I-539, Application to Extend/
Change Nonimmigrant Status
Department of Homeland Security
U.S. Citizenship and Immigration Services
OMB No. 1615-0003; Expires 12/31/08
Part 2. Application type (See instructions for fee.)
Part 1. Information about you
1. I am applying for: (Check one.)
Part 3. Processing information
Part 4. Additional information
START HERE - Please type or print in black ink.
In care of -
Daytime Phone #
Country of Birth
Country of Citizenship
U. S. Social Security # (if any)
Date of Last Arrival
Into the U.S.
Current Nonimmigrant Status
A # (if any)
2. Foreign Address: Street Number and Name
City or Town
Valid to: (mm/dd/yyyy)
State or Province
An extension of stay in my current status.
A change of status. The new status I am requesting is:
2. Number of people included in this application: (Check one.)
I am the only applicant.
Members of my family are filing this application with me.
The total number of people (including me) in the application is:
(Complete the supplement for each co-applicant.)
Reinstatement to student status
1. I/We request that my/our current or requested status be extended until
4. If you answered "Yes" to Question 3, give the name of the petitioner or applicant:
If the petition or application is pending with USCIS, also give the following data:
Office filed at
Filed on (mm/dd/yyyy)
Date of Birth
2. Is this application based on an extension or change of status already granted to your
spouse, child, or parent?
Yes. USCIS Receipt #
3. Is this application based on a separate petition or application to give your spouse,