Application for Temporary Protected Status

DRAFT
OMB No. 1615-0043; Exp. 10/31/10

I-821, Application for
Temporary Protected Status

Department of Homeland Security
U.S. Citizenship and Immigration Services

Instructions
NOTE: This revision of Form I-821 updates instructions required for TPS registration and re-registration at
questions 2, 7, 8, 9, 10, 11, 12, 13 and 16 on Pages 2 and 3. Information on fees and fee waiver requests has also been
updated in these instructions.
Please read these instructions carefully to properly complete this form. If you need more space to answer a question,
use a separate sheet(s) of paper. Write your name and Alien Registration Number (A#) at the top of each sheet
and indicate the number of the item to which the answer refers. An incomplete application may be returned to you, causing
a delay in the processing of your application.

1. Who May File for TPS?

A. Passport;

You must be an eligible national of a foreign state (or parts
thereof) or an alien having no nationality who last
habitually resided in a foreign state that has been
designated for Temporary Protected Status (TPS) by the
Secretary of the Department of Homeland Security
pursuant to section 244A of the Immigration and
Nationality Act. You should check with the nearest office
of USCIS for designations currently in force or visit our
website at www.uscis.gov.

B. I-94 Arrival/Departure Record; or

2. What Documents Should You Submit?
You do not need to provide original documents with
this application.
You must give USCIS copies of documents to prove you
are a national of the country designated for TPS, your
date of entry into the United States, and your U.S. residence.
In addition:
A. In certain circumstances, USCIS may ask you to
submit original documents.
B. Copies of documents in a foreign language must be
accompanied by an English translation. The translator
must certify that the translation is accurate and that he or
she is competent to translate the foreign language into
English.
C. Documentation exception: If you are filing this
application for re-registration, or renewal of temporary
treatment benefits (Parts 1 and 2 on Form I-821), you do
not have to submit any copies of documentation. You may,
however, be asked for additional information and/or
documentation in certain circumstances.

3. What Documents Do You Need
to Prove Identity and Nationality?
Submit any of the following:
A. Passport;
B. Birth certificate accompanied by photo identification; or
C. Any national identity document from your country of
origin bearing your photo and/or fingerprint.

4. What Documents Do You Need to Prove
Date of Entry Into the United States?
Submit any of the following documents:

C. Copies of documents specified in item Number 5 below.

5. What Documents Do You Need to Prove
Residence in the United States?
Submit any relevant documents such as:
A. Employment records (e.g., pay stubs, W-2 Forms,
certification of the filing of Federal income tax
returns, State verification of the filing of state income tax
returns, letters from employer(s), or, if you are
self employed, letters from banks and other firms
with whom you have done business.
NOTE: In all of these documents, your name and the
name of the employer or other interested organization must
appear on the form or letter, as well as relevant dates.
Letters from employers must be in affidavit
form and shall be signed and attested to by the
employer under penalty of perjury.
Such letters must include: (1) your address(es) at the time
of employment; (2) exact period(s) of
employment; (3) period(s) of layoff; (4) duties with the
company. If the employment records are unavailable,
submit an affidavit form letter explaining why these
records cannot be obtained. This affidavit form letter shall
be signed and attested to by the employer under penalty of
perjury.
B. Rent receipts, utility bills (gas, electric, phone, etc.),
receipts, or letters from companies showing the dates
during which you received service.
C. School records (letters, report cards, etc.) from the schools
that you or your children have attended in
the United States, showing the name(s) of the
schools and periods of school attendance.
D. Hospital or medical records concerning treatment or
hospitalization of you or your children, showing the name
of the medical facility or physician and the
date(s) of the treatment or hospitalization.
E. Attestations by churches, unions, or other organizations to
your residence identifying you by name. The
attestation must be signed by an official (whose title is
shown); show inclusive dates of membership; state the
Form I-821 Instructions (Rev. 08/20/10) Y

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address where you resided during membership
period(s); include the seal of the organization impressed on
the letter or the letterhead of the organization, if the
organization has letterhead stationery; establish how the
author knows you; and establish the origin of the
information being attested to.
F. Additional documents may include money order
receipts for money sent in or out of the country;
passport entries; birth certificates of children born in
the United States; dated bank transactions; correspondence
between you and another person or organization; U.S.
Social Security card; Selective Service card; automobile
license receipts, title, vehicle registration, etc.; deeds,
mortgages, contracts to which you have been a party; tax
receipts; insurance policies; receipts; letters; or
G. Any other relevant document.

