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Instruções para o Formulário I-566, Registro Interagência de Solicitação - A, G ou OTAN Autorização de Emprego Dependente ou Mudança / Ajustamento Para / De A, G ou Estado da OTAN

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Instructions for Interagency Record of Request -  
A, G, or NATO Dependent Employment Authorization or  
Change/Adjustment To/From A, G, or NATO Status  
USCIS  
Form I-566  
OMB No. 1615-0027  
Expires 12/31/2023  
Department of Homeland Security  
U.S. Citizenship and Immigration Services  
What Is the Purpose of Form I-566?  
Form I-566 allows certain persons to request employment authorization or change/adjustment of status. Such benefits  
may be available to:  
1. An eligible dependent of an A, G, or NATO nonimmigrant requesting employment authorization;  
2. An A, G, or NATO nonimmigrant requesting a change to another nonimmigrant status;  
3. A nonimmigrant in another status who has been offered a position that requires reclassification as an A, G, or NATO  
nonimmigrant, and any dependents in another nonimmigrant status; or  
4. An A, G, or NATO nonimmigrant requesting adjustment to lawful permanent resident status.  
NOTE: Form I-566 generally accompanies other forms. Form I-566 has no filing fee.  
When Should I Use Form I-566?  
Use Form I-566 as part of the process to request various benefits that may be available to A, G, or NATO nonimmigrants.  
Form I-566 provides information needed to identify you, the requestor, and the person from whom your status is, or will  
be, derived (the principal alien).  
NOTE: Each person requesting employment authorization or change/adjustment of status must file a separate  
Form I-566. You must submit two copies of Form I-566.  
Form I-566 assists government agencies and organizations adjudicate applications and petitions for immigration benefits,  
including requests for employment authorization and change/adjustment of status. The government agencies and  
organizations involved in the process are:  
1. U.S. Department of State (DOS), including the Office of Foreign Missions (DOS OFM), Office of the Chief of  
Protocol (DOS Protocol), USUN Host Country (DOS USUN), and Visa Office (DOS Visa);  
2. North Atlantic Treaty Organization (NATO), Headquarters, Supreme Allied Commander Transformation (HQ SACT);  
3. U.S. Department of Defense (DOD), including the United States Liaison Officer (USLO) to NATO/HQ SACT;  
4. Foreign diplomatic missions and international organizations; and  
5. Department of Homeland Security (DHS), U.S. Citizenship and Immigration Services (USCIS).  
Required Use of Form I-566  
You must use this request if you are requesting:  
1. Employment authorization as an eligible A-1, A-2, G-1, G-3, G-4, or NATO 1-6 dependent. (You can find definitions  
and eligibility requirements in 8 CFR sections 214.2(a), 214.2(g), and 214.2(s)); or  
2. A change or adjustment of status to or from A, G, or NATO status.  
Form I-566 Instructions 12/02/21  
Page 1 of 13  
General Instructions  
USCIS provides forms free of charge through the USCIS website. In order to view, print, or fill out our forms, you should  
use the latest version of Adobe Reader, which you can download for free at http://get.adobe.com/reader/. If you do not  
have Internet access, you may call the USCIS Contact Center at 1-800-375-5283 and ask that we mail a form to you. For  
TTY (deaf or hard of hearing) call: 1-800-767-1833.  
Signature. Each request must be properly signed and filed. For all signatures on this request, USCIS will not accept a  
stamped or typewritten name in place of a signature. If you are under 14 years of age, your parent or legal guardian may  
sign the request on your behalf. A legal guardian may also sign for a mentally incompetent person.  
Validity of Signatures. USCIS will consider a photocopied, faxed, or scanned copy of the original, handwritten signature  
valid for filing purposes. The photocopy, fax, or scan must be of the original document containing the handwritten, ink  
signature.  
Evidence. At the time of filing, you must submit all evidence and supporting documents listed in the What Evidence  
Must You Submit and/or Specific Instructions sections of these Instructions.  
Biometric Services Appointment. USCIS may require that you appear for an interview or provide biometrics  
(fingerprints, photograph, and/or signature) at any time to verify your identity, obtain additional information, and conduct  
background and security checks, including a check of criminal history records maintained by the Federal Bureau of  
Investigation (FBI), before making a decision on your application or petition. After USCIS receives your request and  
ensures it is complete, we will inform you in writing if you need to attend a biometric services appointment. If an  
appointment is necessary, the notice will provide you the location of your local or designated USCIS Application Support  
Center (ASC) and the date and time of your appointment or, if you are currently overseas, instruct you to contact a U.S.  
