Form I-539 Instructions 07/27/24 Page 14 of 17
2. If you need extra space to complete any item within this application, use the space provided in Part 8. 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. Part 1., Item Number 4. Your Current Mailing Address (Safe Address, if applicable). 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 Oce 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.
NOTE: If you have a pending or approved petition or application for classication under the Violence
Against
Women Act (VAWA), as a human tracking victim (T nonimmigrant), or as a victim of qualifying criminal activity
(U nonimmigrant), and you do not want U.S. Citizenship and Immigration Services (USCIS) to send notices about this
application to your physical address, you may provide a safe mailing address in this section/eld. You may provide
a post oce box (PO Box) address or the address of a friend, your attorney, a community-based organization that is
helping you, or any other address where you can safely and timely receive mail.
Part 1.
, Item Number 6. If your U.S. physical address is not the same as your U.S. mailing address in Part 1., Item
Number 4., type or print your physical address in the spaces provided. Note that if your mailing address (including
safe mailing address) is dierent than your physical address, the physical address will NOT be used for USCIS
correspondence.
4. Part 1. Item Number 8. Country of Citizenship or Nationality. Provide the name of the country where you are a
citizen and/or national. This is not necessarily the country where you were born. If you do not have citizenship in any
country, type or print “stateless” and provide an explanation in Part 8. Additional Information.
5. Part 5. Applicant’s Contact Information, Certication, and Signature. You must sign and date your application
and, if applicable, provide your daytime telephone number, mobile telephone number, and email address. The
signature of a parent or legal guardian, if applicable, is acceptable. A stamped or typewritten name in place of a
signature is not acceptable. This certication does not aect the condentiality protections you are entitled to under 8
U.S.C. section 1367(a)(2).
6. Part 6. Interpreter’s Contact Information, Certication, and Signature. If you used anyone as an interpreter
to read the Instructions and questions on this application to you in a language in which you are uent, the interpreter
must ll out this section and sign and date the application.
7. Part 7. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other
Than the Applicant. The person who completed your application, if other than the applicant, must sign this section.
If the same individual acted as your interpreter and your preparer, then that person should complete both Part 6. and
Part 7. A stamped or typewritten name in place of a signature is not acceptable.
We recommend that you print or save a copy of your completed application for your records.
General Requirements
Evidence of Relationship. If you are including other family members on your application, you must submit the
following documents to establish your family relationship. If you are ling for a relative listed below, submit the
following documentation to prove the family relationship.
1. A spouse:
A. A copy of your marriage certicate;