I-765V packet checklist
A printable from H-4 abuse work permit. Fill it in by hand. Nothing you write is collected by this website.
I-765V packet checklist
Form
- Form I-765V, edition 07/23/20, filled out and signed
- Two identical color passport style photos
Me
- Copy of my passport or other ID
- My H-4 visa, I-94 or approval notice
My spouse
- Copy of spouse's H-1B approval, visa, I-94 or pay stubs (if I can get them)
- Spouse's full name and date of birth
Our marriage
- Marriage certificate, or my signed statement if I cannot get it
- Divorce papers, if divorced
The abuse
- My signed statement: what happened, when, how it affected me and my children
- Police reports, protective orders, court records
- Medical records, photos, shelter or counselor letters
- Statements from people who know what happened
Before I mail it
- English translations with translator statements
- Copies only, originals kept safe
- Safe mailing address on the form
- A full copy of the packet for me, kept somewhere my spouse cannot find it
Mail to: USCIS Vermont Service Center, Attn: Humanitarian Division, 38 River Road, Essex Junction, VT 05479-0001.
From H-4 abuse work permit. Facts checked October 21, 2026. Free information, not legal or medical advice.