Form I-539, Application to Extend/Change Nonimmigrant Status Instructions
This form contains 159 fields organized into 30 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Additional Information | ||
| Part 8. Additional Information. 4. Enter Page Number | Text |
Enter the page number where additional information is provided.
|
| Part 8. Additional Information. 4. Enter Part Number | Text |
Enter the part number of the form where additional information is provided.
|
| Part 8. Additional Information. 4. Enter Item Number | Text |
Enter the item number of the form where additional information is provided.
|
| Part 8. Additional Information. 4. Enter Additional Information | Text |
Enter any additional information that is relevant to the application.
|
| Part 8. Additional Information. 5. Enter Page Number | Text |
Enter the page number where additional information is provided.
|
| Part 8. Additional Information. 5. Enter Part Number | Text |
Enter the part number from the form that corresponds to the additional information you are providing.
|
| Part 8. Additional Information. 5. Enter Item Number | Text |
Enter the item number from the form that corresponds to the additional information you are providing.
|
| Part 8. Additional Information. 5. Enter Additional Information | Text |
Provide any additional information that is relevant to your application. Be specific and clear.
|
| Part 8. Additional Information. 3. Enter Page Number | Text |
Enter the page number of the form where the additional information is referenced.
|
| Part 8. Additional Information. 3. Enter Part Number | Text |
Enter the part number of the form where the additional information is referenced.
|
| Part 8. Additional Information. 3. Enter Item Number | Text |
Enter the item number of the form where the additional information is referenced.
|
| Part 8. Additional Information. 6. Enter Page Number | Text |
Enter the page number of the form where the additional information is referenced.
|
| Part 8. Additional Information. 6. Enter Part Number | Text |
Enter the part number of the form where the additional information is referenced.
|
| Part 8. Additional Information. 6. Enter Item Number | Text |
Enter the item number of the form where the additional information is referenced.
|
| Part 8. Additional Information. 6. Enter Additional Information | Text |
Provide any additional information that is relevant to your application.
|
| Part 8. Additional Information. 3. Enter Additional Information | Text |
Provide any additional information that is relevant to your application.
|
| Additional Information About the Applicant | ||
| Part 4. Additional Information About the Applicant. Answer the following questions. 3. Are you an applicant for an immigrant visa? Check this box for No | CheckBox |
Check this box if you are not an applicant for an immigrant visa.
|
| Part 4. Additional Information About the Applicant. Answer the following questions. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation. 3. Are you an applicant for an immigrant visa? Check this box for Yes | CheckBox |
Indicate whether you are an applicant for an immigrant visa by checking this box if the answer is Yes.
|
| Part 4. Additional Information About the Applicant. Answer the following questions. 5. Have you EVER filed Form I-4 85, Application to Register Permanent Residence or Adjust Status? Check this box for No | CheckBox |
Indicate whether you have ever filed Form I-485, Application to Register Permanent Residence or Adjust Status, by checking this box if the answer is No.
|
| Part 4. Additional Information About the Applicant. Answer the following questions. Answer the following questions. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation. 5. Have you EVER filed Form I-4 85, Application to Register Permanent Residence or Adjust Status? Check this box for Yes | CheckBox |
Indicate whether you have ever filed Form I-485, Application to Register Permanent Residence or Adjust Status, by checking this box if the answer is Yes.
|
| Part 4. Additional Information About the Applicant. Answer the following questions. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation. 4. Has an immigrant petition EVER been filed for you? Check this box for Yes | CheckBox |
Indicate whether an immigrant petition has ever been filed for you by checking this box if the answer is Yes.
|
| Part 4. Additional Information About the Applicant. Answer the following questions. 4. Has an immigrant petition EVER been filed for you? Check this box for No | CheckBox |
Indicate whether an immigrant petition has ever been filed for you by checking this box if the answer is No.
|
| Part 4. Additional Information About the Applicant. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. Answer the following questions. 7.d. Engaging in any kind of sexual contact or relations with any person who did not consent or was unable to consent, or was being forced or threatened? Check this box for No | CheckBox |
Indicate whether you have ever engaged in any kind of sexual contact or relations with any person who did not consent or was unable to consent, or was being forced or threatened, by checking this box if the answer is No.
|
| Part 4. Additional Information About the Applicant. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. Answer the following questions. 7.d. Engaging in any kind of sexual contact or relations with any person who did not consent or was unable to consent, or was being forced or threatened? Check this box for Yes. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation | CheckBox |
Indicate whether you have ever engaged in any kind of sexual contact or relations with any person who did not consent or was unable to consent, or was being forced or threatened. Check this box for Yes. If you answer 'Yes', provide an explanation in Part 8.
|
| Part 4. Additional Information About the Applicant. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. Answer the following questions. 7.c. Intentionally and severely injuring any person? Check this box for No | CheckBox |
Indicate whether you have ever intentionally and severely injured any person. Check this box for No.
|
| Part 4. Additional Information About the Applicant. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. Answer the following questions. 7.c. Intentionally and severely injuring any person? Check this box for Yes. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation | CheckBox |
Indicate whether you have ever intentionally and severely injured any person. Check this box for Yes. If you answer 'Yes', provide an explanation in Part 8.
