TOC Form I-765

FORM I-765.DACA.TOC.8-7-12.doc

Application for Employment Authorization

TOC Form I-765

OMB: 1615-0040

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TOC for Form I-765

Application for Employment Authorization

OMB RIN: 1615-0040

8/7/2012


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Current Language

Proposed Language

Do not write in this block.

Failed to establish economic necessity as required in 8 CFR 274a.12(c)(14), (18) and 8 CFR 214.2(f)

Failed to establish economic necessity under 8 CFR 274a.12(c)(14), (18) and 8 CFR 214.2(f)

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Question 16

16. Go to Part 2 of the Instructions, Eligibility Categories. In the space below, place the letter and number of the category you selected from the instructions. (For example, (a)(8), (c)(17)(iii), etc.)


Eligibility under 8 CFR 274a.12 ( ) ( ) ( )


16. Go to the “Who May File Form I-765?” section of the instructions. In the space below, place the letter and number of the eligibility category you selected from the instructions. (For example, (a)(8), (c)(17)(iii), etc.).

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Question 17.

17. If you entered the Eligibility Category, (c)(3)(C), in item 16 above, list your degree, your employer's name as listed in E-Verify, and your employer's E- Verify Company Identification Number or a valid E-Verify Client Company Identification Number in the space below.


17. If you entered the eligibility category, (c)(3)(C), in Question 16 above, list your degree, your employer's name as listed in E-Verify, and your employer's E- Verify Company Identification Number or a valid E-Verify Client Company Identification Number in the space below.


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Certification

Your Certification: I certify, under penalty of perjury under the laws of the United States of America, that the foregoing is true and correct. Furthermore, I authorize the release of any information that U.S. Citizenship and Immigration Services needs to determine eligibility for the benefit I am seeking. I have read the Instructions in Part 2 and have identified the appropriate eligibility category in Block 16

Your Certification: I certify, under penalty of perjury under the laws of the United States of America, that the foregoing is true and correct. Furthermore, I authorize the release of any information that U.S. Citizenship and Immigration Services needs to determine eligibility for the benefit I am seeking. I have read the Instructions in Part 2Who May File Form I-765?” section of the instructions and have identified the appropriate eligibility category in Question 16

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File Typeapplication/msword
File TitleI-765 TOC for Section 106
AuthorL'Antoinella Spiller-Reddick
Last Modified ByMiranda-Valido, Liana M
File Modified2012-08-07
File Created2012-08-07

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