G-845 Document Verification Request

OMB No. 1615-0101; Expires 06/30/08

Department of Homeland Security
U.S. Citizenship and Immigration Services

G-845, Document Verification Request

Section A. To Be Completed by the Submitting Agency
To:

U.S. Citizenship and Immigration Services (USCIS)

6.

Verification Number

7.

Photocopy of Document Attached.
(If printed on both sides, attach a copy of the front and back .)
Other Information Attached (Specify documents)

From: Typed or Stamped Name and Address of Submitting Agency
8.

Attn:

Organization (Specify)

Immigration Status Verification Unit

(USCIS may use above address with a No. 10 window envelope)
1.

Alien Registration Number or Form I-94 Number

2.

Applicant's Name (Last, First, Middle)

3.

Nationality

9.

4.

Date of Birth (mm/dd/yyyy)

10. Title of Submitting Official

Name of Submitting Official

11. Date (mm/dd/yyyy)

5. U.S. Social Security Number

12. Telephone Number

(

)

Section B. To Be Completed by USCIS
USCIS RESPONSES: From the documents or information submitted and/or a review of our records, we find that:
1.

This document appears valid and relates to a Lawful
Permanent Resident alien of the United States.

8.

This document appears valid and relates to an alien who is a
conditional entrant.

2.

This document appears valid and relates to a Conditional
Resident alien of the United States.

9.

This document appears valid and relates to an alien who is a
nonimmigrant.

3.

This document appears valid and relates to an alien authorized
employment as indicated below:

(Specify type or class below)

a.

Full-Time

10.

b.

Part-Time

11.

c.

No Expiration (Indefinite)

d. Expires on (Specify mm/dd/yyyy below):

12.

This document appears valid and relates to an alien not
authorized employment in the United States.
Continue to process as legal alien. USCIS is searching indices
for further information.
This document is not valid because it appears to be:
(Check all that apply)

a. Expired
4.

b. Altered

This document appears valid and relates to an alien who has an
application pending for:
(Specify USCIS benefit below)

c. Counterfeit
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.
Form G-845 (Rev.05/09/08)Y

Comments
13.

No determination can be made from the information submitted. Please obtain a copy of the original alien registration
documentation and resubmit.

14.

No determination can be made without seeing both sides of the document submitted. (Please resubmit request.)

15.

Copy of document is not readable. (Please resubmit request.)

Permanently Residing Under Color of Law "PRUCOL"
PRUCOL requests can only be submitted by the Social Security Administration for Supplemental Security Income cases that pre-date
August 22, 1996.
16.

USCIS is actively pursuing the removal of an alien in this class/category.

17.

USCIS is not actively pursuing the removal of an alien in this class/category at this time.

18.

Other.

Instructions
1. Submit copies (front and back) of alien's original documentation.
2. Make certain a complete return address has been entered in the "From" portion of the form.
3. The Alien Registration Number (A-number) is the letter "A" followed by a series of seven, eight or nine digits. The number found
on Form I-94 may also be recorded in the 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 record available.)
4. If Form G-845 is submitted without a copies of the applicant's original documentation, it will be returned to the submitting agency
without any action taken.
5. Address this verification request to U.S. Citizenship and Immigration Services verification office assigned to you by the SAVE
Program Office. For further information, please visit www.uscis.gov.

Paperwork Reduction Act
An agency may not conduct or sponsor an information collection and a person is not required to respond to a collection of information
unless it displays a currently valid OMB control number. The public reporting burden for this collection of information is estimated at
5 minutes per response, including the time for reviewing instructions and completing and submitting the form. Send comments
regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to:
U.S. Citizenship and Immigration Services, Regulatory Management Division, 111 Massachusetts Avenue, N.W., 3rd Floor, Suite
3008, Washington, DC 20529. OMB No. 1615-0101. Do not mail your application to this address.

Form G-845 (Rev. 05/09/08)Y Page 2