Instructions I-821 Table of Changes

TABLE OF CHANGES – INSTRUCTIONS

Form I-821, Application for Temporary Protected Status

OMB Number: 1615-0043

02/23/2017

Reason for Revision: IC collection, and addition of online filing language.

Current Page Number and Section	Current Text	Proposed Text
Page 1, What Is the Purpose of This Form?	[page 1] What Is the Purpose of This Form? The purpose of this form is to apply for Temporary Protected Status (TPS). Do NOT use Form I-821 to request Deferred Action for Childhood Arrivals (DACA). Form I-821 is only for TPS purposes. Form I-821D must be used to request Deferred Action for Childhood Arrivals.	[Page 1] What Is the Purpose of Form I-821? If you are an eligible national of certain countries that the Secretary of Homeland Security (Secretary) has designated for Temporary Protected Status (TPS) or a person without nationality who last habitually resided in the designated country, then you may apply for TPS by filing Form I-821, Application for Temporary Protected Status. This form is also used if you have TPS and are filing for TPS re-registration. Do NOT use Form I-821 to request Consideration Of Deferred Action for Childhood Arrivals (DACA). Form I-821D must be used to request DACA. Form I-821 is only used to apply for Temporary Protected Status (TPS).
Page 1, When Should I Use Form I-821?	[page 1] When Should I Use Form I-821? Use Form I-821 when registering or re-registering for TPS.	[Page 1] When Should I Use Form I-821? Use Form I-821 when registering initially or re-registering for TPS.
		[Page 1] Do I Have to Request Employment Authorization with My Form I-821? If you want to request an Employment Authorization Document (EAD), you must file Form I-765, Application for Employment Authorization, with your Form I-821. You may wait to file a Form I-765 until after USCIS decides your TPS application. However, please note that if you wait to request an EAD until after USCIS grants TPS or approves re-registration, you will not receive your EAD (assuming you are eligible) until several weeks after you file the Form I-765.
Page 1, Who May File Form I-821?	[page 1] Who May File Form I-821? You must be an eligible national of a foreign state (or an alien having no nationality who last habitually resided in a foreign state) that was designated for TPS by the Secretary of Homeland Security pursuant to section 244 of the Immigration and Nationality Act (INA). You should check with the nearest USCIS office for designations currently in force or visit the USCIS Web site at www.uscis.gov/tps.	[Page 1] Who May File Form I-821? You must be an eligible national of a foreign state (or a person having no nationality who last habitually resided in a foreign state) that the Secretary has designated for TPS under section 244(b) of the Immigration and Nationality Act (INA). You should check with the nearest U.S. Citizenship and Immigration Services (USCIS) office for countries currently designated for TPS and for information pertaining to re-registration periods, or visit the USCIS website at www.uscis.gov/tps.
		[Page 1] Who Is Eligible For TPS? To be eligible for TPS, you must be admissible to the United States as an immigrant under the applicable grounds in INA section 212(a), with certain exceptions. USCIS may grant discretionary waivers for some, but not all of the applicable inadmissibility grounds (See the What Waivers are Available For TPS section of these Instructions.)
		[Page 2] What Waivers are Available For TPS? USCIS may grant discretionary waivers of certain inadmissibility grounds for humanitarian purposes, to assure family unity, or because it is otherwise in the public interest. However, USCIS cannot waive some inadmissibility grounds, by law, including certain criminal grounds in INA sections 212(a)(2)(A-C) and national security, terrorism-related, and persecution grounds in INA sections 212(a)(3)(A-C, E). If you are inadmissible on grounds that can be waived, you may be able to obtain a discretionary waiver. For further information on waivers, including how to apply and the fee for seeking a waiver, see the TPS page on the USCIS website at www.uscis.gov/tps. You may also wish to obtain legal advice if you believe you may be subject to any ground of inadmissibility or another TPS ineligibility ground. If you are re-registering for TPS and you were already granted a waiver of a ground of inadmissibility in conjunction with your prior TPS application, you do not need to seek another waiver for the same action, incident, or circumstance. For example, if on a prior TPS application, USCIS previously granted you a waiver of the health ground of inadmissibility because you had tuberculosis that was treated, you do not need to apply for another waiver for that same health incident. However, you will need to file for a waiver if you have contracted another communicable disease for which a waiver is necessary.
		[Page 2] Does My Spouse, Child, or Parent Have to File a Form I-821? Each person seeking TPS must apply for him or herself on a separate Form I-821. There is no derivative TPS status, meaning that your spouse, children or parents cannot obtain TPS as a result of your approval for TPS. They must each qualify for TPS individually. However, USCIS may accept late initial TPS applications from certain individuals who had a qualifying relationship to a spouse or child during the initial registration period for the TPS-designated country and that relative is also currently eligible for TPS. Even where such a relationship exists, the applicant must still meet all other TPS eligibility requirements before USCIS may grant TPS. Please see the TPS page on the USCIS website at www.uscis.gov/tps or the latest Federal Register Notice regarding the TPS designation for your country for further information on late initial filing.
Pages 1-2, General Instructions	[page 1] General Instructions If you are completing this form on a computer, the data you enter will be captured using 2D barcode technology. This capture will ensure that the data you provide is accurately entered into USCIS systems. As you complete each field, the 2D barcode line at the bottom of each page will shift as data is captured. Upon receipt of your form, USCIS will use decoding equipment to extract the data from the form. Do not damage the 2D barcode (e.g., puncture, staple, spill on, write on, etc.) as this could affect the ability of USCIS to timely process your form. USCIS provides forms free of charge through the USCIS Web site. In order to view, print, or fill out our forms, you should use the latest version of Adobe Reader, which is downloadable for free at http://get.adobe.com/reader/. You must properly sign and file each application. A photocopy of a signed application or typewritten name in place of a signature is not acceptable. If you are under 14 years of age, your parent or legal guardian may sign the application on your behalf. An application is not considered properly filed until accepted by USCIS. Evidence. You must submit all required initial evidence and supporting documentation with your application at the time of filing. Also refer to the most recently published Federal Register notice specific to the country designation under which you are applying. Biometrics Services Appointment. After USCIS receives your application and ensures it is complete, we will inform you in writing if you need to attend a biometrics services appointment. If an appointment is necessary, the written notice will provide you with the location of the local USCIS Application Support Center (ASC) and the date and time of your appointment. If you fail to attend your biometrics services appointment, USCIS may deny your application. Copies. You may submit a legible photocopy of documents requested, unless the instructions specifically state that you must submit an original document. Original documents submitted when not required may remain a part of the record and USCIS will not automatically return them to you. [page 2] Translations. Any document you submit to USCIS with information in a foreign language must be accompanied by a full English translation. The translator must certify that the English language translation is complete and accurate, and that he or she is competent to translate from the foreign language into English. How to Fill Out Form I-821 1. Type or print legibly in black ink. 2. If you need extra space to complete any item, attach a separate sheet of paper. Write your name and Alien Registration Number (A-Number) (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers (e.g., Part 4., Item Number 5.a.); and date and sign each sheet. 3. Answer all questions fully and accurately. If an item is not applicable or the answer is "none," leave the space blank or type or print "N/A" in the appropriate space. However, you must respond to the following questions: A. Part 1.; B. Part 2., Item Numbers 1.a., 1.b., 2.b. - 2.g., 7., 10., and 11.; C. Part 4., all questions; and D. Parts 5., 6., and 7.	