Embassy, U.S. Consulate, or USCIS office outside the United States to set up an appointment.  
If you are required to provide biometrics, at your appointment you must sign an oath reaffirming that:  
1. You provided or authorized all information in the request;  
2. You reviewed and understood all of the information contained in, and submitted with, your request; and  
3. All of this information was complete, true, and correct at the time of filing.  
If you fail to attend your biometric services appointment, USCIS may deny your request.  
Copies. You should submit legible photocopies of documents requested, unless the Instructions specifically state that you  
must submit an original document. USCIS may request an original document at the time of filing or at any time during  
processing of an application or petition. If USCIS requests an original document from you, it will be returned to you after  
USCIS determines it no longer needs your original.  
NOTE: If you submit original documents when not required or requested by USCIS, your original documents may be  
immediately destroyed after we receive them.  
Translations. If you submit a document with information in a foreign language, you must also submit a full English  
translation. The translator must sign a certification that the English language translation is complete and accurate, and that  
he or she is competent to translate from the foreign language into English. The certification must include the translator’s  
signature. DHS recommends the certification contain the translator’s printed name, the signature date, and the translator’s  
contact information.  
Form I-566 Instructions 12/02/21  
Page 2 of 13  
How To Fill Out Form I-566  
1. Type or print legibly in black ink.  
2. If you need extra space to complete any item within this request, use the space provided in Part 7. Additional  
Information or attach a separate sheet of paper. Type or print your name and Alien Registration Number (A-Number)  
(if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer  
refers; and sign and date each sheet.  
3. Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been  
married and the question asks, “Provide the name of your current spouse”), type or print “N/A” unless otherwise  
directed. If your answer to a question which requires a numeric response is zero or none (for example, “How many  
children do you have” or “How many times have you departed the United States”), type or print “None” unless  
otherwise directed.  
4. You must submit two copies of Form I-566. USCIS will consider a photocopied, faxed, or scanned copy of the  
original, handwritten signature valid for filing purposes. The photocopy, fax, or scan must be of the original document  
containing the handwritten, ink signature. If both copies of Form I-566 are not signed, the agency adjudicating your  
request will return your Form I-566 as incomplete. A parent or legal guardian may sign, if appropriate.  
Specific Instructions  
Form I-566 is divided into Parts 1. - 10. The following information will help you fill out the request.  
Part 1. Information About You  
NOTE: The person seeking employment authorization or change/adjustment of status provides the requested information.  
Item Numbers 1.a. - 1.c. Full Legal Name. Provide your legal name as shown on your birth certificate or legal name  
change document. If you have two last names, include both and use a hyphen (-) between the names, if appropriate. Type  
or print your last, first, and middle names in each appropriate field.  
Item Numbers 2.a. - 2.f. U.S. Mailing Address. You must provide a valid mailing address in the United States. You  
may list a valid U.S. residence, APO, or commercial address. You may also list a U.S. Post Office address (PO Box) if  
that is how you receive your mail. If your mail is sent to someone other than yourself, please include an “In Care Of  
Name” as part of your mailing address. If your U.S. mailing address is in a U.S. territory and it contains an urbanization  
name, list the urbanization name in the “In Care Of Name” space provided.  
Item Numbers 3. - 4.e. U.S. Physical Address. Type or print your physical address in the spaces provided if it is  
different from your mailing address. Do not provide a PO Box here.  
Item Number 5. Date of Birth. Enter your date of birth in mm/dd/yyyy format in the space provided as shown on your  
birth certificate or other government-issued identity document. For example, type or print October 5, 1967 as 10/05/1967.  
Item Number 6. Country of Birth. Enter the name of the country where you were born. Type or print the name of the  
country as it was named when you were born, even if the country’s name has changed or the country no longer exists.  
Item Number 7. Country of Citizenship or Nationality. Provide the name of the country of your citizenship or  
nationality. Use the current name of the country.  
1. If you are stateless, type or print the name of the country where you were last a citizen or national.  
2. If you are a citizen or national of more than one country, type or print the name of the foreign country that issued your  
last passport.  
Item Number 8. Gender. Select the box that indicates whether you are male or female.  
Form I-566 Instructions 12/02/21  
Page 3 of 13  
Item Number 9. Marital Status. Select the box that describes the marital status you have on the date you file Form  
I-566.  
