I765-INS-TOC-SS Final-01192017

TABLE OF CHANGES – INSTRUCTIONS

Form I-765, Application for Employment Authorization

OMB Number: 1615-0040

01/19/2017

Reason for Revision: SSA Enumeration.

Current Page Number and Section	Current Text	Proposed Text
Pages 12, General Instructions	[Page 12] … How To Fill Out Form I-765 1. Type or print legibly in black ink. 2. If extra space is needed to complete any item, attach a continuation sheet, write your name and Alien Registration Number (A-Number) (if any), at the top of each sheet of paper, indicate the Part and item number to which your answer refers, and date and sign each sheet. 3. Answer all questions fully and accurately. State that an item is not applicable with “N/A.” If the answer is none, write “None.”	[Page 12] … [no change] 4. Item Numbers 9.a. - 13.b. Questions regarding Social Security Number (SSN). Item Number 9.a. asks you if the Social Security Administration (SSA) has ever officially issued you a Social Security card. If the SSA ever issued a Social Security card to you in your name or a previously used name such as your maiden name, then you must enter the SSN from your card in Item Number 9.b. If your request for employment authorization is approved, the SSA may assign you an SSN and issue you a Social Security card, or issue you a replacement card. If you want the SSA to assign you a Social Security number and issue you a Social Security card, or issue you a new or replacement Social Security card, then answer “Yes” to both Item Number 10. and Item Number 11. You must also provide your father’s and mother’s family and given names at birth in Item Numbers 12.a. - 13.b. SSA will use Item Numbers 12.a. - 13.b. in issuing you an SSN card. You are not required to request an SSN using this application. Completing Item Numbers 10. - 13.b. is optional. However, you must have an SSN properly assigned in your name to work in the United States. NOTE: If your employer uses E-Verify to confirm new employees’ eligibility to legally work in the United States, the information you provide on Form I-9, Employment Eligibility Verification, will be compared to data in SSA and Department of Homeland Security (DHS) databases. Employees must have an SSN in order for E-Verify to confirm their eligibility to legally work in the United States.
New		[This new section goes before USCIS Privacy Act Statement] [Page 18] SSA Privacy Act Statement Sections 205(c) and 702 of the Social Security Act authorizes SSA to collect information to assign you an SSN and issue a Social Security card. The information you furnish on this application is voluntary. However, failure to provide the requested information may prevent SSA from issuing you an SSN and Social Security card. SSA will maintain the information used to assign you an SSN and issue you a Social Security card in SSA’s system of records [Master Files of Social Security Number (SSN) Holders and SSN Applications, 60-0058]. Complete lists of approved routine uses for the information used to assign you an SSN and issue you a Social Security card are available in the System of Records Notice 60-0058, available at www.ssa.gov.

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