Form I-765V was designed for use by victims of battery or extreme cruelty at the hands of abusive spouses who hold nonimmigrant (temporary) visas in one of these categories:
The battery or extreme cruelty must have taken place in the United States.
Such spouses are eligible to apply for employment authorization documents (also called EADs or work permits) through the Violence Against Women Act (VAWA), codified at Section 106 of the Immigration and Nationality Act. The purpose of this legislation is to give abused spouses some measure of freedom from those who subjected them to battery or extreme cruelty.
Form I-765V is available on the I-765V page of the USCIS website. This article describes the 1/19/2017 version, which is due to expire on 1/31/2019.
Firtst, you should be aware of a few general rules for filling out Form I-765V. It's best to type the information into the form on your computer if you can. Otherwise, print it out and type or write with black ink.
For this form, U.S. Citizenship and Immigration Services (USCIS) wants you to enter “None” or “N/A” (for “not applicable”) if that’s your answer, rather than leaving a space blank.
If you can’t fit your answer in the space provided, attach a separate sheet of paper with the information. In case this sheet gets lost in the system, write at the top “I-765V Continuation Sheet,” your name, and your alien registration number (A#—if you have one). Then make sure USCIS knows which questions you are supplying additional information for—start with the question number to which your answer refers. Be sure to date and sign each continuation sheet.
Here is specific guidance on what to enter in the various spaces on Form I-765V.
Part 1: Information About You
Question 1: If this is your first work permit, under “I am applying for,” check “Initial permission to accept employment.” If you’ve applied for a work permit in the past, but it was lost, stolen, or mutilated (but would still be valid), check “Replacement.” If you have a past work permit that is expiring soon, and you are still eligible for employment authorization, check the box for “Renewal” and make a copy of your current work permit to send in your application packet.
Question 2: You would have been given an A-number only if you applied for any immigration benefit once you arrived in the United States or if you were put into removal (deportation) proceedings. Look for the letter A followed by 8 or 9 digits on any correspondence you got from a U.S. immigration agency.
Question 3: It’s entirely possible you don’t have a USCIS Online Account Number. You would only have one if you’d filed certain types of applications with USCIS.
Question 4: If you have a valid Social Security Number (SSN) from the Social Security Administration, enter it here. Otherwise enter "none."
Questions 5 – 13: Self-explanatory.
Question 14: If you previously applied for a U.S. work permit, you are asked in Question 15a “Which USCIS office?” Find the name of the USCIS office that approved or denied your application—it should be on the Form I-797 notice you received. For “Date,” use the date USCIS received your application (also on the I-797). Submit copies of all I-797 forms with your I-765V.
Question 16: Your place of last entry will be the airport where your plane first landed in the U.S. or where you were inspected by a U.S. border officer.
Question 17: Here, you must state the date of your most recent U.S. entry.
Question 18: This asks for your U.S. immigration status upon arrival. If you know the visa category letters and numbers, use those. Otherwise, describe your category (such as “visitor” or “student”).
Question 19a and b: If you entered the United States by plane or ship after April 2013, you can find your I-94 number online on the Customs and Border Protection (CBP) website. (You’ll need your passport number.) If you came before that, or if you came across a land border, you might find a white I-94 card stapled in your passport. Always use the last I-94 number you received, if you have had more than one. The I-94 will tell you the date your status expires.
Question 19c - f: You’ll find all this information in your passport.
Question 20: If your status hasn’t changed, this will be the same answer as you gave to Question 18.
Question 21: Your eligibility category is either (c)(27) if you’re the abused spouse of an A nonimmigrant; (c)(28) if you’re the abused spouse of an E-3 nonimmigrant; (c)(29) if you’re the abused spouse of a G nonimmigrant; or (c)(30) if you’re the abused spouse of an H nonimmigrant.
Part 2. Information About Your Spouse
Because your eligibility for a work permit depends on your relationship to a nonimmigrant spouse, the form asks a number of questions about that spouse. Don’t worry if you aren’t able to fill in every detail; the form specifically says to enter the information “if known.” Enter as much as you can, however; if USCIS isn’t able to identify who your spouse is and find him or her within its records, it will have to deny your application.
Part 3. Marriage Information
You’ll need to fill this in and attach a copy of your marriage certificate, or other evidence showing that you have—or had, if you’ve since divorced—a qualifying relationship with your nonimmigrant spouse.
Part 4. Applicant’s Statement, Contact Information, Declaration, Certification, and Signature
Here, you’ll supply contact information about yourself and also confirm that you understand what you’re signing.
Part 5. Interpreter’s Contact Information, Certification, and Signature
If your English isn’t to a point where you can fill out a form like this yourself and you used an interpreter (professional or otherwise), that’s fine, but that person will need to supply personal information here.
Part 6. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant
If an attorney, paralegal, or someone else filled out this form for you, that person needs to fill in this section. (If you only had help from an interpreter, he or she needs to fill in this section as well.)
Part 7. Additional Information
This is a handy place in which to put extra information about questions within the application. However, it’s not meant for lengthy explanations, such as of the abuse you suffered at the hands of your spouse. You will need to supply a separate statement detailing this, as well as other documentation of the abuse (such as copies of police statements, court records, and so on).
See the USCIS instructions to Form I-797V for a full list of required documents as well as instructions on submitting your application to USCIS.
You will not need to pay a filing fee or a fee for biometric services fee in order to file Form I-765V.
If USCIS approves your application, it will send you an EAD good for a two-year period and renewable for additional two-year periods, assuming you still meets the eligibility requirements. (When filing a renewal application, however, you don’t need to submit proof of the abuse again.)