I-941 Form Table of Changes

I941-006-FRM-TOC-FinalFeeRule-PostG1056-06102020.docx

Application for Significant Public Benefit Entrepreneur and Instructions for Data Reporting Supplement

I-941 Form Table of Changes

OMB: 1615-0136

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TABLE OF CHANGES – FORM

Form I-941, Application for Entrepreneur Parole

OMB Number: 1615-0136

06/10/2020


Reason for Revision: Final Fee Rule.

Project Phase: Post G-1056


Legend for Proposed Text:

  • Black font = Current text

  • Red font = Changes


Please note – all instances of “if any” and “if applicable” have been removed from Form I-941.


Expires 04/30/2022

Edition Date 4/24/2019



Current Page Number and Section

Current Text

Proposed Text

Page 1, For USCIS Use Only

[Page 1]



To be completed by an attorney or accredited representative (if any).

Select this box if Form G-28 or G-28I is attached.

Attorney State Bar Number (if applicable)

Attorney or Accredited Representative USCIS Online Account Number (if any)


[Page 1]



To be completed by an attorney or accredited representative.

Select this box if Form G-28 or G-28I is attached.

Attorney State Bar Number

Attorney or Accredited Representative USCIS Online Account Number


Pages 1-3, Part 1. Information About Entrepreneur (Applicant)

[Page 1]



6. USCIS Online Account Number (if any)


7. U.S. Social Security Number (if any)


14. Current or Last Class of Admission (if any) (for example B-1, F-1, H-1B)


15. If you are present in the United States, other than on the basis of an Entrepreneur Parole, provide the receipt number of your most recent filing with USCIS (if applicable).


Provide information about your most recent Form I-94 Arrival/Departure Record, in Item Numbers 16.a. - 16.f. (if any).



16.c. Travel Document Number (if any)



Where do you want USCIS to send all travel documents for you, and your spouse and dependent children (if applicable)?



[Page 1]



6. USCIS Online Account Number


7. U.S. Social Security Number


14. Current or Last Class of Admission (for example B-1, F-1, H-1B)


15. If you are present in the United States, other than on the basis of an Entrepreneur Parole, provide the receipt number of your most recent filing with USCIS.


Provide information about your most recent Form I-94 Arrival/Departure Record, in Item Numbers 16.a. - 16.f.



16.c. Travel Document Number



Where do you want USCIS to send all travel documents for you, and your spouse and dependent children?



Pages 3-4, Part 3. Information About Family Members Requesting Parole or Re-Parole with Entrepreneur

[Page 3]



2. A-Number (if any)


3. USCIS Online Account Number (if any)


[Page 4]



9. A-Number (if any)


10. USCIS Online Account Number (if any)



15. A-Number (if any)


16. USCIS Online Account Number (if any)



[Page 3]



2. A-Number


3. USCIS Online Account Number


[Page 4]



9. A-Number


10. USCIS Online Account Number



15. A-Number


16. USCIS Online Account Number



Page 4, Part 4. Information About Additional Entrepreneurs Requesting or Have Been Granted Parole or Re-Parole with the Same Start-up Entity

[Page 4]



4. Receipt Number (if applicable)



8. Receipt Number (if applicable)


[Page 4]



4. Receipt Number



8. Receipt Number


Pages 4-8, Part 5. Basis of Eligibility – Qualifying Start-Up Entity and Owners

[Page 4]



4. DUNS number (if any)


[Page 7]



27.d. Legal Entity Name (if any)



29. A-Number (if any)


30. U.S. Social Security Number (if any)

31. USCIS Online Account Number (if any)



35.b. Position Held (if Any) in the Entity Listed in Part 5., Item Number 1.



39. Email Address (if any)


40. Website Address (if any)



[Page 8]


41.d. Legal Entity Name (if any)



43. A-Number (if any)


44. U.S. Social Security Number (if any)


45. USCIS Online Account Number (if any)



49.b. Position Held (if Any) in the Entity Listed in Part 5., Item Number 1.



53. Email Address (if any)


54. Website Address (if any)


[Page 4]



4. DUNS number


[Page 7]



27.d. Legal Entity Name



29. A-Number


30. U.S. Social Security Number

31. USCIS Online Account Number



35.b. Position Held in the Entity Listed in Part 5., Item Number 1.



39. Email Address


40. Website Address


[Page 8]


41.d. Legal Entity Name



43. A-Number


44. U.S. Social Security Number


45. USCIS Online Account Number



49.b. Position Held in the Entity Listed in Part 5., Item Number 1.



53. Email Address


54. Website Address


Pages 8-12, Part 6. Information on Qualified Investors or Government Entities Providing a Grant/Award

[Page 8]



3. A-Number (if any)


4. U.S. Social Security Number (if any)

[Page 9]



9. Email Address (if any)


10. Website Address (if any)



15. DUNS Number (if any)



21. DUNS Number (if any)


[Page 10]



24. DUNS Number (if any)



26.c. DUNS Number (if any)



30. Email Address (if any)


31. Website Address (if any)



[Page 11]


36. DUNS Number (if any)



42. DUNS Number (if any)



45. DUNS Number (if any)


[Page 12]



51. Email Address (if any)


52. Website Address (if any)



[Page 8]



3. A-Number


4. U.S. Social Security Number

[Page 9]



9. Email Address


10. Website Address



15. DUNS Number



21. DUNS Number


[Page 10]



24. DUNS Number



26.c. DUNS Number



30. Email Address


31. Website Address



[Page 11]


36. DUNS Number



42. DUNS Number



45. DUNS Number


[Page 12]



51. Email Address


52. Website Address




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