Freedom of Information/Privcy Act Request

Freedom of Information/Privacy Act Request

G639-INS-Rev-30Day

Freedom of Information/Privcy Act Request

OMB: 1615-0102

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Instructions for
Freedom of Information/Privacy Act Request
Department of Homeland Security
U.S. Citizenship and Immigration Services

USCIS
Form G-639

OMB No. 1615-0102
Expires 04/30/2020

What Is the Purpose of Form G-639?
Use Form G-639 to obtain access to U. S. Citizenship and Immigration Services (USCIS) records as allowed by the
Freedom of Information Act (FOIA) at 5 U.S.C. 552 and the Privacy Act of 1974 (PA) at 5 U.S.C. 552a.

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With certain exceptions, FOIA provides access to Federal agency records. PA allows U.S. citizens or lawful permanent
residents to:
1.	 Request access to information pertaining to themselves in Federal agency records; and
2.	 Correct or amend their records.

PA also prohibits disclosure of any person’s records without his or her written consent, except under certain circumstances
as prescribed by PA.

When May I Use Form G-639?

You may use Form G-639 to obtain access to USCIS records. You may also use this request to allow to another individual
to access USCIS records pertaining to you.
Do not use Form G-639 for the following requests.

1.	 Status Inquires. Contact the USCIS office where the application or petition was filed or visit
https://egov.uscis.gov to check your case status online. You may also reach out to the USCIS Contact Center at
www.uscis.gov/contactcenter for help. The USCIS Contact Center provides information in English and Spanish.
For TTY (deaf or hard of hearing) call: 1-800-767-1833.
2.	 Consular Notification of a Visa Petition Approval. Use Form I-824, Application for Action on an Approved
Application or Petition, to request consular notification of visa petition approval.
3.	 Return of Original Documents. Use Form G-884, Request for the Return of Original Documents, to request the
return of original documents.
4.	 Naturalization Records Before September 27, 1906. Contact the clerk of court where the naturalization occurred to
request naturalization records before September 27, 1906.
5.	 USCIS Manifest Arrivals Before December 1982. Contact the National Archives at
https://www.archives.gov/contact to request information on USCIS manifest arrivals before December 1982.
6.	 Proof of Status for Non-Immigration Benefits. Contact the Federal agency responsible for the benefit (for example,
Social Security benefit, Selective Service requirement) to obtain proof of status.
NOTE: Form G-639 is not required to make a FOIA/PA request. However, you must make all FOIA/PA requests
in writing and in accordance with the applicable statutory and regulatory requirements under the FOIA and PA. For
information about filing an electronic FOIA/PA request, please visit the USCIS FOIA website at www.uscis.gov/foia.

General Instructions
USCIS provides forms free of charge through the USCIS website. To view, print, or fill out our forms, you should use the
latest version of Adobe Reader, which you can download for free at http://get.adobe.com/reader/. If you do not have
internet access, you may order USCIS forms by calling the Forms Request Line at 1-800-870-3676. The Forms Request
Line provides information in English and Spanish. For TTY (deaf or hard of hearing) call: 1-800-767-1833.
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How To Fill Out Form G-639
1.	 Type or print legibly in black ink.
2.	 If you need extra space to complete any item within this request, use the space provided in Part 6. Additional
Information or attach a separate sheet of paper. Type or print the Subject of Record’s name and Alien Registration
Number (A-Number) (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number
to which your answer refers; and sign and date each sheet.
3.	 Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been
married and the question asks, “Provide the name of your current spouse”), type or print “N/A” unless otherwise
directed. If your answer to a question which requires a numeric response is zero or none (for example, “How many
children do you have” or “How many times have you departed the United States”), type or print “None” unless
otherwise directed.

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Specific Instructions

Form G-639 is divided into six parts. The following information will help you complete the request.
Providing the information requested on Form G-639 is voluntary. However, failure to provide complete and specific
information may delay processing of your request or create an inability for USCIS to locate the records or information
requested.
Part 1. Type of Request

Item Numbers 1.a. - 1.b. Select only one box in Part 1. that describes the type of records you are requesting.
NOTE: If you are filing this request on behalf of another individual, select the response as it would apply to that
individual.
Part 2. Requestor Information

