Form I 566 PDF Details

Every day, individuals from all over the world come to the United States seeking asylum. In order to be granted asylum in the U.S., applicants must complete Form I-566, which is known as the “Asylum Application”. This form asks for a great deal of information about the applicant and their situation, so it is important to understand what is required before filling it out. In this blog post, we will provide an overview of Form I-566 and offer some tips on how to complete it successfully. Stay tuned for our next post, which will give more detailed instructions on how to fill out this form.

QuestionAnswer
Form NameForm I 566
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesi 566 omb no 1615 0027 form

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OMB No. 1615-0027; Expires 06/30/2015

 

 

Form I-566, Interagency Record of Request

Department of Homeland Security

A, G, or NATO Dependent Employment Authorization or

U.S. Citizenship and Immigration Services

Change/Adjustment To/From A, G, or NATO Status

 

 

 

 

 

 

 

 

 

 

 

 

START HERE - Type or print in black ink.

Part 1. Information About You (The person seeking employment authorization or change/adjustment of status.)

1.Family Name (Last Name)

Given Name (First Name)

Middle Name

2.Home Address - Street Number and Name

Apt. Number

City

State

Zip Code

3.Mailing Address - Street Number and Name

Apt. Number

C/O (In Care Of):

City

State

Zip Code

Daytime Phone Number (with area code)

4.Date of Birth (mm/dd/yyyy)

5.Country of Birth

6.Country of Citizenship

7.

Gender

 

8. Marital Status

 

9.

A-Number (if any)

 

 

10. U.S. Social Security Number

 

Male

Female

 

Married

Not Married

 

A-

 

 

(if any)

 

 

 

 

 

 

 

 

 

 

 

 

11.

DOS Personal Identification Number

 

12. I-94 Number (Arrival-Departure

 

13. Passport or Travel Document

 

(PID)

 

 

 

 

 

Document)

 

 

 

 

Number

 

 

 

 

 

 

 

 

 

 

 

14.

Country of Issuance for Passport or Travel Document

 

15. Expiration Date for Passport or Travel Document

 

 

 

 

 

 

 

 

 

 

(mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

16.

Date of Last Entry into the U.S.

 

17.

Current Immigration Status

 

18. Relationship to Principal (if applicable)

 

(mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part 2. Information About Principal Alien

1.

Family Name (Last Name)

 

Given Name (First Name)

 

Middle Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

Home Address - Street Number and Name

 

 

 

 

 

 

 

 

 

Apt. Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

 

 

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

3.

Date Tour of Duty Expected to End

4. Country of Citizenship

 

 

 

 

5. Marital Status

 

 

(mm/dd/yyyy)

 

 

 

 

 

 

 

Married

Not Married

 

 

 

 

 

 

 

 

 

 

 

 

 

6.

Job Title

 

 

 

 

7. DOS Personal Identification Number (PID)

 

 

 

 

 

 

 

 

 

 

 

 

8.

I-94 Number (Arrival-Departure Document)

 

9.

Passport or Travel Document Number

 

 

 

 

 

 

 

 

 

 

 

 

 

10.

Country of Issuance for Passport or Travel Document

 

11.

Expiration Date for Passport or Travel Document

 

 

 

 

 

 

 

 

(mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Form I-566 06/12/13 N Page 1

Part 3. Type of Request (See instructions for complete information on the different types of requests.)

1.

2.

I am requesting employment authorization as (select one):

a. spouse.

b.

son or daughter, age:

 

, who:

is a full-time, post-secondary student

is disabled

c.

other dependent recognized by the DOS:

 

 

 

 

 

 

 

 

 

I am requesting change/adjustment of status (Select one)

a.

Change of nonimmigrant status to A, G, or NATO nonimmigrant - specifically to:

 

b.

Section 247(a), immigrant to A or G nonimmigrant.

c.

Change to other nonimmigrant status from A, G, or NATO - specifically to:

 

d.

Adjustment from A, G, or NATO nonimmigrant to immigrant.

e.

A-1, A-2, G-1, or G-2, nonimmigrant applying under Section 13 of the Act of September 11, 1957.

Part 4. Certification (Submit two copies with original signatures.)

I certify under penalty of perjury that the foregoing is true and correct. I understand false information is a basis for denial or termination of the benefit requested and for other penalties provided by law and regulation. If I am requesting employment authorization, I further certify that I do not have a criminal record. I have not violated United States immigration and/or visa laws, I have not worked illegally in the United States, and I have paid Social Security and all applicable taxes on all employment in the United States.

Signature of Applicant

Date (mm/dd/yyyy)

 

 

 

Part 5. Your Personal Information

Name of Applicant (Family, Given, Middle)

 

Date of Birth (mm/dd/yyyy) DOS Personal Identification Number

 

 

 

(PID)

 

 

 

 

 

 

For Official Use Only

Part 6. Certification by Diplomatic Mission, International Organization, NATO/HQ SACT, or NATO Member State (Certifying official must have this information and page to complete process.)

I certify that the information provided on the first page of this Form I-566 is true and correct to the best of my knowledge and according to our official records.

I further certify that the applicant's eligibility for employment authorization has been verified under the provisions of:

A bilateral agreement with:

A de facto agreement with:

Check all that apply:

Without a numerical limit

Based on principal alien's G-4 status

With a numerical limit and this applicant is within the limit; and

I further certify that the applicant for status as a principal alien is being offered the position below and DOS was notified.

Position:

 

DOS Notification Date:

Signature of Certifying Officer or Official

Printed Name Certifying Officer or Official

 

 

 

 

 

 

Name and Address of Diplomatic Mission, International Organization, NATO/HQ SACT, or NATO Member State

Official Seal

 

Duty/Title

 

Phone Number (include area code) Date (mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Form I-566 06/12/13 N Page 2

Part 7. DOS, NATO/HQ SACT, and/or USUN Use Only

1.The Department of State, NATO/HQ SACT, and/or USUN:

Recommends the request be granted

Recommends the request be denied

If the recommendation is for denial, provide a reason(s) for such recommendation:

2.

Date (mm/dd/yyyy)

 

3. Phone Number (include area code)

4.

Office:

 

 

 

 

 

 

 

 

 

 

 

Protocol

USUN

NATO/HQ SACT

Visa

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

Signature 1

 

6.

Signature 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part 8. USCIS Use Only

1.

From:

 

 

 

 

 

Adjudicator's ID Number USCIS Office

 

Office Phone Number (with area code) A-Number/File Number

 

 

 

 

 

 

 

 

2.

To:

 

 

 

 

Protocol

USUN

NATO/HQ SACT

Visa Office (Subject filed under Section 13. Advise USCIS of findings.)

3.Adjustment or Change of Status:

Granted

Date of Decision (mm/dd/yyyy) If change of status granted, give new status:

Denied

 

 

 

4.Request for Employment Authorization:

Granted

Date of Decision (mm/dd/yyyy) Valid to (mm/dd/yyyy) Classification:

Denied

 

 

 

 

 

5.DOS, USUN, NATO/HQ SACT, or Visa Office

Office Notified:

Yes

Date of Notification (mm/dd/yyyy)

No

 

Form I-566 06/12/13 N Page 3

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