[Page 2] General Instructions [deleted] USCIS provides forms free of charge through the USCIS website. In order to view, print, or fill out our forms, you should use the latest version of Adobe Reader, which you can download for free at http://get.adobe.com/reader/. If you do not have Internet access, you may call the USCIS National Customer Service Center at 1-800-375-5283 and ask that we mail a form to you. For TTY (deaf or hard of hearing) call: 1-800-767-1833. Signature. Each application must be properly signed and filed. For all signatures on this application, USCIS will not accept a stamped or typewritten name in place of a signature. If you are under 14 years of age, your parent or legal guardian may sign the application on your behalf. A legal guardian may also sign for a mentally incompetent person. Filing Fee. Each application must be accompanied by the appropriate filing fee and biometric services fee (if applicable). (See the What Is the Filing Fee section of these Instructions.) Evidence. At the time of filing, you must submit all evidence and supporting documentation listed in the Specific Instructions and/or What Evidence Must You Submit sections of these Instructions. You should also refer to the most recently published country-specific Federal Register notice that announces the procedures for TPS registration or re-registration. [Page 3] Biometric Services Appointment. USCIS may require that you appear for an interview or provide fingerprints, photograph, and/or signature at any time to verify your identity, obtain additional information, and conduct background and security checks, including a check of criminal history records maintained by the Federal Bureau of Investigation (FBI), before making a decision on your application, petition, or request. After USCIS receives your application and ensures it is complete, we will inform you in writing or by email notice if you e-file your application, if you need to attend a biometric services appointment. If an appointment is necessary, the notice will provide you the location of your local or designated USCIS Application Support Center (ASC) and the date and time of your appointment or, if you are currently overseas, instruct you to contact a U.S. Embassy, U.S. Consulate, or USCIS office outside the United States to set up an appointment. If you are required to provide biometrics, at your appointment you must sign an oath reaffirming that: 1. You provided or authorized all information in the application; 2. You reviewed and understood all of the information contained in, and submitted with, your application; and 3. All of this information was complete, true, and correct at the time of filing. If you fail to attend your biometric services appointment, USCIS may deny your application. Copies. You should submit legible photocopies of documents requested, unless the Instructions specifically state that you must submit an original document. USCIS may request an original document at the time of filing or at any time during processing of an application, petition, or request. If USCIS requests an original document from you, it will be returned to you after USCIS determines it no longer needs your original. NOTE: If you submit original documents when not required or requested by USCIS, your original documents may be immediately destroyed upon receipt. Translations. If you submit a document with information in a foreign language, you must also submit a full and complete English translation. The translator must certify that the English language translation is complete and accurate, and that he or she is competent to translate from the foreign language into English. The certification should also include the date, the translator’s signature and printed name, and may contain the translator’s contact information. How to Fill Out Form I-821 1. Type or print legibly in black ink. 2. If you need extra space to complete any item within this application, use the space provided in Part 11. Additional Information or attach a separate sheet of paper; type or print your name and Alien Registration Number (A-Number) (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet. 3. Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been married and the question asks “Provide the name of your current spouse”), type or print “N/A,” unless otherwise directed.  If your answer to a question which requires a numeric response is zero or none (for example, “How many children do you have?” or “How many times have you departed the United States?”), type or print “None,” unless otherwise directed. 4. The following Parts and Item Numbers cannot be left blank and must have a response. Failure to provide a response may delay processing of your case or result in denial. A. Part 1. Type of Application; B. Part 2. Information About You, Item Numbers 1.a., 1.b., 2.a. - 2.c., 3.a. - 4.f., 9., and 12. - 16.; C. Part 3. Biographic Information; D. Part 7. Eligibility Standards - All questions must be answered; E. Part 8. Applicant’s Statement, Contact Information, Certification, and Signature; [Page 3] F. Part 9. Interpreter’s Contact Information, Certification, and Signature (if you used an interpreter); and G. Part 10. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other than the Applicant (if you used a preparer and/or have a legal representative).
	[page 2] Specific Instructions 1. USCIS ELIS Account Number (if any). If you, your spouse, or children previously filed a benefit request using USCIS ELIS, provide the USCIS ELIS Account Numbers you, your spouse, or children were issued by the system. Your USCIS ELIS Account Number is not the same as your A-Number. If you, your spouse, or children were issued USCIS ELIS Account Numbers, enter them in the spaces provided. 3. Form I-94 Arrival-Departure Record. Complete Item Numbers 25.a. - 25.f. in Part 2. Information About You of the form regarding the admission or travel document. If U.S. Customs and Border Protection (CBP) or USCIS issued you a Form I-94, Arrival-Departure Record, provide your I-94 admission number and date that your authorized period of stay expires or expired (as shown on the Form I-94). The I-94 admission number also is known as the Departure Number on some versions of Form I-94. [page 3] NOTE: If you were admitted to the United States by CBP at an airport or seaport after April 30, 2013, you may have been issued an electronic Form I-94 by CBP, instead of a paper Form I-94. You may visit the CBP Web site at www.cbp.gov/i94 to obtain a paper version of an electronic Form I-94. CBP does not charge a fee for this service. Some travelers admitted to the United States at a land border, airport, or seaport, after April 30, 2013 with a passport or travel document, who were issued a paper Form I-94 by CBP, may also be able to obtain a replacement Form I-94 from the CBP Web site without charge. If your Form I-94 cannot be obtained from the CBP Web site, it may be obtained by filing Form I-102, Application for Replacement/Initial Nonimmigrant Arrival-Departure Record, with USCIS. USCIS does charge a fee for this service. Passport and Travel Document Numbers. If you used a passport or travel document to travel to the United States, enter either the passport or travel document information in the appropriate space on the form, even if the passport or travel document is currently expired. Categories and Definitions for Ethnicity and Race A. Hispanic or Latino. A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. (NOTE: This category is only included under Ethnicity in Item Number 16.) B. White. A person having origins in any of the original peoples of Europe, the Middle East, or North Africa. C. Asian. A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. D. Black or African American. A person having origins in any of the black racial groups of Africa. E. American Indian or Alaska Native. A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment. F. Native Hawaiian or Other Pacific Islander. A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. 4. Statement, Certification, Signature, and Contact Information of the Applicant Select the box that indicates if you filled out this form or if someone interpreted it for you. Also select the box that indicates if someone filled out this form for you, if applicable. Every form must contain the original signature of the applicant. A photocopy of a signed application or a typewritten name in place of a signature is not acceptable. Sign and date the form and provide your daytime telephone number, mobile telephone number, and e-mail address. If you are under 14 years of age, your parent or legal guardian may sign the application on your behalf. 5. Contact Information, Certification, and Signature of the Interpreter If you used an interpreter to read the instructions and complete the questions on this form, the interpreter must fill out this section. The interpreter must provide his or her full name, the name of his or her business or organization, an address, a daytime telephone number, and an e-mail address. He or she must also sign and date the form. 6. Contact Information, Declaration, and Signature of the Person Preparing this Application, If Other Than the Applicant This section must contain the original signature of the person who completed this form, if other than the person in Part 2. If the person who completed this form is associated with a business or organization, he or she must provide the business/organization name and address. If the person completing this form is an attorney or accredited representative, he or she must submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative, along with this application. 2. Additional Information. You must provide the biometrics information requested in Part 2., Item Numbers 16. - 21. Providing this information as part of your application may reduce the amount of time you spend at your USCIS ASC appointment.	