Privacy Act Statement

USCIS Privacy Act Statement
Form I-824

AUTHORITIES: The information requested on this application, and the associated evidence, is
collected pursuant to 8 C.F.R. 103.5b(a).
PURPOSE: The primary purpose for providing the requested information on this form is to
request further action on a previously approved application or petition.
DISCLOSURE: The information you provide is voluntary. However, failure to provide the
requested information, and any requested evidence, may delay a final decision or result in the
denial of your benefit request.
ROUTINE USES: The information you provide on this benefit application may be shared with
other federal, state, local, and foreign government agencies and authorized organizations in
accordance with approved routine uses, as described in the associated published system of
records notices [DHS/USCIS-001 - Alien File, Index, and National File Tracking System; the
DHS/USCIS-007 – Benefits Information System; by DHS/CBP-006 - Automated Targeting
System May; and DHS/CBP-011 - U.S. Customs and Border Protection TECS, which can be
found at www.dhs.gov/privacy and www.state.gov].

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