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Application to Extend/Change Nonimmigrant Status (efile)

ICR 202009-1615-009 · OMB 1615-0003 · Object 104250101.

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File Title	Application to Extend/Change Nonimmigrant Status (efile)
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myUSCIS copy deck
I-539 Application to Change/Extend Nonimmigrant Status
OMB control number 1615-0003
Baseline version: concluded 10/15/19
Edits in support of: Final Fee Rule

Final Fee Rule - edits made

I-539 INTERACTIVE FORM COPY: QUESTIONS, INSTRUCTIONAL AND

Copy in gray boxes is approved copy from previous forms and should not be edited
Step: Indicates the form navigation element.
Section: Indicates the form sub-navigation element. Copy for questions should be grouped by appro
Questions/Sub-Questions: Based on the questions from the paper form.
Instructional text: Text that appears directly below a question and provides instructions for answer
Help text: Text that appears below or next to an input field, partially hidden. Users can click to expan
CTA: copy for button
Page breaks are indicated by a horizontal line (the same sub-navigation can have multiple pages)
Conditional question logic is indicated in ( ) before question
Heading
Sub-Heading
Application to Extend/Change
Nonimmigrant Status

Before you start your application

Eligibility

Fee

Refund Policy

Filing online
Documents you may need

After you submit your application

Track your case online

Respond to requests for
information
Provide your biometrics
Completing your form online

Provide as many responses as
you can
We will automatically save
your responses
DHS Privacy Notice

USCIS Compliance Review and
Monitoring

Paperwork Reduction Act

UESTIONS, INSTRUCTIONAL AND HELP TEXT, AND OTHER COPY

s forms and should not be edited

Copy for questions should be grouped by appropriate section.
rom the paper form.
a question and provides instructions for answering the question or completing this step/section of the form.
t field, partially hidden. Users can click to expand. Provides additional contextual or clarifying information abo

me sub-navigation can have multiple pages)
estion
Current Body Text
Currently, you may file an Application to Extend/Change Nonimmigrant Status (I-539) online if you are filing for yourself.
You should refer to Instructions for Form I-539 to see if you can use this online form for your nonimmigrant status.

If your nonimmigrant status is based on the fact that you are a family member or dependent of an individual who has already
been granted nonimmigrant status, then you must file your application while that individual continues to maintain a valid
nonimmigrant status. Family members and dependents are limited to the same period of authorized stay as the principal
immigrant.
You may NOT be granted an extension or change of status if you were admitted under the Visa Waiver Program or if your
current status is:
・An alien in transit (C) or in transit without a visa (TWOV)
・A crewman (D)
・A fiancé(e) or dependent of a fiancé(e) (K-1 or K-2)

EXCEPTION: A K-3 and K-4 are eligible to apply for an extension of status. They should file for an extension during the processin
of Form I-130 filed on their behalf and up to completion of their adjustment-of-status application.

We will automatically calculate the cost for you when you submit your application.
The application fee is $370. An additional biometrics services fee of $85 is required for you and for each person
included on a Form I-539A.

USCIS does not refund fees, regardless of any action we take on your application, petition, or request.
By continuing this transaction, you acknowledge that you must submit fees in the exact amount and that you are
paying the fees for a government service. You further agree that the filing fee, biometric fee, and any other paid
costs related to this financial transaction are final and not refundable.
Please refer to the instructions for the form(s) you are filing for additional information or you may call the USCIS
Contact Center at 800-375-5283. The USCIS Contact Center provides information in English and Spanish. For TTY
(deaf or hard of hearing) 800-767-1833.
Submitting your application online is the same as mailing in a completed paper form. They both gather the same
information and cost the same.
Most applicants will be required to submit:
・Nonimmigrant Arrival-Departure Record (I-94) for all applicants
・Passport and travel document numbers
・A valid passport
Several other documents will be required depending on your current nonimmigrant status. We will automatically
determine which documents you should provide us as you fill out your application.
After you submit your form, you can track its status through your USCIS account. Sign in to your account often to
check your case status and read any important messages from USCIS.

If we need more information from you, we will send you a Request for Evidence (RFE) or Request for Information
(RFI). You can respond to our request and upload your documents through your USCIS account.
If necessary, we will contact you to schedule an appointment at an Application Support Center near you. At the
appointment, we will get your fingerprints, photograph, and signature.
You should provide as many responses as you can. Incomplete fields or sections and missing information can slow down the
process after you submit your form. If you do not finish your form in one session, you can sign in to your account to continue
where you left off.

We will automatically save your information when you select next to go to a new page or navigate to another sectio
of the form. Your responses will be saved for 30 days. You can sign in to your account at anytime to continue where
you left off.

AUTHORITIES: The information requested on this application, and the associated evidence, is collected pursuant to
the U.S. Code sections 1103 and 1184 and Title 8 of the Code of Federal Regulations parts 103, 214 and 248.
PURPOSE: The primary purpose for providing the requested information on this application is to apply for an
extension of stay or a change from one nonimmigrant category to another nonimmigrant category. DHS will use the
information you provide to grant or deny the immigration benefit you are seeking.
DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information,
including your Social Security number (if applicable), and any requested evidence, may delay a final decision or resu
in denial of your application.
ROUTINE USES: DHS may share the information you provide on this application and any additional requested
evidence 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/ICE/CBP
001 Alien File, Index, and National File Tracking System, DHS/USCIS-007 Benefits Information System] and the
published privacy impact assessment [DHS/USCIS/PIA-016(a) Computer Linked Application Information Managemen
System and Associated Systems], which can be found at www.dhs.gov/privacy. DHS may also share the information,
as appropriate, for law enforcement purposes or in the interest of national security.

By signing this application, you have stated under penalty of perjury (28 U.S.C. section 1746) that all information and
documentation submitted with this application are complete, true, and correct. You also authorize the release of an
information from your records that USCIS may need to determine your eligibility for the immigration benefit you are
seeking and consent to USCIS verifying such information.

DHS has the authority to verify any information you submit to establish eligibility for the immigration benefit you ar
seeking at any time. USCIS’ legal authority to verify this information is in 8 U.S.C. sections 1103, 1155, and 1184, and
8 CFR parts 103, 204, 205, and 214. To ensure compliance with applicable laws and authorities, USCIS may verify
information before or after your case is decided.
Agency verification methods may include, but are not limited to: review of public records and information; contact
through written correspondence, the internet, fax, other electronic transmission, or telephone; unannounced
physical site inspections of residences and locations of employment; and interviews. USCIS will use information
obtained through verification to assess your compliance with the laws and to determine your eligibility for an
immigration benefit.

Subject to the restrictions under 8 CFR 103.2(b)(16), USCIS will provide you with an opportunity to address any
adverse or derogatory information that may result from a USCIS compliance review, verification, or site visit after a
formal decision is made on your case or after the agency has initiated an adverse action which may result in
revocation or termination of an approval.
An agency may not conduct or sponsor in 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 2.38 hours per response,
including the time for reviewing instructions, gathering the required documentation and information, completing th
application, preparing statements, attaching necessary documentation, and submitting the application. The
collection of biometrics 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
Do not mail your completed Form I-539 to this address.
OMB Number: 1615-0003
Expires: 10/31/2021

form.
ion about a question.

Revised Body Text
You may file an Application to Extend/Change Nonimmigrant Status (I-539) to apply for an extension of stay or a change to
another nonimmigrant status.
In certain situations, you may use this application to apply for an initial nonimmigrant status.
You may also use this application if you are a nonimmigrant F-1 or M-1 student applying for reinstatement.
Learn more about <a href="https://www.uscis.gov/i-539">extending or changing your nonimmigrant status</a>

You may be eligible to apply for an extension of your authorized stay if:
・You were lawfully admitted into the United States with a nonimmigrant visa
・Your nonimmigrant visa status remains valid
・You have not committed any crimes that make you ineligible for a visa
・You have not violated the conditions of your admission
・Your passport is valid and will remain valid for the duration of your stay
・Since obtaining the nonimmigrant status you seek to extend or change, you have not received public benefits for more than
12 months within any 36 month period (unless you qualify for any of the exemptions below):
n On July 2
2020, the U.S. District Court for the Southern District of New York (SDNY) in State of New York, et al. v. DHS, et al. and Make th
Road NY et al. v. Cuccinelli, et al. enjoined the Department of Homeland Security (DHS) from enforcing, applying, implementin
or treating as effective the Inadmissibility on Public Charge Grounds Final Rule (“Public Charge Final Rule”) for any period durin
which there is a declared national health emergency in response to the COVID-19 outbreak. (84 FR 41292, Aug. 14, 2019, final
rule; as amended by 84 FR 52357, Oct. 2, 2019, final rule correction). Subsequently, on August 12, 2020, the U.S. Court of
Appeals for the Second Circuit, in State of New York, et al. v. DHS, et al. and Make the Road NY et al. v. Cuccinelli, granted an
administrative stay of the July 29, 2020 nationwide injunction in all states outside of the Second Circuit, i.e. all states except
New York, Connecticut, and Vermont. This stay allows DHS to continue implementing the Public Charge Final Rule everywhere
except in New York, Connecticut, and Vermont.
During the injunction, applicants requesting an extension of stay or change of status using Form I-539 who physically reside in
New York, Connecticut, or Vermont, should not provide information requested in Part 5. Public Benefits.
PUBLIC BENEFITS:
1. Any Federal, state, local, or tribal cash assistance for income maintenance including:
a. Supplemental Security Income (SSI);
b. Temporary Assistance for Needy Families (TANF); or
c. Federal, state, or local cash benefit programs for income maintenance (often called “General Assistance” in the state
context, but which may exist under other names);
2. Supplemental Nutrition Assistance Program (SNAP, formerly called “Food Stamps”);
3. Section 8 Housing Assistance under the Housing Choice Voucher Program;
4. Section 8 Project-Based Rental Assistance (including Moderate Rehabilitation);
5. Public Housing under the Housing Act of 1937, 42 U.S.C. 1437 et seq.; and
6. Federally-funded Medicaid.
[Exemption accordion - see last tab in spreadsheet]

We will automatically calculate the cost for you when you submit your application.
The application fee is $390.