[Page 3] Specific Instructions This form is divided into eleven parts. Part 1. Type of Application Item Numbers 1.a. - 1.b. Type of Application. Select Item Number 1.a. if this is your first time applying for TPS and you currently do not have TPS. This means you are filing an “initial” TPS application. Please also select Item Number 1.a. if you do not currently have TPS, but you have previously applied. Read the Note on the form regarding additional information you must provide, if available, for any prior TPS applications you submitted. Select Item Number 1.b. only if you currently have TPS and are re-registering. If you select this item, you must also complete Item Number 2. Item Number 2. TPS Granting Authority. Only complete this section if you selected Item Number 1.b. Select USCIS if you received a letter from USCIS granting your previous application for TPS. Select Immigration Judge/Board of Immigration Appeals if you received a written decision from the Immigration Judge or Board of Immigration Appeals granting your previous application for TPS. Item Numbers 3.a. - 3.b. Request For Employment Authorization Document (EAD). Select Item Number 3.a. if you are requesting an Employment Authorization Document (EAD) and are filing the Form I-765 with your I-821, Select Item Number 3.b. if you are not requesting employment authorization at this time, NOTE: You can still apply for an EAD at a later date, after USCIS makes a decision on your application for TPS. Part 2. Information About You Item Numbers 1.a. - 1.c. Your Full Name. Provide your full legal name in the spaces provided. Item Numbers 2.a. - 3.c. Other Names Used (if any). Provide all other names you have used, including but not limited to, maiden names, married names, and nicknames in the space provided. If you need additional space to complete the section, use Part 11. Additional Information. Item Numbers 4.a. - 5. U.S. Mailing Address. Provide the address where you would like to receive written correspondence regarding your application. Item Numbers 6.a. - 6.e. U.S. Physical Address. If your current mailing address is not the same as your physical address, provide your physical street address. You must include a street number and name or a rural route number. Do not provide a post office box (P.O. Box) number here. Item Number 7. Alien Registration Number (A-Number) (if any). Provide your A-Number. Your A-Number is the number used to identify your immigration records. You can find this number on documents you received from USCIS, U.S. Immigration and Customs Enforcement (ICE), or U.S. Department of Justice Executive Office of Immigration Review (EOIR) during immigration proceedings in court. [Page 5] Item Number 8. USCIS Online Account Number (if any). If you have previously filed an application, petition, or request using the USCIS online filing system (previously called USCIS Electronic Immigration System (USCIS ELIS)), provide the USCIS Online Account Number you were issued by the system. You can find your USCIS Online Account Number by logging in to your account and going to the profile page. If you previously filed certain applications, petitions, or requests on a paper form via a USCIS Lockbox facility, you may have received a USCIS Online Account Access Notice issuing you a USCIS Online Account Number. If you received such a notice, your USCIS Online Account Number can be found at the top of the notice. If you were issued a USCIS Online Account Number, enter it in the space provided. The USCIS Online Account Number is not the same as an A-Number. Item Number 9. U.S. Social Security Number (if any). Provide your U.S. Social Security number. If you do not have a U.S. Social Security number, type or print “N/A.” Item Number 10. Date of Birth. Provide your date of birth in mm/dd/yyyy format. Item Numbers 11.a. - 11.b. Other Dates of Birth Used. Provide all other dates of birth used in mm/dd/yyyy format. Item Number 12. Gender. Indicate your gender. Item Number 13. City/Town/Village of Birth. Provide the city/town/village where you were born in the space provided. Item Number 14. Country of Birth. Provide your country of birth in the space provided. Item Number 15. Countries of Residence/You Entered (Before Entering the United States). List all of the countries you entered while traveling to the United States, including any countries where you resided as well as those where you transited through. Provide the dates when you were in those countries and any immigration status you may have had while in those countries. If you have ever been offered an immigration status in another country that you did not accept, please describe that status offer as well and why you did not accept it. Item Number 16. Country of Citizenship or Nationality (if any). Provide the name of EACH country of which you are a citizen or where you have nationality. This is not necessarily the country where you were born. If you do not have citizenship in any country, type or print “stateless” and provide an explanation in Part 11. Additional Information. Item Number 17. Marital Status. Select the appropriate category to indicate your current marital status. If you are uncertain of your marital status or have additional relevant information about your marital status, please use Part 11. Additional Information. Item Number 18. Date of Current Marriage (if currently married). Provide the date of your current marriage (if currently married) in mm/dd/yyyy format. Item Number 19. Date of Last Entry into the United States. Provide the date and place where you last entered the United States in mm/dd/yyyy format. Item Number 20. Immigration Status (or Lack of Status) When You Last Entered the United States. Provide your immigration status, if any, at the time when you last entered the United States. For example, visitor, student, visa overstay. If you entered without inspection or admission or parole, type or print “No Status” as your immigration status. Item Numbers 21. - 22.b. Place of Last Entry into the United States. Provide the U.S. Port of Entry (if any), city or town and state where you last entered into the United States. Item Number 23. Form I-94 Arrival-Departure Record.  If U.S. Customs and Border Protection (CBP) or USCIS issued you a Form I-94, Arrival-Departure Record, provide your Form I-94 number and date that your authorized period of stay expires or expired (as shown on Form I-94). The Form I-94 number also is known as the Departure Number on some versions of Form I-94.  [Page 6] NOTE:  If you were admitted to the United States by CBP at an airport or seaport after April 30, 2013, you may have been issued an electronic Form I-94 by CBP, instead of a paper Form I-94.  You may visit the CBP website at www.cbp.gov/i94 to obtain a paper version of an electronic Form I-94. CBP does not charge a fee for this service.  Some travelers admitted to the United States at a land border, airport, or seaport, after April 30, 2013, with a passport or travel document, who were issued a paper Form I-94 by CBP, may also be able to obtain a replacement Form I-94 from the CBP website without charge.  If your Form I-94 cannot be obtained from the CBP website, it may be obtained by filing Form I-102, Application for Replacement/Initial Nonimmigrant Arrival-Departure Record, with USCIS.  USCIS does charge a fee for this service. Item Number 24. Date Your Authorized Period of Stay in the United States Expired or Will Expire. Provide the date your authorized period of stay expired or will expire in mm/dd/yyyy format. You can locate the date on your Arrival Departure Record or Crewman’s Landing Permit. If you were admitted for Duration of Status (D/S), please note “D/S” in the space provided. Item Numbers 25. - 28. Passport and Travel Document Numbers.  If you used a passport or travel document to travel to the United States, enter either the passport or travel document information in the appropriate spaces on the application, even if the passport or travel document is currently expired. If you have other valid passports, please list all of them and provide all of the requested information about each document. If you need additional space to complete this section, use the space provided in Part 11. Additional Information. Item Number 29. Country of Issuance for Passport or Travel Document. Provide the country of issuance for passport or travel document. Item Number 30. Expiration Date for Passport or Travel Document. Provide the expiration date for passport or travel document. Item Number 31. Current Immigration Status (or Lack of Status). Provide your current immigration status (or lack of status) and indicate whether or not you are now in status. For example, visitor, student, visa overstay, and no status. Item Numbers 32. - 36.c. Immigration Proceedings. If you have ever been in any type of immigration proceeding before the Department of Justice (DOJ), including an Immigration Court or the Board of Immigration Appeals (BIA), or administrative removal proceedings conducted by the former Immigration and Naturalization Service (INS) or the Department of Homeland Security (DHS), provide details. Also respond if you have been involved in any federal court proceeding involving immigration issues. Indicate which entities conducted your proceedings, as requested on the form. Provide all applicable responses, even if your cases involved the same immigration matter, such as when your case may have been on appeal to the BIA or in federal court. Also provide the locations where your proceedings occurred or are currently being held and the dates of your proceedings. NOTE: Even if your removal, exclusion, or deportation proceedings are administratively closed, you are still “in proceedings” until EOIR terminates or dismisses your case. Part 3. Biographic Information Provide the biographic information requested in Part 3., Item Numbers 1. - 6. Providing this information as part of your application may reduce the time you spend at your USCIS ASC appointment as described in the Biometric Services Appointment section of these Instructions. Item Numbers 1. - 2. Ethnicity and Race. Select the boxes that best describe your ethnicity and race. Categories and Definitions for Ethnicity and Race 1. Hispanic or Latino. A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. (NOTE: This category is only included under Ethnicity in Part 3., Item Number 1.) 2. White. A person having origins in any of the original peoples of Europe, the Middle East, or North Africa. [Page 7] 3. Asian. A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. 4. Black or African American. A person having origins in any of the black racial groups of Africa. 5. American Indian or Alaska Native. A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment. 6. Native Hawaiian or Other Pacific Islander. A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. Item Number 3. Height. Select the values that best match your height in feet and inches. For example, if you are five feet and nine inches, select “5” for feet and “09” for inches. Do not enter your height in meters or centimeters. Item Number 4. Weight. Enter your weight in pounds. If you do not know your weight, or need to enter a weight under 30 pounds or over 699 pounds, enter “000.” Do not enter your weight in kilograms. Item Number 5. Eye Color. Select the box that best describes the color of your eyes. Item Number 6. Hair Color. Select the box that best describes the color of your hair. Part 4. Information About Your Current Spouse (if any) Complete this section about your current spouse only if you are filing a late initial application for TPS. Please see the TPS page on the USCIS website at www.uscis.gov/tps for information on late initial filing for TPS. Item Number 1. USCIS Online Account Number (if any). If you have previously filed an application, petition, or request using the USCIS online filing system (previously called USCIS Electronic Immigration System (USCIS ELIS)), provide the USCIS Online Account Number you were issued by the system. You can find your USCIS Online Account Number by logging in to your account and going to the profile page. If you previously filed certain applications, petitions, or requests on a paper form via a USCIS Lockbox facility, you may have received a USCIS Online Account Access Notice issuing you a USCIS Online Account Number. If you received such a notice, your USCIS Online Account Number can be found at the top of the notice. If you were issued a USCIS Online Account Number, enter it in the space provided. The USCIS Online Account Number is not the same as an A-Number. Item Number 2. Alien Registration Number (A-Number) (if any and available to you). Provide your spouse’s A-Number, if available to you. The A-Number is the number used to identify your spouse’s immigration records. Your spouse can find this number on documents he or she received from USCIS, U.S. Immigration and Customs Enforcement (ICE), or DOJ Executive Office of Immigration Review (EOIR) during immigration proceedings in court. Item Numbers 3.a. - 3.c. Full Name. Provide your current spouse’s full name in the space provided. Item Numbers 4.a. - 4.i. Mailing Address of Spouse. Provide your current spouse’s mailing address in the space provided. Item Numbers 5. - 8.d. Other Information About Your Current Spouse. Provide your current spouse’s date or birth, date of present marriage, and place of present marriage. Item Numbers 9. - 11. Your Current Spouse’s TPS. If your current spouse has ever had TPS, indicate the dates of his or her TPS and whether your current spouse’s TPS is still valid, if this information is available to you. [Page 8] Part 5. Information About Your Former Spouses (if any) (Completed by Late Initial Filers Only) NOTE: Only complete this section if you are filing a late initial application for TPS. Please see the TPS page on the USCIS website at www.uscis.gov/tps for information on late initial filing for TPS. If you need additional space to complete this section, use the space provided in Part 11. Additional Information. Item Numbers 1.a. - 1.c. and 11.a - 11.c. Former Spouse’s Full Name. Provide your former spouse’s full legal name. Item Numbers 2. and 12. Former Spouse’s Nationalities. Provide your former spouse’s nationality or nationalities, if more than one. Item Numbers 3. and 13. A-Number (if any). Provide your former spouse’s A-Number, if available to you. The A-Number is the number used to identify your former spouse’s immigration records. Item Numbers 4. and 14. Date of Birth. Provide the date of your former spouse’s birth in a mm/dd/yyyy format. Item Numbers 5. and 15. Date of Death (if applicable). Provide the date of your former spouse’s death in a mm/dd/yyyy format. Item Numbers 6.a. - 7. and 16.a. - 17. Dates of Marriage and How Marriage Ended. Item Numbers 8. - 10. and 18. - 20. Your Former Spouse’s TPS. If your former spouse ever had TPS, indicate the dates of his or her TPS and whether your former spouse’s TPS is still valid, if known. Also indicate if your former spouse is re-registering for TPS, if that information is available to you. Part 6. Information About Your Children (if any) Item Numbers 1.a. - 1.c. and 8.a. - 8.c. Child’s Full Name. Provide the child’s full legal name. Item Numbers 2. and 9. USCIS Online Account Number (if any). If you have previously filed an application, petition, or request using the USCIS online filing system (previously called USCIS Electronic Immigration System (USCIS ELIS)), provide the USCIS Online Account Number you were issued by the system. You can find your USCIS Online Account Number by logging in to your account and going to the profile page. If you previously filed certain applications, petitions, or requests on a paper form via a USCIS Lockbox facility, you may have received a USCIS Online Account Access Notice issuing you a USCIS Online Account Number. If you received such a notice, your USCIS Online Account Number can be found at the top of the notice. If you were issued a USCIS Online Account Number, enter it in the space provided. The USCIS Online Account Number is not the same as an A-Number. Item Numbers 3. and 10. A-Number (if any and available to you). Provide your child’s A-Number, if available to you. The A-Number is the number used to identify your child’s immigration records. You can find your child’s A-number on documents from USCIS, U.S. Immigration and Customs Enforcement (ICE), or DOJ Executive Office of Immigration Review (EOIR) during immigration proceedings in court. Item Numbers 4. and 11. Date of Birth. Provide the date of your child’s birth in a mm/dd/yyyy format. Item Numbers 5.a. - 5.h. and 12.g. - 12.h. Your Child’s U.S. Mailing Address. Provide your child’s U.S. mailing address. Item Numbers 6.a. - 7. and 13.a. - 14. Your Child’s TPS. If your child ever had TPS, please indicate the dates of his or her TPS, if known. Also indicate if your child is re-registering for TPS, if that information is available to you. Part 7. Eligibility Standards Item Numbers 1.a. - 41. Eligibility Standards. Complete Item Numbers 1.a. - 41. If you select “Yes” to any of Item Numbers 3. - 41., provide an explanation in Part 11. Additional Information. [Page 9] Part 8. Applicant’s Statement, Contact Information, Certification, and Signature Item Numbers 1.a. - 6.b. Select the appropriate box to indicate whether you read this application yourself or whether you had an interpreter assist you. If someone assisted you in completing the application, select the box indicating that you used a preparer. Further, you must sign and date your application and provide your daytime telephone number, mobile telephone number (if any), and email address (if any). Every application MUST contain the signature of the applicant (or parent or legal guardian, if applicable). A stamped or typewritten name in place of a signature is not acceptable. Part 9. Interpreter’s Contact Information, Certification, and Signature Item Numbers 1.a. - 7.b. If you used anyone as an interpreter to read the Instructions and questions on this application to you in a language in which you are fluent, the interpreter must fill out this section, provide his or her name, the name and address of his or her business or organization (if any), his or her daytime telephone number, his or her mobile telephone number (if any), and his or her email address (if any). The interpreter must sign and date the application. Part 10. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant Item Numbers 1.a. - 8.b. This section must contain the signature of the person who completed your application, if other than you, the applicant. If the same individual acted as your interpreter and your preparer, that person should complete both Part 8. and Part 9. If the person who completed this application is associated with a business or organization, that person should complete the business or organization name and address information. Anyone who helped you complete this application MUST sign and date the application. A stamped or typewritten name in place of a signature is not acceptable. If the individual person who helped you prepare your application is an attorney or accredited representative whose representation extends beyond preparation of this application, he or she may be obliged to also submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative, or G-28I, Notice of Entry of Appearance as Attorney In Matters Outside the Geographical Confines of the United States along with your application. Part 11. Additional Information Item Numbers 1.a. - 7.d. If you need extra space to provide any additional information within this application, use the space provided in Part 11. Additional Information. If you need more space than what is provided in Part 11., you may make copies of Part 11. to complete and file with your application, or attach a separate sheet of paper. Type or print your name and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet. We recommend that you print or save a copy of your completed application to review in the future and for your records. We recommend that you review your copy of your completed application before you come to your biometric services appointment at a USCIS ASC.   At your appointment, USCIS will permit you to complete the application process only if you are able to confirm, under penalty of perjury, that all of the information in your application is complete, true, and correct.  If you are not able to make that attestation in good faith at that time, USCIS will require you to return for another appointment.
Pages 3-6, General Requirements	[page 3] General Requirements 1. 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 a country designated for TPS (or have no nationality and last habitually resided in a 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. Documentation exception: If you are filing this application for re-registration (Part 1., Item Number 1.b., of Form I-821), you do not have to submit any copies of documentation. However, USCIS may ask you for additional information and/or documentation in certain circumstances. 2. What documents do you need to provide to prove identity and nationality? Examples of documents that you can submit include copies of 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. [page 4] 3. What documents do you need to provide to prove date of entry into the United States to meet the continuous residence requirement for this program? Examples of documents that you can submit include copies of any of the following: A. Passport; B. Form I-94, Arrival-Departure Record; or C. Documents specified in Item Number 4. below. 4. What documents do you need to provide to prove residence in the United States? Submit copies of 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 employers; 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 the employer must also sign and attest to the affidavit under penalty of perjury. Such letters must include: (1) Your address at the time of employment; (2) Exact periods of employment; (3) Periods of layoff; and (4) Duties with the company. If the employment records are unavailable, submit an affidavit explaining why you cannot obtain these records. Your employer must sign and attest to the affidavit 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 names 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 dates 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 address where you resided during membership periods; 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 copies of 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. [page 5] 5. What documents should I submit if I was arrested or convicted for a criminal offense? A. Court Disposition Records If you were ever arrested, charged, and/or convicted for a criminal offense, you will need to provide court disposition records. Provide a certified copy of all arrest reports, court dispositions, sentencing documents, and any other relevant documents. You may also include any mitigating evidence concerning the circumstances of your arrests or convictions that you would like USCIS to consider if you have been arrested or convicted of a crime. If you were placed on probation, you must provide evidence to show that you completed your probationary period. You do not need to submit documentation for traffic fines and incidents (unless the traffic fines or incidents were alcohol- or drug-related) that did not involve an actual arrest if the penalty was only a fine of less than $500 or points on your driver's license. However, if you were arrested for any traffic offense, provide disposition documentation, so USCIS can properly assess whether your conviction may relate to your TPS eligibility. NOTE: Provide the conviction and disposition documentation even if your records were sealed, expunged, or otherwise cleared. You must provide the documentation even if anyone, including a judge, law enforcement officer, or attorney, told you that you no longer have a record or that you do not have to disclose the information. B. Particularly Serious Crimes and Serious Nonpolitical Crimes If you were ever convicted of or ever committed a “particularly serious crime” that constitutes a “danger to the community of the United States,” or there are serious reasons for believing that you have committed “serious nonpolitical crimes” outside of the United States before your arrival in this country, you cannot be granted TPS. USCIS will make the determination as to whether your crimes fall into either of these categories. You must, however, provide information and, if available, any supporting documentation on all crimes which you have committed or were convicted of in the United States or outside of this country so that USCIS can make an appropriate decision. If you believe that any of your arrests or convictions were based on political reasons, describe why in your supplemental statements. 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? A. Yes. Except as noted below, all applicants for initial registration, re-registration, or renewal of TPS must provide fingerprints, photographs, and signatures, which are biometrics. Applicants 14 years of age and older must submit the $85 biometrics services fee or a fee waiver request. See Item Number 9. below for information about fee waiver requests. B. TPS applicants under 14 years of age who are not filing for an EAD are exempt from biometrics collection. C. USCIS may, in its discretion, waive the collection of certain biometrics. D. When a biometrics appointment is necessary, USCIS will send a notice to TPS applicants scheduling them to appear at an ASC for biometrics collection. Failure to comply with this notice may result in the denial of the TPS application. [page 6] 8. Are you also required to file Form I-765, Application for Employment Authorization? Yes. For administrative reasons, each applicant, regardless of age, must also submit a completed Form I-765, even if employment authorization is not requested. As noted in the What is the Filing Fee section of the instructions, only those applicants requesting employment authorization must pay the filing fee for Form I-765. If you are under 14 years of age or over 65 years of age, you may request an Employment Authorization Document (EAD) without fee when filing an initial TPS application. All applicants, regardless of age, must pay the Form I-765 filing fee if requesting an EAD when submitting a TPS re-registration application NOTE: An EAD 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 Form I-131, Application for Travel Document. USCIS will issue a Form I-512 travel document to you if your request is granted. For more information on filing Form I-131, visit the USCIS Web site at www.uscis.gov/I-131 or call the USCIS National Customer Service Center at 1-800-315-5285. For TDD (deaf or hard of hearing) call: 1-800-767-1833. 9. May the filing and biometrics services fees for Forms I-821 and I-765 be waived? Yes. If you are unable to pay the filing and biometrics services fees, 8 CFR 103.7(c) states that you may request a waiver of the fees. To request a fee waiver, a person requesting an immigration benefit must submit a written request or a Form I-912, Request for Fee Waiver, accompanied by documentation of your inability to pay the required fee. In your request you should indicate why you believe you are entitled to or deserving of the benefit requested, the reason for your inability to pay the fees, and evidence to support the reasons you give. You may not appeal the denial of your fee waiver request. 10. Can any of the grounds of inadmissibility that apply to TPS be waived if an applicant is found to be inadmissible on one or more of those grounds? Yes. USCIS may waive some, but not all, of the grounds of inadmissibility in section 212(a) of the INA applicable to TPS, as a matter of discretion, provided that USCIS determines that a waiver is appropriate for humanitarian purposes, to assure family unity, or is otherwise in the public interest. If you are subject to an inadmissibility ground that may be waived, USCIS will send you a notice informing you of your opportunity to apply for a discretionary waiver on Form I-601, Waiver of Grounds of Inadmissibility. If you already know that you are inadmissible on a waivable ground that requires a Form I-601 for TPS purposes, you may also file the Form I-601 with the appropriate fee, (or Form I-912 or fee waiver request), at the time you file your Form I-821. Please note that USCIS cannot waive some inadmissibility grounds, by law, including certain criminal grounds in INA 212(a)(2)(A-C) and national security, terrorism-related, and persecution grounds in INA 212(a)(3)(A-C, E). If you answered "Yes" to any of the questions in Part 4. Eligibility Standards that are not related to crimes, national security, terrorism, genocide, persecution of others, or human rights abuses, you may be able to obtain a discretionary waiver. For further information on procedures for applying for a waiver, see the TPS section of the Form I-601 instructions and additional information on the TPS page on the USCIS Web site at www.uscis.gov/tps. You may also wish to obtain legal advice if you believe you may be subject to any ground of inadmissibility or another TPS ineligibility ground. If you are re-registering for TPS and you were already granted a waiver of a ground of inadmissibility in conjunction with your prior TPS application, you do not need to seek another waiver for the same action, incident, or circumstance. For example, if on a prior TPS application, USCIS previously granted you a waiver of the health ground of inadmissibility because you had tuberculosis that was treated, you do not need to apply for another waiver for that same health incident. However, you would need to file for a waiver if you have contracted another communicable disease for which a waiver is necessary.	[Page 9] General Requirements 1. What documents should you submit? NOTE: You do not need to provide original documents with this application unless USCIS requests that you provide the originals of any copies you submit. [Page 10] You must provide USCIS copies of documents to prove you are a national of a country designated for TPS (or have no nationality and last habitually resided in a country designated for TPS), your date of entry into the United States, and your U.S. residence. In addition: [deleted] Documentation Exception: If you are filing this application for re-registration (Part 1., Item Number 1.b., of Form I-821), you do not have to submit any copies of documentation. However, USCIS may ask you for additional information and/or documentation in certain circumstances. NOTE: If you are submitting a first-time re-registration with USCIS following an Immigration Judge or Board of Immigration Appeals decision granting your TPS application, please include a copy of that decision order with your Form I-821. This will aid USCIS in verifying your grant of TPS and processing your application, as USCIS may not have received records of your grant of TPS by either the immigration judge or the Board of Immigration Appeals. 2. What documents do you need to provide to prove identity and nationality? Examples of documents that you can submit include copies of 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. 3. What documents do you need to provide to prove date of entry into the United States to meet the continuous residence requirement for this program? Examples of documents that you can submit include copies of any of the following: A. Passport; B. Form I-94, Arrival-Departure Record; or C. Documents specified in Item Number 4., below. 4. What documents do you need to provide to prove residence in the United States? Submit copies of any of the following relevant documents. A. Employment records (for example, pay stubs; Form W-2, Wage and Tax Statement; certification of the filing of Federal income tax returns; state verification of the filing of state income tax returns; letters from employers; or, if you are self-employed, letters from banks and other firms with which 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 the employer must also sign and attest to the affidavit under penalty of perjury. Such letters must include: (1) Your address at the time of employment; (2) Exact periods of employment; (3) Periods of layoff; and (4) Duties with the company. If the employment records are unavailable, submit an affidavit explaining why you cannot obtain these records. Your employer must sign and attest to the affidavit under penalty of perjury. B. Rent receipts, utility bills (for example, gas, electric, and phone), and receipts or letters from companies showing the dates during which you received service. C. School records (for example, letters, and report cards) from the schools that you or your children have attended in the United States, showing the names of the schools and periods of school attendance. [Page 11] 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 dates 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 address where you resided during membership periods; 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 copies of 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; deeds, mortgages, contracts to which you have been a party; tax receipts; insurance policies; receipts; and letters. G. Any other relevant documents. 