Item Number 1. Indicate whether you are the Subject of Record. If you answer “No,” indicating you are requesting
access to another individual’s records, complete Part 2. If you answer “Yes,” indicating you are requesting access to your
own records, skip Part 2. and proceed to Part 3. Description of Records Requested.
Item Numbers 2.a. - 3.c. Representative Role to the Subject of Record. Select the appropriate box to indicate your
representative role to the Subject of the Record:
1.	 An attorney eligible to practice law in, and a member of good standing of, the bar of the highest courts of a state,
possession, territory, commonwealth, or District of Columbia;
2.	 An accredited representative of a qualified religious, charitable, social service, or similar organization established in
the United States, so recognized by the Department of Justice, Board of Immigration Appeals, in accordance with
8 CFR 292.2.; or
3.	 A family member or caretaker.
Proof of Parentage. If a parent is filing on behalf of a minor child, then he or she must submit proof of parentage.
Proof of parentage may be in the form of a birth certificate, adoption decree, or similar document naming the requester
as the legal parent. If a guardian is filing on behalf of his or her ward, he or she must submit proof of guardianship.
The signature of the parent/guardian must be notarized or signed under penalty of perjury (6 CFR section 5.21(e)).
Proof of parentage may be submitted under Part 6. Additional Information.
Select the appropriate box to provide further information regarding your representative role to the subject of the
record.
Item Numbers 4.a. - 4.c. Requestor’s Full Name. Provide your full legal name in the spaces provided.

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Item Numbers 5.a. - 5.i. Requestor’s Mailing Address. List your complete mailing address in the spaces provided.
You may list a valid residence, APO, “In Care Of Name,” or commercial address in the United States. You may list a Post
Office address (PO Box) if that is how you receive your mail. If your mail is sent to someone other than yourself, include
an “In Care Of Name” as part of your mailing address. If your mailing address is in a U.S. territory and it contains an
urbanization name, list the urbanization name in the “In Care Of Name” space provided.
Item Numbers 6. - 8. Requestor’s Contact Information. Provide your daytime telephone number, mobile telephone
number (if any), and email address (if any).
Item Numbers 9.a. - 9.b. Requestor’s Certification. Sign and date the request. A stamped or typewritten name in place
of a signature is not acceptable.

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Part 3. Description of Records Requested

You are not required to respond to every item in Part 3. However, failure to provide complete and specific information
may delay processing of your request or prevent USCIS from locating the records or information requested.
Item Number 1. Purpose. State the purpose of your request. This optional information, if provided, may assist USCIS
in locating the records you seek.
Item Numbers 2.a. - 2.c. Full Name of the Subject of Record. Provide the full legal name of the Subject of Record in
the spaces provided.
Item Numbers 3.a. - 4.c. Other Names Used by the Subject of Record. Provide other names the Subject of Record has
used since birth, including any nicknames, aliases, and maiden name (if applicable). If you need extra space to complete
this section, use the space provided in Part 6. Additional Information.
Item Numbers 5.a. - 5.c. Full Name of the Subject of Record at Time of Entry into the United States. If his or her
name has changed since he or she entered the United States, provide the full name he or she used at the time of entry into
the United States.
Item Numbers 6.a. - 6.b. Form I-94, Arrival-Departure Record. If U.S. Customs and Border Protection (CBP) or
USCIS issued him or her a Form I-94, Arrival-Departure Record, provide his or her Form I-94 number and date that his or
her authorized period of stay expires or expired (as shown on your Form I-94). The Form I-94 number also is known as
the Departure Number on some versions of Form I-94.
NOTE: If he or she was admitted to the United States by CBP at an airport or seaport after April 30, 2013, CBP may have
issued him or her an electronic Form I-94 instead of a paper Form I-94. You may visit the CBP website at
www.cbp.gov/i94 to obtain a paper version of an electronic Form I-94. CBP does not charge a fee for this service. Some
travelers admitted to the United States at a land border, airport, or seaport after April 30, 2013, with a passport or travel
document, who were issued a paper Form I-94 by CBP, may also be able to obtain a replacement Form I-94 from the CBP
website without charge. If you cannot obtain his or her Form I-94 from the CBP website, you may obtain it by filing Form
I-102, Application for Replacement/Initial Nonimmigrant Arrival-Departure Record, with USCIS. USCIS does charge a
fee for this service. See the USCIS website at www.uscis.gov/I-102 for more information.
Passport and Travel Document Numbers. If he or she used a passport or travel document to travel to the United States,
enter either the passport or travel document information in the appropriate space on the request, even if the passport or
travel document is currently expired.
Item Number 7. Alien Registration Number (A-Number) (if any). An Alien Registration Number, otherwise known as
an “A-Number,” is typically issued to persons who apply for, or are granted, certain immigration benefits. In addition to
USCIS, CBP, U.S. Immigration and Customs Enforcement (ICE), Executive Office for Immigration Review (EOIR), and
the U.S. Department of State (DOS) may also issue an A-Number to certain aliens. If he or she was issued an A-Number,
type or print it in the spaces provided. If he or she does not have an A-Number, or if he or she does not remember it, leave
this space blank.

