G-1041a FRM TOC

TABLE OF CHANGES – FORM

Form G-1041A, Genealogy Records Request

OMB Number: 1615-0096

06/02/2020

Reason for Revision: Fee Rule

Project Phase: Post G-1056

• Please note – all instances of “if any” and “if applicable” have been removed from Form G-1041A.

Legend for Proposed Text:

• Black font = Current text

• Red font = Changes

Expires 09/30/2022

Edition Date 09/17/2019

Current Page Number and Section	Current Text	Proposed Text
Page 1 Part 1. Information About You (Requestor)	[Page 1] … By my signature, I consent to pay all costs incurred for search, duplication, and review of documents up to $65. (See Form G-1041A Instructions for more information.) …	[Page 1] … By my signature, I consent to pay all costs incurred for search, duplication, and review of documents up to $265. (See Form G-1041A Instructions for more information.) …
Page 2 Part 3. Identification of Requested Record	[Page 2] … NOTE (C-file numbered C650000 and below): The fee for a copy of a microfilm record is $65 per request. NOTE (C-file numbered C650000 and below): The fee for a copy of a textual hard copy file is $65 per request. … 1.a. Certificate Number ►C 1.b. Date of Naturalization (mm/dd/yyyy) 1.c. Court 1.d. City 1.e. County 1.f. Fee (Select all appropriate boxes) [ ] $65 (Microfilm) [ ] $65 (Hard Copy) … 3.b. Fee [ ] $65 (Copy Format - Microfilm) A-File numbered below 8 million 4.a. A-File Number 4.b. Fee [ ] $65 (Copy – Hard Copy) … 5.a. Visa Number 5.b. Date of Entry (mm/dd/yyyy) 5.c. Port-of-Entry 5.d. Ship (seaport arrivals only) 5.e. Fee [ ] $65 (Copy Format – Hard Copy) … 6.a. Registry File Number ►R: 6.b. [ ] $65 (Copy Format – Hard Copy) Total Fees Due/Attached $	[Page 2] … NOTE (C-file numbered C650000 and below): The fee for a copy of a microfilm record is $265 per request. NOTE (C-file numbered C650000 and below): The fee for a copy of a textual hard copy file is $265 per request. … 1.a. Certificate Number ►C 1.b. Date of Naturalization (mm/dd/yyyy) 1.c. Court 1.d. City 1.e. County 1.f. Fee (Select all appropriate boxes) [ ] $265 (Microfilm) [ ] $265 (Hard Copy) … 3.b. Fee [ ] $265 (Copy Format - Microfilm) A-File numbered below 8 million 4.a. A-File Number 4.b. Fee [ ] $265 (Copy – Hard Copy) … 5.a. Visa Number 5.b. Date of Entry (mm/dd/yyyy) 5.c. Port-of-Entry 5.d. Ship (seaport arrivals only) 5.e. Fee [ ] $265 (Copy Format – Hard Copy) … 6.a. Registry File Number ►R: 6.b. [ ] $265 (Copy Format – Hard Copy) Total Fees Due/Attached $

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