Item Number 10. Alien Registration Number (A-Number) (if any). An Alien Registration Number, otherwise known  
as an “A-Number,” is typically issued to people who apply for, or are granted, certain immigration benefits. In addition  
to USCIS; ICE, U.S. Customs and Border Protection (CBP), Executive Office of Immigration Review (EOIR), and DOS  
may also issue an A-Number to certain foreign nationals. If you were issued an A-Number, type or print it in the spaces  
provided. If you have more than one A-Number, use the space provided in Part 7. Additional Information to provide the  
information. If you do not have an A-Number or if you cannot remember it, leave this space blank.  
Item Number 11. U.S. Social Security Number (SSN) (if any). If the Social Security Administration (SSA) ever issued  
you a Social Security card in your name or in a previously used name (such as a maiden name), enter the SSN from your  
card in the space provided. If you were never issued an SSN, leave this space blank.  
Item Number 12. Department of State (DOS) Personal Identification Number (PID). DOS provides this number to  
eligible A and G and certain NATO nonimmigrants. If you are an eligible dependent of a NATO nonimmigrant applying  
for employment authorization, the PID may be entered by the certifying official.  
NOTE: A certifying official is a diplomatic mission chief or authorized deputy, an international organization director or  
authorized deputy, a NATO member state official, or a NATO/HQ SACT legal advisor or designee who is authorized to  
certify information about a requestor.  
Item Number 13. USCIS Online Account Number (if any). If you have previously filed an application or petition  
using the USCIS online filing system (previously called USCIS Electronic Immigration System (USCIS ELIS)), provide  
the USCIS Online Account Number you were issued by the system. You can find your USCIS Online Account Number  
by logging in to your account and going to the profile page. If you previously filed certain applications or petitions on a  
paper form through a USCIS Lockbox facility, you may have received a USCIS Online Account Access Notice issuing  
you a USCIS Online Account Number. You may find your USCIS Online Account Number at the top of the notice. The  
USCIS Online Account Number is not the same as an A-Number. If you were issued a USCIS Online Account Number,  
enter it in the space provided.  
Item Number 14. Relationship to Principal Alien (if applicable). Provide your relationship to the principal alien.  
NOTE: A principal alien is the nonimmigrant working for a foreign government, international organization, or NATO in  
A, G, or NATO status from whom family members derive their A, G, or NATO status.  
Item Numbers 15.a. - 15.d. Form I-94, Arrival-Departure Record. If CBP or USCIS issued you a Form I-94, Arrival-  
Departure Record, provide your Form I-94 number and date that your authorized period of stay expires or expired (as  
shown on your Form I-94). The Form I-94 number also is known as the Departure Number on some versions of Form  
I-94.  
NOTE: If you were admitted to the United States by CBP at an airport or seaport after April 30, 2013, CBP may have  
issued you an electronic Form I-94 instead of a paper Form I-94. You may visit the CBP website at www.cbp.gov/i94 to  
obtain a paper version of an electronic Form I-94. CBP does not charge a fee for this service. Some travelers admitted to  
the United States at a land border, airport, or seaport after April 30, 2013, with a passport or travel document, who were  
issued a paper Form I-94 by CBP, may also be able to obtain a replacement Form I-94 from the CBP website without  
charge. If you cannot obtain your Form I-94 from the CBP website, you may obtain it by filing Form I-102, Application  
for Replacement/Initial Nonimmigrant Arrival-Departure Record, with USCIS. USCIS does charge a fee for this service.  
See the USCIS website at www.uscis.gov/I-102 for more information.  
Passport and Travel Document Numbers. If you used a passport or travel document to travel to the United States, enter  
either the passport or travel document information in the appropriate space on the request, even if the passport or travel  
document is currently expired.  
Item Number 16. Date of Your Last Arrival Into the United States, On or About. Provide the date on which you last  
entered the United States in mm/dd/yyyy format.  
Form I-566 Instructions 12/02/21  
Page 4 of 13  
Item Number 17. Current Immigration Status. Provide your current immigration status. For example, if your current  
status is principal resident representative (G-1), enter the code G-1 in the space provided.  
Part 2. Information About Principal Alien  
NOTE: If you are the principal alien and submitting Form I-566 on your own behalf, do not complete this section.  
Item Numbers 1.a. - 1.c. Principal Alien’s Full Legal Name. Provide his or her legal name as shown on his or her birth  
certificate or legal name change document. If he or she has two last names, include both and use a hyphen (-) between the  
names, if appropriate. Type or print his or her last, first, and middle names in each appropriate field.  
Item Numbers 2.a. - 2.e. Principal Alien’s U.S. Physical Address. Type or print his or her physical address in the  
spaces provided. Do not provide a PO Box here.  
