I-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).

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


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.

Last Reviewed/Updated: