Form I-817
Step 3 - Submit Your Application

Step 1. Reason for Filing Form I-817.
1. Under IMMACT 90.
To prove eligibility for Family Unity Program benefits under
IMMACT 90, you must meet the following conditions.
A. You must have entered the United States prior to
May 5,1988, or December 1, 1988, as appropriate, and
have been continuously residing in the United States
since that date.
B. You were the spouse or unmarried child under the age
of 21 years of a legalized alien as of May 5, 1988, or
December 1, 1988, as appropriate, and you have been
continuously eligible since that date for familysponsored immigrant status based on your relationship
to that person.
NOTE: If you were an unmarried child under the age of
21 as of May 5, 1988 or December 1, 1988, as appropriate,
who has since been married, you will be regarded as
continuously eligible for family sponsored immigration
benefits only if you were married after the legalized alien,
through whom your eligibility was gained, naturalized as a
U.S. citizen.
NOTE: For information on the two dates, May 5, 1988 or
December 1, 1988, go to Page 2 of these instructions and
read "Relationship to a legalized alien."
2. Under LIFE Act Amendments.
To prove eligibility for Family Unity Program benefits under
the LIFE Act Amendments, you must be the spouse or
unmarried child under the age of 21 of an alien who is eligible
for adjustment pursuant to section 1504(b) of the LIFE Act;
and:
A. Your spouse or parent has applied for or been granted
adjustment of status; and
B. You entered the United States before December 1,
1988, and resided in the United States on that date.

Form I-817 Instructions (Rev. 07/30/07) Y

A legalized alien is someone who obtained temporary or
permanent residence in the United States as a Special
Agricultural Worker under section 210 of the Immigration and
Nationality Act (INA), through Legalization under section
245A of the INA or under section 1504(b) of Public Law
106-553 (the LIFE Act). For the purposes of this form, a
legalized alien is also someone who obtained permanent
residence through a Cuban/Haitian Adjustment under section
202 of the Immigration Reform and Control Act of 1986.

5. I am the spouse of a legalized alien who adjusted
undersection 202 of the Immigration Reform and
Control Act of 1986 (Cuban/Haitian Adjustment)
and we have been married since at least May 5,
1988. Check box E if your relationship was
established on or before May 5, 1988 and you
currently meet the residence and continuous
eligibility requirements.
6.

3. The classes of individuals eligible to apply for family
unity benefits are listed below. Check the box in Part 2 of
the Form I-817 that matches your request.
A. Relationship to a legalized alien:
1. I am the spouse of an alien who was legalized
under section 245A of the INA and we have been
married since`at least May 5, 1988. Check box A
if your relationship was established on or before
May 5, 1988 and you currently meet the residence
and continuous eligibility requirements.
2. I am the spouse of an alien who was legalized as a
Special Agricultural Worker under section 210 of
the INA and we have been married since at least
December 1, 1988. Check box B if your
relationship was established on or before
December 1, 1988 and you currently meet the
residence and continuous eligibility requirements.
3. As of May 5, 1988, I was the unmarried child
under the age of 21 of an alien who was legalized
under section 245A of the INA. I am currently the
child, son or daughter of the same parent. That
parent is either a legalized alien or a naturalized
U.S. citizen who was a legalized alien on or before
May 5, 1988 and maintained such status until his
or her naturalization. Check box C if your
relationship was established on or before May 5,
1988 and you currently meet the residence and
continuous eligibility requirements.
4. As of December 1, 1988, I was the unmarried child
under the age of 21 of an alien who was legalized
as a Special Agricultural Worker under section
210 of the INA. I am currently the child, son or
daughter of the same parent. That parent is either a
legalized alien or a naturalized U.S. citizen who
was a legalized alien on or before December 1,
1988 and maintained such status until his or her
naturalization. Check box D if your relationship
was established on or before December 1, 1988
and you currently meet the residence and
continuous eligibility requirements.

As of May 5, 1988, I was the unmarried child under
the age of 21 of an alien who adjusted under section
202 of the Immigration Reform and Control Act of
1986 (Cuban/Haitian Adjustment). I am currently
the child, son or daughter of the same parent. That
parent is either a legalized alien or a naturalized U.
S. citizen who was a legalized alien on or before
May 5, 1988 and maintained such status until his or
her naturalization. Check box F if your relationship
was established on or before May 5, 1988 and you
currently meet the residence and continuous
eligibility requirements.

B. Relationship to an alien eligible for adjustment of
status under the provisions of section 1104(b) of
Public Law 106-553 (the LIFE Act):
1.

I am the spouse of an alien who is eligible for and
has filed for adjustment pursuant to section 1504 of
Public Law 106-554, the LIFE Act Amendments. I
entered the United States before December 1, 1988
and was in the United States on that date. Check
box G if you entered the United States before
December 1, 1988 and you were in the United
States on that date.

2.

I am the unmarried child of an alien who is eligible
for and has filed for adjustment pursuant to section
1504 of Public Law 106-554, the LIFE Act
Amendments. I entered the United States before
December 1, 1988 and was in the United States on
that date. Check box H if you entered the United
States before December 1, 1988 and were in the
United States on that date.

NOTE: When a legalized alien becomes a U.S. citizen, his or
her spouse and unmarried children under the age of 21 will be
eligible to apply for an immigrant visa or to adjust status as a
permanent resident. If you are eligible to apply abroad for an
immigrant visa abroad, you must follow U.S. Department of
State requirements. To apply for adjustment of status, you
must follow the requirements set forth in the INA and Title 8,
Code of Federal Regulations.
4. I am requesting:
A. Initial Family Unity benefits under section 301 of
IMMACT 90. Check box A if this is your first
application requesting Family Unity benefits.
Form I-817 Instructions (Rev. 07/30/07) Y Page 2

B. An extension of Family Unity benefits under
section 301 of IMMACT 90. Check box B if you
already have benefits under the Family Unity Program
and you are requesting an extension. You must submit
proof that a Form I-130, Petition for Alien Relative,
has been filed on your behalf if the legalized alien
through whom Family Unity benefits were obtained is
a lawful permanent resident or naturalized U.S.
citizen.
C. Initial Family Unity benefits under the LIFE Act as
amended. Check box C if this is your first application
requesting Family Unity benefits under the LIFE Act
as amended.

Part 2. Basis for my application.
1. Number 1 - Check one box that applies to your particular
circumstance.
2. Number 2 - Check one box that relates to what you are
requesting.

Part 3. Additional information.
The information requested is about you. You must provide all
the requested information in numbers 1 through 5. You must
answer all the questions numbered 6 through 34.

Step 2. Fill Out the Form I-817.

Part 4. Information about the legalized alien or an
applicant qualifying for Legalization under
the LIFE Act.

Use black ink only. Type or print clearly using CAPITAL
letters. If an item does not apply to you, write "N/A." If the
answer is none, write "NONE."

The information requested is about the legalized alien
through whom you are claiming eligibility or an applicant
qualifying for Legalization under the LIFE Act.

This form is divided into Parts 1 through 8. The following
information should help you fill out the form.

Part 5. Complete only if the legalized alien is
your spouse or if your spouse is eligible
for adjustment under the LIFE Act.

Part 1. Information about you.
1.

2.

Family Name (Last name) - Use your legal name. If you
have two last names, include both and use a hyphen (-)
between the names, if appropriate.
Alien Registration Number (A #) - This is your file
number. If you do not have an A # or do not know it,
leave this blank. If your A # has 8 digits, place a zero
before the first number (example: A12345678 should be
written A012345678).

3.

U.S. Social Security # - If you do not have a U.S. Social
Security number, leave this blank.

4.

Date of Birth - Use eight numbers to show your date of
birth (example: May 1, 1979, should be written
05/01/1979).

5.

Country of Birth - Give the name of the country where
you were born. Include the city, state or province, and
country.

6.

Country of Citizenship - Give the name of the country
or countries of which you are a citizen.

7.

Home Address - Give your physical street address. This
must include a street number and name or a rural route
number. Do not put a post office box (P.O. Box) number
here.

8.

Mailing Address - Give your U.S. mailing address, if
different from your home address.

9.

Daytime Telephone Number - Give a telephone number
where you can be reached during the day. Include area,
country and city codes, if applicable.

Provide the requested information about your qualifying
marriage.

