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Step-by-Step Instructions for the Consideration of Deferred Action for Childhood Arrivals Form I-821D
** This guide is a work in progress. Since this a new program offered by the government, be aware that this form will undergo several updates as the program evolves. Please check keep an eye out for updates on our website at http://www.advancingjustice.net. **

YOU MAY ONLY USE BLACK INK WHEN COMPLETING THE FORM. In the alternative, you may download an electronic version of Form I-821-D from USCIS. Go to http://www.uscis.gov and search for I-821D. The direct web address is: http://www.uscis.gov/portal/site/uscis/menuitem.5af9bb95919f35e66f614176543f6d1a/?vgnextoi d=05faf6c546129310VgnVCM100000082ca60aRCRD&vgnextchannel=db029c7755cb9010Vgn VCM10000045f3d6a1RCRD. You must complete the entire form. If a question does not pertain to you, leave it blank. You must not use N/A or Not Applicable. Do not intentionally omit information, as this would constitute fraud and will make you ineligible for Deferred Action. Moreover, any attempt to defraud the government to qualify for Deferred Action may subject you to removal proceedings, and/or criminal and civil penalties. Part 1. Information About You Full Name Use only the legal name that appears on your birth certificate. If you do not have a copy of your birth certificate, you may use your legal name as it appears on your passport. If you have neither a passport, the name that appears on your consular identification card or EAD is also acceptable. In another section you will be able to list other names you may have used. You will list other names used during your US residency when you reach question 12. Part 1. Mailing Address Please enter your current address where you can safely receive your mail. You may list a P.O. Box as your mailing address. Part 1. Removal Proceedings Information Answer the questions by checking the appropriate fields and supplying necessary information. Part 1. Other Information Numbers correspond to the Questions listed on the I-821D. The lack of consecutive numbers is intentional. 1 of 5
Prepared by the Asian Pacific American Legal Center, Member of Asian American Center for Advancing Justice. Created Aug. 15, 2010.

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4. Alien Registration Number If you do not know what this is, chances are, you have never received one. If so, leave blank. If you received an A-number, and have misplaced your alien registration card, it is in your benefit to look for old documents that may have this number. 5. U.S. Social Security number if you came to the United States and received a social security number, please supply this information. If you do not have any status and may have used someone elses security number or a falsified social security number, please contact a private immigration attorney or a non-profit immigration attorney to discuss whether you should apply for Deferred Action. 6. Actual date of birth listed on your government issued documents. While you may have a different birth date on your passport, your legal birth certificate is what you must use to answer this question. If you do not have your legal birth certificate, then you may rely on the birth date listed on your passport. What if my birth certificate has my Lunar birth date that isnt used by the United States? You might have two birth dates, one based on the solar calendar and the other on the lunar calendar. Here, please rely on the birth date shown on your birth certificate even if it is based on the lunar calendar. 9. This should be, United States. 10. Country of birth. Part 1. Other Names Used (including maiden name) 12. Please list every name ever used during your lifetime. If you have used more than two names, please provide this information under Part 7 on page 6, starting at line 2.a. Example: If you need more space to inform CIS that you have used more than one name, then you go to page 6, part 7, under: 2.a. write in 2 under Page Number, 1 under Part Number, and 12.a, 12.b, and 12.c., under Item Number. As you can see, 2 refers to the page on which the question about Other names appears in the application. The corresponding page, part, and item numbers must correspond to the question that requires more space for a thorough answer. Under 2.d., begin listing your other name not already listed on page 1. Please write your name by last name first, followed by your First Name and Middle names. 2 of 5
Prepared by the Asian Pacific American Legal Center, Member of Asian American Center for Advancing Justice. Created Aug. 15, 2010.

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Part 1. U.S. Entry Information 13. The wording of Date of Initial Entry into the United States, on or about, [italics mine] means that you may approximate the initial date of entry. If you do not know the exact dates, you may submit only the month and year of initial entry. If you lawfully entered the United States during your initial entry into the United States, you may find this information on your visa or passport. 15. Status of Entry: If you entered the United States lawfully, then you should enter the type of visa granted to you when you first came into the United States. If you entered into the United States without a lawful visa or I-94 specifically granted for you, then you must enter, No Lawful Status, as your answer for question 15. If you entered the U.S. unlawfully and filling out the form electronically, scroll down and select, WI Without Inspection. 16.b. List your I-94 number(if applicable): Generally, those who initially came into the United States with the permission of the U.S. government should have an I-94 number. If you do not remember your I-94 number or have misplaced this information, just leave this area blank. If you entered into the United States with an I-94 number not issued to you, do not enter this information and speak to an immigration attorney. Education Information 18. Please indicate your current education status. You must be currently enrolled in school, or have graduated from high school, college, or received a G.E.D. to be eligible for deferred action. 20. Leave blank if currently enrolled in school. Part 2. Arrivals/Resident Information Numbers correspond to the Questions listed on the I821D. The lack of consecutive numbers is intentional.

1.a. Your answer must be, Yes. If not, then you are ineligible for deferred action. 1.b. Your answer should be, Yes. Brief absences with legitimate reasons might be okay, but you will need to explain why you left the country under Part 7. If you answer is, No, please contact a private or non-profit immigration attorney to determine whether you should apply for deferred action. 3 of 5
Prepared by the Asian Pacific American Legal Center, Member of Asian American Center for Advancing Justice. Created Aug. 15, 2010.

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6.a. 7.c. please complete this section with as much accuracy as possible. Check your old travel itineraries, travel stubs, or photos that might be able to provide exact dates. If you cannot remember when you traveled, you should approximate when you travelled. Part 3. Criminal, National Security and Public Safety Information At this point, you should have your Live Scan and/or FBI criminal background check. You must answer each section truthfully. If you mark Yes for any of the questions, it is highly recommended that you speak with an experienced immigration attorney before you apply for deferred action. Part 4. Signature of Requestor & Part. 5. Signature of Person Preparing This Request, If Other Than the Requestor 1.b. Mark this box only if a translator helped you with your application. You must also include your translators full name. Requestors Certification Read this part carefully. The wording of this paragraph means that you are swearing, under penalty of perjury, that all information is true and correct to the best of your knowledge. You must also swear that all documents provided are truthful and correct, and are exact copies of unaltered original documents. Signature of Person Preparing This Request You do not complete this section. The person who helped you prepare this application is required to sign this part. If you have an attorney helping you prepare this Form I-821D, and is representing you in this immigration matter, then he or she must also complete a G-28. Part 6. Signature of Interpreter If you had someone translate this form to you, that person must complete this part of the application. Part 7. Additional Information You must use this area to include additional information that did not fit under previous sections. If you need more room, you may include additional pages to supplement your application. Please remember to include your full name and mailing address on each additional sheet of paper you attach. Congratulations, you are almost done with your application for Deferred Action. Next Steps 4 of 5
Prepared by the Asian Pacific American Legal Center, Member of Asian American Center for Advancing Justice. Created Aug. 15, 2010.

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Now that you have completed your application, you must complete forms I-765 and I-765WS. Form G-1145 for electronic notifications is optional.

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Prepared by the Asian Pacific American Legal Center, Member of Asian American Center for Advancing Justice. Created Aug. 15, 2010.