6. What If Documents Are Not Available?
If documents are not available, you may give USCIS an
affidavit showing proof of unsuccessful efforts to obtain
the documents, explaining why the consular process is
unavailable (for identity documents), and affirming that
you are a national of the designated state. (USCIS may
require a statement from the appropriate issuing authority,
certifying that the document is not available.) Affidavits
may also be used to help prove your date of entry into the
United States and residence in the United States.

7. Will TPS Applicants Need to Provide
Fingerprints and Photographs?

.

.
.
.

Yes, except as noted below, all applicants for initial
registration, re-registration, or renewal of temporary
treatment benefits must provide fingerprints,
photographs, and signatures, which are biometrics.
Applicants must submit the $85 biometrics services fee
or a fee waiver request. Please see No. 12 for
information about fee waiver requests.
TPS applicants under 14 years of age who are not filing
for an EAD are exempt from biometrics collection and
the associated biometrics fee.
USCIS may, in its discretion, waive the collection
of certain biometrics.
TPS applicants will be sent a notice scheduling them
to appear at an Application Support Center (ASC) for
biometrics collection. Failure to comply with this
notice may result in the denial of the TPS application.

8. How Should You Prepare This Form?

Type or print legibly in black ink.
A.
If you need extra space to complete any item,
B. attach a continuation sheet. Write your name and Alien
Registration Number (A#), if any, at the top of each sheet,
indicated the item number to which the answer refers, and
date and sign each sheet.
Answer all questions fully and accurately. If any item does
C. not apply, please write "N/A."

9. Where Should You File This Form?
For filing instructions, refer to the most recently
published Federal Register notice specific to the
designation under which you are applying. You may
also check the USCIS Internet site at: www.uscis.gov or
contact the USCIS National Customer Service Center a
1-800-375-5283.

10. What Is the Fee?
A. An initial (i.e., first-time) applicant must submit:
1. A $50 application fee for Form I-821; and
2. A $85 fee for biometric services, including
fingerprints, photograph, and signature, if required.
(See No. 7, Will TPS Applicants Need to Provide
Fingerprints and Photographs?); and
3. A $380 fee for Form I-765, Application for
Employment Authorization, if you are between the
ages of 14 and 65 (inclusive) and seeking employment.
B. An applicant for TPS re-registration or renewal of
temporary treatment benefits must submit:
1. A $85 fee for biometric services, including
fingerprints, photograph, and signature, if required.
(See No. 7, Will TPS Applicants Need to Provide
Fingerprints and Photographs?); and
2. A $380 fee for Form I-765, Application for
Employment Authorization, if you wish to apply for
employment authorization, regardless of age.
C. The fee must be submitted in the exact amount. It
cannot be refunded. Do Not Mail Cash. All checks
and money orders must be drawn on a bank or other
institution located in the United States and must be
payable in United States currency. Please assure that if a
check or money order is drawn on the account of a
person other than yourself, your name appears in the
lower left corner on the face of the check or money
order. If the check is not honored, USCIS will charge you
$30.
Make the check or money order payable to the
Department of Homeland Security, except:
1. If you live in Guam and are filing your application
there, make the check or money order payable to
''Treasurer, Guam'': or;
2. If you live in the U.S. Virgin Islands and you are filing
your application there, make the check or money order
payable to "Commissioner of Finance of the Virgin
Islands."
NOTE: When preparing a check or money order, spell out
Department of Homeland Security. Do not use the initials
"USDHS" or "DHS."
How to Check If the Fees Are Correct
The fees on this form are 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:
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Visit our Web site at www.uscis.gov, link to
"FORMS," and scroll down to check the appropriate
fees by form; or
Review the Fee Schedule included in your form
package, if you called us to request the form; or
Telephone our National Customer Service Center at
1-800-375-5283 and ask for the fee information.
NOTE: If your petition or application requires a biometric
services fee for USCIS to take your fingerprints, photograph
or signature, you can use the same procedure above to confirm
the biometrics fee.

