I-539 Form Table of Changes

TABLE OF CHANGES – FORM

Form I-539, Application to Extend/Change Nonimmigrant Status

OMB Number: 1615-0003

02/11/2021

Reason for Revision:

Legend for Proposed Text:

• Black font = Current text

• Red font = Changes

Expires 10/31/2021

Edition Date 10/15/2019

Current Page Number and Section	Current Text	Proposed Text
Page 2, Part 2. Application Type	[Page 2] Part 2. Application Type … 5.b. The total number of people (including me) in the application is: (Complete Form I-539A for each co-applicant.)[Fillable field]	[Page 2] Part 2. Application Type … 5.b. The total number of people (including me) in the application is: (Complete the supplement for each co-applicant.)
Page 2-3, Part 4. Additional Information About the Principal Applicant	[Page 2] Part 4. Additional Information About the Principal Applicant Provide Your Current Passport Information (if different from Part 1.) 1.a. Passport Number 1.b. Country of Passport Issuance 1.c. Passport Expiration Date (mm/dd/yyyy) Physical Address Abroad 2.a. Street Number and Name 2.b. Apt. Ste. Flr. 2.c. City or Town 2.d. Province 2.e. Postal Code 2.f. Country Answer the following questions. If you answer “Yes” to any of the questions in Item Numbers 3. - 15., use the space provided in Part 9. Additional Information to provide an explanation. [Page 3] 3. Are you, or any other individual included on the application, an applicant for an immigrant visa? Yes No 4. Has an immigrant petition EVER been filed for you or for any other individual included in this application? Yes No 5. Has Form I-485, Application to Register Permanent Residence or Adjust Status, EVER been filed by you or by any other individual included in this application? Yes No 6. Have you, or any other individual included in this application, EVER been arrested or convicted of any criminal offense since last entering the United States? Yes No Have you, or any other individual included on the application, EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 7.a. Acts involving torture or genocide? Yes No 7.b. Killing any person? Yes No 7.c. Intentionally and severely injuring any person? Yes No 7.d. 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? Yes No 7.e. Limiting or denying any person's ability to exercise religious beliefs? Yes No Have you, or any other individual included on the application, EVER: 8.a. Served in, been a member of, assisted, or participated in any military unit, paramilitary unit, police unit, self-defense unit, vigilante unit, rebel group, guerilla group, militia, insurgent organization, or any other armed group? Yes NO 8.b. Worked, volunteered, or otherwise served in any prison, jail, prison camp, detention facility, labor camp, or any other situation that involved detaining persons? Yes No 9. Have you, or any other individual 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? Yes No 10. Have you, or any other individual 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? Yes No 11. Have you, or any other individual included in this application, EVER received any type of military, paramilitary, or weapons training? Yes No 12. Have you, or any other individual included in this application, done anything that violated the terms of the nonimmigrant status you now hold? Yes No 13. Are you, or any other individual included in this application, now in removal proceedings? Yes No If you answered "Yes" to Item Number 13., provide the following information concerning the removal proceedings in the space provided in Part 9. Additional Information. Include the name of the individual in removal proceedings and information on jurisdiction, date proceedings began, and status of proceedings. 14. Have you, or any other individual included in this application, been employed in the United States since last admitted or granted an extension or change of status? Yes No If you answered "No" to Item Number 14., fully describe how you are supporting yourself in Part 9. Additional Information. Include documentary evidence of the source, amount, and basis for any income. If you answered "Yes" to Item Number 14., fully describe the employment in Part 9. Additional Information. Include the name of the individual employed, name and address of the employer, weekly income, and whether the employment was specifically authorized by USCIS. 15. Are you, or any other individual included in this application, currently or have you ever been a J-1 exchange visitor or a J-2 dependent of a J-1 exchange visitor? Yes No If you answered "Yes" to Item Number 15., you must provide the dates you maintained status as a J-1 exchange visitor or J-2 dependent in Part 9. Additional Information.	[Page 2] Part 4. Additional Information About the Principal Applicant [no change] Answer the following questions. If you answer “Yes” to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation. [Page 3] 3. Are you, or any other person included on the application, an applicant for an immigrant visa? Yes No 4. Has an immigrant petition EVER been filed for you or for any other person included in this application? Yes No 5. Has Form I-485, Application to Register Permanent Residence or Adjust Status, EVER been filed by you or by any other person included in this application? Yes No 6. 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? Yes No Have you, or any other person included on the application, EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: [no change] Have you, or any other person included on the application, EVER: [no change] 9. 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? Yes No 10. Have you, or any other 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? Yes No 11. Have you, or any other person included in this application, EVER received any type of military, paramilitary, or weapons training? Yes No 12. Have you, or any other person included in this application, done anything that violated the terms of the nonimmigrant status you now hold? Yes No 13. Are you, or any other person included in this application, now in removal proceedings? Yes No If you answered "Yes" to Item Number 13., provide the following information concerning the removal proceedings in the space provided in Part 8. Additional Information. Include the name of the person in removal proceedings and information on jurisdiction, date proceedings began, and status of proceedings. 14. 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? Yes No If you answered "No" to Item Number 14., fully describe how you are supporting yourself in Part 8. Additional Information. Include documentary evidence of the source, amount, and basis for any income. If you answered "Yes" to Item Number 14., fully describe the employment in Part 8. Additional Information. Include the name of the person employed, name and address of the employer, weekly income, and whether the employment was specifically authorized by USCIS. 15. Are you, or any other person included in this application, currently or have you ever been a J-1 exchange visitor or a J-2 dependent of a J-1 exchange visitor? Yes No If you answered "Yes" to Item Number 15., you must provide the dates you maintained status as a J-1 exchange visitor or J-2 dependent in Part 8. Additional Information.