Item Number 3. Date Tour of Duty in the United States Expected to End. Provide the date the principal alien’s tour  
of duty in the United States is expected to end in mm/dd/yyyy format.  
Item Number 4. Job Title. Provide the principal alien’s job title.  
Item Number 5. Country of Citizenship or Nationality. Provide the name of the country of his or her citizenship or  
nationality. Use the current name of the country.  
1. If he or she is stateless, type or print the name of the country where he or she was last a citizen or national.  
2. If he or she is a citizen or national of more than one country, type or print the name of the foreign country that issued  
his or her last passport.  
Item Number 6. Marital Status. Select the box that describes the marital status he or she has on the date you file Form  
I-566.  
Item Number 7. DOS Personal Identification Number (PID). DOS provides this number to eligible A and G and  
certain NATO nonimmigrants. If he or she is a NATO nonimmigrant, the certifying officer may enter the DOS PID.  
Item Number 8. USCIS Online Account Number (if any). If he or she has previously filed an application or petition  
using the USCIS online filing system (previously called USCIS Electronic Immigration System (USCIS ELIS)), provide  
the USCIS Online Account Number he or she was issued by the system. He or she can find his or her USCIS Online  
Account Number by logging in to his or her account and going to the profile page. If he or she previously filed certain  
applications or petitions on a paper form through a USCIS Lockbox facility, he or she may have received a USCIS Online  
Account Access Notice issuing him or her a USCIS Online Account Number. He or she may find his or her USCIS Online  
Account Number at the top of the notice. The USCIS Online Account Number is not the same as an A-Number. If he or  
she was issued a USCIS Online Account Number, enter it in the space provided.  
Item Numbers 9.a. - 9.d. Form I-94, Arrival-Departure Record. If CBP or USCIS issued him or her a Form I-94,  
Arrival-Departure Record, provide his or her Form I-94 number and date that his or her authorized period of stay expires  
or expired (as shown on your Form I-94). The Form I-94 number also is known as the Departure Number on some  
versions of Form I-94.  
NOTE: If he or she was admitted to the United States by CBP at an airport or seaport after April 30, 2013, CBP may  
have issued him or her an electronic Form I-94 instead of a paper Form I-94. He or she may visit the CBP website at  
www.cbp.gov/i94 to obtain a paper version of an electronic Form I-94. CBP does not charge a fee for this service. Some  
travelers admitted to the United States at a land border, airport, or seaport after April 30, 2013, with a passport or travel  
document, who were issued a paper Form I-94 by CBP, may also be able to obtain a replacement Form I-94 from the CBP  
website without charge. If he or she cannot obtain his or her Form I-94 from the CBP website, you may obtain it by filing  
Form I-102 with USCIS. USCIS does charge a fee for this service. See the USCIS website at www.uscis.gov/I-102 for  
more information.  
Form I-566 Instructions 12/02/21  
Page 5 of 13  
Passport and Travel Document Numbers. If he or she used a passport or travel document to travel to the United States,  
enter either the passport or travel document information in the appropriate space on the request, even if the passport or  
travel document is currently expired.  
Part 3. Type of Request  
Item Number 1. Select the box that best describes your reason for submitting Form I-566. If you select “Employment  
Authorization,” proceed to Item Numbers 2.a. - 2.d. If you select “Change/Adjustment of Status,” proceed to Item  
Numbers 3.a. - 3.b.  
NOTE: Form I-566 is not required if you have changed from A or G nonimmigrant status to asylum (protected) status.  
Item Numbers 2.a. - 2.d. Requests for Employment Authorization. Select the appropriate box and provide the  
requested information, if applicable.  
Item Numbers 3.a. - 3.b. Requests for Change/Adjustment of Status. Select the appropriate box and provide the  
requested information, if applicable.  
Part 4. Requestor’s Statement, Contact Information, Declaration, Certification, and Signature  
Item Numbers 1.a. - 6.b. Select the appropriate box to indicate whether you read this request yourself or whether you  
had an interpreter assist you. If someone assisted you in completing the request, select the box indicating that you used  
a preparer. Further, you must sign and date your request and provide your daytime telephone number, mobile telephone  
number (if any), and email address (if any). Every request MUST contain the signature of the requestor (or parent or  
legal guardian, if applicable). A stamped or typewritten name in place of a signature is not acceptable.  
Part 5. Interpreter’s Contact Information, Certification, and Signature  
Item Numbers 1.a. - 7.b. If you used anyone as an interpreter to read the Instructions and questions on this request to  
you in a language in which you are fluent, the interpreter must fill out this section; provide his or her name, the name and  
address of his or her business or organization (if any), his or her daytime telephone number, his or her mobile telephone  
number (if any), and his or her email address (if any). The interpreter must sign and date the request.  
