Application for Benefits Under the Family Unity Program

OMB No. 1615-0005: Expires 10/31/08

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. 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.

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.

2. 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.

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.

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.

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.

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.

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."

Form I-817 Instructions (Rev. 05/27/08) Y

2. Under LIFE Act Amendments.

4.

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.
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.
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.

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.

5. I am the spouse of a legalized alien who adjusted
under section 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.

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.
Form I-817 Instructions (Rev. 05/27/08) Y Page 2

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.
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.

Step 2. Fill Out the Form I-817.
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."
This form is divided into Parts 1 through 8. The following
information should help you fill out the form.

Part 1. Information about you.
1. 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.
2. 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.

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.

Part 4. Information about the legalized alien or an
applicant qualifying for Legalization under
the LIFE Act.
The information requested is about the legalized alien
through whom you are claiming eligibility or an applicant
qualifying for Legalization under the LIFE Act.

Part 5. Complete only if the legalized alien is your
spouse or if your spouse is eligible for
adjustment under the LIFE Act.
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.
Form I-817 Instructions (Rev. 05/27/08) Y Page 3

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.

Where To File?
Step 3. Submit Your Application.
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:
For U.S. Postal Service (USPS) deliveries, use the following
P.O. Box number:
USCIS
P.O. Box 805887
Chicago, IL 60680-4120
For courier/special delivery service, use the following
address:
USCIS
Attn: FBAS
131 South Dearborn - 3rd Floor
Chicago, IL 60603-5517
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.
An additional biometric fee of $80 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.
If you are under the age of 14, no biometics fee is required.
You may submit one check or money order for both the
application and biometric fees, for a total of $520.00.
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

Form I-817 Instructions (Rev. 05/27/08) Y Page 4

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.

Biometrics Requirement.
When required, fingerprints must be taken at a 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 biometrics
service, USCIS may also take your signature and photograph.

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: Because of the current USCIS scanning process, if
a digital photo is submitted, it needs to be produced from
a high resolution camera, which has at least a 3.5 mega
pixel.
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. 05/27/08) Y Page 5

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.

6. 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.
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 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 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.
Form I-817 Instructions (Rev. 05/27/08) Y Page 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.
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 stepparentstepchild 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.
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.

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.
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.
Form I-817 Instructions (Rev. 05/27/08) Y Page 7

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.
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.
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, 1998 and
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):

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.
C. Evidence that you have been granted Family Unity
benefits in the past.
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.
E. A list of all your residences in the United States since
your last Form I-817 was approved.
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. 05/27/08) Y Page 8

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 you may complete and
mail a 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 completeness, 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
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.
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.
Decision. The decision on a Form I-817 involves a

determination of whether you have established eligibility for
the requested benefit. You will be notified of the decision in
writing.

USCIS Forms and Information.
To order USCIS forms, call our toll-free number at 1-800870-3676. 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 alternative 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 and 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 completely fill out and sign the form?
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 Instructions (Rev. 05/27/08) Y Page 9