Page 4-5, Part 5. Public Benefits	[Page 4] Part 5. Public Benefits Provide the requested information and submit documentation, as outlined in the Instructions. 1. Since obtaining the nonimmigrant status that you seek to extend or from which you seek to change, have you received, or are you currently certified to receive, any of the following public benefits? (select all that apply) [] Yes, I have received or I am currently certified to receive the following public benefits: [] Any Federal, State, local or tribal cash 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 [] Section 8 Project-Based Rental Assistance (including Moderate Rehabilitation) [] Public Housing under the Housing Act of 1937, 42 U.S.C. 1437 et seq. [] Federally-funded Medicaid [] No, I have not received any of the above listed public benefits. [] No, I am not certified to receive any of the above listed public benefits. 2. If you have received or are currently certified to receive any of the above public benefits provide information about the public benefits below. If you need extra space to complete this section, use the space provided in Part 9. Additional Information. Submit documentation as outlined in the Instructions. A. Type of Benefit Agency That Granted The Benefit Date You Started Receiving the Benefit or if Certified, Date You Will Start Receiving the Benefit or Date Your Coverage Starts (mm/dd/yyyy) Date Benefit or Coverage Ended or Expires (mm/dd/yyyy) B. Type of Benefit Agency That Granted The Benefit Date You Started Receiving the Benefit or if Certified, Date You Will Start Receiving the Benefit or Date Your Coverage Starts (mm/dd/yyyy) Date Benefit or Coverage Ended or Expires (mm/dd/yyyy) C. Type of Benefit Agency That Granted The Benefit Date You Started Receiving the Benefit or if Certified, Date You Will Start Receiving the Benefit or Date Your Coverage Starts (mm/dd/yyyy) Date Benefit or Coverage Ended or Expires (mm/dd/yyyy) D. Type of Benefit Agency That Granted The Benefit Date You Started Receiving the Benefit or if Certified, Date You Will Start Receiving the Benefit or Date Your Coverage Starts (mm/dd/yyyy) Date Benefit or Coverage Ended or Expires (mm/dd/yyyy) 3. If you answered “Yes” to Item Number 1., do any of the following apply to you? (select the applicable box). Provide the evidence listed in the Instructions if any of the following apply to you. [] 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. [] 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. [Page 5] [] 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. [] 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. [] At the time I received the public benefits, I was present in the United States after being granted a waiver from the public charge ground of inadmissibility. [] 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. [] None of the above statements apply to me. 4.a. 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) (Submit evidence as outlined in the Instructions): [] 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. [] 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 apply to me. 4.b. Provide the applicable dates: From (mm/dd/yyyy) To (mm/dd/yyyy)	[delete]
Page 5-6, Part 6. Applicant’s Statement, Contact Information, Declaration, Certification and Signature	[Page 5] Part 6. Applicant's Statement, Contact Information, Declaration, Certification and Signature NOTE: Read the Penalties section of the Form I-539 Instructions before completing this section. Applicant’s Statement NOTE: Select the box for either Item Number 1.a. or 1.b. If applicable, select the box for Item Number 2. 1.a. 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. 1.b. The interpreter named in Part 7. read to me every question and instruction on this application and my answer to every question in [Fillable Field], a language in which I am fluent, and I understood everything. 2. At my request, the preparer named in Part 8. [Fillable field], prepared this application for me based only upon information I provided or authorized. Applicant’s Contact Information 3. Applicant’s Daytime Telephone Number 4. Applicant’s Mobile Telephone Number (if any) 5. Applicant’s Email Address (if any) Applicant's Declaration and Certification 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 will require 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. [Page 6] Federal Agency Disclosure and Authorizations 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 8 CFR 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 public benefit, to the extent permitted by law. I also authorize SSA, USDA, HHS, HUD, and any other U.S. 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 agent, 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. Applicant’s Signature …	[Page 4] Part 5. Applicant's Statement, Contact Information, Declaration, Certification and Signature [no change] 1.b. The interpreter named in Part 6. read to me every question and instruction on this application and my answer to every question in [Fillable Field], a language in which I am fluent, and I understood everything. 2. At my request, the preparer named in Part 7. [Fillable field], prepared this application for me based only upon information I provided or authorized. [no change] 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. [delete] Applicant’s Signature …
Page 6-7, Part 7. Interpreter’s Contact Information, Statement, Certification, and Signature	[Page 7] Part 7. Interpreter’s Contact Information, Statement, Certification, and Signature … I am fluent in English and [Fillable Field], which is the same language specified in Part 6., Item Number 1.b., 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. …	[Page 5] Part 6. Interpreter’s Contact Information, Statement, Certification, and Signature … I am fluent in English and [Fillable Field], which is the same language specified in Part 5., Item Number 1.b., 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. …
Page 7, Part 8. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant	[Page 7] Part 8. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant …	[Page 5] Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant …
Page 8, Part 9. Additional Information	[Page 8] Part 9. Additional Information …	[Page 7] Part 8. Additional Information …

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