Part 6. Contact Information, Declaration, and Signature of the Person Preparing this Request, if Other Than the  
Requestor  
Item Numbers 1.a. - 8.b. This section must contain the signature of the person who completed your request, if other  
than you, the requestor. If the same individual acted as your interpreter and your preparer, that person should complete  
both Part 5. and Part 6. If the person who completed this request is associated with a business or organization, that  
person should complete the business or organization name and address information. Anyone who helped you complete  
this request MUST sign and date the request. A stamped or typewritten name in place of a signature is not acceptable. If  
the person who helped you prepare your request is an attorney or accredited representative, he or she may also need to  
submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative, along with your  
request.  
Part 7. Additional Information  
Item Numbers 1.a. - 7.d. If you need extra space to provide any additional information within this request, use the space  
provided in Part 7. Additional Information. If you need more space than what is provided in Part 7., you may make  
copies of Part 7. to complete and file with your request, or attach a separate sheet of paper. Type or print your name and  
A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your  
answer refers; and sign and date each sheet.  
We recommend that you print or save a copy of your completed request to  
review in the future and for your records.  
Form I-566 Instructions 12/02/21  
Page 6 of 13  
NOTE TO ALL REQUESTORS: Do not complete Parts 8., 9., or 10. The agencies and organizations  
procesing your request will complete these sections.  
Part 8. Certification by Diplomatic Mission, International Organization, NATO/HQ SACT, or NATO Member  
State (For Official Use Only)  
Item Numbers 1. - 9.i. Do NOT fill out this part. It is for official use only.  
Part 9. DOS, USLO to NATO/HQ SACT, and/or DOS USUN Information (For Official Use Only)  
Item Numbers 1.a. - 4.b. Do NOT fill out this part. It is for official use only.  
Part 10. USCIS Information (For Official Use Only)  
Item Numbers 1.a. - 7.b. Do NOT fill out this part. It is for official use only.  
What Evidence Must You Submit?  
You must submit all evidence requested in these Instructions with your request. If you fail to submit required evidence,  
USCIS may reject or deny your request for failure to submit requested evidence or supporting documents in accordance  
with 8 CFR 103.2(b)(1) and these Instructions.  
Dependent Employment Authorization  
Your request for employment authorization as an A, G, or NATO dependent may be based on:  
1. A formal, written, bilateral agreement between the United States and the country that employs the principal alien;  
2. A de facto arrangement between the United States and the country employing the principal alien in which the country  
requires the principal alien is a national of that country; or  
3. The G-4 dependent employment regulations found in 8 CFR 214.2(g).  
If one of these provisions applies, you must also show you are an eligible dependent of a principal alien. Eligible  
dependents are:  
1. Spouses or unmarried children under 21 years of age;  
2. Dependent unmarried sons or daughters who are full-time, post-secondary students between 21 and 23 years of age  
(or between 21 and 25 years of age under certain bilateral agreements);  
3. Dependent unmarried sons or daughters who are mentally or physically unable to care for themselves and cannot  
establish their own households; or  
4. Other qualifying dependents recognized by DOS (only applicable to dependents of A or G principal aliens).  
If you have a question about which provision and dependent category applies to you, or about process or document  
requirements, contact your diplomatic mission or international organization. If you are a NATO dependent, contact one of  
the following:  
1. USLO to NATO/HQ SACT (if your principal alien spouse or parent is posted at, or attached in support of, NATO/HQ  
SACT, or posted at a NATO agency in the United States);  
2. The Defense Attaché’s Office at the embassy of the NATO member employing the principal alien (if your principal  
alien spouse or parent, including military and civilian employees of the sending nation, is posted throughout the  
United States on NATO or national orders or employment contract, but not affiliated with NATO/HQ SACT or a  
NATO agency); or  
Form I-566 Instructions 12/02/21  
Page 7 of 13  
3. DOS OFM through email at OFM-EAD@state.gov.  
NOTE: For details on NATO member embassy contacts and on required documents, visit the DOS website  
www.state.gov/ofm/accreditation/dwa under the topic “Dependent Work Authorization.”  
Required Documentation for Dependent Employment Authorization  
1. You must include a completed and signed Form I-765, Application for Employment Authorization. See the  
Form I-765 Instructions for required supporting documentation.  
2. You must also include the required, supporting documentation listed below with your Form I-566 based on your  
dependent relationship to the principal alien.  
