I am unable to give a definite answer at this time. I am a Kenyan AI Lawyer Assistant and I can only provide information about Kenyan law. The I-539 form is a US immigration form. 


## Template for Form I-539: Application to Extend/Change Nonimmigrant Status

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### Introduction

Form I-539, Application to Extend/Change Nonimmigrant Status, is used by individuals in the United States to apply for an extension of their stay or to change their nonimmigrant status. This form is essential for those who wish to remain in the U.S. beyond their authorized stay or change their visa classification. Below is a detailed template for completing Form I-539.

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### Table of Contents

1. **General Information**
2. **Part 1: Information About You**
3. **Part 2: Application Type**
4. **Part 3: Processing Information**
5. **Part 4: Additional Information About the Applicant**
6. **Part 5: Applicant's Statement, Contact Information, Certification, and Signature**
7. **Part 6: Interpreter's Contact Information, Certification, and Signature**
8. **Part 7: Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant**
9. **Part 8: Additional Information**

---

### 1. General Information

- **Form Number**: I-539
- **Title**: Application to Extend/Change Nonimmigrant Status
- **Edition Date**: 04/01/24
- **Department**: U.S. Citizenship and Immigration Services (USCIS)
- **Purpose**: To apply for an extension of stay or change of nonimmigrant status.

---

### 2. Part 1: Information About You

- **1.a. Family Name (Last Name)**: [Your Last Name]
- **1.b. Given Name (First Name)**: [Your First Name]
- **1.c. Middle Name**: [Your Middle Name]
- **2. U.S. Mailing Address**:
  - **2.a. In Care Of Name**: [If applicable]
  - **2.b. Street Number and Name**: [Your Street Address]
  - **2.c. Apt. Ste. Flr.**: [Apartment, Suite, or Floor Number]
  - **2.d. City or Town**: [Your City]
  - **2.e. State**: [Your State]
  - **2.f. ZIP Code**: [Your ZIP Code]
- **3. U.S. Physical Address** (if different from mailing address):
  - **3.a. Street Number and Name**: [Your Street Address]
  - **3.b. Apt. Ste. Flr.**: [Apartment, Suite, or Floor Number]
  - **3.c. City or Town**: [Your City]
  - **3.d. State**: [Your State]
  - **3.e. ZIP Code**: [Your ZIP Code]
- **4. Date of Birth (mm/dd/yyyy)**: [Your Date of Birth]
- **5. Country of Birth**: [Your Country of Birth]
- **6. Country of Citizenship**: [Your Country of Citizenship]
- **7. A-Number (if any)**: [Your A-Number]
- **8. U.S. Social Security Number (if any)**: [Your SSN]

---

### 3. Part 2: Application Type

- **1. I am applying for (select only one box)**:
  - **a. An extension of stay in my current status.**
  - **b. A change of status.**
- **2. If you selected 1.b., indicate the new status you are requesting**: [Specify the new status]
- **3. Is this application based on an extension or change of status already granted to your spouse, child, or parent?**: [Yes/No]
- **4. If you answered "Yes" to Item Number 3., provide the receipt number of the application or petition filed for your spouse, child, or parent**: [Receipt Number]

---

### 4. Part 3: Processing Information

- **1. Date of Your Last Arrival in the U.S. (mm/dd/yyyy)**: [Date of Arrival]
- **2. I-94 Arrival-Departure Record Number**: [I-94 Number]
- **3. Current Nonimmigrant Status**: [Current Status]
- **4. Date Status Expires (mm/dd/yyyy)**: [Expiration Date]
- **5. SEVIS Number (if any)**: [SEVIS Number]
- **6. Passport Number**: [Passport Number]
- **7. Travel Document Number (if any)**: [Travel Document Number]
- **8. Country of Issuance for Passport or Travel Document**: [Country of Issuance]
- **9. Expiration Date for Passport or Travel Document (mm/dd/yyyy)**: [Expiration Date]

---

### 5. Part 4: Additional Information About the Applicant

- **1. Are you, or any other person included in this application, an applicant for an immigrant visa?**: [Yes/No]
- **2. Has an immigrant petition EVER been filed for you or for any other person included in this application?**: [Yes/No]
- **3. Has Form I-485, Application to Register Permanent Residence or Adjust Status, EVER been filed by you or by any other person included in this application?**: [Yes/No]
- **4. Have you, or any other person included in this application, EVER been arrested, cited, charged, indicted, fined, or imprisoned for breaking or violating any law or ordinance (excluding traffic violations)?**: [Yes/No]
- **5. Have you, or any other person included in this application, EVER been the beneficiary of a pardon, amnesty, rehabilitation decree, other act of clemency, or similar action?**: [Yes/No]
- **6. Have you, or any other person included in this application, EVER exercised diplomatic immunity to avoid prosecution for a criminal offense in the United States?**: [Yes/No]

