I-765WS TOC

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TABLE OF CHANGES – FORM
Form I-765WS, Form I-765 Worksheet
OMB Number: 1615-0040
01/08/2020

Reason for Revision:  Comprehensive Revision.
Project Phase: 30-Day FRN.

Legend for Proposed Text:
    • Black font = Current text
    • Red font = Changes

Expires 05/31/2020
Edition Date 12/26/2019


Current Page Number and Section
Current Text
Proposed Text
Page 1,

Part 1.  Your Full Name
[Page 1]

If you are applying for employment authorization under the (c)(14), Deferred Action, or (c)(33), Consideration of Deferred Action for Childhood Arrivals, categories, you must complete this worksheet so we can determine whether you have an economic need to work.  In the spaces provided, indicate your current annual income, your current annual expenses, and the total current value of your assets.  Supporting evidence is not required, but U.S. Citizenship and Immigration Services (USCIS) will accept and review any documentation that you submit.  You do not need to include other household members' financial information to establish your own economic necessity.

Part 1.  Your Full Name

1.a. Family Name (Last Name)
1.b. Given Name (First Name)
1.c. Middle Name

[Page 1]

If you are applying for employment authorization under the (c)(14), Deferred Action, or (c)(33), Consideration of Deferred Action for Childhood Arrivals, categories, you must complete this worksheet so we can determine whether you have an economic need to work.  In the spaces provided, indicate your current annual income, your current annual expenses, and the total current value of your assets.  You do not have to submit supporting evidence, but U.S. Citizenship and Immigration Services (USCIS) will accept and review any documentation that you submit.  You do not need to include other household members' financial information to establish your own economic necessity.

Part 1.  Your Full Name

1. Family Name (Last Name)
Given Name (First Name)
Middle Name

Page 1,

Part 2.  Financial Information
[Page 1]

Part 2.  Financial Information

1. My current annual income is:
2. My current annual expenses are:
3. The total current value of my assets is:

[Page 1]

Part 2.  Financial Information

1. My current annual income is:
2. My current annual expenses are:
3. The total current value of my assets is:

Page 1,

Part 3.  Explanation
[Page 1]

Part 3.  Explanation

If you would like to provide an explanation regarding your current financial information or your economic need for employment authorization, use the space below.

[Fillable field]

[Page 1]

Part 3.  Explanation

If you would like to provide an explanation regarding your current financial information or your economic need for employment authorization, use the space below.

[Fillable field]