USCIS does not refund fees, regardless of any action we take on your application, petition or request, or how long
USCIS takes to reach a decision. By continuing this transaction, you acknowledge that you must submit fees in the
exact amount and that you are paying the fees for a government service.
Please refer to the instructions for the form(s) you are filing for additional information or you may call the USCIS
Contact Center at 800-375-5283. For TTY (deaf or hard of hearing) 800-767-1833.

CTA

Learn more about <a
href="https://www.uscis.gov/feewaiver">filing a fee waiver</a>.

Agency verification methods may include, but are not limited to: review of public records and information; contact
through written correspondence, the internet, fax, other electronic transmission, or telephone; unannounced physi
inspections of residences and locations of employment; and interviews. USCIS will use information obtained through
verification to assess your compliance with the laws and to determine your eligibility for an immigration benefit.

Subject to the restrictions under 8 CFR 103.2(b)(16), USCIS will provide you with an opportunity to address any adve
or derogatory information that may result from a USCIS compliance review, verification, or site visit after a formal
decision is made on your case or after the agency has initiated an adverse action which may result in revocation or
termination of an approval.

Final Fee Rule - no edits

I-539 INTERACTIVE FORM COPY: QUESTIONS, INSTRUCTIONAL AND

Copy in gray boxes is approved copy from previous forms and should not be edited
Step: Indicates the form navigation element.
Section: Indicates the form sub-navigation element. Copy for questions should be grouped by appro
Questions/Sub-Questions: Based on the questions from the paper form.
Instructional text: Text that appears directly below a question and provides instructions for answer
Help text: Text that appears below or next to an input field, partially hidden. Users can click to expan
CTA: copy for button
Page breaks are indicated by a horizontal line (the same sub-navigation can have multiple pages)
Conditional question logic is indicated in ( ) before question
Step
Section
Paper Form Question
Question #
Getting
Basis for eligibility
1.15a What is your current
Started
nonimmigrant status?

1.16 Were you granted Duration of
Status (D/S)?

1.15b When does your current
nonimmigrant status expire?

Reason for request

2.1

What are you applying for?

2.2
2.3.a
2.3.c

(IF CHANGE OF STATUS) What is
the change of status you are
requesting?

2.3.b

(IF CHANGE OF STATUS) What is
the effective date of change?

3.1

What date are you requesting
your current or requested
status be extended until?

Preparer and interpreter
information

Is someone assisting you with
completing this application?
(IF YES) Is a preparer assisting
you with completing this
application?
(IF YES) Is an interpreter
assisting you with completing
this application?

Preparer information

(IF YES TO PREPARER) What is

8.1.b your preparer's full name?
8.1.a

What is your preparer's
business or organization
8.2 name?

What is your preparer's

8.3.h mailing address?
8.3.a
8.3.b
8.3.c
8.3.d/8.3.f
8.3.e/8.3.g

What is your preparer's

8.4 contact information?
8.5

8.6

Interpreter information

(IF YES TO INTERPRETER)
What is your interpreter's full
7.1.b name?
7.1.a

What is your interpreter's
business or organization
7.2 name?

What is your interpreter's
7.3.h mailing address?
7.3.a
7.3.b
7.3.c
7.3.d/f
7.3.e/g

What is your interpreter's
7.4 contact information?
7.5

7.6

What language is your
interpreter using to interpret
6.1.b this application for you?

NSTRUCTIONAL AND HELP TEXT, AND OTHER COPY

uld not be edited

s should be grouped by appropriate section.
m.
ovides instructions for answering the question or completing this step/section of the form.
dden. Users can click to expand. Provides additional contextual or clarifying information about a question.

n can have multiple pages)
Sub-Question

Field Type
Dropdown

Yes/No

Radio

Date

Reinstatement to student
status

checkbox

An extension of stay in my
current status

checkbox

A change of status

checkbox
dropdown

Instructional Text

month/day/year

date

month/day/year

date

Yes/No

Radio

Yes/No

Radio

Yes/No

Radio

Given name (first name)

Text

Family name (last name)

Text
Text

A preparer is anyone who
completes or helps you complete
all or part of your application using
information and answers that you
provide.

My preparer is not part of a Checkbox
business or organization.
Text
Country
Address line 1
Text
Address line 2
Text
Text
City or town
Dropdown
State/Province (FOR
FOREIGN ADDRESS)
ZIP code/Postal code (FOR Text
FOREIGN ADDRESS)
Daytime telephone number Text
Mobile telephone number Text

Street number and name
Apartment, suite, unit, or floor

My preparer does not have Checkbox
a mobile telephone
number.
Text
Email address
My preparer does not have Checkbox
an email address.
Text
Given name (first name)
Family name (last name)

Text
Text

My interpreter is not part
of a business or
organization.
Country

Checkbox
Text

Address line 1
Text
Address line 2
Text
Text
City or town
Dropdown
State/Province (FOR
FOREIGN ADDRESS)
ZIP code/Postal code (FOR Text
FOREIGN ADDRESS)
Daytime telephone number Text
Mobile telephone number
My interpreter does not
have a mobile telephone
number.
Email address
Text
My interpreter does not
Checkbox
have an email address.
Text

Street number and name
Apartment, suite, unit, or floor

ction of the form.
ng information about a question.

Help Text

Notation on certain nonimmigrant
Form I-94 indicating that the individual,
such as an F-1 nonimmigrant student, is
authorized to remain in the U.S. as long
as he or she maintains a valid status.

Primary Secondary CTA
CTA

Final Fee Rule - edits made

I-539 INTERACTIVE FORM COPY: QUESTIONS, INSTRUCTIONAL AND

Section

About You Your Name

Paper Form Question
Question #
1.1.b What is your current legal
name?

Given name (first name)
Middle name (if applicable)

1.1.c

Your Contact
Information

Sub-Question

1.1.a
Family name (last name)
1.4.a What is your current mailing In care of name (if any)

address?

1.4.b

Address line 1

1.4.c
1.4.d
1.4.e
1.4.f

Address line 2
City or town
State
ZIP code
I live at my current mailing
address

Where do you live now?

1.5.a
1.5.b
1.5.c
1.5.d
1.5.e

Address line 1
Address line 2
City or town
State
ZIP code

4.2.a What is your physical address
abroad?
4.2.b
4.2.c
4.2.d
4.2.e
4.2.f
6.3 How can we contact you?
6.4

Additional
Information

6.5
1.2 What is your A-Number?

1.3 What is your USCIS Online

Account Number?

1.8 What is your date of birth?

Address line 1
Address line 2
City or town
Province
Postal Code
Country
Daytime telephone number
Mobile telephone number
This is the same as my
mobile telephone number.
Email address
I do not have or know my
A-number
I do not have an USCIS
Online Account Number

month/date/year

1.9 What is your U.S. Social

Security number?

I do not have a U.S. Social
Secuirity Number
What is your current
4.1.a passport number?
4.1.b What country issued your
passport?
Your Immigration
Information

Country

4.1.c What date does your passport
expire?
month/date/year
1.6
What is your country of birth?

1.7 What is your country of
citizenship or nationality?

1.10

What is your date of last arrival
into the United States?
1.11 What is your I-94 ArrivalDeparture Record Number?
1.12 What is the passport number
listed on your I-94?
1.13 What is your travel document
number?
1.14.a What country issued your
passport or travel document?
1.14.b What is the expiration date for
your passport or travel
document?