Part 6. Complete only if the legalized alien is
your parent or if your parent is eligible
for adjustment under the LIFE Act.
1. Provide the requested information about your relationship
to the alien.
2. If you are married, divorced or widowed, provide the
requested information.

Part 7. Your signature.
1. You must sign and date your application. If you do not
sign the form, the application will be returned as
incomplete.
2. A parent or legal guardian may sign the application on
behalf of a child under the age of 14 years.

Part 8. Signature of person preparing form, if
other than applicant.
1. If you do not fill out the Form I-817, the preparer must
also sign and date the form and give his or her address.
2. If the preparer is a business or organization, its name must
be included on the application.
3. Signature for placement on Employment
Authorization Document.
Please make sure that your signature fits into the box
provided. No part of your signature should be outside the
box.
Form I-817 Instructions (Rev. 07/30/07)Y Page 3

Where To File.

If you are under the age of 14 their is no biometics fee
required.

Step 3. Submit Your Application.

You may submit one check or money order for both the
application and biometric fees, for a total of $520.00.

If you are filing under section 1504 of Public Law 106-554,
LIFE Act, as amended - You must mail your application
package to the following USCIS location:
U.S. Citizenship and Immigration Services
P.O. Box 7219
Chicago, IL 60680-7219
If you are filing under section 301 of IMMACT 90 - You
must mail your application package to the USCIS service
center with jurisdiction over the place where you live.
If you currently live in or intend to live in Connecticut,
Delaware, District of Columbia, Maine, Maryland,
Massachusetts, New Jersey, New Hampshire, New York,
Pennsylvania, Puerto Rico, Rhode Island, Vermont, Virginia,
West Virginia, or the U.S. Virgin Islands, mail the I-817 to:
USCIS Vermont Service Center
75 Lower Welden Street
St. Albans, VT 05479-0001
If you currently live in or intend to live in Arizona,
California, Guam, Hawaii or Nevada, mail the I-817 to:
USCIS California Service Center
P.O. Box 10817
Laguna Niguel, CA 92607-0817
If you currently live in or intend to live in Alabama,
Arkansas, Florida, Georgia, Kentucky, Louisiana,
Mississippi, New Mexico, North Carolina, Oklahoma,
South Carolina, Tennessee, or Texas, mail the I-817 to:
USCIS Texas Service Center
P.O. Box 850965
Mesquite, TX 75185-0965
If you currently live or intend to live anywhere else in the
United States, mail the I-817 to:
USCIS Nebraska Service Center
P.O. Box Box 87817
Lincoln, NE 68501-7817

What Is the Filing Fee.
The filing fee for a Form I-817 is $440.00.
An additional biometric fee of $80.00 is required when filing
this Form I-817. After you submit Form I-817, USCIS will
notify you about when and where to go for biometric services.

Use the following guidelines when you prepare your check or
money order for the Form I-817 and the biometric service fee:
1. The check or money order must be drawn on a bank or
other financial institution located in the United States and
must be payable in U.S. currency; and
2. Make the check or money order payable to U.S.
Department of Homeland Security, unless:
A. If you live in Guam and are filing your petition there,
make it payable to Treasurer, Guam.
B. If you live in the U.S. Virgin Islands and are filing your
petition there, make it payable to Commissioner of
Finance of the Virgin Islands.
NOTE: Please spell out U.S. Department of Homeland
Security; do not use the initials "USDHS" or "DHS."

How to Check If the Fees Are Correct.
The form fee on this form is current as of the edition date
appearing in the lower right corner of this page. However,
because USCIS fees change periodically, you can verify if the
fees are correct by following one of the steps below:
1. Visit our website at www.uscis.gov, select "Immigration
Forms" and check the appropriate fee;
2. Review the Fee Schedule included in your form package,
if you called us to request the form or
3. Telephone our National Customer Service Center at
1-800-375-5283 and ask for the fee information.
Notice to Those Making Payment by Check. If you send us
a check, it will be converted into an electronic funds transfer
(EFT). This means we will copy your check and use the
account information on it to electronically debit your account
for the amount of the check. The debit from your account will
usually take 24 hours, and will be shown on your regular
account statement.
You will not receive your original check back. We will
destroy your original check, but we will keep a copy of it. If
the EFT cannot be processed for technical reasons, you
authorize us to process the copy in place of your original
check. If the EFT cannot be completed because of insufficient
funds, we may try to make the transfer up to two times.

