Instructions For Form I-865 - Sponsor'S Notice Of Change Of Address (Page 2 of 5) in pdf

Translations. If you submit a document with information in a foreign language, you must also submit a full English

translation. The translator must sign a certification that the English language translation is complete and accurate, and that

he or she is competent to translate from the foreign language into English.

How To Fill Out Form I-865

Type or print legibly in black ink.

If you need extra space to complete any item within this notice, use the space provided in

Part 6. Additional

Information

or attach a separate sheet of paper; type or print your name 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.

Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been

married and the question asks “Provide the name of your current spouse”), type or print “N/A,” unless otherwise

directed. If your answer to a question which requires a numeric response is zero or none (for example, “How many

children do you have” or “How many times have you departed the United States”), type or print “None,” unless

otherwise directed.

Specific Instructions

Form I-865 is divided into Parts 1. through 6. The following information should help you fill out the notice.

Part 1.

Information About You (Sponsor)

Item Number 1.a.

- 1.c. Your Full Name. Provide your Family Name (Last Name), Given Name (First Name), and

Middle Name.

Item Number 2.

Date of Birth. Provide your date of birth in the mm/dd/yyyy format.

Item

Numbers 3.a. - 5. Your New Physical Address. Provide your new physical address in the spaces provided. Do

not provide a post office box (PO Box) number in the spaces. Also, include the date that your physical address change

became effective in the mm/dd/yyyy format and indicate if your physical address is the same as your mailing address.

Item

Numbers 6.a. - 7. Your New Mailing Address. Provide your new mailing address, including “In Care Of Name,”

if applicable. Also, include the date that your mailing address change became effective in the mm/dd/yyyy format.

NOTE: You do not need to complete these

Item

Numbers if your new mailing address is the same as your new physical

address.

Part 2.

Information on the Sponsored Immigrants

Item

Numbers 1.a. - 8. Provide the names and Alien Registration Numbers (A-Number) (if any) of the immigrants you

are sponsoring. If you are sponsoring more than four immigrants, provide the requested information for each additional

immigrant in the space provided in

Part 6.

Additional Information.

Part 3.

Sponsor’s Statement, Contact Information, Certification and Signature.

Item Numbers 1.a. - 6.b. Select the appropriate box to indicate that you either read this notice yourself or someone

interpreted this notice for you from English to a language in which you are fluent. If applicable, select the box to indicate

if someone prepared this notice for you. Further, you must sign and date your notice and provide your daytime telephone

number, mobile telephone number (if any), and email address (if any). Every notice MUST contain the signature of the

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

Form I-865 Instructions 07/17/15 N

Page 2 of 5

Instructions For Form I-865 - Sponsor'S Notice Of Change Of Address Page 2

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