CTIONAL AND HELP TEXT, AND OTHER COPY

e edited

be grouped by appropriate section.

structions for answering the question or completing this step/section of the form.
ers can click to expand. Provides additional contextual or clarifying information about a question.

e multiple pages)
Field Type
Text

Instructional Text
Your current legal name is the name on your birth certificate, unless it changed after birth
by a legal action such as marriage or court order. Do not provide any nicknames here.

Text
Text
Text

Text

Street number and name

Text
Text
Text
Text
Checkbox

Apartment, suite, unit, or floor

Text
Text
Text
Text
Text

Street number and name
Apartment, suite, unit, or floor

Text

Street number and name

Text
Text
Text
Text
Dropdown

Apartment, suite, unit, or floor

Text
Text
Checkbox
Text

Text
Checkbox
Checkbox

You can find your USCIS Online Account Number by signing in to your account and
going to your profile page.
If you previously filed an application, petition, or request using the USCIS online
filing system, provide the USCIS Online Account Number you were issued.
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. You can find this number at the
top of the notice.

Date

The USCIS Online Account Number is not the same as an A-Number. The USCIS
Online Account Number was previously called the USCIS Electronic Immigration
System (USCIS ELIS) Number.

Text

Checkbox

Dropdown
date

Dropdown

If you are the Principal Applicant, provide your current passport information.

Provide the name of the country as it currently exists, where you are currently a citizen or
national. If the country no longer exists, use the current name of the country.
If you are a citizen or national of more than one country, provide the name of the foreign
country that issued your last passport.
Text

Text
Text

Text
Dropdown

date

If you are stateless, enter the name of the current country where you were last a citizen or
national.
Provide information about your most recent entry into the United States

estion.

Revised Instructional Text

Providing your unique USCIS Online Account Number (OAN) helps us manage
your account. You may already have an OAN if you previously filed certain
paper forms and received an Account Access Notice in the mail. You can find
the OAN at the top of the notice; it is not the same as an A-Number.

Help Text

We will use your current mailing
address to contact you throughout the
application process. We may not be
able to contact you if you do not
provide a complete and valid address.
Please provide a U.S. address only.

Revised Help Text

Primary
CTA

Certain paper forms: I-90, I-130, I-485,
I-821, I-821D, N-336, N-400, N-565, N600, N-600K

This information may be found on your
Nonimmigrant Arrival/Departure Record (I94) issued by U.S. Customs and Border
Protection (CBP) or USCIS upon arrival to
the United States. 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 I-94 by CBP,
instead of a paper form. Visit CBP
[https://www.cbp.gov/travel/internationalvisitors/i-94] to obtain a paper version of
your I-94.
If you are unable to obtain a copy of your I94 from CBP, go to the USCIS I-102
[https://www.uscis.gov/i-102] to find
additional I-94 Replacement Information.

Secondary CTA

Final Fee Rule - no edits

I-539 INTERACTIVE FORM COPY: QUESTIONS, INSTRUCTIONAL AND

Copy in gray boxes is approved copy from previous forms and should not be edited
Step: Indicates the form navigation element.
Section: Indicates the form sub-navigation element. Copy for questions should be grouped by appro
Questions/Sub-Questions: Based on the questions from the paper form.
Instructional text: Text that appears directly below a question and provides instructions for answer
Help text: Text that appears below or next to an input field, partially hidden. Users can click to expan
CTA: copy for button
Page breaks are indicated by a horizontal line (the same sub-navigation can have multiple pages)
Conditional question logic is indicated in ( ) before question
Step
Section
Paper Form Question
Question #
Moral
Party and group
Character affiliations

4.7.a

4.7.b

4.7.c

4.7.d

4.7.e

Have you, or any other person included on this
application, EVER ordered, incited, called for,
committed, assisted, helped with, or otherwise
participated in acts involving torture or genocide?
(IF YES) Provide an explanation.
Have you, or any other person included on this
application, EVER ordered, incited, called for,
committed, assisted, helped with, or otherwise
participated in killing any person?
(IF YES) Provide an explanation.
Have you, or any other person included on this
application, EVER ordered, incited, called for,
committed, assisted, helped with, or otherwise
participated in intentionally and severely injuring any
person?
(IF YES) Provide an explanation.

Have you, or any other person included on this
application, EVER ordered, incited, called for,
committed, assisted, helped with, or otherwise
participated in engaging in any kind of sexual contact or
relations with any person who did not consent or was
unable to consent, or was being forced or threatened?
(IF YES) Provide an explanation.
Have you, or any other person included on this
application, EVER ordered, incited, called for,
committed, assisted, helped with, or otherwise
participated in limiting or denying any person's ability to
exercise religious beliefs?
(IF YES) Provide an explanation.

4.8.a

4.8.b

4.9

4.10

4.11

Immigration
Proceedings

4.12

4.13

Have you, or any person included on the application,
EVER served in, been a member of, assisted, or
participated in any military unit, paramilitary unit, police
unit, self-defense unit, vigilante unit, rebel group,
guerrilla group, militia, insurgent organization, or any
other armed group?
(IF YES) Provide an explanation.
Have you, or any person included in this application,
EVER worked, volunteered, or otherwise served in any
prison, jail, prison camp, detention facility, labor camp,
or any other situation that involved detaining persons?
(IF YES) Provide an explanation.
Have you, or any other person included in this
application, EVER been a member of, assisted, or
participated in any group, unit, or organization of any
kind in which you or other persons used any type of
weapon against any person or threatened to do so?
(IF YES) Provide an explanation.
Have you, or any person included in this application,
EVER assisted or participated in selling, providing, or
transporting weapons to any person who, to your
knowledge, used them against another person?
(IF YES) Provide an explanation.
Have you, or any person included in this application
EVER received any type of military, paramilitary, or
weapons training?
(IF YES) Provide an explanation.
Have you, or any person included in this application,
done anything that violated the terms of the
nonimmigrant status you now hold?
(IF YES) Provide an explanation.
Are you, or any other person included in this application,
now in removal proceedings?
(IF YES) Provide an explanation with the name of the
person in removal proceedings, and information on
jurisdiction, date proceedings began, and status of
proceedings.

RUCTIONAL AND HELP TEXT, AND OTHER COPY

ot be edited

ould be grouped by appropriate section.

es instructions for answering the question or completing this step/section of the form.
n. Users can click to expand. Provides additional contextual or clarifying information about a question.

n have multiple pages)
Sub-Question

Field Type

Yes/No

Radio

Yes/No

Textarea
Radio

Yes/No

Textarea
Radio

Yes/No

Textarea
Radio

Yes/No

Textarea
Radio

Textarea

Instructional Text

Yes/No

Radio

Yes/No

Textarea
Radio

Yes/No

Textarea
Radio

Yes/No

Textarea
Radio

Yes/No

Textarea
Radio

Yes/No

Textarea
Radio

Yes/No

Textarea
Radio
Textarea

p/section of the form.
rifying information about a question.

Help Text

Primary Secondary CTA
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I-539 INTERACTIVE FORM COPY: QUESTIONS, INSTRUCTIONAL AND

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Questions/Sub-Questions: Based on the questions from the paper form.
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CTA: copy for button
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Conditional question logic is indicated in ( ) before question
Step
Section
Paper Form Question
Question #
Your
Application

Information about request

3.2.a.

Is this application based on an extension
or change of status already granted to
your spouse, child, or parent?

3.2.b

(IF YES) Provide the USCIS receipt
number for the extension or change
already granted to your spouse, child, or
parent.

3.3.a

Is this application based on a separate
petition or application to give your
spouse, child, or parent an extension or
change if status?

3.3.b

(IF YES PENDING) Provide the USCIS
receipt number for the pending case.

3.4

(IF YES PENDING) What is the name of
the petitioner or applicant for the
pending application?

3.5

What date was the petition or
application filed?

Additional information about
request

4.3

4.4

4.5

4.6

4.14

4.15

Co-Applicants

2.4/2.5.a

Are you, or any other person included on
the application, an applicant for an
immigrant visa?
(IF YES) Provide an explanation.
Has an immigrant petition EVER been
filed for you or for any other person
included in this application?
(IF YES) Provide an explanation.
Has an Application to Register
Permanent Resident or Adjust Status (I485), EVER been filed by you or by any
other person included in this
application?
(IF YES) Provide an explanation.
Have you, or any other person included
in this application, EVER been arrested or
convicted of any criminal offense since
last entering the United States?
(IF YES) Provide an explanation.
Have you, or any other person included
in this application, been employed in the
United States since last admitted or
granted an extension or change of
status?
(IF YES)Describe the employment and
include the name of the person
employed, name and address of the
employer, weekly income, and whether
the employment was specifically
authorized by USCIS.
(IF NO)Describe how you are supporting
yourself. Include any documentary
evidence of the source, amount, and
basis for any income.

Are you, or any other person included on
the application, currently or have you
ever been a J-1 exchange visitor or a
J-2 dependent of a J-1 exchange
visitor?
(IF YES)Provide the dates you maintained
status as a J-1 exchange visitor or J-2
dependent.
Are you the only applicant applying with
this form?

