G-1041a Ins Toc

G1041A-005-INS-TOC-EXT-30Day-04012022.docx

Genealogy Index Search Request and Genealogy Records Request

G-1041A INS TOC

OMB: 1615-0096

Document [docx]
Download: docx | pdf


TABLE OF CHANGES – INSTRUCTIONS

Form G-1041A, Instructions for Genealogy Records Request

OMB Number: 1615-0096

04/01/2022


Reason for Revision: Extension

Project Phase: 30Day


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 5,

DHS Privacy Notice

[Page 5]


DHS Privacy Notice


AUTHORITIES: The information requested on this historical records request, and the associated evidence, is collected under 8 CFR parts 103.38 through 103.41.


PURPOSE: The primary purpose for providing the requested information on this request form is to assist USCIS with identifying and obtaining copies of the requested USCIS historical records.


DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and any requested evidence, prevents USCIS from processing your request.


ROUTINE USES: DHS may share the information you provide on this form with other Federal, state, local, and foreign government agencies and authorized organizations. DHS follows approved routine uses, as described in the associated published system of records notice [DHS/USCIS-001 Alien File, Index, and National File Tracking System of Records] and as described in the published privacy impact assessment [DHS/USCIS/PIA-017(a) Microfilm Digitization Application System], which you can find at www.dhs.gov/privacy. DHS may also share the information, as appropriate, for law enforcement purposes or in the interest of national security.


[Page 5]


DHS Privacy Notice


AUTHORITIES: The information requested on this historical records request, and the associated evidence, is collected under 8 CFR §§103.38 through 103.41.


PURPOSE: The primary purpose for providing the requested information on this request form is to assist USCIS with identifying and obtaining copies of the requested USCIS historical records.


DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and any requested evidence, prevents USCIS from processing your request.


ROUTINE USES: DHS may share the information you provide on this form with other Federal, state, local, and foreign government agencies and authorized organizations. DHS follows approved routine uses, as described in the associated published system of records notice [DHS/USCIS/ICE/CBP-001 Alien File, Index, and National File Tracking System of Records] and as described in the published privacy impact assessment [DHS/USCIS/PIA-017(a) Microfilm Digitization Application System], which you can find at www.dhs.gov/privacy. DHS may also share the information, as appropriate, for law enforcement purposes or in the interest of national security.



1

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorLauver, James L
File Modified0000-00-00
File Created2022-05-24

© 2024 OMB.report | Privacy Policy