|
| Part 4. Additional Information About the Applicant. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. Answer the following questions. 7.b. Killing any person? Check this box for No | CheckBox |
Indicate whether you have ever killed any person. Check this box for No.
|
| Part 4. Additional Information About the Applicant. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. Answer the following questions. 7.b. Killing any person? Check this box for Yes. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation | CheckBox |
Indicate whether you have ever killed any person. Check this box for Yes. If you answer 'Yes', provide an explanation in Part 8.
|
| Part 4. Additional Information About the Applicant. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. Answer the following question. 7.a. Acts involving torture or genocide? Check this box for No | CheckBox |
Indicate whether you have ever been involved in acts involving torture or genocide. Check this box for No.
|
| Part 4. Additional Information About the Applicant. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. Answer the following question. 7.a. Acts involving torture or genocide? Check this box for Yes. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation | CheckBox |
Indicate whether you have ever been involved in acts involving torture or genocide. Check this box for Yes. If you answer 'Yes', provide an explanation in Part 8.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 11. Have you, or any other person included in this application, EVER received any type of military, paramilitary, or weapons training? Check this box for Yes. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation | CheckBox |
Indicate whether you or any other person included in this application have ever received any type of military, paramilitary, or weapons training by checking this box for Yes. If Yes, provide an explanation in Part 8.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 11. Have you, or any other person included in this application, EVER received any type of military, paramilitary, or weapons training? Check this box for No | CheckBox |
Indicate whether you or any other person included in this application have ever received any type of military, paramilitary, or weapons training by checking this box for No.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 12. Have you EVER violated the terms of the nonimmigrant status you now hold? Check this box for Yes. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation | CheckBox |
Indicate whether you have ever violated the terms of the nonimmigrant status you now hold by checking this box for Yes. If Yes, provide an explanation in Part 8.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 12. Have you EVER violated the terms of the nonimmigrant status you now hold? Check this box for No | CheckBox |
Indicate whether you have ever violated the terms of the nonimmigrant status you now hold by checking this box for No.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 13. Are you now in removal proceedings? Check this box for Yes. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation | CheckBox |
Indicate whether you are currently in removal proceedings by checking this box for Yes. If Yes, provide an explanation in Part 8.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 13. Are you now in removal proceedings? Check this box for No | CheckBox |
Indicate whether you are currently in removal proceedings by checking this box for No.
|
| Part 4. Additional Information About the Applicant. Answer the following questions. 6. Have you been arrested or convicted of any criminal offense since last entering the United States? Check this box for Yes. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation | CheckBox |
Indicate whether you have been arrested or convicted of any criminal offense since last entering the United States by checking this box for Yes. If Yes, provide an explanation in Part 8.
|
| Part 4. Additional Information About the Applicant. Answer the following questions. 6. Have you been arrested or convicted of any criminal offense since last entering the United States? Check this box for No | CheckBox |
Indicate whether you have been arrested or convicted of any criminal offense since last entering the United States by checking this box for No.
|
| Additional Information About the Principal Applicant | ||
| Part 4. Additional Information About the Principal Applicant. 1. Current Passport Information. If your current passport information is different from the information you provided in Part 1., provide your current passport information. If your current passport information matches the information you provided in Part 1., proceed to Item Number 3. Enter Expiration Date for Passport. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text |
If your current passport information is different from the information you provided in Part 1, provide your current passport information. Enter the expiration date of your current passport in the format MM/DD/YYYY.
|
| Part 4. Additional Information About the Principal Applicant. 1. Current Passport Information. If your current passport information is different from the information you provided in Part 1., provide your current passport information. If your current passport information matches the information you provided in Part 1., proceed to Item Number 3. Enter Country of Passport Issuance | Text |
If your current passport information is different from the information you provided in Part 1, provide your current passport information. Enter the country where your current passport was issued.
|
| Applicant Additional Information | ||
| Part 4. Additional Information About the Applicant. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. Answer the following questions. 7.e. Limiting or denying any person's ability to exercise religious beliefs? Check this box for Yes. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation | CheckBox |
Indicate whether you have ever limited or denied any person's ability to exercise religious beliefs by checking this box for Yes. If you answer 'Yes', provide an explanation in Part 8.