2.5.b

(IF NO) What is the total number of
people (including yourself) in this
application?

UCTIONAL AND HELP TEXT, AND OTHER COPY
be edited

ld be grouped by appropriate section.

instructions for answering the question or completing this step/section of the form.
Users can click to expand. Provides additional contextual or clarifying information about a question.

ave multiple pages)
Sub-Question

Field Type

yes/no

radio

number

Instructional Text

The USCIS receipt number is a unique 13character identifier that consists of three capital
letters followed by 10 numbers (for example,
ABC1234567890). You can find it on notices of
action USCIS has sent your spouse, child or
parent.

Yes, filed with this I- checkbox
539

Yes, filed previously checkbox
and pending with
USCIS
No
checkbox
number

Given name (first Text
name)
Family name (last Text
name)
Month/day/year

date

Yes/No

radio

yes/no

text area
radio

yes/no

text area
radio

yes/no

text area
radio

yes/no

text area
radio

text area

yes/no

radio

text area

Yes/No

Radio button

Such evidence may include, but is not limited to:
• complete bank statements for checking
and/or savings accounts showing all
transactions,
• other cash assets, or
• affidavits of support from a sponsor.

Textfield

f the form.
ormation about a question.

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Primary Secondary CTA
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I-539 INTERACTIVE FORM COPY: QUESTIONS, INSTRUCTIONAL AND
Step

Section

Paper Form Question
Question #

Public Benefit

Public benefit information

5.1

(IF 5.1 = Yes) Public benefit
information to

Since obtaining the nonimmigrant status that
you seek to extend or from which you seek to
change, have you ever received, or are you
currently certified to receive in the future any
of the following public benefits? (See below
and select all that apply)

(if Yes) Select all of the public benefits which
you received or are currently certified to
receive:

(IF 5.1 = Yes) Public benefit history

Your public benefits
5.2.a-d What type of public benefit have you
received?

Public benefit additional
information

5.4.a.

What Agency Granted You the Benefit?
What date did you start receiving the
benefit?
What date did the benefit or coverage end or
what is the date it expires?
Have you received, applied for, or have been
certified to receive federally-funded
Medicaid in connection with any of the
following? (Select all that apply)

5.4.b.

(IF 5.4.a ≠ None of the above) Provide the
applicable start and end dates for federallyfunded Medicaid.

5.3

(If Yes to 5.1) Do any of the following apply to
you?

CTIONAL AND HELP TEXT, AND OTHER COPY
Sub-Question

Field Type

Yes, I have received or I am currently
certified to receive public benefits.

checkbox

No, I have not received any of the public
benefits listed above

checkbox

No, I am not certified to receive any of the checkbox
public benefits listed above
Any federal, state, local or tribal cash
checkbox
assistance for income maintenance
Supplemental Security Income (SSI)
Temporary Assistance for Needy Families
(TANF)
General Assistance (GA)
Supplemental Nutrition Assistance
Program (SNAP, formerly called “Food
Stamps”)
Section 8 Housing Assistance under the
Housing Choice Voucher Program

checkbox
checkbox
checkbox
checkbox

checkbox

Section 8 Project-Based Rental Assistance checkbox
(including Moderate Rehabilitation)
Public Housing under the Housing Act of
1937, 42 U.S.C. 1437 et seq.
Federally-funded Medicaid

checkbox
checkbox

dropdown

text area
date
date
text area

An emergency medical condition.
For a service under the Individuals with
Disabilities Education Act (IDEA).
Other school-based benefits or services
available up to the oldest age eligible for
secondary education under state law.

checkbox
checkbox

While you were under the age of 21.
While you were pregnant or during the
60-day period following the last day of
pregnancy.
None of the above statements apply to
me.
From

checkbox
checkbox

checkbox

checkbox
date

To
date
I am enlisted in the Armed Forces, or am checkbox
serving in active duty or in the Ready
Reserve Component of the U.S. Armed
Forces.
I am the spouse or the child of an
checkbox
individual who is enlisted in the Armed
Forces, or who is serving in active duty or
in the Ready Reserve Component of the
U.S. Armed Forces.

At the time I received the public benefits, I checkbox
(or my spouse or parent) was enlisted in
the Armed Forces, or was serving in active
duty or in the Ready Reserve Component
of the U.S. Armed Forces.
At the time I received the public benefits, I checkbox
was present in the United States in a
status exempt from the public charge
ground of inadmissibility.
At the time I received the public benefits, I checkbox
was present in the United States after
being granted a waiver off the public
charge ground of inadmissibility.
I am a child currently residing abroad who checkbox
entered the United States with a
nonimmigrant visa to attend an N-600K,
Application for Citizenship and Issuance of
Certificate under INA Section 322
interview.
None of the above statements apply to
checkbox
me.

ER COPY
Instructional Text
1. Any Federal, state, local, or tribal cash assistance for income
maintenance including:
a. Supplemental Security Income (SSI);
b. Temporary Assistance for Needy Families (TANF); or
c. Federal, state, or local cash benefit programs for income
maintenance (often called “General Assistance” in the state context,
but which may exist under other names);
2. Supplemental Nutrition Assistance Program (SNAP, formerly
called “Food Stamps”);
3. Section 8 Housing Assistance under the Housing Choice Voucher
Program;
4. Section 8 Project-Based Rental Assistance (including Moderate
Rehabilitation);
5. Public Housing under the Housing Act of 1937, 42 U.S.C. 1437 et
seq.; and
6. Federally-funded Medicaid.

Help Text

List all of the public benefits which you received or are set to
receive below.
This dropdown list is based on the public benefits you indicated you Add Public Benefit History Information
are currently receiving or certified to receive. Select from the public
benefits listed in the dropdown menu to provide the additional
information about that public benefit.
Date You Started Receiving the Benefit or if Certified, Date You Will
Start Receiving the Benefit or Date Your Coverage Starts

Primary CTA

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I-539 INTERACTIVE FORM COPY: QUESTIONS, INSTRUCTIONAL AND

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Step: Indicates the form navigation element.
Section: Indicates the form sub-navigation element. Copy for questions should be grouped by appro
Questions/Sub-Questions: Based on the questions from the paper form.
Instructional text: Text that appears directly below a question and provides instructions for answer
step/section of the form.
Help text: Text that appears below or next to an input field, partially hidden. Users can click to expan
clarifying information about a question.
CTA: copy for button
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Conditional question logic is indicated in ( ) before question
Step

Section

Paper Form Question
Question #

Additional
Explanation

Additional
explanation

9.1.a-9.7.d

You may provide additional information
for your application

, INSTRUCTIONAL AND HELP TEXT, AND OTHER COPY

should not be edited

tions should be grouped by appropriate section.
r form.
d provides instructions for answering the question or completing this

lly hidden. Users can click to expand. Provides additional contextual or

ation can have multiple pages)
Sub-Question

Field Type

Instructional Text

Additional
information

Textbox

If you need to provide any additional
information for any of your answers to the
questions in this form, enter it into the
space below. You should include the
questions that you are referencing.
If you do not need to provide any
additional information, you may leave this
section blank.

Help
Text

Notes

Final Fee Rule - no edits

I-539 INTERACTIVE FORM COPY: QUESTIONS, INSTRUCTIONAL AND

Required
evidence

Your Nonimmigrant Arrival/Departure Record (I-94)

Upload

Additional applicants' Nonimmigrant Arrival/Departure Record Upload
(I-94)

Your Nonimmigrant Arrival/Departure Record (I-94) or
Approval Notice (I-797)

Upload

Additional applicants' Nonimmigrant Arrival/Departure Record Upload
(I-94) or Approval Notice (I-797)

Your Interagency Record of Request - A, G, or NATO
Dependent Employment, Authorization, or
Change/Adjustment to/from A, G, or NATO Status (I-566)
Your employer's Nonimmigrant Arrival/Departure Record (I94)
Your employer's Nonimmigrant Arrival/Departure Record (I94)
Letter from your employer

Your employer's Interagency Record of Request - A, G, or
NATO Dependent Employment, Authorization, or
Change/Adjustment to/from A, G, or NATO Status (I-566)

Upload

Upload
Upload
Upload

Upload

Your written statement

Upload

Evidence of your lawful residence in Commonwealth of
Northern Mariana Islands
Evidence of your relationship with the CW-1 transitional
worker

Upload

Additional evidence for CW-2 applicants

Upload

Evidence of your relationship with the principal E
nonimmigrant

Upload

Additional evidence for dependents of principal E
nonimmigrants

Upload

Your Certificate of Eligibility for Nonimmigrant Student (I-20)

Upload

Proof of ability to pay

Upload

Evidence for reinstatement

Upload

Evidence of your relationship with the H temporary worker

Upload

Additional evidence for dependents of an H temporary worker Upload

Letter from your employer

Upload

Evidence of your relationship with the principal nonimmigrant Upload

Your Certificate of Eligibility for Exchange Visitor Status (DS2019)
Evidence of your relationship with the L intracompany
transferee

Upload

Additional evidence for dependents of an L intracompany
transferee

Upload

Evidence supporting your reason for an extension

Upload

Evidence of your relationship with the O nonimmigrant
worker

Upload

Additional evidence for dependents of an O nonimmigrant
worker

Upload

Evidence of your relationship with the P nonimmigrant worker Upload

Additional evidence for dependents of an P nonimmigrant
worker

Upload

Evidence of your relationship with the R religious worker

Upload

Additional evidence for dependents of an R religious worker

Upload

Evidence of your relationship with the TN professional worker Upload

Additional evidence for dependents of a TN professional
worker

Upload

Evidence demonstrating law enforcement need

Upload

Evidence demonstrating exceptional circumstances

Upload

Evidence supporting your reason for an extension

Upload

Evidence of your relationship with the T-1 nonimmigrant
principal

Upload

Evidence demonstrating law enforcement need

Upload

Evidence of your relationship with the U-1 nonimmigrant
principal

Upload

Evidence you received any public benefits.