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Item Number 8. USCIS Online Account Number (if any). If he or she has previously filed an application or petition
using the USCIS online filing system (previously called USCIS Electronic Immigration System (USCIS ELIS)), provide
the USCIS Online Account Number he or she was issued by the system. He or she can find his or her USCIS Online
Account Number by logging in to his or her account and going to the profile page. If he or she previously filed certain
applications or petitions on a paper form through a USCIS Lockbox facility, he or she may have received a USCIS Online
Account Access Notice issuing him or her a USCIS Online Account Number. He or she may find his or her USCIS Online
Account Number at the top of the notice. The USCIS Online Account Number is not the same as an A-Number. If he or
she was issued a USCIS Online Account Number, enter it in the space provided.
Item Number 9. Application or Petition Receipt Number. Provide the USCIS receipt number that corresponds to any
application or petition he or she previously filed with USCIS.

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Item Numbers 10.a. - 13. Information About Family Members that May Appear on Requested Records. Provide
the family member’s full name and his or her relationship to the Subject of Record for any individual that may appear on
the requested records (for example, a spouse or children). If you need extra space to complete this section, use the space
provided in Part 6. Additional Information.
Item Numbers 14.a. - 15.d. Parents’ Names for the Subject of Record. Provide the full names of his or her father and
mother in the spaces provided. If applicable, include his or her mother’s maiden name.
Item Number 16. Describe the records you are seeking. If you need additional space, use the space provided in Part 6.
Additional Information.
Part 4. Verification of Identity and Subject of Record Consent

If you are the Subject of Record and requesting records about yourself, you must verify your identity by providing the
information requested in addition to Item Numbers 1.a. - 4.i. You must also sign your request and have your signature
notarized OR submitted under penalty of perjury in Item Number 8.a. or 8.b.
If you are NOT the Subject of Record but are requesting records on behalf of that individual, you must still provide a
statement from the individual verifying his or her identity and certifying the individual’s agreement that USCIS may
release his or her records to you. Again, you may fulfill these requirements by completing Item Numbers 1.a. - 4.i. and
having the individual complete Item Numbers 8.a. or 8.b.
If the Subject of Record is deceased, select Item Number 8.c. and attach appropriate proof of death, such as an obituary
or a death certificate with your request.
NOTE: If your request is NOT on behalf of the individual whose records you seek, you may use the space provided
in Part 6. Additional Information to provide additional information you want USCIS to consider in processing your
request. You should also attach any documentation in support of your request. For example, if you believe disclosure
of the Subject of Record’s information would further a public interest recognizable under FOIA, you may use Part 6. to
explain the public interest and attach any documentation in support of your position.
Item Numbers 1.a. - 1.c. Full Name of the Subject of Record. Provide the full legal name of the Subject of Record in
the spaces provided. If you are completing this request using a computer, this information will automatically appear based
on your responses in Part 3., Item Numbers 2.a. - 2.c.
Item Number 2. Date of Birth. Provide the date of birth (mm/dd/yyyy) of the subject of record.
Item Number 3. Country of Birth. Provide the country of birth of the subject of record.
Item Numbers 4.a. - 4.i. Mailing Address for the Subject of Record. Provide the current address of the Subject of
Record in the spaces provided. You may list a valid residence, APO, “In Care Of Name,” or commercial address in the
U.S. You may list a Post Office address (PO Box) if that is how the Subject of Record receives mail. If the mail is sent
to someone other than the Subject of Record, include an “In Care Of Name” as part of the mailing address. If the mailing
address is in a U.S. territory and it contains an urbanization name, list the urbanization name in the “In Care Of Name”
space provided.

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Item Numbers 5. - 7. Contact Information for the Subject of Record. Provide the daytime telephone number, mobile
telephone number (if any), and email address (if any) for the Subject of Record. Providing this information is optional.
Item Numbers 8.a. - 8.c. Signature and Notarized Affidavit or Declaration of the Subject of Record. Select only
one box. The Subject of Record MUST provide a signature in Item Number 6.a. OR Item Number 6.b., regardless if
you submit this request for yourself or on behalf of another individual. If the Subject of Record is deceased, select Item
Number 6.c. and attach proof of death.
NOTE: Appropriate consent from the Subject of Record is established by submitting Form G-639 with required
information and signatures or an authorizing letter with verification of identity for the Subject of Record. You may also
use U.S. Department of Justice (DOJ) Form 361, Certification of Identity, to verify identity for the Subject of Record.
Form DOJ-361 is available at www.justice.gov/oip/forms/cert_ind.pdf. If you are a parent or legal guardian submitting
Form G-639 on behalf of a child or other individual, you must also establish your own identity as the child’s or other
individual’s parent or legal guardian.

