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Using an outdated form will result in your OPT application being returned or rejected.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