3. If you are filing as a spouse or an unmarried child under 21 years of age:  
A. Bilateral agreement - Submit documentation if specified in the applicable agreement;  
B. De facto arrangement or G-4 regulations - Submit a statement from your prospective employer that:  
(1) Is written on the employer’s letterhead and identifies you as an eligible dependent;  
(2) Describes the position offered, duties to be performed, salary offered, and hours to be worked and verifies you  
possess the qualifications for the position; and  
(3) Includes the telephone number, name, and original signature of the person making the statement.  
4. If you are filing as a dependent unmarried son or daughter who is a full-time, post-secondary student between 21 and  
23 years of age (or between 21 and 25 years of age under certain bilateral agreements):  
A. Bilateral agreement - Submit documentation if specified in the applicable agreement and a statement from your  
school that:  
(1) Is written on the school’s letterhead and includes your full name;  
(2) Certifies you are a full-time student and identifies the courses being taken, credit hours being carried, and  
expected graduation date; and  
(3) Includes the telephone number, name, and original signature of the school official making the statement.  
B. De facto arrangement or G-4 regulations - Submit a statement from your prospective employer and school.  
(1) A statement from your prospective employer must:  
(a) Be written on the employer’s letterhead and include your full name;  
(b) Describe the position offered, duties to be performed, salary offered, and hours to be worked and verify  
you possess the qualifications for the position; and  
(c) Include the telephone number, name, and original signature of the person making the statement.  
(2) A statement from your school must:  
(a) Be written on the school’s letterhead and include your full name;  
(b) Certify you are a full-time student and identify the courses being taken, credit hours being carried, and  
expected graduation date; and  
(c) Include the telephone number, name, and original signature of the school official making the statement.  
Form I-566 Instructions 12/02/21  
Page 8 of 13  
5. If you are filing as a dependent unmarried son or daughter who is mentally or physically unable to care for yourself  
and cannot establish your own household:  
A. Bilateral agreement - Submit documentation if specified in the applicable agreement and a statement from your  
physician that:  
(1) Is written on the physician’s letterhead and includes your full name;  
(2) Identifies your condition and describes the symptoms and prognosis;  
(3) Certifies you are physically and/or mentally unable to care for yourself and establish, re-establish, or maintain  
a home of your own; and  
(4) Includes the telephone number, name, and original signature of the physician making the statement.  
B. De facto arrangement or G-4 regulations - Submit a statement from your prospective employer and physician.  
(1) A statement from your prospective employer must:  
(a) Be written on the employer’s letterhead and include your full name;  
(b) Describe the position offered, duties to be performed, salary offered, and hours to be worked and verify  
you possess the qualifications for the position; and  
(c) Include the telephone number, name, and original signature of the person making the statement.  
(2) A statement from your physician must:  
(a) Be written on the physician’s letterhead and include your full name;  
(b) Identify your condition and describe the symptoms and prognosis;  
(c) Certify you are physically and/or mentally unable to care for yourself and establish, re-establish, or  
maintain a home of your own; and  
(d) Include the telephone number, name, and original signature of the physician making the statement.  
6. If you are filing as a DOS-qualified dependent of an A-1, A-2, G-1, G-3, or G-4 principal alien, other than an eligible  
dependent listed above in Items 3. - 5.:  
A. Bilateral agreement - Submit documentation as specified in the applicable agreement;  
B. De facto arrangement or G-4 regulations - Submit a statement from your prospective employer that:  
(1) Is written on the employer’s letterhead and includes your full name;  
(2) Describes the position offered, duties to be performed, salary offered, and hours to be worked and verifies you  
possess the qualifications for the position; and  
(3) Includes the telephone number, name, and original signature of the person making the statement.  
7. If you are requesting a renewal of your employment authorization, submit the required documents as noted on the  
DOS website www.state.gov/ofm/accreditation/dwa under the topic “Dependent Work Authorization” and any other  
documents required by the mission, organization, or agency that certifies or endorses the application.  
Change To/From Nonimmigrant A, G, or NATO Status or Adjustment of Status  
1. Change of Nonimmigrant Status TO A, G, or NATO  
Include these required, supporting documents:  
A. Form I-94;  
B. Form I-539, Application to Extend/Change Nonimmigrant Status; and  
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C. If you are applying as the principal alien, Form DS-2003, Notification of Appointment of Foreign Diplomatic  
Officer and Career Consular Officer, or Form DS-2004, Notification of Appointment of Foreign Government  
Employee, as appropriate.  
