Official Federal Forms > US Citizenship And Immigration Services
Request For The Return Of Original Documents G-884 - Official Federal Forms
| Request For The Return Of Original Documents Form. This is a national form and can be used in US Citizenship And Immigration Services . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
OMB No. 1615-0100; Expires 02/28/2015 Department of Homeland Security U.S. Citizenship and Immigration Services G-884, Request for the Return of Original Documents For USCIS Use Only Remarks START HERE - Type or print in black ink Part 1. Information About You (Person requesting the return of original documents) Family Name Given Name Middle Name Mailing Address - Street Number and Name Apt./SuiteNumber File No. Date City State Zip Code A-Number (if any) City/Town/Village of Birth Country of Birth Date of Birth (mm/dd/yyyy) Daytime Phone Number (with area code) Specific information about desired document(s) or record(s) (e.g., marriage license, birth certificate, death certificate, etc.) Part 2. Data for Identification of Personal Record (Person requesting the return of original documents) Family Name Given Name Middle Name Other Names Used (if any) Date of Birth (mm/dd/yyyy) Place of Birth Date of Entry (mm/dd/yyyy) Port of Entry Type of Entry (visitor, student, etc.) A-Number (if any) Name on Certificate of Naturalization Certificate of Naturalization Number Certificate of Naturalization Date (mm/dd/yyyy) Name on Certificate of Citizenship Certificate of Citizenship Number Certificate of Citizenship Date (mm/dd/yyyy) Naturalization Court/USCIS Office and Location Verification of Identity In person with identification Legible photocopies Form G-884 (02/27/13)Y American LegalNet, Inc. www.FormsWorkFlow.com Part 3. Signature of Requester - Affidavit of Identity I certify, under penalty of perjury under the laws of the United States of America, that this request and evidence submitted is all true and correct. I authorize the release of any information from my records that U.S. Citizenship and Immigration Services needs to respond to my request. I Swear Affirm that I am the person named in Part 1 on Page 1 of this form. I understand that if I willfully make false statements on this form, I may be punished by fine or imprisonment (18 U.S.C.1101). Print Your Full Name Signature (Your signature must be notarized. Do not sign until before the Certifying Official) Date (mm/dd/yyyy) I do hereby certify that the requester named in Part 1 on Page 1 of this form personally appeared before me and executed the Affidavit of Identity. Signature of USCIS Official Title Date (mm/dd/yyyy) Printed Name of USCIS Official Certifying Official I do hereby certify that the requester named in Part 1 on Page 1 of this form personally appeared before me and executed the Affidavit of Identity. Printed Name of Certifying Official Signature of Certifying Official In and for the: Given under my hand and official seal Date (mm/dd/yyyy) Form G-884 (02/27/13)Y Page 2 American LegalNet, Inc. www.FormsWorkFlow.com
|
|||||||