Upload

Evidence of public benefit disenrollment request.

Upload

Evidence your enlistment in the U.S. Armed Forces, serving in Upload
active duty or in the Ready Reserve component of the U.S.
Armed forces.

Evidence of your relationship to a service member of the U.S. Upload
Armed forces.

Evidence of receiving Federal-Funded Medicaid by a child
under 21 years of age.

Upload

Proof of child's N-600K interview notice.

Upload

Evidence you received public benefits while in a category that Upload
is exempt from public charge.

Evidence you received public benefits while in a category
which had received a waiver for public charge.

Additional Additional evidence you want to provide
evidence

Upload

NSTRUCTIONAL AND HELP TEXT, AND OTHER COPY

ld not be edited

s should be grouped by appropriate section.
m.
vides instructions for answering the question or completing this step/section of the form.
dden. Users can click to expand. Provides additional contextual or clarifying information about a question.
can have multiple pages)
Instructional Text
Upload an image or copy of both sides of your Nonimmigrant Arrival/Departure Record
(I-94).
If you were admitted to the United States by U.S. Customs and Border Protection (CBP)
at an airport or seaport after April 30, 2013, you may have been issued an electronic I94 by CBP, instead of a paper form. Visit <a href="https://www.cbp.gov/i94">CBP</a>
to obtain a copy of your I-94.
If you are unable to obtain a copy of your I-94 from CBP, go to <a
href="https://www.uscis.gov/i-102">USCIS I-102</a> to find additional I-94
Replacement Information.
Upload an image or copy of both sides of the Nonimmigrant Arrival/Departure Record
(I-94) for each person included in your application.
If they were admitted to the United States by CBP at an airport or seaport after April
30, 2013, they may have been issued an electronic Nonimmigrant Arrival/Departure
Record by CBP, instead of a paper form. Visit the <a
href="https://www.cbp.gov/i94">CBP website</a> to obtain a paper version of their
Nonimmigrant Arrival/Departure Record.
If you are unable to obtain a copy of their I-94 from CBP, go to the <a
href="https://www.uscis.gov/i-102">USCIS I-102</a> page to find additional I-94
Replacement Information.

Upload an image or copy of both sides of your Nonimmigrant Arrival/Departure Record
(I-94). If you do not have your Nonimmigrant Arrival/Departure Record, you can upload
a copy of your Approval Notice (I-797) or an image of your passport that shows you
have already been granted status.
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 Nonimmigrant Arrival/Departure Record
by CBP, instead of a paper form. Visit the <a href="https://www.cbp.gov/i94">CBP
website</a> to obtain a paper version of your Nonimmigrant Arrival/Departure
Record.
If you are unable to obtain a copy of your I-94 from CBP, go to the <a
href="https://www.uscis.gov/i-102">USCIS I-102</a> page to find additional I-94
Replacement Information.
Upload an image or copy of both sides of the Nonimmigrant Arrival/Departure Record
(I-94) for each person included in your application. If you do not have your
Nonimmigrant Arrival/Departure Record, you can upload a copy of your Approval
Notice (I-797) or an image of your passport that shows you have already been granted
status.
If they were admitted to the United States by CBP at an airport or seaport after April
30, 2013, they may have been issued an electronic Nonimmigrant Arrival/Departure
Record by CBP, instead of a paper form. Visit the <a
href="https://www.cbp.gov/i94">CBP website</a> to obtain a paper version of their
Nonimmigrant Arrival/Departure Record.
If you are unable to obtain a copy of their I-94 from CBP, go to the <a
href="https://www.uscis.gov/i-102">USCIS I-102</a> page to find additional I-94
Replacement Information.
Upload an image or copy of the Iteragency Record of Request - A, G, or NATO
Dependent Employment, Authorization, or Change/Adjustment to/from A, G, or NATO
Status (I-566) that is certified by the Department of State and indicates your accredited
status.
Upload an image or copy of your employer's Nonimmigrant Arrival/Departure Record
(I-94) or an approval notice demonstrating their A status.
Upload an image or copy of your employer's Nonimmigrant Arrival/Departure Record
(I-94) or an approval notice demonstrating their G status.
Upload an image or copy of a letter from your employer stating:
・Your duties
・That the employer intends to personally employ you for the entirety of your contract
・Arrangements you have made to depart from the United States
Upload an image or copy of your employer's Interagency Record of Request - A, G, or
NATO Dependent Employment, Authorization, or Change/Adjustment to/from A, G, or
NATO Status (I-566) that is certified by the Department of State and indicates your
employer's continuing accredited status.

Upload a written statement explaining in detail:
・The reasons for your request for an extension or change
・The reasons why your extended stay would be temporary, including what
arrangements you have made to depart from the United States
・Any effect the extended stay may have on your foreign employment or residency
Upload an image or copy of proof of your lawful presence in the Commonwealth of the
Northern Mariana Islands (CNMI) as defined in 8 CFR 214.2(w)(l)(v).
Upload an image or copy of any evidence that shows each applicant's relationship to
the CW-1 transitional worker. This may include a birth certificate, marriage certificate,
or proof of termination of any prior marriages.
Upload an image or copy of one of the following:
1. Petition for a Nonimmigrant Worker in the CNMI (I-129CW) that was filed on behalf
of the CW-1 transitional worker
2. A copy of the Receipt Notice (I-797) related to the transitional worker's already
pending petition
3. A copy of the front and back of the transitional worker's most recent Nonimmigrant
Arrival/Departure Record (I-94)
4. A copy of the Approval Notice (I-797) showing the transitional worker has already
been granted status for the period requested on your application
Upload an image or copy of any evidence that shows each applicant's relationship to
the principal E nonimmigrant. This may include a birth certificate, marriage certificate,
or proof of termination of any prior marriages.

Upload an image or copy of one of the following:
1. Petition for a Nonimmigrant Worker (I-129) that was filed on behalf of the principal E
nonimmigrant
2. A copy of the Receipt Notice (I-797) related to the principal E nonimmigrant's already
pending Petition for a Nonimmigrant Worker (I-129)
3. A copy of the front and back of the principal E nonimmigrant's most recent
Nonimmigrant Arrival/Departure Record (I-94)
4. A copy of the Approval Notice (I-797) showing the principal E nonimmigrant has
already been granted status for the period requested on your application.

Upload an image or copy of your Certificate of Eligibility for Nonimmigrant Student (I20), issued by the school where you will study.
Upload an image or copy of any documentation that demonstrates your ability to pay
for your studies and support yourself, and any accompanying dependent family
members, while you are in the United States.
Upload an image or copy of any documentation that shows that your violation of status
resulted from circumstances beyond your control or that your violation relates to a
reduction in your course load that would have been within a Designated Schools
Official's (DSO's) power to authorize, and that failure to approve reinstatement would
result in extreme hardship for you.
If you have been out of status for more than 5 months at the time of filing your request
for reinstatement, you must also provide evidence that your failure to file within the 5
month period was the result of exceptional circumstances and that you filed your
request for reinstatement as promptly as possible under these exceptional
circumstances.
Upload an image or copy of any evidence that shows each applicant's relationship to
the H temporary worker. This may include a birth certificate, marriage certificate, or
proof of termination of any prior marriages.

