Form I-821 Table of Changes

I821-TOC-83C-FRM-06162017.docx

Application for Temporary Protected Status

Form I-821 Table of Changes

OMB: 1615-0043

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TABLE OF CHANGES – FORM

I-821, Application for Temporary Protected Status

OMB Number: 1615-0043

06/16/2017


Reason for Revision: 83C




Current Page Number and Section

Current Text

Proposed Text

Page 1,

Part 1. Type of Application (select one)






NOTE: Select the box for Item Number 1.a., 1.b., or 2. If applicable, select the box for Item Number 3.a. or 3.b.




3.b. No, I am not currently requesting an EAD.



[Page 1]


Part 1. Type of Application (select one)


NOTE: Select the box for Item Number 1.a., 1.b., or 2. If applicable, select the box for Item Number 3.a. or 3.b. For Item Number 4., enter the name of the designated TPS country.


3.b. No, I am not currently requesting an EAD.


4. Name of designated TPS country under which you are applying.


Page 2,

Part 2. Information About You,

Other Dates of Birth Used (if any)





15. Countries of Residence (Before entering the U.S.)






16. Country or Countries of Citizenship or Nationality (if any) (List all countries that apply.)


[Page 2]


Part 2. Information About You,

Other Dates of Birth Used (if any)

Countries of Residence (Before entering the U.S.)


15.a.

15.b.

15.c.

15.d.

Country or Countries of Citizenship or Nationality (if any) (List all countries that apply.)


16.a.

16.b.

16.c.

16.d.



1


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleTABLE OF CHANGE – FORM I-687
Authorjdimpera
File Modified0000-00-00
File Created2021-01-22

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