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Part 5. Processing Information

Item Number 1. Select the box next to any of the circumstances that apply to your request. USCIS may consider your
request for expedited processing if any of these circumstances apply.
Item Number 2. If you have a pending Immigration Court hearing, submit a copy of one of the following documents
with your Form G-639: I-862, Notice to Appear; Form I-122, Order to Show Cause; Form I-863, Note of Referral to
Immigration Judge, or a written notice of continuation of a future scheduled hearing before the immigration judge.
Part 6. Additional Information

Item Numbers 1.a. - 7.d. If you need extra space to provide any additional information within this request, use the space
provided in Part 6. Additional Information. If you need more space than what is provided in Part 6., you may make
copies of Part 6. to complete and file with your request, or attach a separate sheet of paper. Type or print the Subject
of Record’s name and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item
Number to which your answer refers; and sign and date each sheet.

We recommend that you print or save a copy of your completed request to review in the future and for
your records.

What Is the Filing Fee?
There is no filing fee for Form G-639.
Processing Fees
Please do not send any fees payment at the time of your request. After receiving your FOIA request, USCIS will contact
you if any fees are required.
Except for commercial requestors, the first 100 pages of reproduction and the first two hours of search time are provided
without charge. Thereafter, requests processed under FOIA/PA may incur fees of 10 cents per page for duplication. Other
costs for searches and duplication are charged at the actual direct cost.
Fees are charged if the combined costs for searches, duplication, and/or review is more than $14, and by submitting Form
G-639, you as the requestor agree to pay for fees up to $25. If total anticipated fees are more than $250, or you have
failed to pay for fees in the past, USCIS may request an advance deposit. Also, USCIS will not process any Form G-639
until the requestor pays all unpaid fees from any of their prior requests.
NOTE: The processing fees are not refundable, regardless of any action USCIS takes on this request. DO NOT MAIL
CASH. You must submit all fees in the exact amounts.
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Payments by Check or Money Order
Use the following guidelines when you prepare your check or money order for the Form G-639 processing fees:
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 Treasury of the United States.
Notice to Those Paying by Check. If you send USCIS a check, we will convert it 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 your bank will show it on your regular
account statement.

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You will not receive your original check back. We will destroy your original check, but will keep a copy of it. If USCIS
cannot process the EFT for technical reasons, you authorize us to process the copy in place of your original check. If
your check is returned as unpayable, we will re-submit the payment to the financial institution one time. If the check is
returned as unpayable a second time, we will reject your Form G-639 and charge you a returned check fee.

Where To File?

Please see our website at www.uscis.gov/G-639 or visit the USCIS Contact Center at www.uscis.gov/contactcenter for
the most current information about where to file this request. The USCIS Contact Center provides information in English
and Spanish. For TTY (deaf or hard of hearing) call: 1-800-767-1833.

Processing Information

Requests for More Information. We may request that you provide more information or evidence to support your
request.
Decision. The decision on Form G-639 involves a determination of whether you have provided the information required
for USCIS to process your records access request. USCIS will notify you of the decision in writing.

USCIS Forms and Information
To ensure you are using the latest version of this request, visit the USCIS website at www.uscis.gov where you can obtain
the latest USCIS forms and immigration-related information. If you do not have internet access, you may order USCIS
forms by calling the Forms Request Line at 1-800-870-3676. The Forms Request Line offers services in English and
Spanish. For TTY (deaf or hard of hearing) call: 1-800-767-1833.

DHS Privacy Notice
AUTHORITIES: The information requested on this form, and the associated evidence, is collected under the Freedom
of Information Act (FOIA), 5 U.S.C. Section 552, and the Privacy Act of 1974 (PA), 5 U.S.C. Section 552a, together with
the Department of Homeland Security implementing regulations found in volume 6 of the Code of Federal Regulations
(CFR).
PURPOSE: The primary purpose for providing the requested information on this form is to request access to information
under the FOIA and/or PA. DHS uses the information you provide to grant or deny the information request you are
seeking.
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DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and
any requested evidence, may delay access to information or result in denial of your information request.
ROUTINE USES: DHS may share the information you provide on this form and any additional requested evidence with
other Federal, state, local, and foreign government agencies and authorized organizations. DHS follows approved routine
uses described in the associated published system of records notices [DHS/ALL-001 DHS FOIA and Privacy Act Record
System and DHS/ALL-037 E-Authentication Records System of Records] and the published privacy impact assessments
[DHS/USCIS/PIA-077 FOIA Immigration Records System (FIRST) and DHS/ALL/PIA-038 FOIA/PA Information
Processing System], which you can find at www.dhs.gov/privacy. DHS may also share this information, as appropriate,
for law enforcement purposes or in the interest of national security.

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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 Office of Management and Budget (OMB) control number. The
public reporting burden for this collection of information is estimated at 40 minutes per response, including the time
for reviewing instructions, gathering the required documentation and information, completing the request, preparing
statements, attaching necessary documentation, and submitting the request. 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 Coordination Division, Office of Policy and Strategy, 20 Massachusetts
Ave NW, Washington, DC 20529-2140; OMB No. 1615-0102. Do not mail your completed Form G-639 to this
address.

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