2. Change of Nonimmigrant Status FROM A, G, or NATO  
Include these required, supporting documents:  
A. Form I-94;  
B. Form I-539;  
C. Form I-129, Petition for a Nonimmigrant Worker (as appropriate); and  
D. If you are applying as the principal alien, Form DS-2003 or Form DS-2004, as appropriate.  
3. Adjustment of Status Under Immigration and Nationality Act (INA) Section 247(a) from Immigrant to A or G  
Nonimmigrant  
Include these required, supporting documents:  
A. Form I-551, Permanent Resident Card;  
B. Form I-407, Record of Abandonment by Alien of Status as Lawful Permanent Resident; and  
C. If you are applying as the principal alien, Form DS-2003 or Form DS-2004, as appropriate.  
NOTE: If you are a lawful permanent resident seeking employment with a foreign mission or international  
organization and want to retain your lawful permanent resident status, then you must work with your prospective  
foreign mission/international organization employer who will work with DOS to verify that you can retain your LPR  
status. (See INA sections 247(a) and (b) for more information.)  
4. Adjustment of Status from A, G, or NATO Nonimmigrant to Immigrant  
Include these required, supporting documents:  
A. Form I-94;  
B. Form I-485, Application to Register Permanent Residence or Adjust Status;  
C. Form I-508, Request for Waiver of Certain Rights, Privileges, Exemptions, and Immunities;  
D. If you are a French national, Form I-508F, Request for Waiver of Certain Rights, Privileges, Exemptions, and  
Immunities for French Nationals; and  
E. All documentation required to establish eligibility for the status you are requesting.  
5. Adjustment of Status Under 8 U.S.C. 1255b (Section 13 of the Act of September 11, 1957) from A-1, A-2, G-1, or G-2  
Nonimmigrant to Lawful Permanent Resident  
Include these required, supporting documents:  
A. Form I-94;  
B. Form I-485; and  
C. All documentation required to establish eligibility for the status you are requesting.  
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What Is the Filing Fee?  
There is no filing fee for Form I-566.  
NOTE: Any associated petition or application you file with your Form I-566 may have a filing fee or biometrics services  
fee. Read the Instructions for any application or petition you submit with your Form I-566 for fee information.  
How To Check If the Fees Are Correct  
Form I-566’s filing fee is current as of the edition date in the lower left corner of this page. However, because USCIS fees  
change periodically, you can verify that the fee is correct by following one of the steps below.  
1. Visit the USCIS website at www.uscis.gov, select “FORMS,” and check the appropriate fee; or  
2. Call the USCIS Contact Center at 1-800-375-5283 and ask for fee information. For TTY (deaf or hard of hearing)  
call: 1-800-767-1833.  
Where To File?  
Please see our website at www.uscis.gov/I-566 or call our USCIS Contact Center at 1-800-375-5283 for the most current  
information about where to file this request. For TTY (deaf or hard of hearing) call: 1-800-767-1833.  
Address Change  
A requestor who is not a U.S. citizen must notify USCIS of his or her new address within 10 days of moving from  
his or her previous residence. For information on filing a change of address, go to the USCIS website at  
www.uscis.gov/addresschange or contact the USCIS Contact Center at 1-800-375-5283. For TTY (deaf or hard of  
hearing) call: 1-800-767-1833.  
NOTE: Do not submit a change of address request to the USCIS Lockbox facilities because the Lockbox does not  
process change of address requests.  
Processing Information  
You must have a United States address to file this request.  
Initial Processing. Once USCIS accepts your request, we will check it for completeness. If you do not completely fill  
out this request, you will not establish a basis for your eligibility and USCIS may reject or deny your request.  
Requests for More Information. USCIS may request that you provide more information or evidence to support your  
request. We may also request that you provide the originals of any copies you submit. If we request an original document  
from you, it will be returned to you after USCIS determines it no longer needs your original.  
Requests for Interview. We may request that you appear at a USCIS office for an interview based on your request. At  
the time of any interview or other appearance at a USCIS office, we may require that you provide your biometrics to  
verify your identity and/or update background and security checks.  
Decision. The decision on Form I-566 involves a determination of whether you have established eligibility for the  
immigration benefit you are seeking. USCIS will notify you of the decision in writing.  
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Employment Authorization. If you are an A or G dependent, DOS or USUN will forward your favorably endorsed  
Form I-566 and I-765 package directly to USCIS. If your Form I-765 is approved, USCIS will provide your employment  
authorization based on current procedures.  
If you have questions regarding the process or document requirements, email OFM-EAD@state.gov.  
