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Part 5. Interpreter’s Contact Information, Certification, and Signature

Item Numbers 1.a. - 6.b. If you used anyone as an interpreter to read the Instructions and questions on this request to

you in a language in which you are fluent, the interpreter must fill out this section, provide his or her name, the name and

address of his or her business or organization (if any), his or her daytime telephone number, and his or her email address

(if any). The interpreter must sign and date the request.

Part 6. Contact Information, Declaration, and Signature of the Person Preparing this Request, if Other Than the

Requestor

Item Numbers 1.a. - 8.b. This section must contain the signature of the person who completed your request, if other

than you, the requestor. If the same individual acted as your interpreter and your preparer, that person should complete

both Part 5. and Part 6. If the person who completed this request is associated with a business or organization, that

person should complete the business or organization name and address information. Anyone who helped you complete

this request MUST sign and date the request. A stamped or typewritten name in place of a signature is not acceptable. If

the person who helped you prepare your request is an attorney or accredited representative whose representation extends

beyond preparation of this request, he or she may be obliged to also submit a completed Form G-28, Notice of Entry of

Appearance as Attorney or Accredited Representative, along with your form.

Part 7. Additional Information

Item Numbers 1.a. - 7.d. If you need extra space to provide any additional information within this request, use the

space provided in Part 7. Additional Information. If you need more space than what is provided in Part 7., you may

make copies of Part 7. to complete and file with your request, or attach a separate sheet of paper. Include your name and

A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your

answer refers; and sign and date each sheet.

We recommend that you print or save a copy of your completed request to review in the future and for your

records.

Part 8. Certification by Diplomatic Mission, International Organization, NATO/HQ SACT, or NATO Member

State (For Official Use Only)

Item Numbers 1. - 9.i. Do not fill out this part. It is for official use only.

Part 9. DOS OFM, DOS Visa Office, NATO/HQ SACT, and/or USUN USE ONLY

Item Numbers 1. - 6. Do not fill out this part. It is for official use only.

Part 10. USCIS USE ONLY

Item Numbers 1. - 5. Do not fill out this part. It is for USCIS use only.

What Is the Filing Fee?

There is no filing fee for Form I-566. However, the associated petition or application may have a filing fee. Read the

Instructions on any associated petition or application submitted with this request for fee information.

Where To File?

Please see our Web site at

or call our National Customer Service Center at 1-800-375-5283 for the

most current information about where to file this request. For TTY (deaf or hard of hearing) call: 1-800-767-1833.

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 9