5. What documents should I submit if I was arrested, charged, and/or convicted for a criminal offense? In answering any question on this form about your criminal history: You have been “convicted” for immigration purposes if: (1) A court has entered against you a judgment of guilt; or (2) The court has not entered a formal judgment, but; (3) You were found guilty after a trial, entered a guilty or “no contest” plea or admitted in court to facts that would warrant a finding of guilt; and (4) The court has imposed any restrictions on your liberty, including any probation, punishment or other penalty. “Felony” means a crime committed in the United States, punishable by imprisonment for a term of more than one year, regardless of the term such alien actually served, if any, except: When the offense is defined by the State as a misdemeanor and the sentence actually imposed is one year or less regardless of the term such alien actually served. Under this exception for purposes of TPS, the crime shall be treated as a misdemeanor. See 8 C.F.R. 244.1. Misdemeanor means a crime committed in the United States, either: (1) Punishable by imprisonment for a term of one year or less, regardless of the term such alien actually served, if any; or (2) A crime treated as a misdemeanor under the term “felony” of this section. For purposes of TPS, any crime punishable by imprisonment for a maximum term of five days or less shall not be considered a felony or misdemeanor. See 8 C.F.R. 244.1. Please remember, however, that even if you were not convicted, you must provide records of any arrest or charge for a criminal offense. A. Court Disposition Records If you were ever arrested, charged, and/or convicted for a criminal offense, you will need to provide court disposition records. Provide a certified copy of all arrest reports, court dispositions, sentencing documents, and any other relevant documents. You may also include any mitigating evidence concerning the circumstances of your arrests or convictions that you would like USCIS to consider if you have been arrested or convicted of a crime. If you were placed on probation, you must provide evidence to show that you completed your probationary period. [Page 12] You do not need to submit documentation for traffic fines and incidents (unless the traffic fines or incidents were alcohol- or drug-related) that did not involve an actual arrest if the penalty was only a fine of less than $500 or points on your driver's license. However, if you were arrested for any traffic offense, provide disposition documentation, so USCIS can properly assess whether your conviction may relate to your TPS eligibility. NOTE: Provide the conviction and disposition documentation even if your records were sealed, expunged, or otherwise cleared. You must provide the documentation even if anyone, including a judge, law enforcement officer, or attorney, told you that you no longer have a record or that you do not have to disclose the information. Please see Item 6. about what you should submit if you are not able to obtain a true copy of the official record concerning any arrest, charge, or conviction, including any records of juvenile criminal history or records that are otherwise sealed. NOTE: An adjudication of juvenile delinquency is not a “conviction” under U.S. immigration law. However, if a minor is charged with a crime in a criminal court proceeding rather than being placed in a juvenile court proceeding, the charges could be relevant. You must disclose all arrests and charges. If any arrest or charge was disposed of as a matter of juvenile delinquency, include the court or other public record that establishes this disposition. B. Particularly Serious Crimes and Serious Nonpolitical Crimes If you were ever convicted of or ever committed a “particularly serious crime” that constitutes a “danger to the community of the United States,” or there are serious reasons for believing that you have committed “serious nonpolitical crimes” outside of the United States before your arrival in this country, you cannot be granted TPS. USCIS will make the determination as to whether your crimes fall into either of these categories. You must, however, provide information and, if available, any supporting documentation on all crimes which you have committed or were convicted of in the United States or outside of this country so that USCIS can make an appropriate decision. If you believe that any of your arrests or convictions were politically motivated, describe why in your supplemental statements. 6. What if official documents are not available? USCIS always prefers receiving true copies of official records. However, USCIS also understands that an applicant may not be able to obtain copies of some official records. You do not need to submit an official record if you establish that the record is not available to you or your designated representative. (In some cases, the law will allow you to obtain your own records, but does not necessarily allow someone other than you or your designated representative to obtain the records. If you or your representative can obtain the records, you must do so.) Ordinarily, a certificate from the custodian of the records explaining that the records cannot be disclosed to you is enough. But if you claim that a record is not available because of a “confidentiality” law or other reason, please submit: (1) A copy of your petition or motion to the court or other custodian of the record seeking permission to obtain a copy to submit with your application; and (2) A copy of the court’s or custodian’s order denying permission, if possible. If you show that you cannot obtain a copy of the official record, you can submit any secondary evidence that might be available, such as copies that you or your attorney may have retained. If you cannot obtain primary or secondary evidence, you must provide at least one written statement.  Each written statement must: (1) Be from a named individual who has personal knowledge to the proceeding; (2) Explain the source of the individual’s personal knowledge; (3) Describe the nature of the proceeding, the underlying charges, and the disposition; and [Page 13] (4) Be signed by the individual under oath, affirmation, or penalty of perjury. If more than one individual provides a written statement, it must be a separate typed or written statement from each, that is, two individuals cannot sign the same statement.    If documents, such as identity and nationality documents, are not available to you, you may provide an affidavit showing proof of unsuccessful efforts to obtain such documents, why the consular process is unavailable to you (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, photographs, and a signature? A. Yes. Except as noted below, all applicants for initial registration, re-registration, or renewal of TPS must provide fingerprints, photographs, and a digital signature, which are referred to as “biometrics.” For re-registrations, USCIS may be able to re-use your previously collected biometrics for identity verifications, background checks and other authorized purposes. Applicants for both initial TPS and for re-registration who are14 years of age and older must submit the $85 biometric services fee or a fee waiver request. See Item Number 9. below for information about fee waiver requests. B. TPS applicants under 14 years of age who are not filing for an Employment Authorization Document (EAD) are exempt from biometrics collection. C. USCIS may, in its discretion, waive the collection of certain biometrics. D. When a biometric services appointment is necessary, USCIS will send a notice to TPS applicants and re-registrants scheduling them to appear at an ASC for biometrics collection. Failure to comply with this notice may result in the denial of the TPS application. 8. Can Form I-765, Application for Employment Authorization, be filed at the same time as Form I-821? Yes. When filing an initial TPS application with USCIS or re-registering for TPS, you can also request an Employment Authorization Document (EAD) by submitting a completed Form I-765, with the appropriate Form I-765 filing fee, if any, or fee waiver request, together with your Form I-821. If you are not requesting employment authorization, you do not need to file Form I-765. If you want to wait to file for an EAD until after USCIS decides your TPS application, you may file the Form I-765 later if you are approved for TPS. However, filing Form I-821 with Form I-765 helps you to receive your EAD more promptly if you are eligible for one. As noted in the What Is the Filing Fee section of these Instructions, if you are under 14 years of age or over 65 years of age, you may request an EAD without fee when filing an initial TPS application. All applicants, regardless of age, must pay the Form I-765 filing fee if requesting an EAD when submitting a TPS re-registration application. NOTE: An EAD 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 an Advance Parole Document from USCIS by filing Form I-131, Application for Travel Document. USCIS will issue a Form I-512, Advance Parole Document, to you if your request is granted. For more information on filing Form I-131, visit the USCIS website at www.uscis.gov/I-131 or call the USCIS National Customer Service Center at 1-800-375-5283. For TTY (deaf or hard of hearing) call: 1-800-767-1833. 9. May the filing fee and biometric services fee for Forms I-821 and I-765 be waived? Yes. If you are unable to pay the filing fee and biometric services fee, 8 CFR Section 103.7(c) states that you may request a waiver of the fees. To request a fee waiver, a person requesting an immigration benefit must either submit a written request that the fee be waived or submit a Form I-912, Request for Fee Waiver. Either form of request must be accompanied by documentation of your inability to pay the required fee. In your request, you should indicate why you believe you are entitled to or deserving of the benefit requested, the reason for your inability to pay the fees, and evidence to support the reasons you give. If your fee waiver request is denied, there is no appeal of the denial. [delete]
New		[Page 14] What Evidence Must You Submit? You must submit all evidence requested in these Instructions with your application. If you fail to submit required evidence, USCIS may reject or deny your application for failure to submit requested evidence or supporting documents in accordance with 8 CFR 103.2(b)(1) and these Instructions. See the General Requirements section of these Instructions for additional evidence that must be submitted. Photographs. You must submit two identical color passport-style photographs of yourself taken within 30 days of filing 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. The two identical color passport-style photos must be 2 by 2 inches. 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 inches from top of hair to bottom of chin, and eye height is between 1 1/8 to 1 3/8 inches from bottom of photo. Your head must be bare unless you are wearing headwear as required by a religious denomination of which you are a member. Using a pencil or felt pen, lightly print your name and Alien Registration Number (A-Number) (if any) on the back of the photo.
