Historical Records Services Request

Historical Records Services Request

G-1041instr

Historical Records Services Request

OMB: 1615-0096

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OMB 1615-0096; Expires 04/30/09

Instructions for G-1041, Genealogy
Index Search Request

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

Instructions
Read all instructions carefully before completing this form.

What Is the Purpose of This Form?

What Information Is Required To Begin an
Index Search?

Use Form G-1041 to request a search of U.S. Citizenship and
Immigration Services (USCIS) historical indices. (To obtain
copies of USCIS historical records, use Form G-1041A,
Genealogy Records Request.)

The following information is required to initiate a search of
USCIS historical indices:

Requests for searches of USCIS historical indices are used to
determine whether any USCIS records exist on the subject
and, if such records exist, to capture the file number and/or
other identifier of each record.

Who Should Use This Form?

1.

Required Information:
A. Immigrant's full name (last, first, and middle);
B. Alias names or variant spellings, if any;
C. Date of birth (state whether date given is exact or an
estimated year); and
D. Country or place of birth.

Use this form if you are a:
1. Researcher seeking records of your ancestors for
genealogical/family history purposes;
2. Historian or social scientist seeking historical records of
persons you can identify by name, date of birth, and place
of birth; or
3. Researcher involved in heir location.

When Should This Form Not Be Used?
This form should not be used to request a copy of a USCIS
historical record or a copy of any record.
Do not use this form to request index searches for:
1. Records of naturalization prior to September 27, 1906.
Consult Federal records stored at the National Archives
and Records Administration (NARA) Record Group 21,
or write to the clerk of the court where the naturalization
occurred; or
2. Sea, land, or air passenger manifest lists recording arrivals
prior to December 1982. For these documents, contact
NARA.
NOTE: For any records not specifically mentioned in Form
G-1041 or not available through any other USCIS program,
use Form G-639, Freedom of Information/Privacy Act
Request.

2. Additional data will help identify a certain immigrant from
others with the same name, such as:
A. Date of immigrant's arrival in the United States (state
whether the date is actual or estimated); and
B. Immigrant's residence(s) in the United States (State,
city, or exact street address - Example: "in
Pennsylvania until 1938, then lived in Madison,
Wisconsin.")
3. If the immigrant's date of birth is less than 100 years
before today's date, you must attach documentary proof of
death to this request form. Examples of acceptable
documentary proof of death include:
A. Death certificate (uncertified copy);
B. Printed obituaries, funeral programs, or photographs
of gravestones;
C. Bible, church, or other religious records;
D. U.S. Social Security Death Index records (individual
records only, not lists);
E. Records relating to the payment of death benefits;
and/or
F. Other documents demonstrating that the immigrant
subject of the request is deceased.
Submit copies of these items with this request form. Do not
include original records because such documents will not be
returned.

G-1041 Instructions (Rev. 09/10/08)Y

What If the Required
Information Is Not Provided?
No search can be made without you providing at least the
immigrant's name, year of birth, and country of birth.
If the immigrant appears in USCIS records under a name
other than that provided, no matching record will be returned.
Alternative names will be searched only if the names,
spellings, and aliases are provided by you. Similarly, if
multiple immigrants with the same name appear having the
identical birth year and country, no matching record will be
returned. Only if additional information is provided (e.g.,
actual or estimated date of arrival or naturalization, or place
of residence when naturalized) can an immigrant be
identified from among others with the same name.
NOTE: We will consider foreign versions to be the same
name. Example: Giuseppe and Joseph, which are different
spellings of the same name.
To learn about various foreign spellings of common names
and about alternate sources for some USCIS record file
numbers, visit the USCIS Genealogy Program website at
www.uscis.gov/genealogy.

Notice to Those Making Payment by Check. If you send us
a check, it will be converted into an electronic funds transfer
(EFT). This means we will copy your check and use the
account information on it to electronically debit your account
for the amount of the check. The debit from your account will
usually take 24 hours, and will be shown on your regular
account statement.
You will not receive your original check back. We will
destroy your original check, but we will keep a copy of it. If
the EFT cannot be processed for technical reasons, you
authorize us to process the copy in place of your original
check. If the EFT cannot be completed because of insufficient
funds, we may try to make the transfer up to two times.

Where Should You Mail the Request?
Mail your request to:
USCIS Genealogy Program
PO Box 805925
Chicago, IL 60680-4120

Address Changes
What Is the Fee?
A fee of $20 must be submitted with this form to request a
genealogy index search.
Use the following guidelines when you prepare your check or
money order for filing the fee:
1. The check or money order must be drawn on a bank or
other financial institution located in the United States and
must be payable in U.S. currency; and
2. Make the check or money order payable to U.S.
Department of Homeland Security, unless:
A. If you live in Guam, make it payable to Treasurer,
Guam.
B. If you live in the U.S. Virgin Islands, make it payable
to Commissioner of Finance of the Virgin Islands.

You may change your address on-line at www.uscis.gov, click
on "Change your address with USCIS" and follow the
prompts, or you may complete and mail Form AR-11, Alien's
Change of Address Card, to:
U.S. Citizenship and Immigration Services
Change of Address
P.O. Box 7134
London, KY 40742-7134
For commercial overnight or fast freight services only, mail to:
U.S. Citizenship and Immigration Services
Change of Address
1084-I South Laurel Road
London, KY 40744

NOTE: Please spell out U.S. Department of Homeland
Security; do not use the initials "USDHS" or "DHS."

G-1041 Instructions (Rev. 09/10/08)Y Page 2

Privacy Act Notice
We ask for the information on this form, and associated
evidence, to determine if you have established eligibility for
the immigration benefit for which you are filing. Our legal
right to ask for this information can be found in the
Immigration and Nationality Act, as amended. We may
provide this information to other government agencies. Failure
to provide this information, and any requested evidence, may
delay a final decision or result in denial of your Form G-1041.

USCIS Forms and Information
To order USCIS forms, call our toll-free forms line at
1-800-870-3676. You can also get USCIS forms and
information on immigration laws, regulations, and procedures
by telephoning our National Customer Service Center at
1-800-375-5283 or visiting our Internet website at
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 30 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. 1615-0096. Do not mail your application to this
address.

G-1041 Instructions (Rev. 09/10/08)Y Page 3


File Typeapplication/pdf
File TitleGenealogy Immigration Index Search Request
AuthorMarian Smith
File Modified2008-09-11
File Created2006-11-16

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