I-765, Application For Employment Authorization
START HERE - Type or print in black ink. Part 1. Reason for Applying Your Full Legal Name 1.a. Family Name (Last Name) 1.b. Given Name (First Name) 1.c. Middle Name. Initial permission to accept employment. I am applying for (select only one box): Replacement of lost, stolen, or damaged employment authorization document, or correction of my ................
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