Daca Renewal Eligibility Screening Form (Page 2 of 3) in pdf

4. Did you have any contact with police like arrests, convictions, tickets, or juvenile offenses

that happened before you got DACA but that you did not disclose to immigration on your

application? (Do not include minor traffic violations that did not involve alcohol)

If you answered “yes” you must consult with an ILCM or another experienced

☐YES

immigration attorney before filing any DACA renewal application, to make sure you

are still eligible.

If you answered “no,” proceed to the next question.

☐NO

5. Since your initial DACA was approved, have you had contact with ICE or been placed in

removal proceedings?

If you answered “yes” you should consult with ILCM or another experienced

☐YES

immigration attorney before filing any DACA renewal application.

If you answered “no,” proceed to the next question

☐NO

6. Since your initial DACA was approved, have you traveled outside of the United States?

If you answered “yes” you should consult with ILCM or another experienced

☐YES

immigration attorney before filing any DACA renewal application.

If you answered “no,” proceed to the next section.

☐NO

Information about filing your DACA renewal or requesting assistance from ILCM

If you did not have any “yes” answers that indicate a red flag and would like to file to renew your DACA

on your own, please see ILCM’s “DACA Renewal Frequently Asked Questions” on our website:

You can also find DACA renewal guidance and application forms from U.S.

Citizenship and Immigration Services (USCIS) on the USCIS website:

If you had “yes” answers or would like ILCM’s assistance in filing to renew your DACA, please fill in your

contact information on the next page, as well as information regarding your household income, so that we

can evaluate whether you are financially eligible for ILCM’s services. ILCM is a non-profit law office that

serves clients whose household income is below 187.5% of the federal poverty guidelines.

ILCM will try to serve as many clients as possible in their DACA renewals. However, our resources are

limited and we cannot guarantee that we will be able to serve everyone who contacts us or submits this

form. Thank you for your understanding.

Daca Renewal Eligibility Screening Form Page 2