11. Are You Also Required to File Form I-765,
Application for Employment Authorization?
Yes. Each applicant, regardless of age, must also submit a
completed Form I-765, even if employment authorization
is not being requested. As noted in No. 10, What is the
Fee?, only those applicants requesting employment
authorization must pay the fee for Form I-765.
NOTE: An Employment Authorization Document is not a
travel document. If your application for TPS is granted and
you must travel outside the United States and return, you
must request advanced parole from USCIS by filing a
Form I-131, Application for Travel Document, with the
appropriate USCIS office. A Form I-512 travel document
will be issued to you if your request is granted.

12. May the Filing and Biometrics Fees for
Forms I-821 and I-765 Be Waived?
Yes. If you are unable to pay the filing and biometrics fees,
8 CFR 103.7(c) states that you may apply for a waiver of
fees. To request a fee waiver, a person requesting an
immigration benefit must submit a written request for
permission to have their request processed without
payment of a fee with their benefit request. The request
must state the person's belief that he or she is entitled to or
deserving of the benefit requested, the reasons for his or
her inability to pay, and evidence to support the reasons
indicated. There is no appeal of the denial of a fee waiver
request.

13. What If I Change My Address?
If you change your address after filing for TPS, you
must complete and mail us a Form AR-11, Alien's
Change of Address Card. Mail the completed form to the
address specified on the form. You are also advised to mail
a copy of your completed AR-11 together with copies of
your application and any related USCIS documents or
correspondence to the USCIS office having jurisdiction
over your application for TPS. Retain a copy of your Form
AR-11 for your records. You can also file your AR-11
online. To do so, visit our Web site at
www.uscis.gov and click "Online Change of Address" in
Related Links.

NOTE: If you informed your U.S. Post Office but
not USCIS about your address change, please be
advised that notifying the U.S. Post Office of a change
of address does not fullfill your obligation to file Form
AR-11. The U.S. Post Office will not forward certain
USCIS correspondence.

14. What Is Our Authority for
Collecting This Information?
We request the information on the form to carry out the
immigration laws contained in Title 8, United States Code,
Section 1154(a). We need this information to determine
whether you are eligible for immigration benefits.
The information you provide may also be disclosed to
other Federal, State, local, and foreign law enforcement
and regulatory agencies. You do not have to give this
information. However, if you do not give some or all of the
requested information, your application may be denied.

15. Do You Need USCIS Forms or Information?
To order USCIS forms, call our toll-free forms line at
1-800-870-3676. You can also get USCIS forms and
information on immigration laws, regulations, or
procedures by calling our National Customer Service
Center at 1-800-375-5283 or visiting our Internet Web site
at www.uscis.gov.

16. Reporting Burden
Under the Paperwork Reduction Act, an agency may
not conduct or sponsor an information collection, and a
person is not required to respond to an information
collection unless it displays a currently valid OMB control
number.
We try to create forms and instructions that are accurate,
can easily be understood, and impose the least possible
burden on you to provide us with information. Often this
is difficult because some immigration laws are very
complex.
The estimated average time to complete this application is
1 hour and 30 minutes computed as follows: 1) learning
about the form and understanding the instructions, 30
minutes; 2) collecting the necessary supporting documents,
15 minutes; 3) completing the form, 15 minutes; and 4)
traveling to and waiting at a preparer's office (e.g., attorney
or voluntary agency), 30 minutes.
If you have comments regarding the accuracy of this
estimate, or suggestions for making this form simpler,
you can write to the U.S. Citizenship and Immigration
Services, Regulatory Products Division 111 Massachusetts
Avenue N.W., 3rd Floor, Suite 3008,Washington, DC
20529-2210; OMB No. 1615-0043. Do not mail your
completed application to this address.

Form I-821 Instructions (Rev. 08/20/10) Y Page 3