Instructions For Form I-821 - Application For Temporary Protected Status (Page 4 of 18) in pdf

D. Part 7. Eligibility Standards - All questions must be answered;

E. Part 8. Applicant’s Statement, Contact Information, Certification, and Signature;

F. Part 9. Interpreter’s Contact Information, Certification, and Signature (if you used an interpreter); and

G. Part 10. Contact Information, Declaration, and Signature of the Person Preparing this Application, if

Other than the Applicant (if you used a preparer and/or have a legal representative).

Specific Instructions

This form is divided into eleven parts.

Part 1. Type of Application

Item Numbers 1.a. - 1.b. Type of Application. Select Item Number 1.a. if this is your first time applying for TPS and

you currently do not have TPS. This means you are filing an “initial” TPS application. Please also select Item Number

1.a. if you do not currently have TPS, but you have previously applied. Read the Note on the form regarding additional

information you must provide, if available, for any prior TPS applications you submitted. Select Item Number 1.b. only

if you currently have TPS and are re-registering. If you select this item, you must also complete Item Number 2.

Item Number 2. TPS Granting Authority. Only complete this section if you selected Item Number 1.b. Select

USCIS if you received a letter from USCIS granting your previous application for TPS. Select Immigration Judge/

Board of Immigration Appeals if you received a written decision from the Immigration Judge or Board of Immigration

Appeals granting your previous application for TPS.

Item Numbers 3.a. - 3.b. Request For Employment Authorization Document (EAD). Select Item Number 3.a. if

you are requesting an Employment Authorization Document (EAD) and are filing the Form I-765 with your Form I-821.

Select Item Number 3.b. if you are not requesting employment authorization at this time.

NOTE: You can still apply for an EAD at a later date, after USCIS makes a decision on your application for TPS.

Item Number 4. TPS Country. Provide the name of the designated TPS country (or part thereof) under which you are

applying.

Part 2. Information About You

Item Numbers 1.a. - 1.c. Your Full Name. Provide your full legal name in the spaces provided.

Item Numbers 2.a. - 3.c. Other Names Used (if any). Provide all other names you have used, including but not limited

to, maiden names, married names, and nicknames in the space provided. If you need additional space to complete the

section, use Part 11. Additional Information.

Item Numbers 4.a. - 5. U.S. Mailing Address. Provide the address where you would like to receive written

correspondence regarding your application.

Item Numbers 6.a. - 6.e. U.S. Physical Address. If your current mailing address is not the same as your physical

address, provide your physical street address. You must include a street number and name or a rural route number. Do not

provide a post office box (P.O. Box) number here.

Item Number 7. Alien Registration Number (A-Number) (if any). Provide your A-Number. Your A-Number is the

number used to identify your immigration records. You can find this number on documents you received from USCIS,

U.S. Immigration and Customs Enforcement (ICE), or U.S. Department of Justice Executive Office of Immigration

Review (EOIR) during immigration proceedings in court.

Form I-821 Instructions 10/19/17 N

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Instructions For Form I-821 - Application For Temporary Protected Status Page 4