Upload an image or copy of one of the following:
1. Petition for a Nonimmigrant Worker (I-129) that was filed on behalf of the H
temporary worker
2. A copy of the Receipt Notice (I-797) related to the H temporary worker's already
pending Petition for a Nonimmigrant Worker (I-129)
3. A copy of the front and back of the H temporary worker's most recent Nonimmigrant
Arrival/Departure Record (I-94)
4. A copy of the Approval Notice (I-797) showing the H temporary worker has already
been granted status for the period requested on your application.
Upload an image or copy of a letter from the employing media organization that:
・Verifies your employment
・Establishes that you are a representative of that media organization
・Describes your compensation and work to be performed
Upload an image or copy of any evidence that shows each applicant's relationship to
the principal nonimmigrant. This may include a birth certificate, marriage certificate, or
proof of termination of any prior marriages.
Upload an image or copy of your Certificate of Eligibility for Exchange Visitor Status
(DS-2019).
Upload an image or copy of any evidence that shows each applicant's relationship to
the L intracompany transferee. This may include a birth certificate, marriage certificate,
or proof of termination of any prior marriages.
Upload an image or copy of one of the following:
1. Petition for a Nonimmigrant Worker (I-129) that was filed on behalf of the L
intracompany transferee
2. A copy of the Receipt Notice (I-797) related to the L intracompany transferee's
already pending Petition for a Nonimmigrant Worker (I-129)
3. A copy of the front and back of the L intracompany transferee's most recent
Nonimmigrant Arrival/Departure Record (I-94)
4. A copy of the Approval Notice (I-797) showing the L intracompany transferee has
already been granted status for the period requested on your application.
Upload an image or copy of any evidence supporting your reason for requesting an
extension. You may request an extension if:
・Compelling educational or medical reasons have resulted in a delay of your course of
study
・You are applying for a post-completion optional practical training
・You are transferring to a different school
If you are transferring schools 6 months, or more, after the date you first admitted, you
will need to upload evidence showing you are unable to remain at the school you were
initially admitted to attend due to circumstances beyond your control.
Upload an image or copy of any evidence that shows each applicant's relationship to
the O nonimmigrant worker. This may include a birth certificate, marriage certificate,
or proof of termination of any prior marriages.

Upload an image or copy of one of the following:
1. Petition for a Nonimmigrant Worker (I-129) that was filed on behalf of the O
nonimmigrant worker
2. A copy of the Receipt Notice (I-797) related to the O nonimmigrant worker's already
pending Petition for a Nonimmigrant Worker (I-129)
3. A copy of the front and back of the O nonimmigrant worker's most recent
Nonimmigrant Arrival/Departure Record (I-94)
4. A copy of the Approval Notice (I-797) showing the O nonimmigrant worker has
already been granted status for the period requested on your application.
Upload an image or copy of any evidence that shows each applicant's relationship to
the P nonimmigrant worker. This may include a birth certificate, marriage certificate, or
proof of termination of any prior marriages.
Upload an image or copy of one of the following:
1. Petition for a Nonimmigrant Worker (I-129) that was filed on behalf of the P
nonimmigrant worker
2. A copy of the Receipt Notice (I-797) related to the P nonimmigrant worker's already
pending Petition for a Nonimmigrant Worker (I-129)
3. A copy of the front and back of the P nonimmigrant worker's most recent
Nonimmigrant Arrival/Departure Record (I-94)
4. A copy of the Approval Notice (I-797) showing the P nonimmigrant worker has
already been granted status for the period requested on your application.
Upload an image or copy of any evidence that shows each applicant's relationship to
the R religious worker. This may include a birth certificate, marriage certificate, or
proof of termination of any prior marriages.
Upload an image or copy of one of the following:
1. Petition for a Nonimmigrant Worker (I-129) that was filed on behalf of the R religious
worker
2. A copy of the Receipt Notice (I-797) related to the R religious worker's already
pending Petition for a Nonimmigrant Worker (I-129)
3. A copy of the front and back of the R religious worker's most recent Nonimmigrant
Arrival/Departure Record (I-94)
4. A copy of the Approval Notice (I-797) showing the R religious worker has already
been granted status for the period requested on your application.
Upload an image or copy of any evidence that shows each applicant's relationship to
the TN professional worker. This may include a birth certificate, marriage certificate, or
proof of termination of any prior marriages.
Upload an image or copy of one of the following:
1. Petition for a Nonimmigrant Worker (I-129) that was filed on behalf of the TN
professional worker
2. A copy of the Receipt Notice (I-797) related to the TN professional worker's already
pending Petition for a Nonimmigrant Worker (I-129)
3. A copy of the front and back of the TN professional worker's most recent
Nonimmigrant Arrival/Departure Record (I-94)
4. A copy of the Approval Notice (I-797) showing the TN professional worker has
already been granted status for the period requested on your application.
Upload an image or copy of any evidence demonstrating law enforcement need. This
may include a Declaration of Law Enforcement Officer for Victims or Trafficking in
Persons (I-914, Supplement B) or other evidence from law enforcement explaining that
your presence is necessary, and any other credible evidence.

Upload an image or copy of any evidence that demonstrates your exceptional
circumstances. This may include an affirmative statement or any other credible
evidence.
Upload a written statement explaining the need and reason for your request for an
extension.
Upload an image or copy of any evidence that shows each applicant's relationship to
the T-1 nonimmigrant principal. This may include a birth certificate, marriage
certificate, or proof of termination of any prior marriages.
Upload an image or copy of any evidence demonstrating law enforcement need. This
may include a U Nonimmigrant Status Certification (I-918, Supplement B) or other
evidence from law enforcement explaining that your presence is necessary, and any
other credible evidence.
Upload an image or copy of any evidence that shows each applicant's relationship to
the U-1 nonimmigrant principal. This may include a birth certificate, marriage
certificate, or proof of termination of any prior marriages.
Upload evidence in the form of a letter, notice, certification, or other agency
documents that contain the following:
1. Your name;
2. Name and contact information for the public benefit granting agency;
3. Type of benefit;
4. Date you started receiving the benefit or if certified, date you will start receiving the
benefit; and
5. Date benefit or coverage ended or expires (mm/dd/yyyy) (if applicable)

Upload evidence of your request to disenroll if the public benefit-granting agency has
not processed your request (if applicable).
Upload certified evidence of alien’s enlistment/service issued by the authorizing official
of the executive department in which service member is serving.

Upload a copy of Form DD-1173, United States Uniformed Services Identification and
Privilege Card (Dependent).

Upload a copy of the following (if applicable):
1. A statement with information regarding the "emergency medical condition"
determination (if applicable);
2. Documentation of these payments under the IDEA or school-based
service; and
3. Pregnancy verification letter from medical professional
including estimated duration of pregnancy.

Upload a copy of the N-600K interview notice.

Upload information that evidences of your status or that you
received a waiver for the public charge ground of inadmissibility, such as
1. Approval notice (such as Form I-797, Notice of
Action); or
2. Form I-94, Arrival/Departure Record.
Upload information that evidences of your status or that you
received a waiver for the public charge ground of
inadmissibility, such as
1. Approval notice (such as Form I-797, Notice of
Action); or
2. Form I-94, Arrival/Departure Record.

You can provide additional documents that support your application and help explain
any of your answers on the application. If you want to provide additional evidence
now, upload any documents below.

section of the form.
fying information about a question.

Logic
Required for all applicants (exclude T and U nonimmigrants)

Required for all additional applicants (exclude T and U
nonimmigrants)

If nonimmigrant status = T (law enforcement OR exceptional
circumstances), T derivative (T-2, T-3, T-4, T-5, T-6), U (law
enforcement OR exceptional circumstances), U-1, U-2, U-3, U-4,
U-5

If nonimmigrant status = A, G

If nonimmigrant status = A-3
If nonimmigrant status = G-5
If nonimmigrant status = A-3, G-5

If nonimmigrant status = A-3, G-5

If nonimmigrant status = B-1 or B-2

If nonimmigrant status = CW-2 (Dependent of CW-1)
If nonimmigrant status = CW-2

If nonimmigrant status = CW-2

If nonimmigrant status = E-1 Treaty Traders, E-1 employees, E-2
Treaty Investors, E-2 employees, E-2 CNMI Investors, E-3
Australian Specialty Occupation Professionals

If nonimmigrant status = F-1 (and requesting change or
reinstatement), M-1
If nonimmigrant status = F-1 (and requesting change or
reinstatement), M-1
If nonimmigrant status = F-1 (requesting reinstatement), M-1
(requesting reinstatement)

If nonimmigrant status = H-4

If nonimmigrant status = I

If nonimmigrant status = I (dependent)

If nonimmigrant status = J-1 (changing to J-1)
If nonimmigrant status = L-2

If nonimmigrant status = L-2

if nonimmigrant status = M-1 (extension)

If nonimmigrant status = O-3

If nonimmigrant status = P-4

If nonimmigrant status = R-2

If nonimmigrant status = TD

If nonimmigrant status = T (law enforcement need)

If nonimmigrant status = T (exceptional circumstances), U
(exceptional circumstances)
If nonimmigrant status = T-2, T-3, T-4, T-5, T-6, U-2, U-3, U-4, U5
If nonimmigrant status = T-2, T-3, T-4, T-5, T-6

If nonimmigrant status = U (law enforcement need)

If nonimmigrant status = U-2, U-3, U-4, U-5

If selected 5.1: “Yes, I have received or I am currently certified
to receive public benefits."