Page 7, What Is the Filing Fee?	[page 7] What Is the Filing Fee? 1. An initial (first-time) applicant must submit a $50 application fee for Form I-821. Additionally: A. If you are 14 years of age or older, an $85 biometrics services fee is required; and B. If you are seeking employment authorization, you must submit a $380 filing fee and the Form I-765, if you are between the ages of 14 and 65 (inclusive). C. If you are not seeking employment authorization, you must still file the Form I-765 but you do not need to pay the filing fee. NOTE: Applicants under 14 years of age and over age 65 years of age may request an EAD without a fee when filing for initial TPS registration. 2. An applicant for TPS re-registration must submit the completed Form I-821 but is not required to pay the filing fee, unless: A. You are 14 years of age or older; then, an $85 biometrics services fee is required; and B. Regardless of your age, if you are filing Form I-765 to request an EAD with your re-registration, a $380 filing fee for Form I-765 is required. C. If you are not seeking employment authorization, you must still file Form I-765, but you do not need to pay the fee. 3. You must submit the fees in the exact amount.  Fees cannot be refunded.  Do not mail cash.  Please ensure 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. Use the following guidelines when you prepare your check or money order: 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. NOTE: 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 filing and biometrics services fees on this form are current as of the edition date appearing in the lower left 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 the USCIS Web site at www.uscis.gov, select "FORMS" and check the appropriate fee; or 2. Call the USCIS National Customer Service Center at 1-800-375-5283 and ask for the fee information. For TDD (deaf or hard of hearing) call: 1-800-767-1833. [new]	[Page 14] What Is the Filing Fee? Initial TPS Applications 1. An initial (first-time) applicant must submit a $50 application fee for Form I-821. Additionally: A. If you are 14 years of age or older, you must pay an $85 biometric services fee or a fee waiver request; and B. If you are seeking employment authorization, you must submit Form I-765. 2. If you are between 14 and 65 years of age and seeking employment authorization, you must submit a $410 filing fee and the Form I-765, in addition to the $50 application fee and $85 biometric services fee – a total of $545 or a fee waiver request. 3. If you are under 14 years of age or over 65 years of age and seeking an EAD, you are not required to pay a fee for the EAD when filing for initial TPS registration. Your only fees are the $50 application fee and $85 biometric services fee – a total of $135 or a fee waiver request. TPS Re-Registration 1. If you have TPS and you are filing for re-registration, you must submit the completed Form I-821, but you are not required to pay the $50 application fee for Form I-821. However: A. If you are 14 years of age or older, you must still pay the $85 biometric services fee; and B. If you are seeking employment authorization, you must still submit Form I-765. 2. Regardless of your age, if you are filing Form I-765 to request an EAD with your re-registration, you must pay the $410 filing fee for Form I-765. If you are 14 years or older and requesting an EAD, your fees will be the $85 biometric services fee and the $410 EAD filing fee – a total of $495. If you are under 14 years of age and requesting an EAD, your only fee will be the $410 EAD filing fee. NOTE: When filing an initial or re-registration TPS application, if you are not seeking employment authorization, you do not need to file Form I-765 and you do not need to pay the $410 fee. 3. The Form I-821 filing fee and biometric services fee are not refundable, regardless of any action USCIS takes on this application. DO NOT MAIL CASH. You must submit all fees in the exact amounts. [Page 15] Use the following guidelines when you prepare your checks or money orders for the Form I-821 filing fee and biometric services 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 checks or money orders payable to U.S. Department of Homeland Security. NOTE: Spell out U.S. Department of Homeland Security; do not use the initials "USDHS" or "DHS." Notice to Those Making Payment by Check. If you send us a check, USCIS will convert it 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 your bank will show it on your regular account statement. You will not receive your original check back. We will destroy your original check, but will keep a copy of it. If USCIS cannot process the EFT for technical reasons, you authorize us to process the copy in place of your original check. If USCIS cannot complete the EFT because of insufficient funds, we may try to make the transfer two additional times. NOTE: The fees that apply to your registration or re-registration application packet may all be combined into a single check or money order. For example, if you also choose to submit Form I-131, Application for Travel Document, and include that application with your TPS application, the Form I-131 fee may be included with the check or money order for the TPS application, as well. Please note that if you use a single check or money order, and the fee amount is incorrect, then your entire application packet will be rejected. How to Check If the Fees Are Correct Form I-821’s filing fee and biometric services fee are current as of the edition date in the lower left 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 the USCIS website at www.uscis.gov, select "FORMS" and check the appropriate fee; or 2. Call the USCIS National Customer Service Center at 1-800-375-5283 and ask for the fee information. For TTY (deaf or hard of hearing) call: 1-800-767-1833. NOTE: If you are age 14 or older and, therefore, must pay the biometric services fee with your Form I-821, you can use the same procedure to obtain the correct biometric services fee. Fee Waiver You may be eligible for a fee waiver under 8 CFR 103.7(c). If you believe you are eligible for a fee waiver, complete Form I-912, Request for Fee Waiver (or a written request), and submit it and any required evidence of your inability to pay the filing fees with this application. You can review the fee waiver guidance at www.uscis.gov/feewaiver.
Page 7, Where to File?	[page 7] Where to File? For filing instructions, refer to the most recently published Federal Register notice specific to the country designation under which you are applying. You may also check the USCIS Web site at www.uscis.gov/tps and choose a TPS country-specific page, or contact the USCIS National Customer Service Center at 1-800-375-5283. For TDD (deaf or hard of hearing) call: 1-800-767-1833.	[Page 15] Where to File? Please see our website at www.uscis.gov/I-821 or call our National Customer Service Center at 1-800-375-5283 for the most current information about where to file this application. For TTY (deaf or hard of hearing) call: 1-800-767-1833.
Page 8, Address Change	[page 8] Address Change You must inform USCIS if you change your address.  For information on filing a change of address go to the USCIS Web site at www.uscis.gov/addresschange or contact the USCIS National Customer Service Center at 1-800-375-5283. For TDD (deaf or hard of hearing) call: 1-800-767-1833. NOTE:  Do not submit a change of address request to the USCIS Lockbox facilities because the USCIS Lockbox facilities do not process change of address requests.	[Page 16] Address Change An applicant who is not a U.S. citizen must notify USCIS of his or her new address within 10 days of moving from his or her previous residence. For information on filing a change of address go to the USCIS website at www.uscis.gov/addresschange or contact the USCIS National Customer Service Center at 1-800-375-5283. For TTY (deaf or hard of hearing) call: 1-800-767-1833. NOTE: Do not submit a change of address request to the USCIS Lockbox facilities because the Lockbox does not process change of address requests. If you have an online account, you may also change your address in the USCIS online filing system by logging into your user account and updating your Account Profile.
