Sample DACA Table of Contents

Cindy Medina

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Immigration Attorney

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TABLE OF CONTENTS

Forms:

  1. Form I-821D, Consideration of Deferred Action for Childhood Arrivals

  2. Form I-765, Application for Work Authorization

  3. Form I-765 Worksheet

Fees:

  1. Form I-765 Filing Fee: $380

  2. Biometrics Fee: $85

I. Proof of identity and under 31 years of age on June 15, 2012

? Copy of Passport: EXHIBIT ___

? Copy of Birth Certificate and Photo Identification: EXHIBIT ___

? Copy of national identity document from country of origin with photo and/or fingerprints: EXHIBIT ___

? Copy of Employment Authorization Document: EXHIBIT ___

? Copy of expired visa: EXHIBIT ___

? Driver’s License: EXHIBIT ___

? School identification card(s): EXHIBIT ___

? OTHER: : EXHIBIT ___

II. Proof of entry prior to 16th Birthday

? Copy of passport with admission stamp indicating entry date: EXHIBIT ___

? Copy of I-94/I-95/I-94W Arrival/Departure Record: EXHIBIT ___

? Copy of I-862, Notice to Appear: EXHIBIT ___

? Travel records: EXHIBIT ___

? School records: EXHIBIT ___

? Immunization Records: EXHIBIT ___

? Hospital and/or medical records: EXHIBIT ___

? Official records from a religious entity in the United States confirming participation in a religious ceremony, rite, or passage: EXHIBIT ___

? OTHER: : EXHIBIT ___

III. Proof of unlawful status as of June 15, 2012

? Not applicable because entered without inspection and never in removal proceedings

? Copy of I-94/I-95/I-94W Arrival/Departure Record showing the date authorized stay expired: EXHIBIT ___

? Copy of final order of EXCLUSION, DEPORTATION or REMOVAL issued as of June 15, 2012 and related charging documents: EXHIBIT ___

? Copy of an INS or DHS charging document placing into removal proceedings: EXHIBIT ___

? OTHER: : EXHIBIT ___

IV. Proof of presence in the United States on June 15, 2012

? Rent receipts: EXHIBIT ___

? Bank Statements: EXHIBIT ___

? Cell Phone Records: EXHIBIT ___

? Utility Bills: EXHIBIT ___

? Receipts for payments made: EXHIBIT ___

? Copies of W-2s: EXHIBIT ___

? Pay stubs: EXHIBIT ___

? Proof of filing of tax return: EXHIBIT ___

? Letter from employer: EXHIBIT ___

? Letter from Church: EXHIBIT ___

? Self-employed: Letter from BANK(S) and/or FIRMS with whom business has been transacted: EXHIBIT ___

? School records: EXHIBIT ___

?Military records: EXHIBIT ___

? Immunization Records: EXHIBIT ___

? Hospital and/or medical records: EXHIBIT ___

? Official records from a religious entity in the U.S.: EXHIBIT ___

? Money order receipts: EXHIBIT ___

? OTHER: : EXHIBIT ___

V. Documentation evidencing either (a) was in school in the U.S. at the time of filing; or (b) Graduated or received a certificate of completion from a U.S. High School; or (c) Obtained a general education development certificate in the U.S.

? School records: EXHIBIT ___

? U.S. high school diploma or certificate of completion: EXHIBIT ___

? U.S. GED certificate: EXHIBIT ___

? OTHER: : EXHIBIT ___

VI. Documentation demonstrating honorable discharge veteran status of the Coast Guard or Armed Forces of the United States.

? Form DD-214, Certificate of release or discharge from active duty: EXHIBIT ___

? NGB Form 22, National guard report of separation and record of service:EXHIBIT ___

? Military personnel records:EXHIBIT ___

? Military health records:EXHIBIT ___

? OTHER: :EXHIBIT ___

VII. Evidence of continuous residence in the U.S. during the 5-year period immediately before June 15, 2012, and up to present date.

? Rent receipts: EXHIBIT ___

? Utility bills: EXHIBIT ___

? Receipts: EXHIBIT ___

? Bank Statements: EXHIBIT ___

? Cell Phone Records: EXHIBIT ___

? Letters received from companies showing the dates during which service was received: EXHIBIT ___

? Pay stubs: EXHIBIT ___

? Copies of W-2s: EXHIBIT ___

? Certificate of tax return filing: EXHIBIT ___

? School records: EXHIBIT ___

? Letter from Church: EXHIBIT ___

? Military records: EXHIBIT ___

? Immunization Records: EXHIBIT ___

? Hospital and/or medical records: EXHIBIT ___

? Official records from a religious entity in the U.S. : EXHIBIT ___

? Money order receipts: EXHIBIT ___

? OTHER: :EXHIBIT ___

VIII. Evidence of brief, casual, and innocent absence

? Travel documentation

? Passport entries on copy of passport

? Hotel receipts evidencing dates abroad

? Evidence of proof of travel

? Copy of advance parole document

? OTHER:

IX. Criminal history records (if applicable):

? Records Check:EXHIBIT ___

? Court Disposition:EXHIBIT ___

? Arrest Record(s): EXHIBIT ___

? OTHER: : EXHIBIT ___

X. Other Relevant Documentation:

: EXHIBIT ___

: EXHIBIT ___

: EXHIBIT ___

Additional Resources

www.uscis.gov

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