Sample I-765 Form– Post Completion OPT Applications

Use this sample to help you fill out the I-765. The IO advisor will review the form with you. Always down-

load and use the most recent I-765 directly from www.uscis.gov .

Using an outdated form will result in your OPT application being returned or rejected.

***Print single sided****

Mark for

Post Com-

pletion OPT

#3 is where

your EAD

card will be

sent. We

HIGHLY rec-

ommend you

use the IO

address.

This form is

the most

current– do

not worry

about the

expiration

date.

If you already

have a Social

Security

number, fill

out #9a as

yes, #9b and

answer no to

#10. Skip to

#14.

If you do not

have a Social

Security

number, an-

swer no to

#9a, yes to

#10 and #11,

and complete

questions

#12 and 13.

#20

(c) (3) (b) for

Post Comple-

tion OPT/

#15

Only indicate

yes if you

have applied

for OPT be-

fore: CPT does

not count

#22 & #23

Leave this

blank for Post

Completion

OPT

DON’T FOR-

GET TO SIGN,

DATE AND

INCLUDE

PHONE

NUMBER.

#21

Leave this

blank for Post

Completion

OPT

#14

Your I-94

number from

the last entry

to the US

Leave this

area blank

for Post Com-

pletion OPT