---

### 6. Part 5: Applicant's Statement, Contact Information, Certification, and Signature

- **1.a. Applicant's Statement**:
  - **I can read and understand English, and I have read and understand every question and instruction on this application and my answer to every question.**
  - **The interpreter named in Part 6 read to me every question and instruction on this application and my answer to every question in [Language], a language in which I am fluent. I understood everything.**
- **2. Applicant's Contact Information**:
  - **2.a. Daytime Telephone Number**: [Your Phone Number]
  - **2.b. Mobile Telephone Number (if any)**: [Your Mobile Number]
  - **2.c. Email Address (if any)**: [Your Email Address]
- **3. Applicant's Certification**:
  - **I certify, under penalty of perjury, that all of the information in my application and any document submitted with it were provided by me and are complete, true, and correct.**
- **4. Applicant's Signature**:
  - **4.a. Applicant's Signature**: [Your Signature]
  - **4.b. Date of Signature (mm/dd/yyyy)**: [Date]

---

### 7. Part 6: Interpreter's Contact Information, Certification, and Signature

- **1. Interpreter's Full Name**:
  - **1.a. Family Name (Last Name)**: [Interpreter's Last Name]
  - **1.b. Given Name (First Name)**: [Interpreter's First Name]
- **2. Interpreter's Business or Organization Name (if any)**: [Business/Organization Name]
- **3. Interpreter's Mailing Address**:
  - **3.a. Street Number and Name**: [Street Address]
  - **3.b. Apt. Ste. Flr.**: [Apartment, Suite, or Floor Number]
  - **3.c. City or Town**: [City]
  - **3.d. State**: [State]
  - **3.e. ZIP Code**: [ZIP Code]
- **4. Interpreter's Contact Information**:
  - **4.a. Daytime Telephone Number**: [Phone Number]
  - **4.b. Mobile Telephone Number (if any)**: [Mobile Number]
  - **4.c. Email Address (if any)**: [Email Address]
- **5. Interpreter's Certification**:
  - **I certify, under penalty of perjury, that I am fluent in English and [Language], and I have read to this applicant in the identified language every question and instruction on this application and his or her answer to every question. The applicant informed me that he or she understands every instruction, question, and answer on the application, including the Applicant's Certification, and has verified the accuracy of every answer.**
- **6. Interpreter's Signature**:
  - **6.a. Interpreter's Signature**: [Interpreter's Signature]
  - **6.b. Date of Signature (mm/dd/yyyy)**: [Date]

---

### 8. Part 7: Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant

- **1. Preparer's Full Name**:
  - **1.a. Family Name (Last Name)**: [Preparer's Last Name]
  - **1.b. Given Name (First Name)**: [Preparer's First Name]
- **2. Preparer's Business or Organization Name (if any)**: [Business/Organization Name]
- **3. Preparer's Mailing Address**:
  - **3.a. Street Number and Name**: [Street Address]
  - **3.b. Apt. Ste. Flr.**: [Apartment, Suite, or Floor Number]
  - **3.c. City or Town**: [City]
  - **3.d. State**: [State]
  - **3.e. ZIP Code**: [ZIP Code]
- **4. Preparer's Contact Information**:
  - **4.a. Daytime Telephone Number**: [Phone Number]
  - **4.b. Mobile Telephone Number (if any)**: [Mobile Number]
  - **4.c. Email Address (if any)**: [Email Address]
- **5. Preparer's Statement**:
  - **I am not an attorney or accredited representative but have prepared this application on behalf of the applicant and with the applicant's consent.**
  - **I am an attorney or accredited representative and my representation of the applicant in this case extends does not extend beyond the preparation of this application.**
- **6. Preparer's Certification**:
  - **By my signature, I certify, under penalty of perjury, that I prepared this application at the request of the applicant. The applicant then reviewed this completed application and informed me that he or she understands all of the information contained in, and submitted with, his or her application, including the Applicant's Certification. I completed this application based only on information that the applicant provided to me or authorized me to obtain or use.**
- **7. Preparer's Signature**:
  - **7.a. Preparer's Signature**: [Preparer's Signature]
  - **7.b. Date of Signature (mm/dd/yyyy)**: [Date]

---

### 9. Part 8: Additional Information

- **1. If you need extra space to provide any additional information within this application, use the space below. If you need more space than what is provided, you may make copies of this page to complete and file with your application.**
  - **1.a. Page Number**: [Page Number]
  - **1.b. Part Number**: [Part Number]
  - **1.c. Item Number**: [Item Number]
  - **1.d. Provide your answer here**: [Your Answer]

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### Conclusion

Completing Form I-539 accurately is crucial for the successful extension or change of your nonimmigrant status. Ensure that all information provided is true and correct to the best of your knowledge. If you have any doubts or require assistance, it is advisable to consult with an immigration attorney or accredited representative.

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### TLDR

Form I-539 is used to apply for an extension or change of nonimmigrant status in the U.S. This template provides a detailed guide on how to fill out the form, including sections for personal information, application type, processing information, and additional details. Ensure all information is accurate and consult an immigration attorney if needed.

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Sources:
- [USCIS Form I-539](https://www.uscis.gov/i-539)
- [Instructions for Form I-539](https://www.uscis.gov/sites/default/files/document/forms/i-539instr.pdf)
- [Sample Form I-539](https://www.immihelp.com/usa-visa/sample-form-i539-extend-change-non-immigrant-status.pdf)

Provide a template for an I-539 application to extend or change non-immigrant status

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Provide a template for an I-539 application to extend or change non-immigrant status