|
| Part 4. Additional Information About the Applicant. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. Answer the following questions. 7.e. Limiting or denying any person's ability to exercise religious beliefs? Check this box for No | CheckBox |
Indicate whether you have ever limited or denied any person's ability to exercise religious beliefs by checking this box for No.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 9. Have you EVER been a member of, assisted, or participated in any group, unit, or organization of any kind in which you or other persons used or threatened to use any type of weapon against any person or threatened to do so? Check this box for Yes. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation | CheckBox |
Indicate whether you have ever been a member of, assisted, or participated in any group, unit, or organization that used or threatened to use any type of weapon against any person by checking this box for Yes. If you answer 'Yes', provide an explanation in Part 8.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 9. Have you EVER been a member of, assisted, or participated in any group, unit, or organization of any kind in which you or other persons used or threatened to use any type of weapon against any person or threatened to do so? Check this box for No | CheckBox |
Indicate whether you have ever been a member of, assisted, or participated in any group, unit, or organization that used or threatened to use any type of weapon against any person by checking this box for No.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 8.a. Served in, been a member of, assisted, or participated in any military unit, paramilitary unit, police unit, self-defense unit, vigilante unit, rebel group, guerrilla group, militia, insurgent organization, or any other armed group? Check this box for Yes. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation | CheckBox |
Indicate whether you have ever served in, been a member of, assisted, or participated in any military unit, paramilitary unit, police unit, self-defense unit, vigilante unit, rebel group, guerrilla group, militia, insurgent organization, or any other armed group by checking this box for Yes. If you answer 'Yes', provide an explanation in Part 8.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 8.a. Served in, been a member of, assisted, or participated in any military unit, paramilitary unit, police unit, self-defense unit, vigilante unit, rebel group, guerrilla group, militia, insurgent organization, or any other armed group? Check this box for No | CheckBox |
Indicate whether you have ever served in, been a member of, assisted, or participated in any military unit, paramilitary unit, police unit, self-defense unit, vigilante unit, rebel group, guerrilla group, militia, insurgent organization, or any other armed group by checking this box for No.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 8.b. Worked, volunteered, or otherwise served in any prison, jail, prison camp, detention facility, labor camp, or any other situation that involved detaining persons? Check this box for No | CheckBox |
Indicate whether you have ever worked, volunteered, or otherwise served in any prison, jail, prison camp, detention facility, labor camp, or any other situation that involved detaining persons by checking this box for No.
|
| Applicant Information | ||
| Part 1. Information About You. 2. Enter Alien Registration Number, A. Number, if any. Must be 9 digits; no dashes | Text |
Enter your Alien Registration Number (A-Number) if you have one. It must be exactly 9 digits long and should not include any dashes.
|
| Part 1. Information About You. 3. Enter U S C I S Online Account Number, if any. Must be 12 digits; no dashes | Text |
Enter your USCIS Online Account Number if you have one. It must be exactly 12 digits long and should not include any dashes.
|
| Part 1. Information About You. 1. Your Full Legal Name. Enter Family Name, Last Name | Text |
Enter your full legal family name (last name).
|
| Part 1. Information About You. 1. Your Full Legal Name. Enter Given Name, First Name | Text |
Enter your full legal given name (first name).
|
| Part 1. Information About You. 1. Your Full Legal Name. Enter Middle Name, if applicable | Text |
Enter your middle name if applicable.
|
| Part 1. Information About You. 4. Your U.S. Mailing Address, Safe Address, if applicable. Enter In Care Of Name, if any | Text |
Enter the 'In Care Of' name if applicable for your U.S. mailing address.
|
| Part 1. Information About You. 4. Your U.S. Mailing Address, Safe Address, if applicable. Enter Street Number and Name | Text |
Enter the street number and name for your U.S. mailing address.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 8.b. Worked, volunteered, or otherwise served in any prison, jail, prison camp, detention facility, labor camp, or any other situation that involved detaining persons? Check this box for Yes. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation | CheckBox |
Indicate whether you have ever worked, volunteered, or otherwise served in any prison, jail, prison camp, detention facility, labor camp, or any other situation that involved detaining persons. If you answer 'Yes', provide an explanation in Part 8. Additional Information.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 14. Have you EVER been employed in the United States since last admitted or granted an extension or change of status? Check this box for No. If you answered "No" to Item Number 14., fully describe how you are supporting yourself in Part 8. Additional Information. Include documentary evidence of the source, amount, and basis for any income | CheckBox |
Indicate whether you have ever been employed in the United States since your last admission or granted an extension or change of status. If you answer 'No', describe how you are supporting yourself in Part 8. Additional Information and include documentary evidence of the source, amount, and basis for any income.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer athe following questions. 14. Have you EVER been employed in the United States since last admitted or granted an extension or change of status? Check this box for Yes. If you answered "Yes" to Item Number 14., fully describe any and all periods of employment in Part 8. Additional Information. Include the name and address of the employer, weekly income, and whether the employment was specifically authorized by USCIS | CheckBox |
Indicate whether you have ever been employed in the United States since your last admission or granted an extension or change of status. If you answer 'Yes', describe any and all periods of employment in Part 8. Additional Information, including the name and address of the employer, weekly income, and whether the employment was specifically authorized by USCIS.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 15.Are you currently or have you EVER been a J-1 exchange visitor or a J-2 dependent of a J-1 exchange visitor? Check this box for Yes. If you answered "Yes" to Item Number 15., you must provide the dates you maintained status as a J-1 exchange visitor or J-2 dependent in Part 8. Additional Information | CheckBox |
Indicate whether you are currently or have ever been a J-1 exchange visitor or a J-2 dependent of a J-1 exchange visitor. If you answer 'Yes', provide the dates you maintained status as a J-1 exchange visitor or J-2 dependent in Part 8. Additional Information.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 15.Are you currently or have you EVER been a J-1 exchange visitor or a J-2 dependent of a J-1 exchange visitor? Check this box for No | CheckBox |
Indicate whether you are currently or have ever been a J-1 exchange visitor or a J-2 dependent of a J-1 exchange visitor. Check this box for 'No'.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 10. Have you EVER sold, provided, or transported weapons, or assisted any person in selling, providing, or transporting weapons, which, you knew or believed would be used against another person? Check this box for Yes. If you answer "Yes" to any of the questions in Item Numbers 3. - 15., use the space provided in Part 8. Additional Information to provide an explanation | CheckBox |
Indicate whether you have ever sold, provided, or transported weapons, or assisted any person in selling, providing, or transporting weapons, which you knew or believed would be used against another person. If you answer 'Yes', provide an explanation in Part 8. Additional Information.
