Work Authorization Approval Likelihood Assessment Form
Use this form to evaluate the likelihood that a work authorization request will be approved. Provide the request details, eligibility factors, and supporting information needed for an approval-likelihood review.
Applicant and Request Details
Applicant Full Name
*
First Name
Middle Name
Last Name
Email Address
*
example@example.com
Requested Work Authorization Type
*
Initial Authorization
Renewal
Extension
Change of Employer
Other
Intended Start Date / Requested Effective Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Current Location or Jurisdiction
*
Eligibility and Case Factors
Current authorization expiration timing
*
Already expired
Expires within 30 days
31-90 days
More than 90 days
Not applicable
Continuous eligibility history or prior compliance issues
*
No issues identified
Minor issues resolved
Some concerns need review
Significant issues identified
Not applicable
Documentation completeness
*
Incomplete
1
2
3
4
5
6
7
8
9
Complete
10
1 is Incomplete, 10 is Complete
Employer sponsorship/support strength
*
1
2
3
4
5
Urgency or filing timing risk
*
1
2
3
4
5
Supporting Information for Likelihood Review
Supporting evidence status
*
Rows
Available
Incomplete
Not available
Required documents available
1
2
3
Proof of employment available
4
5
6
Prior approvals on record
7
8
9
Gaps or issues needing review
10
11
12
Explanatory notes
Overall likelihood rating
*
1
2
3
4
5
Assessor recommendation
*
Proceed
Proceed with conditions
Hold for review
Recommend denial
Submit
Should be Empty: