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ent of Homeland Security U.S. Citizenship and Immigration Services USCIS Form 1-765 OMB No. 1615-0040 Expires 05/31/2020 For USCIS Use Only El Authorization/Extension Valid From Fee Stamp Action Block 0 Authorization/Extension K Valid Through Allen Registration Number A-L i I Remarks To be completed by an

Fee Stamp Action Block 0 Authorization/Extension K Valid Through Allen Registration Number A-L i I Remarks To be completed by an attorney or Board of Immigration Appeals (BIA)- accredited representative (if any). O Select this box if Form G-28 is attached. Attorney or Accredited Representative USCIS Online Accoun

ent of Homeland Security U.S. Citizenship and Immigration Services USCIS Form 1-765 OMB No. 1615-0040 Expires 05/31/2020 For USCIS Use Only El Authorization/Extension Valid From Fee Stamp Action Block 0 Authorization/Extension K Valid Through Allen Registration Number A-L i I Remarks To be completed by an

From For Authorization/Extension Valid Through USCIS Use Only Alien Registration Number A- I I I Remarks To be completed by an attorney or Board of Immigration Appeals (13IA)- accredited representative (if any). Select this box if Form G-28 is attached. Attorney or Accredited Representative USCIS Online Account

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