Form I-817 Instructions (Rev. 07/30/07)Y Page 4

Biometrics Requirement.
When required, fingerprints must be taken at USCIS
Application Support Center (ASC) after you file your
application. USCIS will send you a notice about where to go
and when to get your fingerprints taken. As part of the
biometric services, USCIS may also take your signature and
photograph.

C. If the legalized alien is your parent - Give evidence
of a valid parent-child relationship. This evidence can
vary depending on the circumstances of your
relationship.
1.

If your mother is the legalized alien, submit a copy
of your birth certificate showing your mother's
name.

2.

If you were born in wedlock and the legalized alien
is your natural father, submit a copy of your birth
certificate showing your father's name, your
parent's marriage certificate and proof of
termination of any of their prior marriages.

3.

If you are the legitimated child of a legalized
father, submit a copy of your birth certificate and
evidence of your legitimation. Legitimation may
be established by the marriage certificate of your
natural parents or by documents of legitimation
issued by civil authorities. The legitimation must
have occurred while you were unmarried and prior
to your 18th birthday. You must also submit
evidence of any legal termination of your parent's
prior marriages, if your legitimation resulted from
your natural parents' marriage to each other.

4.

If you were born out of wedlock and the legalized
alien is your natural father, submit a copy of your
birth certificate showing your father's name.
Evidence showing that a bona fide relationship
exists must also be provided. Such evidence may
include but is not limited to: money order receipts
or canceled checks showing your father's financial
support; your father's income tax returns; your
father's medical or insurance records showing you
as a beneficiary; your school records; your father's
work documents showing you as a beneficiary;
correspondence; and/or notarized affidavits from
witnesses who are knowledgeable about the
relationship.

5.

If the legalized alien is your stepparent, whether or
not you were born in wedlock, evidence must be
provided showing that you had not yet reached the
age of 18 years at the time of the marriage creating
your status as a stepchild. Submit a copy of your
birth certificate showing the name of your natural
parent to whom your stepparent is married. You
must also provide copy of the marriage certificate
that created the stepparent-stepchild relationship
and evidence of termination of any previous
marriages of your natural parent and stepparent.

Photographs.
You must submit two identical color photographs of yourself
taken within 30 days of the filing of this application. The
photos must have a white to off-white background, be printed
on thin paper with a glossy finish, and be unmounted and
unretouched. NOTE: Digital photos are not acceptable.
Passport-style photos must be 2" x 2." The photos must be in
color with full face, frontal view on a white to off-white
background. Head height should measure 1" to 1 3/8" from
top of hair to bottom of chin, and eye height is between 1 1/8"
to 1 3/8" from bottom of photo. Your head must be bare
unless you are wearing a headdress as required by a religious
order of which you are a member. Using pencil or felt pen,
lightly print your name and Alien Receipt Number on the back
of the photo.

Evidence Requirements.
Attach copies showing the front and back of the documents
you need to support your application. Do not send original
documents unless instructed to do so.
NOTE: If you send us a document in a foreign language, it
must have a full English translation that the translator has
certified as complete and correct. The translator must also
certify that he or she is competent to translate the foreign
language into English.
1.

If you are requesting initial Family Unity benefits
under section 301 of IMMACT 90. Copies of the
following documents are evidence that the required
relationship exists and that you may be eligible to file an
initial application:
A. A copy, front and back, of the document issued by
USCIS to your legalized spouse or parent (for example:
Form I-551, Permanent Resident Card, N-550,
Certificate of Naturalization, etc.).
B. If the legalized alien is your spouse - Submit a copy,
front and back, of a registered marriage certificate. If
you or your spouse were previously married, submit a
copy of a final divorce decree or death certificate.

Form I-817 Instructions (Rev. 07/30/07)Y Page 5

6.

Such evidence may include, but is not limited to:
money order receipts or canceled checks showing your
father's financial support; your father's income tax
returns; your father's medical or insurance records
showing you as a beneficiary; your school records;
your father's work documents showing you as a
beneficiary.

If you are the adopted child of a legalized alien
parent, submit a certified copy of your adoption
decree showing that you were adopted while under
the age of 16 years; a copy of the legal custody
decree if your custody was obtained before
adoption; and a statement showing the dates and
places where you and your adoptive parent(s) have
lived.

NOTE: If you or your parent have had a name change, the
document authorizing the name change must be submitted.

5.

If the alien eligible for adjustment under the LIFE
Act is your stepparent, whether or not you were born
in wedlock, evidence must be provided showing that
you had not yet reached the age of 18 years at the time
of the marriage creating your status as a stepchild.
Submit a copy of your birth certificate showing the
name of your natural parent to whom your stepparent
is married. A copy of the marriage certificate that
created the stepparrent-stepchild relationship and
evidence of termination of any previous marriages of
your natural parent and stepparent must also be
provided.

6.

If you are the adopted child of an alien parent eligible
for adjustment under the LIFE Act, submit a certified
copy of your adoption decree showing that you were
adopted while under the age of 16 years; a copy of the
legal custody decree if your custody was obtained
before adoption; and a statement showing the dates
and places you and your adoptive parent(s) have lived
together.

2. If you are requesting initial Family Unity benefits
under section 1504 of Pub. L. 106-554, LIFE Act, as
amended. Copies of the following documents are
evidence that the required relationship exists and that you
may be eligible to file an initial application:
A. If the alien eligible for adjustment under the LIFE Act
is your spouse, submit a copy, front and back, of a
registered marriage certificate. If you or your spouse
were married previously, submit a copy of a final
divorce decree or death certificate.
B. If the alien eligible for adjustment under the LIFE Act
is your parent, give evidence of a valid parent-child
relationship. This evidence can vary depending on the
circumstances of your relationship:
1.

If your mother is the alien eligible for adjustment
under the LIFE Act, submit a copy of your birth
certificate showing your mother's name.

2.

If you were born in wedlock and the alien eligible
for adjustment under the LIFE Act is your natural
father, submit a copy of your birth certificate, your
parent's marriage certificate and proof of
termination of any prior marriages.

3.

If you are the legitimated child of an alien eligible
for adjustment under the LIFE Act, submit a copy
of your birth certificate and evidence of your
legitimation. Legitimation may be established by
the marriage certificate of your natural parents or
by documents of legitimation issued by civil
authorities. The ligitimation must have occured
while you were unmarried and prior to your 18th
birthday. You must also submit evidence of any
legal termination of your parent's prior marriages,
if your legitimation resulted from your natural
parents' marriage to each other.

4.

If you were born out of wedlock and the alien
eligible for adjustment under the LIFE Act is your
natural father, submit a copy of your birth
certificate showing your father's name. Evidence
showing that a bona fide relationship exists must
also be submitted.

NOTE: If you or your parent have had a name change,
the document authorizing the name change must be
submitted.
3. Secondary evidence (for applicants of both section 301
of IMMACT 90 and section 1504 of Public Law
106-554, the LIFE Act, as amended) - Official
documents must be issued by the civil registrar, vital
statistics office or other civil authority. If such documents
are unavailable, you must file your application with
evidence from those authorities establishing that the
primary evidence is unavailable. You must then submit
secondary evidence to establish the facts in question.
Submit as many types of secondary evidence as possible to
verify the claimed relationship. Any evidence submitted
must contain enough information (dates, names, etc.) to
establish the event you are trying to prove. Listed below
are examples of secondary evidence:
A. Baptismal certificate. A certificate under the seal of
the church or other religious entity where the baptism
or similar rite took place. The certificate must have
been issued within two months of the birth, show the
date and place of the birth, date of the baptism, and
names of the child's parents.

Form I-817 Instructions (Rev. 07/30/07)Y Page 6

B. School record. A letter from the school official
charged with recording attendance. The letter must
show the date of admission, the child's date of birth or
age at the time of admission, and the place of birth of
the parents, if shown in the record.

E. Rent receipts, utility bills or letters from companies
showing the dates when you received service.
F. School records (letters, report cards, etc.) from schools
you or your children have attended in the United States
that show the name of the school and periods of
attendance.

