Looking for a Uscis Forms And Templates? Download it for free!

2. If you need extra space to complete any item within this application, attach a separate sheet of paper; type or print your

company or organization 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.

3. Answer all questions fully and accurately. If an item is not applicable or the answer is “none,” type or print “N/A,”

unless otherwise directed.

Statement, Certification, Signature, and Contact Information of the Applicant

Select the box that indicates if you filled out this form or if someone interpreted this form for you. Additionally, if

applicable, select the box that indicates if someone filled out this form for you. Every application must contain the

original signature of the applicant. Sign and date the form and provide your daytime telephone number, mobile telephone

number, and email address.

Contact Information, Certification, and Signature of Interpreter

If you used an interpreter to read the instructions and complete the questions on this form, the interpreter must fill out this

section, provide the name of his or her business/organization, the business/organization's address, his or her daytime

telephone number, and his or her email address. The interpreter must also sign and date the form.

Contact Information, Declaration, and Signature of the Person Preparing this Application, If Other Than the

Applicant

This section must contain the original signature of the person who completed this form, if other than the applicant filing

this form. If the person who completed this form is associated with a business or organization, you should complete the

business/organization name and address sections. If the person completing this form is an attorney or accredited

representative, he or she must submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited

Representative, along with this application/petition.

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 benefit request. For TDD (deaf or hard of hearing) call:

1-800-767-1833.

What Is the Filing Fee?

The filing fee for Form I-905 is $230.

Use the following guidelines when you prepare your check or money order for Form I-905:

1. The check or money order must be drawn on a bank or other financial institution located in the United States and must

be payable in U.S. currency; and

2. Make the check or money order payable to U.S. Department of Homeland Security.

NOTE: Spell out U.S. Department of Homeland Security; do not use the initials "USDHS" or "DHS."

3. If you live outside the United States, contact the nearest U.S. Embassy or U.S. Consulate for instructions on the

method of payment.

How to Check If the Fees Are Correct

The form fee on this form is current as of the edition date appearing in the lower left corner of this page. However,

because USCIS fees change periodically, you can verify if the fees are correct by following one of the steps below:

1. Visit our Web site at , select "FORMS" and check the appropriate fee; or

2. Call the USCIS National Customer Service Center at 1-800-375-5283 and ask for fee information. For TDD (deaf or

hard of hearing) call: 1-800-767-1833.

Page 6 of 7

Form I-905 Instructions 02/11/14 Y

Instructions For Form I-905 - Application For Authorization To Issue Certification For Health Care Workers Page 6