If selected 5.1: "Yes, I have received or I am currently certified
to receive public benefits."
If 5.3 = "I am enlisted in the Armed Forces, or am serving in
active duty or in the Ready Reserve Component of the U.S.
Armed Forces"
OR;
"At the time I received the public benefits, I (or my spouse or
parent) was enlisted in the Armed Forces, or was serving in
active duty or in the Ready Reserve Component of the U.S.
Armed Forces."
If 5.3 = "I am the spouse or the child of an individual who is
enlisted in the Armed Forces, or who is serving in active duty or
in the Ready Reserve Component of the U.S. Armed Forces."
OR;
"At the time I received the public benefits, I (or my spouse or
parent) was enlisted in the Armed Forces, or was serving in
active duty or in the Ready Reserve Component of the U.S.
Armed Forces."

If 5.4.a. = "While you were under the age of 21."OR;
"An emergency medical condition." OR;
"For a service under the Individuals with Disabilities Education
Act (IDEA)." OR;
"Other school-based benefits or services available up to the
oldest age eligible for secondary education under state law."
OR;
"While you were pregnant or during the 60-day period following
the last day of pregnancy."

If 5.3 = "I am a child currently residing abroad who entered the
United States with a nonimmigrant visa to attend an N-600K,
Application for Citizenship and Issuance of Certificate Under INA
Section 322 interview."
If 5.3 = "At the time I received the public benefits, I was present
in the United States in a status exempt from the public charge
ground of inadmissibility."

If 5.3 = "At the time I received the public benefits, I was present
in the United States after being granted a waiver off the public
charge ground of inadmissibility."

All applicants

Final Fee Rule - edits made

I-539 INTERACTIVE FORM COPY: QUESTIONS, INSTRUCTIONAL AND

Copy in gray boxes is approved copy from previous forms and should not be edited
Step: Indicates the form navigation element.
Section: Indicates the form sub-navigation element. Copy for questions should be grouped by appro
Questions/Sub-Questions: Based on the questions from the paper form.
Instructional text: Text that appears directly below a question and provides instructions for answer
Help text: Text that appears below or next to an input field, partially hidden. Users can click to expan
CTA: copy for button
Page breaks are indicated by a horizontal line (the same sub-navigation can have multiple pages)
Conditional question logic is indicated in ( ) before question
Step
Section
Paper Form Question
Question #
Review and Submit
Review your
Check your
application
application before
you submit

Your fee

Alerts and warnings

Your application
summary

Preparer signature

8.7.a

Preparer's
statement

8.7.b
8.7.b
8

Interpreter
signature

Preparer's
certification

8.8.a/b Preparer's signature
upload
Interpreter's
certification

Your signature

7.7.a/b Interpreter's
signature upload
6.1.a
Applicant's
statement
6.2

Applicant's
statement regarding
the preparer

6.1.b

Applicant's
statement regarding
the interpreter

Applicant's
declaration,
certification and
signature

Federal Agency
Disclosure and
Authorizations

6.6.a

6.6.b

Your signature

Pay and submit

Pay for and submit
your application

TIONS, INSTRUCTIONAL AND HELP TEXT, AND OTHER COPY

ms and should not be edited

y for questions should be grouped by appropriate section.
the paper form.
estion and provides instructions for answering the question or completing this step/section of the form.
ld, partially hidden. Users can click to expand. Provides additional contextual or clarifying information about a

ub-navigation can have multiple pages)
on
Sub-Question

I am not an attorney or accredited representative but have prepared this application on behalf of the
applicant and with the applicant's consent.

I am an attorney or accredited representative and my representation of the applicant in this case does
not extend beyond the preparation of this application.
I am an attorney or accredited representative and my representation of the applicant in this case
extends beyond the preparation of this application.
By my signature, I certify, under penalty of perjury, that I prepared this application at the request of
the applicant. The applicant then reviewed this completed application and informed me that he or
she understands all of the information contained in, and submitted with, his or her application,
including the Applicant's Declaration and Certification, and that all of this information is complete,
true, and correct. I completed this application based only on information that the applicant provided
to me or authorized me to obtain or use.
As the applicant's preparer, you must sign on paper and provide your signature page to the applicant.
Follow these steps:
1. Download the Preparer Signature page
2. Print the Preparer Signature page
3. Read and sign the Preparer Signature page
4. Give the signed Preparer Signature page to the applicant
The applicant will need to scan and upload your completed signature page on the next screen.
I certify, under penalty of perjury, that: I am fluent in English and the language provided in the Getting
Started section of this application, and I have read to this applicant in the identified language every
question and instruction on this application and his or her answer to every question. The applicant
informed me that he or she understands every instruction, question, and answer on the application,
including the Applicant's Declaration and Certification, and has verified the accuracy of every answer.

As the applicant's interpreter, you must sign on paper and provide your signature page to the
applicant. Follow these steps:
1. Download the Interpreter Signature page
2. Print the Interpreter Signature page
3. Read and sign the Interpreter Signature page
4. Give the signed Interpreter Signature page to the applicant
The applicant will need to scan and upload your completed signature page on the next screen.
I can read and understand English, and I have read and understand every question and instruction on
this application and my answer to every question.
At my request, the preparer named in the Getting Started section of this application/[preparer name]
prepared this application for me based only upon information I provided or authorized.
The interpreter named in the Getting Started section of this application read to me every question
and instruction on this application and my answer to every question in the language I specified in the
Getting Started section, a language in which I am fluent, and I understood everything.

Copies of any documents I have submitted are exact photocopies of unaltered, original documents,
and I understand that USCIS may require that I submit original documents to USCIS at a later date.
Furthermore, I authorize the release of any information from any and all of my records that USCIS
may need to determine my eligibility for the immigration benefit that I seek.
I furthermore authorize release of information contained in this application, in supporting documents,
and in my USCIS records, to other entities and persons where necessary for the administration and
enforcement of U.S. immigration law.
I understand that USCIS willrequire me to appear for an appointment to take my biometrics
(fingerprints, photograph, and/or signature) and, at that time, I will be required to sign an oath
reaffirming that:
1) I reviewed and understood all of the information contained in, and submitted with, my application;
and
2) All of this information was complete, true, and correct at the time of filing.
I certify, under penalty of perjury, that all of the information in my application and any document
submitted with it were provided or authorized by me, that I reviewed and understand all of the
information contained in, and submitted with, my application and that all of this information is
complete, true, and correct.

I authorize, as applicable, the Social Security Administration (SSA) to verify my Social Security number
(to match my name, Social Security number, and date of birth with information in SSA records and
provide the results of the match) to USCIS. I authorize SSA to provide explanatory information to
USCIS as necessary.
I authorize, as
applicable, the SSA, U.S. Department of Agriculture (USDA), U.S. Department of Health and Human
Services (HHS), U.S. Department of Housing and Urban Development (HUD), and any other U.S.
Government agency that has received and/or adjudicated a request for a public benefit, as defined in
8CFR 212.21(b), submitted by me or on my behalf, and/or granted one or more public benefits to me,
to disclose to USCIS that I have applied for, received, or have been certified to receive, a public
benefit from such agency, including the type and amount of benefits, dates of receipt, and any other
relevant information provided to the agency for the purpose of obtaining such as public benefit, to
the extent permitted by law. I also authorize SSA, USDA, HHS, HUD, and any other US. Government
agency to provide any additional data and information to USCIS, to the extent permitted by law.
I authorize, as applicable, custodians of records
and other sources of information pertaining to my request for or receipt of public benefits to release
information regarding my request for and/or receipt of public benefits, upon the request of the
investigator, special agents, or other duly accredited representative of any Federal agency authorized
above, regardless of any previous agreement to the contrary.
I understand that the information released by records custodians and
sources of information is for official use by the Federal Government, that the U.S. Government will
use it only to review if I have received public benefits in regards to my eligibility for immigration
benefits and to enforce immigration laws, and that the U.S. Government may disclose the information
only as authorized by law.
I have read and agree to the applicant's statement

[Date of signature]

on of the form.
information about a question.

Field Type

Current Instructional Text
We will review your application to check for accuracy and
completeness before you submit it.
We encourage you to provide as many responses as you can
throughout the application, to the best of your knowledge. Missing
information can slow down the review process after you submit your
application.
You can return to this page to review your application as many times as
you want before you submit it.
Your form filing fee is: $370
Refund Policy: USCIS does not refund fees, regardless of any action we
take on your application, petition, or request. By continuing this
transaction, you acknowledge that you must submit fees in the exact
amount and that you are paying the fees for a government service.

You have one or more alerts and warnings based on the information
you provided in your application.
A red alert means you have incomplete or incorrect responses to
certain questions. You cannotsubmit your application with any alerts.
A yellow warning means you may be missing information or may need
to follow-up with us about your responses. You can still submit your
application, but some warnings may slow down the review process
after you submit your application.

