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Instructions For Form I-566 - Interagency Record Of Request - A, G Or Nato Dependent Employment Authorization Or Change/adjustment To/from A, G Or Nato Status Page 11

PURPOSE: The primary purpose for providing the requested information on this request is to determine if you have

established eligibility for the immigration benefit for which you are filing. 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, and

any requested evidence, may delay a final decision in your case or result in denial of your request.

ROUTINE USES: DHS may share the information you provide on this request 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-007 - Benefits Information System and DHS-USCIS-001

- Alien File, Index, and National File Tracking System of Records], which you can find at DHS

may also share the 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 1 hour and 25 minutes per response, including the time

for reviewing instructions, gathering the required documentation and information, completing the request, preparing

statements, attaching necessary documentation, and submitting the request. 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. 1615-0027. Do not mail your completed Form I-566 to this address.

Check List

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Did you fill out the request completely?

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Did you print two copies?

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Did you sign both copies?

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Did you attach all other required documents?

Form I-566 Instructions 12/07/16 N

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Instructions For Form I-566 - Interagency Record Of Request - A, G Or Nato Dependent Employment Authorization Or Change/adjustment To/from A, G Or Nato Status Page 11

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