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Item Number 10. U.S. Social Security Number. Provide your U.S. Social Security Number. If you do not have one,

leave this blank.

Item Number 11. DOS Personal Identification Number (PID). This is the number provided to eligible A and G

nonimmigrants by DOS. If you are an eligible NATO nonimmigrant dependent applying for work authorization, the PID

is provided by the certifying officer or official. NATO nonimmigrants should leave this field blank.

Item Number 12. USCIS Online Account Number (if any). If you have previously filed an application, petition, or

request using the USCIS online filing system (previously called USCIS Electronic Immigration System (USCIS ELIS)),

provide the USCIS Online Account Number you were issued by the system. You can find your USCIS Online Account

Number by logging in to your account and going to the profile page. 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. If you received such a notice, your USCIS Online Account Number can be

found at the top of the notice. If you were issued a USCIS Online Account Number, enter it in the space provided. The

USCIS Online Account Number is not the same as an A-Number.

Item Numbers 13. - 16. Form I-94 Arrival-Departure Record. If U.S. Customs and Border Protection (CBP) or USCIS

issued you a Form I-94, Arrival-Departure Record, provide your Form I-94 number and date that your authorized period of

stay expires or expired (as shown on Form I-94). The Form I-94 number also is known as the Departure Number on some

versions of Form I-94.

NOTE: 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 Form I-94 by CBP, instead of a paper Form I-94. You may visit the CBP Web site at

to obtain a paper version of an electronic Form I-94. CBP does not charge a fee for this service. Some travelers admitted

to the United States at a land border, airport, or seaport, after April 30, 2013 with a passport or travel document, who were

issued a paper Form I-94 by CBP, may also be able to obtain a replacement Form I-94 from the CBP Web site without

charge. If your Form I-94 cannot be obtained from the CBP Web site, it may be obtained by filing Form I-102, Application

for Replacement/Initial Nonimmigrant Arrival-Departure Record, with USCIS. USCIS does charge a fee for this service.

Passport and Travel Document Numbers. If you used a passport or travel document to travel to the United Sates, enter

either the passport or travel document information in the appropriate space on the request, even if the passport or travel

document is currently expired.

Item Number 17. Date of Last Entry Into the United States. Provide the date you last entered the United States.

Item Number 18. Current Immigration Status. Provide your current status. If you changed status after admission to

the United States, give your new status.

Item Number 19. Relationship to Principal (if applicable). Provide your relationship to the principal requestor.

Part 2. Information About Principal Alien

Item Numbers 1.a. - 12. If you are the principal alien, complete this section.

Part 3. Type of Request

Item Numbers 1. - 2.e. Select the appropriate boxes and fill in any spaces that apply to your request.

Part 4. Requestor’s Statement, Contact Information, Certification, and Signature

Item Numbers 1.a. - 6.b. Select the appropriate box to indicate whether you read this request yourself or whether you

had an interpreter assist you. If someone assisted you in completing the request, select the box indicating that you used

a preparer. Further, you must sign and date your request and provide your daytime telephone number, mobile telephone

number (if any), and email address (if any). Every request MUST contain the signature of the requestor (or parent or

legal guardian, if applicable). A stamped or typewritten name in place of a signature is not acceptable.

Form I-566 Instructions 12/07/16 N

Page 8 of 11

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 8