Legal Disclaimer The Information Contained In This Page 2
Download a blank fillable Legal Disclaimer The Information Contained In This in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Legal Disclaimer The Information Contained In This with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2ORIGINAL SUBMISSION – REQUEST FOR RENEWAL OF CONSIDERATION OF DEFERRED ACTION FOR
CHILDHOOD ARRIVALS AND EMPLOYMENT AUTHORIZATION
_________________________________________
___________
Last, First, and Middle Name
Date
________________________
A#
Alien Registration Number
Email
________________________
________________________
Address Line 1
Phone Number
________________________
Address Line 2
________________________
City, State, and Zip
_______________________
DELIVERED VIA
Method of Delivery, e.g. First Class, Priority Mail, etc.
United States Citizenship and Immigration Services
________________________
________________________
________________________
________________________
Lockbox Facility
RE:
Request for Renewal of Deferred Action for Childhood Arrivals and Employment Authorization
________________________________________
for:
Last, First, and Middle Name
Dear USCIS Officer:
Under the Department of Homeland Security’s June 15, 2012 memorandum establishing an affirmative
application for childhood arrivals seeking deferred action and the subsequent renewal process
established on June 6, 2014, enclosed please find the following materials in support of my request for
renewal of deferred action.
I have included the following required items (check all):
□ Completed Form I-821D, Request for Consideration of DACA
□ Completed Form I-765, Application for Employment Authorization
□ Scanned Copy of Front and Back of Employment Authorization Document
□ $465 Check or Money Order
□ Two Passport-Style Photos
□ Completed Form I-765WS, I-765 Worksheet
I have also included the following items (check all that apply):
□ Completed Form G-1145, Electronic Notification of Acceptance
□ Documents Regarding Exclusion, Deportation, or Removal Proceedings
□ Documents Regarding Charging or Conviction of a Felony or Misdemeanor
□ Documents Regarding Travel Outside the United States
Thank you for your prompt assistance in this matter. If there are questions or updates, please reach me
at the phone number or email listed in this cover letter.
Sincerely,
____________________________________
Signature
____________________________________
Printed Name
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal