Form I-765 Supplemental Guide

This supplemental guide to filling out the Form I-765 has been prepared by the Office of Global Services to assist students as they complete their paper application for OPT and the STEM OPT Extension. Because these applications are personal petitions to USCIS, OGS is unable to advise on how to complete each section of the form. However, this guide offers clarification on some of the I-765 instructions provided by USCIS. Students should also reference the following resource:

Form I-765, Application For Employment Authorization (uscis.gov)

Form I-765, Instructions for Application for Employment Authorization (uscis.gov)

The numbers below correspond to the numbered items on Form I-765. This form may be downloaded from uscis.gov. Please refer to USCIS I-765 Instructions.

Below are some general guidelines for completing Form I-765 for STEM OPT Extension. Please read the instructions for each item and write the information on the form, printing clearly and legibly or you may type the form online and print it.

Part 1. Reason for Applying

• Field 1: I am applying for… – Unless you are applying for a replace of a lost EAD card, you should indicate that you are applying for “Initial permission to accept employment.”

Part 2. Information About You

• Field 1: Your Name – Print clearly or type your family name in capital letters, followed by the first or given and middle name(s) if any. Write your name as it appears in your passport.
• Fields 2-4: Other Names Used – Fill this out only if you have used other names on official documents or if you have a maiden name (name used prior to marriage, usually applies to women who have married).
• Fields 5-6: Mailing Address – The address you enter here should be the address to which correspondence can be sent for the next 1-5 months during the OPT application period. If you are providing an address where you do no reside, please provide the name of the person who resides at that address in Field 5.a. “In Care of ______”.

Address errors (i.e. undeliverable address, moving before OPT is approved, etc.) are a common cause for delay of or failure to receive the OPT EAD.

• Field 7: Physical Address – If different from mailing address, the address where you reside in the U.S.
• Field 8: Alien Registration Number – If you have an A-Number, enter it here.
• Field 9: USCIS Online Account Number – If you have created an online account with USCIS, enter your account number here.
• Field 10: Sex – Check the appropriate box (this should match your passport).
• Field 11: Marital Status – Check the appropriate box.
• Field 12: Previously filed I-765? – Check no if you have never applied to USCIS for F-1 OPT/STEM OPT or other work authorization. Check yes if you have previously submitted a Form I-765 for USCIS, even if it was rejected, denied or withdrawn.
• Field 13: Provide your Social Security number (SSN) (if known) – If you do not yet have a SSN, you can apply in person at the Social Security Administration (SSA) once you receive your Employment Authorization Document (EAD)
• Field 14: Your Country or Countries of Citizenship or Nationality – List all countries where you are currently a citizen or national. The country of citizenship should match what appears on the applicant’s I-20.
• Field 15: Place of Birth – Provide city, state, and country of applicant’s birth.
• Field 16: Date of Birth – Enter the numerical date of birth as month/day/year (4 digits). For example, June 29, 1988 should be entered as 06/29/1988.
• Field 17: Information About Your Last Arrival in the U.S. – Enter the 11-digit I-94 number that is found on the electronic I-94. It is called “Admission (I-94) Record Number.”
• Field 18: Passport Number of Your Most Recently Issued Passport – Enter your passport number
• Field 19: Travel Document Number (if any) 
• Field 20: Country that Issued Your Passport or Travel Document – Enter the country that issued your passport or travel document
• Field 21: Expiration Date for Passport or Travel Document – Enter the numerical date of the expiration date of your passport/travel document (month/day/year)
• Field 22: Date of Your Last Arrival Into the U.S. – Enter the numerical date of latest entry as month/day/year (4 digits).
• Field 23: Place of your Last Arrival Into the U.S. – Enter the place of last entry. The place of entry is often written in three letter abbreviations, such as BOS for Boston and SFR for San Francisco.
• Field 24: Immigration Status at Your Last Arrival – If F-1 appears on your I-94, enter F-1 student. If you entered in another status and changed your non-immigrant status in the U.S. and have not travelled outside of the U.S. since receiving your change of status, please indicate the status you held upon initial entry into the U.S.
• Field 25: Current Immigration Status – Enter F-1 student.
• Field 26: Student and Exchange Visitor Information System (SEVIS) Number – Enter the 10-digit SEVIS ID starting with N that is found on the top left of your I-20.
• Field 27: Eligibility Category – Enter the appropriate code for the work authorization you are requesting.
  • Pre-Completion OPT is (c) (3) (A)
  • Post-Completion OPT is (c) (3) (B)
  • STEM OPT Extension is (c) (3) (C)

If you are applying for the STEM OPT Extension (c) (3) (C), complete fields 28a – 28c. If you are not applying for the STEM OPT Extension, skip to Part 3.

• Field 28: (c) (3) (c) STEM OPT Eligibility Category – Provide your degree, employer’s name as listed in E-Verify, and employer’s E-Verify identification number.

Part 3. Applicant’s Statement, Contact Information, Certification, and Signature

• Fields 1-2: Applicant’s Statement – Check Item 1.a. unless an interpreter translated the form for you or another person prepared the form on your behalf. You should not check Item 1.b. nor Item 2 if you are filing on your own without the help of an interpreter or another person.
• Fields 3-5: Applicant’s Contact Information – Provide requested contact information.
• Field 6: Select this box if you are a Salvadoran or Guatemalan national eligible for benefits under the AVC settlement agreement – Check box if applicable.
• Field 7: Applicant’s Signature – Acknowledge Applicant’s Declaration and Certification by providing your signature (in pen) and date.

Parts 4-5

• These sections should only be completed if you have an interpreter translate the form for you or another person complete the form on your behalf. You should not complete this section if you are filing on your own without the help of an interpreter or another person.

Part 6. Additional Information

• Use this extra space to provide any additional information required on the application.