|
| Part 4. Additional Information About the Applicant. Have you EVER. Answer the following questions. 10. Have you EVER sold, provided, or transported weapons, or assisted any person in selling, providing, or transporting weapons, which, you knew or believed would be used against another person? Check this box for No | CheckBox |
Indicate whether you have ever sold, provided, or transported weapons, or assisted any person in selling, providing, or transporting weapons, which you knew or believed would be used against another person. Check this box for 'No'.
|
| Applicant's Certification and Signature | ||
| Part 5. Applicant's Contact Information, Certification, and Signature. Applicant's Certification and Signature. 4. Enter the Applicant's Signature. This field cannot be signed electronically. Print form and enter an ink signature | Text |
Enter the applicant's signature. This field cannot be signed electronically. Print the form and sign it with an ink signature.
|
| Part 5. Applicant's Contact Information, Certification, and Signature. Applicant's Certification and Signature. 4. Enter the Date of Applicant's Signature. Enter date as 2-digit month, 2-digit day, and 4-digit year | Text |
Enter the date of the applicant's signature. The date should be in the format of 2-digit month, 2-digit day, and 4-digit year (MM/DD/YYYY).
|
| Applicant's Contact Information | ||
| Part 5. Applicant's Contact Information, Certification, and Signature. Applicant's Contact Information. 1. Enter Applicant's Daytime Telephone Number | Text |
Enter the applicant's daytime telephone number. This should be a number where the applicant can be reached during normal business hours.
|
| Part 5. Applicant's Contact Information, Certification, and Signature. Applicant's Contact Information. 2. Enter Applicant's Mobile Telephone Number, if any | Text |
Enter the applicant's mobile telephone number, if available. This is an optional field.
|
| Part 5. Applicant's Contact Information, Certification, and Signature. Applicant's Contact Information. 3. Enter Applicant's Email Address, if any | Text |
Enter the applicant's email address, if available. This is an optional field.
|
| Application Type | ||
| Part 2. Application Type. 3. Number of people included in this application, select only one box. Select I am the only applicant | CheckBox |
Select this checkbox if you are the only applicant included in this application.
|
| Part 2. Application Type. 3. Number of people included in this application, select only one box. Select I am filing this application for myself and members of my family | CheckBox |
Select this checkbox if you are filing this application for yourself and members of your family.
|
| Part 2. Application Type. 1. I am applying for, select only one box. Check this box for an extension of stay in my current status | CheckBox |
Select this checkbox if you are applying for an extension of stay in your current status.
|
| Part 2. Application Type. 1. I am applying for, select only one box. Check this box for a change of status | CheckBox |
Select this checkbox if you are applying for a change of status.
|
| Part 2. Application Type. 1. I am applying for, select only one box. Check this box for reinstatement of student status | CheckBox |
Select this checkbox if you are applying for reinstatement of student status.
|
| Part 2. Application Type. 4. The total number of people, including me in the application. Form I-5 39 A is required for each co-applicant. Enter the number of people | Text |
Enter the total number of people, including yourself, in this application. Note that Form I-539A is required for each co-applicant.
|
| Part 2. Application Type. 2. If you are applying for a change of status, complete the following: I am requesting the change to be effective on date. Enter date as 2-digit Month, 2-digit Day, and 4-digit Year | Text |
If you are applying for a change of status, enter the date you are requesting the change to be effective. Use the format MM/DD/YYYY.
|
| Part 2. Application Type. 5. The name of the school you will attend, if applicable, as an Academic Student, Vocational Student, or Exchange Visitor. Enter the name of the school | Text |
Enter the name of the school you will attend if applicable, as an Academic Student, Vocational Student, or Exchange Visitor.
|
| Part 2. Application Type. 6. Your Student and Exchange Visitor Information System S E V I S, I D Number, if applicable. Enter number | Text |
Enter your Student and Exchange Visitor Information System (SEVIS) ID Number, if applicable.
|
| Part 2. Application Type. 2. If you are applying for a change of status, complete the following: I am requesting to change my status to. Select new status from the list | ComboBox |
Select the new status you are requesting to change to from the provided list.
