Form M-1152 - Optional Checklist For Form I-765 (C)(9) Fillings Application For Employment Authorization

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Optional Checklist for Form I-765 (c)(9) Filings
Adjustment of Status Applicants
USCIS
Form M-1152
Department of Homeland Security
Checklist
U.S. Citizenship and Immigration Services
This is an optional checklist to assist applicants who are filing Form I-765 together with
or based on a pending adjustment of status application (Form I-485).
Do not submit this checklist to USCIS.
NOTE: This optional checklist does not replace or change statutory or regulatory requirements. We recommend
that you review these requirements, as well as the appropriate form instructions, before completing and
submitting Form I-765. Do not send original documents unless specifically requested in the form instructions.
See
for the most recent version of the Form I-765 and its instructions.
Form Checklist
Did you complete all sections of the form that apply to you? (See the General Instructions section on
Page 12 of the How To Fill Out Form I-765 section of the
Form I-765
Instructions.)
Did you sign and date the form? (See the General Instructions section on Page 12 of the
Form I-765
Instructions.)
Did you submit the correct fee, if applicable? (See the What Is the Filing Fee section on Page 15 of the
Form I-765
Instructions.)
Did you provide your current U.S. mailing address? Do not write the address of your attorney or
accredited representative. (See the Address Change section on Page 17 of the
Form I-765
Instructions.)
Filing Checklist
Did you provide the following?
Completed
Form G-28
(only if you are represented by an attorney or an accredited representative).
NOTE: If you want your Employment Authorization Document (EAD) mailed to your attorney or
accredited representative, please indicate it on the Form G-28. (See Part 4., Items 1. - 2.b., in the
Specific Instructions section on Page 3 of the
Form G-28
Instructions.)
Proof that you have a pending
Form I-485
(only if you have a previously filed Form I-485). (See Item 7.A.
in the Who May File Form I-765 section on Page 10 of the
Form I-765
Instructions.)
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-1152 07/17/17 N
Page 1 of 1

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