Form I-905 - Application For Authorization To Issue Certification For Health Care Workers
Download a blank fillable Form I-905 - Application For Authorization To Issue Certification For Health Care Workers in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form I-905 - Application For Authorization To Issue Certification For Health Care Workers with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3Application for Authorization to Issue Certification
for Health Care Workers
USCIS
Form I-905
Department of Homeland Security
U.S. Citizenship and Immigration Services
Approved for all requested
Returned
Reloc Sent
Receipt
Action Block
occupations.
Partial approval (USCIS must list
approved occupations.)
For
Resubmitted
Reloc Rec'd
VOLAG#
USCIS
Use
Only
To Be Completed by
ATTY State License Number
Attorney or Representative, if any
Select the box if Form G-28 is
attached to represent the applicant
►
START HERE -
Please type or print in black ink.
Description of your organization.
Part 1. Information About the Applicant Filing
This Form
1.
Name of Company or Organization
Address
2.a.
Street Number
Occupations for which you are seeking authorization.
and Name
2.b.
Apt.
Ste.
Flr.
2.c.
City or Town
2.d.
State
2.e.
ZIP Code
3.
IRS Tax Number
Describe the process you will use to issue certificates.
Point of Contact
4.a. Family Name
(Last Name)
4.b.
Given Name
(First Name)
4.c.
Middle Name
5.
Title
6.
Date the organization was created.
►
(mm/dd/yyyy)
Page 1 of 3
Form I-905 02/11/14 Y
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal