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Optional Checklist for Form I-765 (c)(9) Filings

Adjustment of Status Applicants

USCIS

Form M-1152

Department of Homeland Security

Checklist

U.S. Citizenship and Immigration Services

This is an optional checklist to assist applicants who are filing Form I-765 together with

or based on a pending adjustment of status application (Form I-485).

Do not submit this checklist to USCIS.

NOTE: This optional checklist does not replace or change statutory or regulatory requirements. We recommend

that you review these requirements, as well as the appropriate form instructions, before completing and

submitting Form I-765. Do not send original documents unless specifically requested in the form instructions.

See for the most recent version of the Form I-765 and its instructions.

Form Checklist

Did you complete all sections of the form that apply to you? (See the General Instructions section on

Page 7 of the How To Fill Out Form I-765 section of the Form I-765 Instructions.)

Did you sign and date the form? (See the General Instructions section on Page 7 of the Form I-765

Instructions.)

Did you submit the correct fee, if applicable? (See the What Is the Filing Fee section on Page 9 of the

Form I-765 Instructions.)

Did you provide your current U.S. mailing address? Do not write the address of your attorney or

accredited representative. (See the Address Change section on Page 10 of the Form I-765 Instructions.)

Filing Checklist

Did you provide the following?

Completed Form G-28 (only if you are represented by an attorney or an accredited representative).

Note: If you want your Employment Authorization Document (EAD) mailed to your attorney or

accredited representative, please indicate it on the Form G-28. (See Part 4, Items 1. - 2.b., in the

Specific Instructions section on Page 3 of the Form G-28 Instructions.)

Proof that you have a pending Form I-485 (only if you have a previously filed Form I-485). (See Item 7.A.

in the Who May File Form I-765 section on Page 5 of the Form I-765 Instructions.)

Certified English translations of any non-English documents. (See the Translations paragraph in the

General Instructions section on Page 7 of the Form I-765 Instructions.)

Proof of Identity. (See Item 2.B. in the Required Documentation section on Page 8 of the Form I-765

Instructions.)

Photographs. (See Item 2.C. in the Required Documentation section on Page 8 of the Form I-765

Instructions.)

Do not submit this checklist to USCIS.

Form M-1152 04/01/16 N

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Uscis Form M-1152 - Optional Checklist For Form I-765 (C)(9) Filings Adjustment Of Status Applicants