J2S
A3
A1
T3
B1D
CH
U4
V3
B1
5
G4
U2
V1
H4
V2
C1
WB
1
N8
T4
K3
F1
T1
C2
B1C
N5
N6
TD
E2C
G2
A2
G5
9
N4
3
F2
CW1
10
CW2
I
T2
G1
J1S
M1
WT
N2
G3
J1
M2
N1
C4
U3
C3
U1
U5
N7
N3
P4
B1A
B1B
2
6
K4
B2
4
N9
O3
T5
R2
J2
|
| Attorney or Representative Information | ||
| To be completed by an Attorney or Accredited Representative (if any). Check this box for this box if Form G-28 is attached | CheckBox |
Check this box if Form G-28 (Notice of Entry of Appearance as Attorney or Accredited Representative) is attached.
|
| To be completed by an Attorney or Accredited Representative (if any). Enter Attorney State Bar Number (if applicable) | Text |
Enter the Attorney State Bar Number if applicable.
|
| To be completed by an Attorney or Accredited Representative (if any). Enter Attorney or Accredited Representative U S C I S Online Account Number (if any). Must be 12 digits; no dashes | Text |
Enter the USCIS Online Account Number of the Attorney or Accredited Representative if they have one. It must be exactly 12 digits long and should not include any dashes.
|
| Barcode | ||
| PDF417BarCode1 | Text |
This is a barcode field that contains encoded information about the form. No input is required.
|
| Barcode Information | ||
| PDF417BarCode1 | Text |
This field contains a barcode that encodes specific information about the form.
|
| Current Nonimmigrant Status | ||
| Part 1. Information About You. Other Information About You. 12. Current Nonimmigrant Status (for example, F-1 student, H-4 dependent, etc.). Select Current Nonimmigrant Status from the list | ComboBox |
Select your current nonimmigrant status from the provided list. Examples include F-1 student, H-4 dependent, etc.
FUG
A3
H3B
1B2
E3
X
V3
P1S
OP
V1
PI
WB
L1
T4
K1
ML
H3
H2R
MIS
N4
F2
WT
J1S
M1
N2
UU
PAR
P3
U3
N7
D2
P4
K4
B1B
T5
O3
N9
R2
AS
DA
A1
H1A
S2
BE
TWO
1B3
1B1
C1
1
RE
N5
N6
WD
A2
RW
PAL
T2
CW1
1B4
UN
EWI
GB
N1
CP
DT
TC
L1A
P1
S1
Q1
B1A
K2
M2
T3
J2S
B1D
DX
U4
G4
IN
GT
H3A
H4
U2
H1
N8
P2S
RE5
P3S
DE
E2
TB
IMM
C2
HSC
TD
E2C
ST
G5
SDF
EAO
CC
I
G3
H2B
H1B
J1
0
C4
H1C
U5
N3
WI
O1A
ASD
J2
FSM
S9
TN2
CH
H2
B1
TN1
V2
O2
H2A
P2
K3
F1
T1
B1C
L1B
G2
P1A
R1
L2
CW2
G1
AW
1B5
C3
D1
Q3
U1
E1
P1B
1BS
B2
LZ
O1
O1B
|
| Part 1. Information About You. Other Information About You. 12. Current Nonimmigrant Status (for example, F-1 student, H-4 dependent, etc.). Enter Expiration Date of Current Nonimmigrant Status. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text |
Enter the expiration date of your current nonimmigrant status in the format MM/DD/YYYY.
|
| Part 1. Information About You. Other Information About You. 12. Current Nonimmigrant Status (for example, F-1 student, H-4 dependent, etc.). Check this box for this box if you were granted Duration of Status (D / S) | CheckBox |
Check this box if you were granted Duration of Status (D/S).
|
| Current Physical Address | ||
| Part 1. Information About You. 6. Your Current Physical Address. Select Suite | CheckBox |
Check this box if your current physical address includes a suite.
|
| Part 1. Information About You. 6. Your Current Physical Address. Select Floor | CheckBox |
Check this box if your current physical address includes a floor.
|
| Part 1. Information About You. 6. Your Current Physical Address. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number | Text |
Enter the number of your apartment, suite, or floor if applicable.
|
| Part 1. Information About You. 6. Your Current Physical Address. Enter City or Town | Text |
Enter the city or town of your current physical address.
|
| Part 1. Information About You. 6. Your Current Physical Address. Select State from list of States | ComboBox |
Select the state of your current physical address from the list of states.
ID
PA
NH
NY
GA
SD
CA
VA
ND
AA
VT
WV
RI
MD
OK
IN
MH
LA
AE
GU
AZ
MN
OH
NV
VI
NM
DE
MS
PR
NJ
WA
MO
MT
MI
PW
KS
CO
MA
KY
TX
NC
NE
ME
UT
IA
AP
FL
AR
MP
TN
AK
DC
AL
FM
CT
OR
SC
WI
HI
WY
IL
AS
|
| Part 1. Information About You. 6. Your Current Physical Address. Enter Enter 5-digit Zip Code | Text |
Enter the 5-digit zip code of your current physical address.
|
| Entry Information | ||
| Part 1. Information About You. Other Information About You. 11. Provide Information About Your Most Recent Entry Into the United States. Enter Date of Last Arrival Into the United States. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text |
Enter the date of your most recent arrival into the United States in the format MM/DD/YYYY.
|
| Part 1. Information About You. Other Information About You. 11. Provide Information About Your Most Recent Entry Into the United States. Enter Form I-94 Arrival-Departure Record Number | Text |
Enter your Form I-94 Arrival-Departure Record Number. It must be up to 11 digits long.
|
| Part 1. Information About You. Other Information About You. 11. Provide Information About Your Most Recent Entry Into the United States. Enter Passport Number, if any | Text |
Enter your passport number, if you have one. It can be up to 30 characters long.
|
| Part 1. Information About You. Other Information About You. 11. Provide Information About Your Most Recent Entry Into the United States. Enter Travel Document Number, if any | Text |
Enter your travel document number, if you have one. It can be up to 30 characters long.
|
| Part 1. Information About You. Other Information About You. 11. Provide Information About Your Most Recent Entry Into the United States. Enter Country of Passport or Travel document Issuance | Text |
Enter the country where your passport or travel document was issued.
|
| Part 1. Information About You. Other Information About You. 11. Provide Information About Your Most Recent Entry Into the United States. Enter Expiration Date for Passport or Travel Document. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text |
Enter the expiration date of your passport or travel document in the format MM/DD/YYYY.
|
| Form Metadata | ||
| PDF417BarCode1 | Text |
This field contains a barcode for the form I-539. No input is required.
|
| General Information | ||
| PDF417BarCode1 | Text |
This is a barcode field that contains encoded information about the form.
|
| PDF417BarCode1 | Text |
This field contains a barcode that encodes specific information about the form and its version.
|
| Internal Use | ||
| PDF417BarCode1 | Text |
This is a barcode field for internal use. No input is required.
|
| Interpreter's Certification and Signature | ||
| Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Certification and Signature. I certify, under penalty of perjury, that I am fluent in English and I have interpreted every question on the application and Instructions and interpreted the applicant's answers to the questions in that language, and the applicant informed me that they understood every instruction, question, and answer on the application. Enter the language | Text |
Enter the language in which the interpreter is fluent and used to interpret the application and instructions.
|
| Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Certification and Signature. 6. Enter the Interpreter's Signature. This field cannot be signed electronically. Print form and enter an ink signature | Text |
The interpreter must sign this field in ink after printing the form. Electronic signatures are not accepted.
|
| Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Certification and Signature. 6. Enter the Date of Intepreter's Signature. Enter date as 2-digit month, 2-digit day, and 4-digit year | Text |
Enter the date when the interpreter signed the form. Use the format MM/DD/YYYY.
|
| Interpreter's Contact Information | ||
| Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Full Name. 1. Enter the Interpreter's Family Name, Last Name | Text |
Enter the interpreter's family name (last name). This is required if an interpreter is used.
|
| Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Full Name. 1. Enter the Interpreter's Given Name, First Name | Text |
Enter the interpreter's given name (first name). This is required if an interpreter is used.
|
| Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Full Name. 2. Enter the Interpreter's Business or Organization Name | Text |
Enter the name of the interpreter's business or organization, if applicable.
|
| Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Contact Information. 5. Enter the Interpreter's Email Address, if any | Text |
Enter the interpreter's email address, if available. This is an optional field.
|
| Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Contact Information. 3. Enter the Interpreter's Daytime Telephone Number | Text |
Enter the daytime telephone number of the interpreter who assisted with this application.
|
| Part 6. Interpreter's Contact Information, Certification, and Signature. Interpreter's Contact Information. 4. Enter the Interpreter's Mobile Telephone Number, if any | Text |
Enter the mobile telephone number of the interpreter who assisted with this application, if available.
|
| Mailing Address | ||
| Part 1. Information About You. 4. Your U.S. Mailing Address, Safe Address, if applicable. Select Apartment | CheckBox |
Select this checkbox if your U.S. mailing address includes an apartment number.
|
| Part 1. Information About You. 4. Your U.S. Mailing Address, Safe Address, if applicable. Select Suite | CheckBox |
Select this checkbox if your U.S. mailing address includes a suite number.
|
| Part 1. Information About You. 4. Your U.S. Mailing Address, Safe Address, if applicable. Select Floor | CheckBox |
Select this checkbox if your U.S. mailing address includes a floor number.
|
| Part 1. Information About You. 4. Your U.S. Mailing Address, Safe Address, if applicable. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number | Text |
If you selected Apartment, Suite, or Floor, enter the corresponding number here.
|
| Part 1. Information About You. 4. Your U.S. Mailing Address, Safe Address, if applicable. Enter City or Town | Text |
Enter the city or town of your U.S. mailing address.
|
| Part 1. Information About You. 4. Your U.S. Mailing Address, Safe Address, if applicable. Select State from list of States | ComboBox |
Select the state of your U.S. mailing address from the provided list.
ID
PA
NH
NY
GA
SD
CA
VA
ND
AA
VT
WV
RI
MD
OK
IN
MH
LA
AE
GU
AZ
MN
OH
NV
VI
NM
DE
MS
PR
NJ
WA
MO
MT
MI
PW
KS
CO
MA
KY
TX
NC
NE
ME
UT
IA
AP
FL
AR
MP
TN
AK
DC
AL
FM
CT
OR
SC
WI
HI
WY
IL
AS
|
| Part 1. Information About You. 4. Your U.S. Mailing Address, Safe Address, if applicable. Enter 5-digit Zip Code | Text |
Enter the 5-digit ZIP code of your U.S. mailing address.
|
| Part 1. Information About You. 5. Is your mailing address the same as your physical address? Check this box for No. If you answered “No” to Item Number 5., provide information on your physical address in Item Number 6 | CheckBox |
Check this box if your mailing address is different from your physical address.
