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PrintI-905, Application for Authorization to Issue Certification for Health Care Workers
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).
Dates are listed in mm/dd/yy format.
Where to File
Send your I-905 application to the:
Nebraska Service Center
P.O. Box 82521
Lincoln, NE 68501-2521
Additional Information for Completing Your Form:
If you submit Form I-905 on paper: Be sure to sign the form at Part 2, Item Number 3.a., Applicant’s Signature. The fillable version of Form I-905 now includes “Don’t forget to sign!” messages and an arrow pointing to the signature box as reminders for when you print the completed form for mailing. USCIS rejects any unsigned Form I-905. Having to return it to you for a signature will delay processing of your application.
Filing Fee
$230.
When you send a payment, you agree to pay for a government service. Filing and biometric service fees are final and non-refundable, regardless of any action we take on your application, petition, or request, or if you withdraw your request.
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.
