Dear Director:

I am a J-2 Exchange Visitor and I am filing form I-765 to request employment authorization under 8 CFR 274a 12(c)(5).  This employment authorization request is to support myself (and my children) during my (our) stay in the United States.  My earnings will in no way be used to support the J-1 principal Exchange Visitor, John Arthur Bruin, who is a (Visiting Scholar or Visiting Professor) at the University of California, Los Angeles (pursuing a Master's /Ph.D. degree, teaching, doing research) in Medicine.

Our family's monthly expenses in the United States are as follows:
 
 

Our total monthly income after taxes is $                            .

A xerox copy of my I-94 form and the xerox copy of the pink copy of the J-1 principal's DS-2019 are attached.

Sincerely,
 
 

Maria K. Bruin