Thank you for your consideration. Sincerely


Thank you for your consideration. Sincerely
Certified Mail
Dallas Lockbox Facility
P.O. Box 660045
Dallas, TX 752660045
Re: Request for Renovation of Deferred Action for Childhood Arrivals
Dear Sir or Madam:
I am requesting deferred action as a childhood arrival. Enclosed please find the following:
□□Filing Fee of $465.00
□□Two (2) Passport Style Photographs with name and date of birth written on back
G-1145, E-Notification of Application/Petition Acceptance
I-821D, Consideration of Deferred Action for Childhood Arrivals
I-765, Application for Employment Authorization
I-765 Worksheet
Proof of Approval
□□Employment Authorization Document (EAD)
□□Notice Of Action (I-797)
Departure Records (if applicable)
□□Advance Parole Document
Criminal Records (if applicable)
□□Certified copies of dispositions of all arrests
Thank you for your consideration.
(Printed Name)
DREAM Act Oklahoma
DAOK DACA No. 02 Date Revised April 2014
Addresses & Expenses Worksheet
List With Examples of How to Come Prepared For The DACA Clinic
Lista Con Ejemplos de Como Venir Preparado para la Clinica DACA
Come prepared with the following: | Venga preparado con lo siguiente:
1.Email Address | Correo Electrónico
2.Telephone Number | Numero de teléfono
3.Date when you entered the United States for the first time & last time (if available) | Fecha de cuando
entro a los Estados Unidos por primera vez
4.List of all the address where you have lived since you entered the United States & the time that you
lived in each vicinity | Una lista de todas las direcciones donde ha vivido desde que entro a los Estados
Unidos & el tiempo que vivio en cada una.
Example | Ejemplo:
Current Address | Direccion Actual
456 East 106th Street, Springdale, CA 90044
Lived here from June 26th, 2005 to the Present
Vivi aqui desde Junio 26, 2004 hasta el presente
Previous Address | Direccion Previa
123 South Able Street, Oklahoma City, OK 73211
Lived here from August 15, 2004 to June 25, 2005
Vivi aqui desde Agosto 15, 2004 hasta Junio 25, 2005
Previous Address | Direccion Previa
321 NW 27th Street, Tulsa, OK 74110
Lived here from November 3, 2001 to August 14, 2005
Vivi aqui desde Noviembre 3, 2001 hasta Agosto 14, 2005
5.An average of all your expenses (any money that is spent on you) | Un promedio de todos sus gastos
(cualquier cantidad de dinero gastado en usted)
Example | Ejemplo
Attire | Vestuario - $100/month x 12 = $1200
Utilities | Utilidades – $450/month x 12 = $5400
Mortgage | Renta – $700/month x 12 = $8400
Food | Comida – $300/month x 12 = $3600
Personal Hygiene | Higiene Personal – $100/month x 12 = $1200
Entertainment | Entretenimiento – $150/month x 12 = $1800
Medical Expenses | Gastos Medicos – $500 (Total Per Year | Por Año) = $500
Gas | Gasolina – $80/month x 12 = $960
Car Maintenance | Mantenimiento del vehículo – $100 x 4 (Times Per Year | Por Año) = $400
School (Books, Tuition, Supplies) | Escuela (Libros, Colegiatura, Utiles)– $4900 x 2 (Semesters | Semestres) = $9800
Total Per Year | Total Por Año - $33,260
Addresses & Expenses Worksheet

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