C. Census record. State or federal census record showing
the name(s) and place(s) of birth, and date(s)
of birth or age(s) of the person(s) listed.
As noted above, if all forms of primary and secondary
evidence are unavailable, you must file your application
with evidence from those authorities stating that such
evidence is not available. In such case, you may submit at
least two affidavits sworn to or affirmed by persons who
are not parties to the application who have direct personal
knowledge of the events or circumstances. The persons
making the affidavits do not have to be U.S. citizens.
Each affidavit must contain the full name, address, date
and place of birth, and signature of the person attesting to
the event(s). The affidavit must also explain the person's
relationship to you, full information concerning the
event(s); and complete details of how the person acquired
the information.
4. Evidence of continuous residence requirements for
Family Unity applicants under section 301 of
IMMACT 90 You must submit at least three documents that prove
residence in the United States since May 5, 1988 or
December 1, 1988. Such evidence may include but is not
limited to:
A.

Employment records, pay stubs, W-2 Forms, federal
and/or state tax returns, letter(s) from employers or, if
you are self-employed, letters from banks and other
firms with whom you have done business. Your name
and the name of the employer or other interested
organization must appear on the form or letter.

B. Employment letters must be in affidavit form and must
be signed by the employer under penalty of perjury.
The letters must include dates of employment, your
home address at the time of employment, and your
duties with the company.
C. Hospital or medical records showing treatment or
hospitalization of you or your children in the United
States. The records must show the name of the medical
facility or physician and the date(s) of the treatment or
hospitalization.

G. Any other relevant documents such as money order
receipts, passport entries, insurance documents, birth
certificates of children born in the United States,
correspondence between you and another person or
organization, automobile license receipts, deeds,
mortgages, contracts to which you have been a party,
insurance policies, etc.
5.

Evidence requirements for Family Unity applicants
under section 1504 of Public Law 106-554, the LIFE
Act, as amended - You must submit documents that
prove entry into the United States before December 1,
1998and residence on that date. Such evidence may
include but is not limited to:
A. At least three documents that prove entry into the
United States before December 1, 1988. Examples: a
photocopy of your Form I-94, Arrival Departure
Record; Form I-862, Notice to Appear; Form I-122,
Notice to Applicant for Admission Detained for
Hearing Before an Immigration Judge; Form I-221,
Order to Show Cause; photocopies of other DHS
(including USCIS) documents, including any
application or petition for benefits under the Act filed
by or on your behalf on or prior to December 1, 1988,
or a fee receipt issued for such application or petition.
B. Other government documentation issued by a Federal,
State, or local authority, provided such documentation
bears the signature, seal, or other authenticating
authority, was dated at the time of issuance, and bears
the date of issuance not later than November 30, 1988,
when proving entry. Examples: a State driver's
license; a State identification card issued in lieu of a
driver's license; a county or municipal hospital record;
a public college or public school transcript; income tax
records; property tax payment; private or religious
school transcripts, the school having been registered
with, or approved or licensed by appropriate State or
local authorities, or having been accredited by the
State or regional accrediting body, or by the
appropriate private school association.

D. Attestations by an official of a church, union or other
organization indicating your residence, dates of
membership, and attendance. The statement must
include the organization's seal and be on official
letterhead stationary, if available.
Form I-817 Instructions (Rev. 07/30/07)Y Page 7

C. Non-governmental documents that include actual
dates. Examples: employment records; pay stubs;
employer letters; or if self-employed, letters from
banks and other firms with whom you have done
business (your name and the name of the employer or
interested organization must appear on the form or
letter and must be in affidavit form, signed by the
employer, under penalty of perjury, and must include
dates of employment, home address at the time of
employment, and duties with the company); hospital
or medical records showing hospitalization or
treatment showing the name of the medical facility or
physician and dates of the treatment; attestation by a
church official, union or other organization indicating
your residence, dates of membership and attendance,
including the organization's seal and letterhead.
D. Other relevant documents, including but not limited to:
rent receipts, credit card statements, utility bills,
money orders, passport entries, insurance documents,
birth certificate of child born in the United States,
automobile license receipts, deeds, mortgages and
contracts to which you have been a party.
6.

Request for extension of Family Unity benefits.
Copies of the following documents are evidence that the
required relationship exists and that you may be eligible
to file an application for extension of Family Unity
benefits:
A. A copy, front and back, of the document issued by
USCIS to your legalized spouse or parent (for
example: Form I-551, Permanent Resident Card,
N-550, Certificate of Naturalization, etc.).
B. If the legalized alien through whom Family Unity
benefits were obtained is a lawful permanent resident
or naturalized U.S. citizen, evidence that a Form I-130,
Petition for Alien Relative, has been filed on your
behalf.

