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I-905, Application for Authorization to Issue Certification for Health Care Workers

Purpose of Form

For an organization to apply for authorization to issue certificates to health care workers.

Number of Pages

Form 3; Instructions 7.

Edition Date

02/11/14 (10/30/11 edition also accepted). 

Where to File

Send your I-905 application to the:

Nebraska Service Center
P.O. Box 87140
Lincoln, NE 68501-7140

Filing Fee


Special Instructions

Checks should be made payable to Department of Homeland Security or U.S. Citizenship and Immigration Services.

Note on Filing Requirement: This application must be filed in duplicate.

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Last Reviewed/Updated: 02/11/2014