Building the STEM OPT Application Packet

Leave the box at the top of the page blank.

Start filling out the form where it says, “START HERE.”

Part 2. Information About You

• Select 1.c. because you are applying for STEM OPT Extension, a renewal of your work authorization.

Part 2. Information About You

• Your Full Legal Name
  • 1.a. Write your family name
  • 1.b. Write your given name
  • 1.c. Write your middle name
• Other Names Used
  • USCIS wants to know of any other legal names you may have that are written on official documents.  Enter those names below.  If you do not have any other legal names leave these blank. 

Part 2. Information About You (continued)

• Your U.S. Mailing Address
  • 5.a. If you will not be receiving the mail from USCIS, write the name of the person who will be receiving the receipt notices and EAD card in the mail on your behalf.  Do not put your name here.
  • 5.b. Write the street name and number of your mailing address
  • 5.c. Select if you live in an Apt. (apartment), Ste. (suite), or Flr. (floor) and write the number in the blank
  • 5.d. Write the city of your mailing address
  • 5.e. Select the state abbreviation of your mailing address from the drop down menu
  • 5.f. Write the zip code of your mailing address
  • 6.  Select Yes if your mailing address is the same as your physical address where you live.  Select No if you are having your EAD card mailed to an address where you do not live.
• U.S. Physical Address
  • If you selected Yes to question 6, leave this blank.
  • If you selected No to question 6:
    • 7.a. Write the street name and number of your mailing address
    • 7.b. Select if you live in an Apt. (apartment), Ste. (suite), or Flr. (floor) and write the number in the blank
    • 7.c. Write the city of your mailing address
    • 7.d. Select the state abbreviation of your mailing address from the drop down menu
    • 7.e. Write the zip code of your mailing address
• Other Information
  • 8.  Write the USCIS Number listed on your OPT EAD card.
  • 9.  Fill this in only if you have applied for an USCIS Online Account.  
  • 10.  Select your Gender.
  • 11.  Select your Marital Status
  • 12.  Select yes.
  • 13.a. Select if the Social Security Administration has ever officially issued you a Social Security Number. 
  • 13.b.  Write your Social Security number
    • Leave this question blank if you selected no in question 13.a.
    • Write your SSN if you selected Yes in question 13.a.
  • 14. If you do not have a Social Security Number, select Yes and go to question 15.  If you already have a Social Security Number, select No and go to question 18.a.
    • REMEMBER: If you already have an SSN, you do not need another one.
  • 15. If you answered No to question 14, select yes to authorize SSA to review your information and issue you an SSN.
    • If you already have an SSN, you should leave question 15 blank.
    • If you answered yes to questions 14 and 15, answer questions 16.a. – 17.b. 
  • 16.a. Write your father’s last name.
  • 16.b. Write your father’s first name.
  • 17.a. Write your mother’s last name.
  • 17.b. Write your mother’s first name.
• Your Country or Countries of Citizenship or Nationality
  • 18.a. Write your country of Citizenship.
  • 18.b. If you have a second citizenship, write your country of additional citizenship.  If you are only a citizen of one country, leave this blank. 

Part 2. Information About You (continued)

• Place of Birth
  • 19.a. Write your City/Town/Village of Birth 19.b. Write your State/Province of Birth
  • 19.c. Write your Country of Birth
  • 20. Write your Date of Birth (mm/dd/yyyy)
• Information About Your Last Arrival in the United States 
  • 21.a. Write your I-94 Arrival-Departure Record found on your most recent I-94.
  • 21.b. Write your most recently issued VALID passport number.
  • 21.c. If you used a travel document (not a passport) to travel to the United States, write the travel document number here. If you entered a passport number in 21.b., leave blank.
  • 21.d. Write the country that issued your passport or travel document
  • 21.e. Write the expiration date listed in your passport or travel document (mm/dd/yyyy).
  • 22. Write the Date of your last Arrival into the United States. You can find it on your I-94.
  • 23. Write the Place of your last arrival into the United States. You can find it on your I-94.  You can write the airport code and city name.
  • 24. Write your Immigration Status at your Last Arrival. If you entered last time as F–1 list “F-1 Student.”  If you last entered in another visa status, such as “H-4 Dependent” or “B-2 Visitor,” list that visa type. 
  • 25. Write“F-1 Student.”
  • 26. Write your SEVIS Number. This number can be found on the top left corner of your I-20.
  • 27. Write ( C ) ( 3 ) ( C ) to show you are applying for the STEM OPT Extension.
  • 28.a. Write your degree level, major, and CIP Code found on page 1 of your I-20.
    • Note: You may need to neatly hand write some of your answer in this box.
  • 28.b.  Write your employer’s name.
  • 28.c. Write your employer’s E-Verify number.  The E-Verify number consists of four to seven numbers.  It is not the same as the employer’s EIN.
  • 29-30.c. Leave blank. 

Part 2. Information About You (continued)

• 30.d.-31.b. Leave blank.

Part 3. Applicant’s Statement, Contact Information, Declaration, Certification, and Signature

• Applicant’s Statement
  • 1.a. Check here to acknowledge that you can read and understand English unless you are using an interpreter to help you complete the I-765 form.
  • 1.b. Leave Blank unless you are using an interpreter to help you complete the I-765 form.
    • If you are using an interpreter, enter the language used in translation of the I-765.
  • 2. Leave blank unless someone else is completing the I-765 form for you, then write their name.
    • For example: Lawyer
• Applicant’s Contact Information
  • 3. Write your daytime phone number. It can be your cell phone.
  • 4. Write your mobile telephone number. If you entered your mobile number in question 3, leave this blank. 
  • 5. Write your email address. It can be any email address that you check regularly.
  • 6. Leave blank.
• Applicants Declaration and Certification

Part 3. Applicant’s Statement, Contact Information, Declaration, Certification, and Signature (continued)

• Applicant’s Signature
  • 7.a. Sign here in black ink after you complete and print the entire I-765 form.  DO NOT sign electronically. 
  • 7.b. Enter the date you sign the form. (mm/dd/yyyy) 

Part 4. Interpreter’s Contact Information, Certification, and Signature

• If an interpreter did not assist you in completing the I-765, leave all of Part 4 blank.
• Complete this section ONLY if you are using an interpreter to complete the I-765 and you marked number 1.b. in the Applicant’s Statement in Part 3 on Page 4.

Part 5. Contact Information, Declaration, and Signature of the Person Preparing this  Application, if Other Than the Applicant.

• If no one assisted you in completing the I-765, leave all of Part 5 blank.
• Complete this section ONLY if you have someone else complete the I-765 and you marked number 2 in the Applicant’s Statement in Part 3 on Page 4.

Part 6. Additional Information

• 1.a. Write your family name
• 1.b. Write your given name
• 1.c. Write your middle name
• 2. Write your A-Number (if you have one)
• 3.a. Write 3.
• 3.b. Write 2.
• 3.c. Write 27.
• 3.d. Write:
  • OPT Authorization
    Full-Time
    Your SEVIS ID Number
  • Dates of OPT validity listed on your EAD card
  • Level of Education
• Use the rest of this page if you need extra space to provide any additional information within this application.  See the sample I-765 Page 7 for examples.
  • If you have additional information to provide:
    • a. Write the page number to which your explanation refers
    • b. Write the part number to which your explanation refers
    • c. Write the item number to which your explanation refers
    • d. Write a brief description of your additional information for USCIS.