Document Verification Request and Document Verification Request Supplement

OMB No. 1615-0101; Expires 07/31/2011

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Instructions for Form G-845,
Document Verification Request

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

Instructions

Read these instructions carefully to properly complete this form. If you do not follow the instructions, U.S. Citizenship and
Immigration Services (USCIS) Systematic Alien Verification for Entitlements (SAVE) Program may return this form, which may
delay processing.

What Is the Purpose of This Form?

An agency that is registered with the USCIS SAVE Program
may file this form to request immigration status verification
information for an applicant.

Complete items numbered 1 through 15
1. Enter the Alien Registration Number (A-Number) or the
I-94 (Arrival-Departure Record) Number in the space
provided or both the A-Number and I-94 Number if both
numbers are listed on the provided document. The
A-Number is the letter "A" followed by a 7, 8, or 9-digit
number. The I-94 Number is found on Form I-94 and is 11
digits. (Check the front and back of the Form I-94. If the
A-Number appears, record that number when requesting
information instead of the I-94 Number because the ANumber refers to the most integral record available.) If the
A-Number or I-94 Number is not available, enter another
immigration number such as the Certificate of Citizenship
document number on the line marked "Other immigration
number." Provide the name of the document that contains
this immigration number on the line below.

For Production

Who May File This Form?

Any agency that has executed a Memorandum of Agreement
with the USCIS SAVE Program.

General Instructions
A separate Form G-845, Document Verification Request, must
be completed for each applicant and must include copies of
documents only for that individual. If a family unit applies for
a benefit, submit a separate Form G-845 for each family
member.
When completing Form G-845, type or print legibly in black
ink (unless electronically generated).
Submit copies (front and back) of the alien's original
documentation. Ensure that copies are legible.
Make certain that a complete return address has been entered
in the "From" portion of the form and all items in Section A
have been completed. (SAVE may use this portion of the form
for your address in a number 10 window envelope.)

Section A. To Be Completed by Registered Agency
Only
1. In the "To" section: stamp or legibly write the mailing
address of the agency's assigned Status Verification
Office; this can be found at www.uscis.gov/save.
2. In the "From" section: stamp or legibly write the
registered agency name and mailing address with the Zip
Code.

2. Enter the applicant's last, first, and middle name, as printed
on the documents.
3. Enter the applicant's nationality.
4. Enter the applicant's date of birth in the format indicated.
5. Enter the applicant's Social Security Number, if applicable.
6. Enter the applicant's Student and Exchange Visitor
Information System (SEVIS) Number, if applicable.
7. Enter the case verification number if a query has been
initiated in the SAVE online system. If the SAVE online
system is not used, leave this line blank.
8. Enter the registered agency case number, if applicable.
9. Check the proper box indicated for copies or other
information attached. If an immigration document is
printed on both sides, you must attach a copy of the front
and back. Ensure copies are legible.
10. Check the corresponding benefit box for submitting
agency.
11 - 14. Enter the submitting name of agency official, title,
telephone number, and fax number in the space provided.
15. Enter the date that the Form G-845 is completed.
Registered Agency Comments Box (Optional). Agency may
enter additional information about the immigration
verification request.
Form G-845 Instructions (Rev. 02/14/11) N

Processing Information

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Upon receipt, the SAVE Program Status Verification Office
will review the form for completeness, including submission
of any attached documents. Please be aware that if the Form
G-845 is not completely filled out, USCIS will return the
form to you with no verification response.
Please be aware that if the Form G-845 is submitted without a
copy of the applicant's documentation, it will be returned to
you with no verification response.

If USCIS responds by checking response box number 13 of
Section B, this indicates that the immigration status
information requested cannot be found immediately. In such
case, USCIS will conduct further records research. While this
search is pending, USCIS will return a copy of Form G-845
and Form G-1120 to notify you that the case is pending. The
original Form G-845 will be returned to you when the research
is complete and a final response is prepared. The inability of
USCIS to provide an immediate response does not mean
that the applicant is not in a lawful immigration status.

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 Products Division, Office of the Executive
Secretariat, 20 Massachusetts Avenue, N.W., Washington, DC
20529-2020, OMB No. 1615-0101. This form expires July 31,
2011. Do not mail your verification request to this address.

For Production

USCIS Privacy Act Statement
The information provided in this form is subject to the Privacy
Act of 1974 (5 U.S.C. § 552a) and must be protected from
unauthorized disclosure or secondary uses. In accordance with
the Privacy Act, the information collected and provided to
authorized agencies pursuant to this form is covered by the
System of Records Notice "DHS/USCIS-004 - Systematic
Alien Verification for Entitlements Program System of
Records" September 21, 2011, 76 FR 58525.

Form G-845 Instructions (Rev. 02/14/11) N Page 2