Official Federal Forms > US Citizenship And Immigration Services
Document Verification Request G-845S - Official Federal Forms
| Document Verification Request Form. This is a national form and can be used in US Citizenship And Immigration Services . |
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OMB No. 1653-0032 Department of Homeland Security U.S. Citizenship and Immigration Services SAVE G-845S, Document Verification Request Section A-To be completed by the submitting agency. 6. Verification Number To: U.S. Citizenship and Immigration Services (USCIS) 7. Photocopy of Document Attached. (If printed on both sides, attach a copy of the front and back.) Other Information Attached (Specify documents). 8. (Benefit) (Your Case Number) From: Typed or Stamped Name and Address of Submitting Agency AFDC Education Grant/Loans/Workstudy Food Stamp Housing Assistance Medicaid/Medical Assistance Attn: Status Verifier Unemployment Insurance (USCIS may use above address with a No. 20 window envelope) Employment Authorization 1. Alien Registration Number or Form I-94 Number Other(specify) 2. Applicants Name (Last, First, Middle) 9. Name of Submitting Official 3. Nationality 10. Title of Submitting Official 4. Date of Birth (mm/dd/yyyy) 11. Date 5. U.S. Social Security Number 12. Telephone Number ( ) Section B-To be completed by USCIS USCIS RESPONSE: From the documents or information submitted and/or a rev iew of our records we find that: 1. This document appears valid and relates to a Lawful 8. This document appears valid and relates to an alien who Permanent Resident alien of the United States. is a conditional entrant. 9. This document appears valid and relates to an alien who2. This document appears valid and relates to a Conditional is a nonimmigrant. Resident alien of the United States. (Specify type or class below) 3. This document appears valid and relates to an alien authorized employment as indicated below: 10. This document appears valid and relates to an alien not authorized employment in the United States. a. Full-Time 11. Continue to process as legal alien. USCIS is searching b. Part-Time indices for further information. c. No Expiration (Indefinite) 12. This document is not valid because it appears to be: d. Expires on: (Check all that apply) (Specify mm/dd/yyyy below) a. Expired b. Altered 4. This document appears valid and relates to an alien who c. Counterfeit has an application pending for: (Specify USCIS below) USCIS Stamp 5. This document relates to an alien having been granted asylum/refugee status in the United States. 6. This document appears valid and relates to an alien paroled into the United States pursuant to Section 212 of the I&N Act. 7. This document appears valid and relates to an alien who is a Cuban/Haitian entrant. Please see reverse for additional comments. Form G-845S (Rev. 01/31/05) N (Prior versions may be used until 06/30 /05) American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2 Comments 13. No determination can be made from the information submitted. Please obta in a copy of the original alien registration documentation and resubmit. 14. No determination can be made without seeing bothsides of the document submitted. (Please resubmit request.) 15. Copy of document is not readable. (Please resubmit request.) "PRUCOL" For Purposes of Determining OnlyIf Alien Is Permanently Residing Under Color of Law! 16. USCIS is actively pursuing the removal of an alien in this class/categor y. 17. USCIS is not actively pursuing the removal of an alien in this class/cat egory at this time. 18. Other. Instructions Submit copies (front and back) of aliens original documentation. Make certain a complete return address has been entered in the "From" portion of the form. The Alien Registration Number ("A" Number) is the letter "A" f ollowed by a series of seven or eight digits. The number found on Form I-94 may also be recorded in this block. (Check the front and back of the Form I-94 document. If the "A" Number appears, record that number when requesting information instead of the longer admission number because the "A" Number refers to the most integral reco rd available.) If Form G-845 is submitted without copies of the applicants original do cumentation, it will be returned to the submitting agency without any action taken. Address this verification request to the local office of the U.S. Citize nship and Immigration Services. Form G-845S (Rev. 01/31/05) N (Prior versions may be used until 06/30 /05) Page 2 American LegalNet, Inc. www.USCourtForms.com
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