|
| Part 1. Information About You. 5. Is your mailing address the same as your physical address? Check this box for Yes. If you answered “Yes” to Item Number 5. skip to Item Number 7 | CheckBox |
Check this box if your mailing address is the same as your physical address.
|
| Passport Information | ||
| Part 4. Additional Information About the Principal Applicant. 1. Current Passport Information. If your current passport information is different from the information you provided in Part 1., provide your current passport information. If your current passport information matches the information you provided in Part 1., proceed to Item Number 3. Enter Passport Number | Text |
Enter the passport number of your current passport if it is different from the one provided in Part 1.
|
| Personal Information | ||
| Part 1. Information About You. Other Information About You. 9. Enter Date of Birth. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text |
Enter your date of birth in the format MM/DD/YYYY.
|
| Part 1. Information About You. Other Information About You. 8. Enter Country of Citizenship or Nationality | Text |
Enter the country where you hold citizenship or nationality.
|
| Part 1. Information About You. Other Information About You. 7. Enter Country of Birth | Text |
Enter the country where you were born.
|
| Part 1. Information About You. Other Information About You. 10. Enter U.S. Social Security Number, if any. Must be 9 digits; no dashes | Text |
Enter your U.S. Social Security Number, if you have one. It must be 9 digits long without any dashes.
|
| Physical Address | ||
| Part 1. Information About You. 6. Your Current Physical Address. Enter Street Number and Name | Text |
Enter the street number and name of your current physical address.
|
| Part 1. Information About You. 6. Your Current Physical Address. Select Apartment | CheckBox |
Select this checkbox if your current physical address includes an apartment number.
|
| Physical Address Abroad | ||
| Part 4. Additional Information About the Principal Applicant. 2. Physical Address Abroad. Enter Street Number and Name | Text |
Enter the street number and name of your physical address abroad.
|
| Part 4. Additional Information About the Principal Applicant. 2. Physical Address Abroad. Check this box for Apartment | CheckBox |
Check this box if your physical address abroad includes an apartment.
|
| Part 4. Additional Information About the Principal Applicant. 2. Physical Address Abroad. Check this box for Suite | CheckBox |
Check this box if your physical address abroad includes a suite.
|
| Part 4. Additional Information About the Principal Applicant. 2. Physical Address Abroad. Check this box for Floor | CheckBox |
Check this box if your physical address abroad includes a floor.
|
| Part 4. Additional Information About the Principal Applicant. 2. Physical Address Abroad. Enter the Apartment, Suite, or Floor Number | Text |
Enter the apartment, suite, or floor number of your physical address abroad.
|
| Part 4. Additional Information About the Principal Applicant. 2. Physical Address Abroad. Enter the City or Town | Text |
Enter the city or town of your physical address abroad.
|
| Part 4. Additional Information About the Principal Applicant. 2. Physical Address Abroad. For International address enter the Province | Text |
Enter the province of your physical address abroad if it is an international address.
|
| Part 4. Additional Information About the Principal Applicant. 2. Physical Address Abroad. For International address enter the Postal Code | Text |
Enter the postal code of your physical address abroad if it is an international address.
|
| Part 4. Additional Information About the Principal Applicant. 2. Physical Address Abroad. For International address enter the Country | Text |
Enter the country of your physical address abroad if it is an international address.
|
| Preparer's Certification and Signature | ||
| Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant. Preparer's Certification and Signature. 6. Preparer's Signature. This field cannot be signed electronically. Print form and enter an ink signature | Text |
The preparer must sign this field with an ink signature. This field cannot be signed electronically. Print the form and enter the signature.
|
| Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant. Preparer's Certification and Signature. 6. Preparer's Signature. Enter Date of Signature. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text |
Enter the date when the preparer signed the form. Use the format MM/DD/YYYY.
|
| Preparer's Contact Information | ||
| Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant. Preparer's Contact Information. 5. Enter Preparer's Email Address, if any | Text |
Enter the email address of the person who prepared this application, if it is someone other than the applicant.
|
| Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant. Preparer's Contact Information. 3. Enter Preparer's Daytime Telephone Number | Text |
Enter the daytime telephone number of the person who prepared this application, if it is someone other than the applicant. The number should be 10 digits long.
|
| Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant. Preparer's Contact Information. 4. Enter Preparer's Mobile Telephone Number, if any | Text |
Enter the mobile telephone number of the person who prepared this application, if it is someone other than the applicant. The number should be 10 digits long.
|
| Preparer's Information | ||
| Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant. Preparer's Full Name. 1. Enter Preparer's Family Name, Last Name | Text |
Enter the family name (last name) of the person who prepared this application, if it is someone other than the applicant.
|
| Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant. Preparer's Full Name. 1. Enter Preparer's Given Name, First Name | Text |
Enter the given name (first name) of the person who prepared this application, if it is someone other than the applicant.
|
| Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant. Preparer's Full Name. 1. Enter Preparer's Business or Organization Name | Text |
Enter the business or organization name of the person who prepared this application, if applicable.
