This two-page document is a fee waiver application that eligible immigrants may file with their EOIR forms in immigration court. This fee waiver is specific to EOIR forms and immigration court. A different fee waiver form is required for USCIS applications and may be found here: https://niwaplibrary.wcl.american.edu/pubs/i-912.

This form is an Application for Cancellation of Removal for Certain Nonpermanent Residents. The application includes instructions as well as the application itself. The instructions review eligibility, burden of proof, required documents, fees, and filing.