Page 8, Processing Information	[page 8] Processing Information Initial Processing After USCIS accepts your Form I-821, the agency will check it for completeness, including submission of the required initial evidence. If you do not completely fill out the form and required supplements, or file it without the required initial evidence, you will not establish a basis for eligibility, and we may deny your Form I-821. Requests for More Information or Interview USCIS 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. Decision The decision on your Form I-821 involves a determination of whether you have established eligibility for the requested benefit. USCIS will notify you of the decision in writing.	[Page 16] Processing Information Initial Processing. Once USCIS accepts your application, we will check it for completeness, including submission of the required initial evidence. If you do not completely fill out this application, you will not establish a basis for eligibility, and USCIS may reject or deny your application. Requests for More Information. We may request that you provide more information or evidence to support your application. We may also request that you provide the originals of any copies you submit. If USCIS requests an original document from you, it will be returned to you after USCIS determines it no longer needs your original. Requests for Interview. We may request that you appear at a USCIS office for an interview based on your application. At the time of any interview or other appearance at a USCIS office, we may require that you provide your fingerprints, photograph, and/or signature to verify your identity and/or update background and security checks. Decision. The decision on Form I-821 involves a determination of whether you have established eligibility for the immigration benefit you are seeking. USCIS will notify you of the decision in writing.
Page 8, Penalties	[page 8] USCIS Forms and Information To ensure you are using the latest version of this form, visit the USCIS Web site at www.uscis.gov where you can obtain the latest USCIS forms and immigration-related information. If you do not have Internet access, you may order USCIS forms by calling our toll-free number at 1-800-870-3676.  You may also obtain forms and information by calling the USCIS National Customer Service Center at 1-800-375-5283. For TDD (deaf or hard of hearing) call: 1-800-767-1833. As an alternative to waiting in line for assistance at your local USCIS office, you can now schedule an appointment through the USCIS Internet-based system, InfoPass. To access the system, visit the USCIS Web site at infopass.uscis.gov/. 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.	[Page 16] USCIS Forms and Information To ensure you are using the latest version of this application, visit the USCIS website at www.uscis.gov where you can obtain the latest USCIS forms and immigration-related information. If you do not have Internet access, you may order USCIS forms by calling the Forms Request Line at 1-800-870-3676. You may also obtain forms and information by calling the USCIS National Customer Service Center at 1-800-375-5283. For TTY (deaf or hard of hearing) call: 1-800-767-1833. Instead of waiting in line for assistance at your local USCIS office, you can schedule an appointment online at www.uscis.gov. Select “Schedule an Appointment” and follow the screen prompts to set up your appointment. Once you finish scheduling an appointment, the system will generate an appointment notice for you.
Page 8, USCIS Forms and Information	[page 8] Penalties If you knowingly and willfully falsify or conceal a material fact or submit a false document with Form I-821, we will deny your Form I-821 and may deny any other immigration benefit. In addition, you will face severe penalties provided by law and may be subject to criminal prosecution.	[Page 16] Penalties If you knowingly and willfully falsify or conceal a material fact or submit a false document with Form I-821, we will deny your Form I-821 and may deny any other immigration benefit. In addition, you will face severe penalties provided by law and may be subject to criminal prosecution.
Pages 8-9, USCIS Privacy Act Statement	[page 8] USCIS Privacy Act Statement AUTHORITIES: Section 244 of the Immigration and Nationality Act (INA), as amended, and 8 CFR 244.9 authorize USCIS to collect the information and the associated evidence for this benefit application. INA 264(f) (8 U.S.C. 1304(f)) also provides the Secretary of Homeland Security with the authority to collect Social Security Number (SSN) information. PURPOSE: The primary purpose for providing the requested information on this form is to determine if you have established eligibility for the Temporary Protected Status for which you are filing. USCIS may also use the information you provide to grant or deny the benefit sought. [page 9] DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and any requested evidence, may delay a final decision or result in denial of your request for Temporary Protected Status. ROUTINE USES: The information you provide on this form may be disclosed to other Federal, state, local, and foreign government agencies and authorized organizations in accordance with approved routine uses, as described in the associated published system of records notices, DHS/USCIS-015 - Electronic Immigration System-2 Account and Case Management System of Records, which can be found at www.dhs.gov/privacy. USCIS may also make the information available, as appropriate, for law enforcement purposes or in the interest of national security.	[Page 17] USCIS Privacy Act Statement AUTHORITIES: The information requested on this application, and the associated evidence, is collected under INA section 101 and 244. INA section 264(f) (8 U.S.C. 1304(f)) also provides the Secretary of Homeland Security with the authority to collect Social Security number (SSN) information. PURPOSE: The primary purpose for providing the requested information on this application is to determine if you have established eligibility for TPS. DHS will use the information you provide to grant or deny the benefit you are seeking. DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and any requested evidence, may delay a final decision or result in denial of your application. ROUTINE USES: DHS may share the information you provide on this application, including supporting documentation you provide, with other Federal, state, local, and foreign government agencies and authorized organizations. DHS follows approved routine uses described in the associated published system of records notices [DHS/USCIS-007 - Benefits Information System and DHS/USCIS-001 - Alien File, Index] which you can find at www.dhs.gov/privacy. DHS may also share the information, as appropriate, for law enforcement purposes or in the interest of national security.
Page 9, Paperwork Reduction Act	[page 9] 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 1 hour and 55 minutes per response, including the time for gathering the required documentation and information, reviewing the instructions, and completing and submitting the application. 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 Coordination Division, Office of Policy and Strategy, 20 Massachusetts Ave NW, Washington, DC 20529-2140; OMB No. 1615-0043. Do not mail your completed Form I-821 to this address.	[Page 17] 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 Office of Management and Budget (OMB) control number. The public reporting burden for this collection of information is estimated at 2 hours and 25 minutes per response, including the time for reviewing instructions, gathering the required documentation and information, completing the application, attaching necessary documentation, and submitting the application. The collection of biometrics, where required, is estimated to require 1 hour and 10 minutes. 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 Coordination Division, Office of Policy and Strategy, 20 Massachusetts Ave NW, Washington, DC 20529-2140; OMB No. 1615-0043. Do not mail your completed Form I-821 to this address.
Page 9, Checklist	[page 9] Checklist Please ensure that you complete the following actions before you file Form I-821 with USCIS. Did you answer each question? Did you sign your Form I-821? Did you include the required applications and filing and biometrics services fees, (or Form I-912, Request for Fee Waiver, or a written request for a waiver of the filing fees)? Did you include full, certified English language translations for any supporting document containing information in another language, with your application? Did you include the supporting evidence to prove identity, nationality, date of entry, and residence, with your application? Did you include other required supporting documents (such as photos, etc.) for your application? If you were ever arrested or convicted for any criminal offense, did you include certified copies of all arrest reports, court dispositions, sentencing documents, and any other relevant documents? Did you include Form I-765? If you are also requesting employment authorization, did you submit the Form I-765 filing fee (if applicable) or Form I-912 or a written request for a waiver of the filing fee? (See instructions, General Requirements, Item Numbers 8. and 9.). If you used an interpreter and/or a preparer to complete this application, did he or she complete Part 6. and/or Part 7. on your Form I-821?	[Page 18] Checklist Please ensure that you complete the following actions before you file Form I-821 with USCIS. Did you answer each question? Did you sign your Form I-821? Did you include the required applications, filing fees, and biometric services fee (or Form I-912, Request for Fee Waiver, or a written request for a waiver of the filing fees)? Did you include full, certified English language translations for any supporting document containing information in another language, with your application? Did you include the supporting evidence to prove identity, nationality, date of entry, and residence, with your application? Did you include other required supporting documents (such as photos) for your application? If you were ever arrested or convicted for any criminal offense, did you include certified copies of all arrest reports, court dispositions, sentencing documents, and any other relevant documents? If you are requesting an Employment Authorization Document, did you include Form I-765? If you are requesting employment authorization, did you submit the Form I-765 filing fee (if applicable) or Form I-912 or a written request for a waiver of the filing fee? (See General Requirements, Item Numbers 8. and 9. of these Instructions.) If you are requesting an Advance Parole Document, did you include Form I-131? If you are requesting an Advance Parole Document, did you submit the Form I-131 filing fee (if applicable) or Form I-912 or a written request for a waiver of the filing fee? (See What Is the Filing Fee section of these Instructions). If you used an interpreter and/or a preparer to complete this application, did he or she complete Part 9. and/or Part 10. on your Form I-821?

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