Here is a summary of all the information you provided in your
application.
Make sure you have provided responses for everything that applies to
you before you submit your application. You can edit your responses
by going to each application section using the site navigation.
Radio

Radio

Your preparer must read the statements below and select the
statement that applies to him or her.
If your preparer is an attorney or accredited representative whose
representation extends beyond preparation of this application, he or
she may be obliged to submit a completed Notice of Entry of
Appearance as Attorney or Accredited Representative (G-28) with your
application.

Radio
Checkbox

Your preparer must read and agree to the certification below.

Upload

Scan and upload your preparer's completed signature page below.

Checkbox

Your interpreter must read and agree to the certification below.

Upload

Scan and upload your interpreter's completed signature page below.

Checkbox

You must read and agree to the statement below.

Checkbox

You must read and agree to the statement below.

Checkbox

You must read and agree to the statement below.

You must read and agree to the certification below. If you knowingly
and willfully falsify or conceal a material fact or submit a false
document with your application, we can deny your application and may
deny any other immigration benefit. You may also face criminal
prosecution and penalties provided by the law.

Checkbox
You must provide your digital signature below by typing your full legal
name. We may deny your application if you do not completely fill out
this application or fail to submit required documents. We will record
the date of your signature with your application.

The final step to submit your Application to Extend/Change
Nonimmigrant Status (I-539) is to pay the required fee.
Your application fee is: $370
Refund Policy: USCIS does not refund fees, regardless of any action we
take on your application, petition, or request. By continuing this
transaction, you acknowledge that you must submit fees in the exact
amount and that you are paying the fees for a government service.

If you have a form fee, we will send you to Pay.gov — our safe, secure
payment website — to make your payment and submit your
application online.
Here are the steps in the payment and submission process:
1. Provide your billing information on Pay.gov
2. Provide your information for one of two billing options: credit card
or U.S. bank account
3. Submit your payment
When you have paid your fee, your application will be submitted.
Pay.gov will redirect you to an application confirmation screen. You can
track the status of your application through your USCIS online account.

Revised Instructional Text

Your form filing fee is: $390
Refund Policy: USCIS does not refund fees, regardless of any action we
take on your application, petition or request, or how long USCIS takes
to reach a decision. By continuing this transaction, you acknowledge
that you must submit fees in the exact amount and that you are paying
the fees for a government service.

The final step to submit your Application to Extend/Change
Nonimmigrant Status (I-539) is to pay the required fee.
Your application fee is: $390
Refund Policy: By continuing this transaction, you agree that you are
paying for a government service and that the filing fee, biometric
services fee and all related financial transactions are final and not
refundable, regardless of any action USCIS takes on an application,
petition or request, or how long USCIS takes to reach a decision. You
must submit all fees in the exact amounts.

Help Text

Primary CTA
Review my
application

Secondary CTA

Read the Penalties section of the Form I539 Instructions before completing this
section.

NOTE TO ALL APPLICANTS: If you do not
completely fill out this application or fail
to submit required documents listed in
the Instructions, USCIS may deny your
application.

Pay and submit

Final Fee Rule - no edits

I-539 FORM COPY: WARNINGS, ALERTS, NOTICES, AND ERRORS
Copy in gray boxes is approved copy from the N600 and should not be edited
Alert: Appears in red box; indicates missing required information or lack of eligibility; user cannot submit application
Warning: Appears in yellow box; indicates potential eligibility issue or follow-up step; user can submit application
Notice: Appears in blue box; indicates potential exemptions or other useful information; user can submit application
Error: Appears in red text below a form field; user can submit application

Number Type
Logic
1 Yellow alert This alert will show up
during Beta - Beta 2.1

1.1 Yellow alert This alert will show up
during Beta 4.

1.1 Yellow alert This alert will show up
during Beta 5.

2 Yellow alert This alert will show up
during Beta - Beta 2.1

3 Red alert

This alert will show up
during Beta - Beta 3. This
will go away with Beta 4.

4 Red alert

This alert will show up
during Beta - Beta 4. This
will go away with Beta 5.

5 Red alert

This will show up if I-94
is not uploaded

6 Yellow alert

Will show up if the user
has not answered
question about having
Public Benefits

7 Yellow alert

Will show up on Public
Benefits Additional
Information page

GS, ALERTS, NOTICES, AND ERRORS

om the N600 and should not be edited

required information or lack of eligibility; user cannot submit application
potential eligibility issue or follow-up step; user can submit application
ntial exemptions or other useful information; user can submit application
d; user can submit application

Message
h3. You can file an individual extension request online only for certain
statuses
At this time, you cannot file online if you:
* Need to extend your status and your nonimmigrant status is not listed
above,
* Want to reinstate or change your nonimmigrant status, or
* Have additional applicants.
* Have an A, G, NATO, V, T or U nonimmigrant status
* Require a lawyer or accredited representative
You will need to file a paper Form I-539.
h3. You can file an individual extension request online only for certain
statuses
At this time, you cannot file online if you:
* Need to extend your status and your nonimmigrant status is not listed
above,
* Have additional applicants.
* Have an A, G, NATO, V, T or U nonimmigrant status
* Require a lawyer or accredited representative
You will need to file a paper Form I-539.
h3. You can file an individual extension request online only for certain
statuses
At this time, you cannot file online if you:
* Need to extend your status and your nonimmigrant status is not listed
above,
* Have additional applicants.
* Have an A, G, NATO, V, T or U nonimmigrant status
You will need to file a paper Form I-539.
h3. You can file your extension request online only for certain statuses.
You can complete this online form if your current nonimmigrant status is
listed above and you are requesting an extension of status. You should
submit the paper Form I-539 if your current nonimmigrant status is not
listed above or you want to change or reinstate your nonimmigrant
status.

h3. Online filing is available only for extension of status requests.
You can complete this online form only if you are requesting an
extension of your nonimmigrant status. You should file a paper Form I539 if you want to change or reinstate your nonimmigrant status.
h3. You can file Form I-539 online only for yourself and no other
applicants at this time.
You can complete the online version of Form I-539 if you are requesting
an extension for only yourself. If you want to include co-applicants, you
must file the paper Form I-539.
h3. You must upload an image or copy of your Nonimmigrant
Arrival/Departure Record (I-94).
You cannot submit your application until you upload an image or copy of
your I-94.
h3. There are new question in the form

On October 15, 2019, the Public Benefits section was added to the I-539. If you
started your I-539 before October 15, 2019, you may not have seen this
section. You should fill out the Public Benefits section before submitting your
form.
CTA button link: "Go to Public Benefits section"
h3. There is evidence that you should upload for public benefits
Click on Next to go to the Evidence section.

Where the alert exists
https://qa-my.uscis.dhs.gov/apply/application-to-extend-changenonimmigrant-status/overview

https://qa-my.uscis.dhs.gov/apply/application-to-extend-changenonimmigrant-status/overview

https://qa-my.uscis.dhs.gov/apply/application-to-extend-changenonimmigrant-status/2497/basis-for-eligibility

https://qa-my.uscis.dhs.gov/apply/application-to-extend-changenonimmigrant-status/2497/reason-for-request

https://qa-my.uscis.dhs.gov/apply/application-to-extend-changenonimmigrant-status/2497/additional-applicants

https://qa-my.uscis.dhs.gov/apply/application-to-extend-changenonimmigrant-status/4870/required-evidence

https://qa-my.uscis.dhs.gov/apply/application-to-extend-changenonimmigrant-status/4870/review-your-application

https://qa-my.uscis.dhs.gov/apply/application-to-extend-changenonimmigrant-status/4870/public-benefits-additional-information

Link goes to: https://www.uscis.gov/i539

Link goes to:
https://qa-my.uscis.dhs.gov/apply/applicati
on-to-extend-change-nonimmigrantstatus/4870/public-benefits-information

Final Fee Rule - no edits

Heading
Sub-Heading
Before you start your Eligibility
application

Body Text
EXEMPTIONS: The following
are exempted from the public
benefits listed above.

Accordion Header
Public benefits received by U.S. Armed
Forces;
Federal-funded Medicaid;

Children who will naturalize under INA
322;
Public benefits received while in an
immigration category exempt from
public charge;

Accordion Body
An alien enlisted in the U.S. Armed Forces, serving in active duty or in the Ready Reserve component of the U.S.
1. Receipt by a child under 21 years of age;
"emergency medical condition;"
Act (IDEA);

3. The receipt of Medicaid for services

4. The receipt of Medicaid for school-based benefits for children who are of an age eligible

law; or
the 60-day period after the last day of pregnancy.
Child currently residing abroad who entered the United States with a nonimmigrant visa to attend N-600K, Appli
Section 322 interview.
Received public benefits while in a category that is exempt from public charge; or received public benefits while