Form M-1162 - Optional Checklist For Form I-765 (C)(8) Fillings Asylum Applicants (With A Pending Asylum Application) Who Filed For Asylum On Or After January 4, 1995 Page 2

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NOTE: If you have lodged your Form I-589 at an immigration court window, submit a legible copy of the
form containing the following two stamps:
1)
A Received Date stamp that shows the date and time your Form I-589 was lodged but not filed at an
immigration court window.
2)
A stamp which reads:
RECEIVED
DEPARTMENT OF JUSTICE
DEPARTMENT OF JUSTICE
LODGED NOT FILED
[DATE]
EXECUTIVE OFFICE FOR
EXECUTIVE OFFICE FOR
IMMIGRATION REVIEW
IMMIGRATION REVIEW
IMMIGRATION COURT
IMMIGRATION COURT
[COURT LOCATION]
[COURT LOCATION]
The docket number, if applicable. (You will have this information if an immigration judge denied your
Form I-589 or if you have evidence of any appeal pending with a Circuit court or any court outside of the
Board of Immigration Appeals.)
Certified English translations of any non-English documents. (See the Translations paragraph in the
General Instructions section on Page 12 of the
Form I-765
Instructions.)
Proof of Identity. (See Item 2.B. in the Required Documentation section on Page 13 of the
Form I-765
Instructions.)
Photographs. (See Item 2.C. in the Required Documentation section on Page 13 of the
Form I-765
Instructions.)
Do not submit this checklist to USCIS.
Form M-1162 07/17/17 N
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