Address Changes.
If you change your address and you have an application or
petition pending with USCIS, you may change your address
on-line at www.uscis.gov, click on "Change your address
with USCIS" and follow the prompts or by completing and
mailing Form AR-11, Alien's Change of Address Card, to:
U.S. Citizenship and Immigration Services
Change of Address
P.O. Box 7134
London, KY 40742-7134
For commercial overnight or fast freight services only, mail
to:
U.S. Citizenship and Immigration Services
Change of Address
1084-I South Laurel Road
London, KY 40744

Processing Information.
Any Form I-817 that is not signed or accompanied by the
correct fee, will be rejected with a notice that the Form
I-817 is deficient. You may correct the deficiency and
resubmit the Form I-817. An application or petition is not
considered properly filed until accepted by USCIS.

Initial processing. Once a Form I-817 has been accepted, it

will be checked for completness, including submission of the
required initial evidence. If you do not completely fill out the
form, or file it without required initial evidence, you will not
establish a basis for eligibility and we may deny your Form
I-817.

Requests for more information or interview. We may

C. Evidence that you have been granted Family Unity
benefits in the past.

request more information or evidence, or we may request that
you appear at a USCIS office for an interview. We may also
request that you submit the originals of any copy. We will
return these originals when they are no longer required.

D. A list of all trips you have made outside the United
States since you were last granted Family Unity
benefits. This statement must include the dates and
reason for each absence. If you have not been outside
the United States since your last Form I-817 was
approved, provide a statement affirming this fact.

Service Processing Information. Our goal at USCIS is to
process all applications fairly. The processing time will vary,
depending on the specific circumstances of each case. We
may reject an incomplete application. We may deny your
application if you do not give us the requested information or
do not go to a scheduled interview.

E. A list of all your residences in the United States since
your last Form I-817 was approved.

Decision. The decision on a Form I-817 involves a
determination of whether you have established eligiblity for
the requested benefit. You will be notified of the decision in
writing.

F. Fingerprints, if you were under the age of 14 years
when your last Form I-817 was approved, but are now
14 years of age or older, or if USCIS requests them, as
part of the biometric services.

Form I-817 Instructions (Rev. 07/30/07)Y Page 8

USCIS Forms and Information.
To order USCIS forms, call our toll-free number at
1-800-870-3676. You can also get USCIS forms and
information on immigration laws, regulations and procedures
by telephoning our National Customer Service Center at
1-800-375-5283 or visiting our internet website at www.uscis.
gov.
As an altenative to waiting in line for assistance at your local
USCIS office, you can now schedule an appointment through
our internet-based system, InfoPass. To access the system,
visit our website. Use the InfoPass appointment scheduler and
follow the screen prompts to set up your appointment.
InfoPass generates an electronic appointment notice that
appears on the screen.

Privacy Act Notice.
We ask for the information on this form, and associated
evidence, to determine if you have established eligibility for
the immigration benefit for which you are filing. Our legal
right to ask for this information can be found in the
Immigration and Nationality Act, as amended. We may
provide this information to other government agencies.
Failure to provide this information, and any requested
evidence, may delay a final decision or result in denial of
your Form I-817.

Paperwork Reduction Act.
An agency may not conduct or sponsor an information
collection and a person is not required to respond to a
collection of information unless it displays a currently valid
OMB control number. The public reporting burden for this
collection of information is estimated at 2 hours per response,
including the time for reviewing instructions, completing and
submitting the form. Send comments regarding this burden
estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: U.S.
Citizenship and Immigration Services, Regulatory
Management Division, 111 Massachusetts Avenue, N.W., 3rd
Floor, Suite 3008, Washington, DC 20529. OMB No.
1615-0005. Do not mail your application to this address.

Application Check List
Did you completely fill out and sign the form?
Did you attach all required evidence?
Did you attach three color photos?
Did you attach a check or money order for the
appropriate fee for the Form I-817, plus the
appropriate fee if you are required to obtain
fingerprints or other biometric services?
For your records you should keep copies of your
application and supporting documents.

Form I-817 (Rev. 07/30/07) Y Page 9