Form I-539A, Supplemental Information for Application to Extend/Change Nonimmigrant Status

Instructions for Form I-539A
Department of Homeland Security
U.S. Citizenship and Immigration Services

USCIS
Form I-539A

OMB No. 1615-0003
Expires 08/31/2020

What Is the Purpose of Form I-539A?
I-539A is part of Form I-539. If you are applying for more than one person using your I-539 application, use a separate
Form I-539A to provide all of the requested information for each additional applicant listed. Each Form I-539A must
include the signature of the individual applicant. If you are under 14 years of age, your parent or legal guardian may sign
the application on your behalf. A legal guardian may also sign for a mentally incompetent person.

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Special Instructions for V Nonimmigrants

If you are physically present in the United States and are applying for V nonimmigrant status, see the Who Is Eligible for
V Nonimmigrant Status section below.
NOTE: If you are filing Form I-539A, you do not necessarily have to be in valid nonimmigrant status to obtain V
nonimmigrant status in the United States. See the Who Is Eligible for V Nonimmigrant Status section for more
information.

Who Is Eligible for V Nonimmigrant Status?

To be eligible for V nonimmigrant status, you must be the spouse or child of a lawful permanent resident and be the
beneficiary of a properly filed Form I-130, Petition for Alien Relative, filed on or before December 21, 2000. In addition,
Form I-130 must have been filed three or more years prior to the date of filing Supplement A to Form I-539, and be:
1. Still pending; or

2. Approved, and your beneficiary must either:

A. Wait for an immigrant visa number to become available; or

B. If the visa number is immediately available, you must have pending an application for adjustment of status or an
application for an immigrant visa.
In addition, you must be admissible to the United States, except where the grounds of inadmissibility do not apply or have
been waived. The grounds of inadmissibility that do not apply are Immigration and Nationality Act (INA) sections:
1. 212(a)(6)(A) -- Aliens present without admission or parole;
2. 212(a)(7) -- Aliens without valid passports, visas, or other entry documents; and
3. 212(a)(9)(B) -- Aliens who were unlawfully present for more than 180 days, then departed, and seek admission while
barred from doing so.
Additional Instructions
1. Select Part 2. Application Type, Item Number 3.a. of Form I-539, and indicate “V” in Item Number 3.c.
2. Use information from the qualifying Form I-130 for your response to Part 3., Item Number 3.a. of Form I-539.

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Additional Evidence Requirements for V Nonimmigrants
In addition to the General Filing Instructions and Initial Evidence required by the Form I-539 Instructions, you must
submit:
1. Form I-693, Report of Medical Examination and Vaccination Record, without the vaccination supplement; and
2. Proof of filing of the immigrant petition that qualifies you for V nonimmigrant status, and if necessary, proof of filing
of Form I-485, Application to Register Permanent Residence or Adjust Status. Proof of filing may be in the form of
Form I-797, Notice of Action, that serves as a receipt or as a notice of approval, or a receipt for a filed Form I-130 or
Form I-485, or notice of approval issued by a local district/field office.
If you do not have such proof, U.S. Citizenship and Immigration Services (USCIS) will review other forms of
evidence, such as correspondence to or from USCIS regarding a pending petition.

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If you do not have any of the above items, but believe you are eligible for V nonimmigrant status, you must state
where and when the petition was filed, the name and alien registration number of the petitioner, and the names of all
beneficiaries.

