LEGAL DISCLAIMER

The information contained in this template cover letter has been gathered from a number of sources and, while it is believed to be generally accurate, neither the Mexican American Legal Defense and Educational Fund (MALDEF) nor any volunteer attorney using this template cover letter gives any guarantee or assurance of the accuracy or completeness of any particular information contained in this cover letter.

The information provided is for general guidance and reference purposes only, and it is not intended to serve as, nor can it be relied upon as, legal advice to address any specific situation.

This template cover letter does not create any attorney-client relationship with MALDEF. Due to the complexity of deferred action and the intricacies of the immigration system, potential applicants (1) with criminal backgrounds, (2) with previous contact with immigration authorities, or (3) who may have committed fraud upon entry should contact a licensed immigration attorney before applying.

DO NOT INCLUDE THIS DISCLAIMER WITH YOUR DACA REQUEST

ORIGINAL SUBMISSION – REQUEST FOR RENEWAL OF CONSIDERATION OF DEFERRED ACTION FOR CHILDHOOD ARRIVALS AND EMPLOYMENT AUTHORIZATION

_________________________________________ ___________ Last, First, and Middle Name Date

A# ________________________ Alien Registration Number Email

________________________ ________________________ Address Line 1 Phone Number

________________________ Address Line 2

________________________ City, State, and Zip

DELIVERED VIA _______________________ Method of Delivery, e.g. First Class, Priority Mail, etc.

United States Citizenship and Immigration Services

________________________ ________________________ ________________________ ________________________ Lockbox Facility

RE: Request for Renewal of Deferred Action for Childhood Arrivals and Employment Authorization

for: ________________________________________ Last, First, and Middle Name

Dear USCIS Officer: Under the Department of Homeland Security’s June 15, 2012 memorandum establishing an affirmative application for childhood arrivals seeking deferred action and the subsequent renewal process established on June 6, 2014, enclosed please find the following materials in support of my request for renewal of deferred action. I have included the following required items (check all):

□ Completed Form I-821D, Request for Consideration of DACA □ Completed Form I-765, Application for Employment Authorization □ Scanned Copy of Front and Back of Employment Authorization Document □ $465 Check or Money Order □ Two Passport-Style Photos □ Completed Form I-765WS, I-765 Worksheet

I have also included the following items (check all that apply): □ Completed Form G-1145, Electronic Notification of Acceptance □ Documents Regarding Exclusion, Deportation, or Removal Proceedings □ Documents Regarding Charging or Conviction of a Felony or Misdemeanor □ Documents Regarding Travel Outside the United States

Thank you for your prompt assistance in this matter. If there are questions or updates, please reach me at the phone number or email listed in this cover letter. Sincerely,

____________________________________ Signature

____________________________________ Printed Name