Page 3,
Part 3. Information
About Your Eligibility Category
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[Page 3]
Part 3. Information About Your
Eligibility Category
1.
Eligibility Category. Refer to the Who May File Form I-765
section of the Form I-765 Instructions to determine the
appropriate eligibility category for this application. Enter the
appropriate letter and number for your eligibility category below
(for example, (a)(8), (c)(17)(iii)).
[Three
fillable fields separated by parenthesis]
2. (c)(3)(C) STEM OPT
Eligibility Category. If you entered the eligibility category
(c)(3)(C) in Item Number 1., provide the information
requested in Items A. - C.
A. Degree
B. Employer's Name as Listed
in E-Verify
C. Employer's E-Verify
Company Identification Number or a Valid E-Verify Client Company
Identification Number
3.A. (c)(8) Eligibility Category.
If you entered the (c)(8) eligibility category in Item
Number 1., are you eligible for benefits under the ABC
settlement agreement as a Salvadoran or Guatemalan national?
Yes
No
B. If you entered the
eligibility category (c)(8) in Item Number 1., have you
EVER been arrested for and/or convicted of any crime?
Yes
No
NOTE: If you answered “Yes”
to Item B. in Item Number 3., refer to Special
Filing Instructions for Those With Pending Asylum Applications
(c)(8) in the Required Documentation section of the
Form I-765 Instructions for information about providing court
dispositions.
[New]
4. (c)(26) Eligibility Category.
If you entered the eligibility category (c)(26) in Item
Number 1., provide the receipt number of your H-1B spouse’s
most recent Form I-797 Notice for Form I-129, Petition for a
Nonimmigrant Worker.
5.A. (c)(35) and (c)(36)
Eligibility Category. If you entered the eligibility category
(c)(35) in Item Number 1., please provide the receipt
number of your Form I-797 Notice for Form I-140, Immigrant
Petition for Alien Worker. If you entered the eligibility
category (c)(36) in Item Number 1., please provide the
receipt number of your spouse's or parent's Form I-797 Notice for
Form I-140.
B. If you entered the
eligibility category (c)(35) or (c)(36) in Item Number
1., have you EVER been arrested for and/or convicted of
any crime?
Yes
No
NOTE: If you answered “Yes”
to Item B. in Item Number 7., refer to
Employment-Based Nonimmigrant Categories, Items 8. - 9.,
in the Who May File Form I-765 section of the Form I-765
Instructions for information about providing court dispositions.
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[Page 3]
Part 3. Information About Your
Eligibility Category
1.
Eligibility Category. Refer to the Who May File Form I-765
section of the Form I-765 Instructions to determine the
appropriate eligibility category for this application. Enter the
appropriate letter and number for your eligibility category below
(for example, (a)(8), (c)(17)(iii)).
[Three
fillable fields separated by parenthesis]
2. (c)(3)(C) STEM OPT
Eligibility Category. If you entered the eligibility category
(c)(3)(C) in Item Number 1., provide the information
requested in Items A. - C.
A. Degree
B. Employer's Name as Listed
in E-Verify
C. Employer's E-Verify
Company Identification Number or E-Verify
Client Company Identification Number
[No change]
B. If you entered the (c)(8)
eligibility category in Item
Number 1., have you EVER been arrested for and/or
convicted of any crime?
Yes No
[Delete]
4.A.
(c)(18) Eligibility Category. If
you entered the eligibility category (c)(18) in Item
Number 1. and are filing for
initial or renewal of employment authorization based on your
removal being impracticable, you must submit a copy of your Form
I-220B with annotation from ICE noting that your removal is
impracticable because all countries from whom travel documents
have been requested have affirmatively declined to issue a travel
document. Refer to Special Filing
Instructions for Aliens on Orders of Supervision
in the Required Documentation
section of the Form I-765
Instructions for information about
who qualifies under this category.
If you
selected Item
C. in Part 1. Reason for Applying,
provide the information requested below.
Employer's
Name as Listed in E-Verify
Employer's
E-Verify Company Identification Number or E-Verify Client Company
Identification Number
B.
If you entered the (c)(18)
eligibility category in Item
Number 1., have you EVER
been arrested for and/or
convicted of any crime?
Yes No
NOTE: If
you answered “Yes” to Item
B. in
Item Number 4., refer to Special
Filing Instructions for Applications Filed Under (c)(18) in
the Required Documentation section
of the Form I-765 Instructions for information about providing
arrest reports and court dispositions.
5.
(c)(26) Eligibility Category. If you entered
the eligibility category (c)(26) in Item Number 1., provide
the receipt number of your H-1B spouse’s most recent Form
I-797 Notice for Form I-129, Petition for a Nonimmigrant Worker.
6.A.
(c)(35) and (c)(36) Eligibility Category. If you entered the
eligibility category (c)(35) in Item Number 1., please
provide the receipt number of your Form I-797 Notice for Form
I-140, Immigrant Petition for Alien Worker. If you entered the
eligibility category (c)(36) in Item Number 1., please
provide the receipt number of your spouse's or parent's Form I-797
Notice for Form I-140.
[No change]
NOTE: If you answered “Yes”
to Item B. in Item Number 6.,
refer to Employment-Based Nonimmigrant Categories, Items
8. - 9., in the Who May File Form I-765 section of the
Form I-765 Instructions for information about providing court
dispositions
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