General Instructions

1. Biometric Services Appointment. Every individual who is an applicant, petitioner, derivative, or beneficiary of
an immigration benefit request or other request submitted to USCIS is required to submit biometrics unless USCIS
waives the requirement. USCIS will notify you of the time and place of your appointment if you must appear and will
provide requirements for rescheduling if necessary. If you fail to submit any biometric as required, USCIS may deny
your application, petition, or request.
Department of Homeland Security (DHS) may store the biometrics submitted by an individual and use or reuse
biometrics to conduct background and security checks, including a check of criminal history records maintained by
the Federal Bureau of Investigation (FBI), verify identity, produce documents, determine eligibility for immigration
and naturalization benefits, or to perform any other functions necessary for administering and enforcing immigration
and naturalization laws, and any other law within DHS authority.
If you are required to provide biometrics, at your appointment you must sign an oath reaffirming that:
A. You provided or authorized all information in the application;

B. You reviewed and understood all of the information contained in, and submitted with, your application; and
C. All of this information was complete, true, and correct at the time of filing.
2. Part 2. Biographic Information. Provide the biographic information requested. Providing this information as part
of your application may reduce the time you spend at your USCIS ASC appointment as described in the Biometric
Services Appointment section of these Instructions.
A. Ethnicity and Race. Select the boxes that best describe your ethnicity and race.
B. Categories and Definitions for Ethnicity and Race
(1) Hispanic or Latino. A person of Cuban, Mexican, Puerto Rican, South or Central American, or other
Spanish culture or origin, regardless of race. (NOTE: This category is only included under Ethnicity in
Part 3., Item Number 1.)
(2) American Indian or Alaska Native. A person having origins in any of the original peoples of North and
South America (including Central America), and who maintains tribal affiliation or community attachment.
(3) Asian. A person having origins in any of the original peoples of the Far East, Southeast Asia, or the
Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the
Philippine Islands, Thailand, and Vietnam.

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(4) Black or African American. A person having origins in any of the black racial groups of Africa.
(5) Native Hawaiian or Other Pacific Islander. A person having origins in any of the original peoples of
Hawaii, Guam, Samoa, or other Pacific Islands.
(6) White. A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
C. Height. Select the values that best match your height in feet and inches. For example, if you are five feet and
nine inches, select “5” for feet and “09” for inches. Do not enter your height in meters or centimeters.
D. Weight. Enter your weight in pounds. If you do not know your weight or need to enter a weight under 30 pounds
or over 699 pounds, enter “000.” Do not enter your weight in kilograms.

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E. Eye Color. Select the box that best describes the color of your eyes.

F. Hair Color. Select the box that best describes the color of your hair.

What Is the Filing Fee?

See the Form I-539 Instructions for required fees.

Where to File?

See the Form I-539 Instructions for filing instructions.

Penalties

If you knowingly and willfully falsify or conceal a material fact or submit a false document with your Form I-539, we will
deny your Form I-539 and may deny any other immigration benefit. In addition, you will face severe penalties provided
by law and may be subject to criminal prosecution.

USCIS Compliance Review and Monitoring

By signing this request, you have stated under penalty of perjury (28 U.S.C. section 1746) that all information
and documentation submitted with this request is complete, true, and correct. The Department of Homeland
Security (DHS) has the authority to verify any information you submit to establish eligibility for the
immigration benefit you are seeking at any time. USCIS’ legal authority to verify this information is in 8
U.S.C. sections 1103 and 1184, and 8 CFR parts 103, 214, and 248. 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 via written
correspondence, the Internet, facsimile, 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.

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DHS Privacy Notice
AUTHORITIES: The information requested on this application, and the associated evidence, is collected pursuant to the
Immigration and Nationality Act sections 1103 and 1184, and 8 CFR 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 result in
denial of your application.

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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 DHS/USCIS-018
Immigration Biometric and Background Check] and the published privacy impact assessment [DHS/USCIS/PIA-016(a)
Computer Linked Application Information Management System and Associated Systems and DHS/USCIS/PIA-071
myUSCIS Account Experience] which can be found at www.dhs.gov/privacy. DHS may also share this information, as
appropriate, for law enforcement purposes or in the interest of national security.

Paperwork Reduction Act

An agency may not conduct or sponsor an 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 30 minutes per response, including the time for
reviewing instructions, gathering the required documentation and information, completing the application, preparing
statements, attaching necessary documentation, and submitting the application. The collection of biometrics is estimated
to require 3 hours and 40 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; OMB No.
1615-0004. Do not mail your completed Form I-539A to this address.

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