If a bilateral agreement for dependent employment contains a numerical limitation, the USLO to NATO/HQ SACT,  
NATO/HQ SACT, or the Defense Attaché’s Office at the embassy of the NATO member employing the principal alien will  
consult with DOS to determine whether this numerical limitation has been reached.  
Change/Adjustment of Status. If you are requesting a change of nonimmigrant status TO A, G, or NATO status, the  
foreign diplomatic mission, international organization, or NATO/HQ SACT will forward your favorably endorsed  
Form I-566 and Form I-539 package to the DOS/Visa Office or USUN. The DOS/Visa Office or USUN will forward your  
favorably endorsed Form I-566 and I-539 package to USCIS.  
If you are requesting adjustment FROM A, G, or NATO nonimmigrant to immigrant status, a DOS/USUN/USLO to  
NATO/HQ SACT favorable endorsement is not required prior to USCIS adjudication of the adjustment application.  
Please see the When Should I Use Form I-566 and What Evidence Must You Submit section of these Instructions.  
If you are applying for adjustment of status under 8 U.S.C. 1255b (Section 13 of the Act of September 11, 1957) from  
A-1, A-2, G-1, or G-2 nonimmigrant to lawful permanent resident, USCIS will forward your favorably endorsed  
Form I-566 and Form I-485 package to the DOS/Visa Office or USUN, as appropriate. The DOS/Visa Office or USUN  
will advise USCIS of its official position, provide the dates your status begins and terminates, and state any objections to  
the requested adjustment under Section 13 of the Act of September 11, 1957.  
USCIS Forms and Information  
To ensure you are using the latest version of this request, visit the USCIS website at www.uscis.gov where you can obtain  
the latest USCIS forms and immigration-related information. If you do not have internet access, you may order USCIS  
forms by calling the USCIS Contact Center at 1-800-375-5283. The USCIS Contact Center provides information in  
English and Spanish. For TTY (deaf or hard of hearing) call: 1-800-767-1833.  
Instead of waiting in line for assistance at your local USCIS office, you can schedule an appointment online at  
www.uscis.gov. Select “Tools,” then under “Self Service Tools,” select “Appointments” and follow the screen prompts to  
set up your appointment. Once you finish scheduling an appointment, the system will generate an appointment notice for  
you.  
Penalties  
If you knowingly and willfully falsify or conceal a material fact or submit a false document with your Form I-566, we will  
deny your Form I-566 and may deny any other immigration benefit. In addition, you will face severe penalties provided  
by law and may be subject to criminal prosecution.  
DHS Privacy Notice  
AUTHORITIES: The information requested on this form, and the associated evidence, is collected under the INA  
sections 103, 208(c)(1)(C), 211, 212(d)(5)(A), and 215 and 8 CFR sections 211.1(a)(3-4), 212.5, and 223.1-223.3.  
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PURPOSE: The primary purpose for providing the requested information on this form is to determine if you have  
established eligibility to receive employment authorization or change or adjust status. DHS uses the information you  
provide to grant or deny the immigration benefit you are seeking.  
DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information,  
including your Social Security number (if applicable), and any requested evidence, may delay a final decision or result in  
denial of your form.  
ROUTINE USES: DHS may share the information you provide on this form and any additional requested evidence with  
other Federal, state, local, and foreign government agencies and authorized organizations. DHS follows approved routine  
uses described in the associated published system of records notices [DHS-USCIS-001 - Alien File, Index, and National  
File Tracking System and DHS-USCIS-007 - Benefits Information System] and the published privacy impact assessments  
[DHS/USCIS/PIA-016a Computer Linked Application Information Management System and Associated Systems,  
DHS/USCIS/PIA-051 Case and Activity Management for International Operations, and DHS/USCIS/PIA-056 USCIS  
Electronic Immigration System] which you can find at www.dhs.gov/privacy. DHS may also share this information, as  
appropriate, for law enforcement purposes or in the interest of national security.  
Paperwork Reduction Act  
An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection  
of information, unless it displays a currently valid Office of Management and Budget (OMB) control number. The public  
reporting burden for this collection of information is estimated at 1 hour and 25 minutes per response, including the time  
for reviewing instructions, gathering the required documentation and information, completing the request, preparing  
statements, attaching necessary documentation, and submitting the request. Send comments regarding this burden  
estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S.  
Citizenship and Immigration Services, Office of Policy and Strategy, Regulatory Coordination Division, 5900 Capital  
Gateway Drive, Mail Stop #2140, Camp Springs, MD 20588-0009; OMB No. 1615-0027. Do not mail your completed  
Form I-566 to this address.  
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