|
| Prepopulated Information | ||
| Part 8. Additional Information. If you need extra space to provide any additional information within this declaration, use the space below. If you need more space than what is provided, you may make copies of this page to complete and file with this declaration or attach a separate sheet of paper. Type or print your name and A-Number, if any 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. No Entry 1. Family Name, Last Name, prepopulated from page 1 | Text |
This field is prepopulated with your family name (last name) from page 1. Ensure it is correct.
|
| Part 8. Additional Information. If you need extra space to provide any additional information within this declaration, use the space below. If you need more space than what is provided, you may make copies of this page to complete and file with this declaration or attach a separate sheet of paper. Type or print your name and A-Number, if any 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. No Entry. 1. Given Name, First Name. Prepopulated from page 1 | Text |
This field is prepopulated with your given name (first name) from page 1. Ensure it is correct.
|
| Part 8. Additional Information. If you need extra space to provide any additional information within this declaration, use the space below. If you need more space than what is provided, you may make copies of this page to complete and file with this declaration or attach a separate sheet of paper. Type or print your name and A-Number, if any 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. No Entry. 1. Middle Name, if applicable. Prepopulated from page 1 | Text |
This field is prepopulated with your middle name, if applicable, from page 1. Ensure it is correct.
|
| Part 8. Additional Information. If you need extra space to provide any additional information within this declaration, use the space below. If you need more space than what is provided, you may make copies of this page to complete and file with this declaration or attach a separate sheet of paper. Type or print your name and A-Number, if any 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. No Entry. 2. A-Number. Prepopulated from page 1 | Text |
This field is prepopulated with your A-Number from page 1. Ensure it is correct.
|
| Processing Information | ||
| Part 3. Processing Information. 2. Is this application based on an extension or change of status already granted to your spouse, child, or parent? Check this box for No | CheckBox |
Check this box if the application is NOT based on an extension or change of status already granted to your spouse, child, or parent.
|
| Part 3. Processing Information. 2. Is this application based on an extension or change of status already granted to your spouse, child, or parent? Check this box for Yes | CheckBox |
Check this box if the application is based on an extension or change of status already granted to your spouse, child, or parent.
|
| Part 3. Processing Information. 1. I / We request that my / our current or requested status be extended until. Enter Date. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text |
Enter the date until which you request your current or requested status to be extended. Use the format MM/DD/YYYY.
|
| Part 3. Processing Information. 5. If you answered "Yes" to Item Number 2. or 3., provide the U S C I S Receipt Number. Enter U S C I S Receipt Number | Text |
If you answered 'Yes' to Item Number 2 or 3, provide the USCIS Receipt Number here. The number should be up to 13 characters long.
|
| Part 3. Processing Information. If the petition or application is pending with U S C I S, also provide the following information. 6. First and Last Name of Beneficiary or Applicant. Enter First Name of Beneficiary or Applicant | Text |
If the petition or application is pending with USCIS, enter the first and last name of the beneficiary or applicant.
|
| Part 3. Processing Information. 3. Is this application based on a separate petition or application to provide your spouse, child, or parent an extension or change of status? Check this box for No | CheckBox |
Indicate whether this application is based on a separate petition or application to provide your spouse, child, or parent an extension or change of status by checking 'No'.
|
| Part 3. Processing Information. 3. Is this application based on a separate petition or application to provide your spouse, child, or parent an extension or change of status? Check this box for Yes, filed with this Form I-5 39 | CheckBox |
Indicate whether this application is based on a separate petition or application to provide your spouse, child, or parent an extension or change of status by checking 'Yes, filed with this Form I-539'.
|
| Part 3. Processing Information. 3. Is this application based on a separate petition or application to provide your spouse, child, or parent an extension or change of status? Check this box for Yes, filed previously and pending with U.S. Citizenship and Immigration Services, U S C I S | CheckBox |
Indicate whether this application is based on a separate petition or application to provide your spouse, child, or parent an extension or change of status by checking 'Yes, filed previously and pending with U.S. Citizenship and Immigration Services (USCIS)'.
|
| Part 3. Processing Information. 7. Enter Date Filed. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text |
Enter the date when the application was filed. Use the format MM/DD/YYYY.
|
| Part 3. Processing Information. 4. If you answered "Yes" to Item Number 2. or Item Number 3., select the Form type below. Check this box for Form I-5 39, Application to Extend/Change Nonimmigrant Status | CheckBox |
If you answered 'Yes' to Item Number 2 or Item Number 3, select the form type by checking 'Form I-539, Application to Extend/Change Nonimmigrant Status'.
|
| Part 3. Processing Information. 4. If you answered "Yes" to Item Number 2. or Item Number 3., select the Form type below. Check this box for Check this box for Form I-1 29, Petition for a Nonimmigrant Worker | CheckBox |
If you answered 'Yes' to Item Number 2 or Item Number 3, select the form type by checking 'Form I-129, Petition for a Nonimmigrant Worker'.
|
| Part 3. Processing Information. If the petition or application is pending with U S C I S, also provide the following information. 6. First and Last Name of Beneficiary or Applicant. End Last Name of Beneficiary or Applicant | Text |
Provide the first and last name of the beneficiary or applicant if the petition or application is pending with USCIS.
|
| System Information | ||
| PDF417BarCode1 | Text |
This field contains a barcode that is automatically generated and should not be modified.
|