3 FN SelectiveService Verification

Request for Status Information Letter
This is a fillable form. Please type in ALL CAPS before printing, or PRINT clearly using BLACK INK
Before you fill out and submit this form, please check to verify your registration status with the Selective Service
System at https://www.sss.gov. If you cannot check or verify your registration online and you are not claiming an
exemption, or if you have already received a Status Information Letter (SIL) from us in the past, please call
(888) 655-1825.
Please check each item. You should only submit this form if the following are true:

You have passed your 26th birthday
You have verified that you are in fact “NOT REGISTERED”
You were born after December 31, 1959
You are claiming that you were exempt from the requirement to register
You were born male or you are transgender (born female)
You have not received a Status Information Letter from us in the past

YOU MUST PROVIDE AT LEAST ONE RESPONSE to each of the seven (7) Sections below. We cannot process your letter
until we receive the required information and documents. Never send originals. KEEP A COPY of this form and any documents
or correspondence you send to us.

SECTION 1 - GENERAL INFORMATION
Type or Print Clearly (ALL CAPS) – Must be Readable.
Full Legal Name:

First Name

Middle Name

Last Name(s)

List any other names used (Include multiple last names):
Social Security Number:
Date of Birth:

Month / Day / Year

Current Mailing Address:

City

State

Zip Code

Daytime Telephone Number:
Email Address:
What is your reason for this SIL?
Financial Aid

Citizenship

Employment

Security Clearance

Other

List each City & State (Country if overseas) where you lived between your 18th and 26th birthdays.
Use a separate sheet if needed:

SECTION 2 - MILITARY
If you served in the U.S. military, attach your proof of military service, such as a copy of your DD Form 214, NGB Form
22, DD Form 4 (if still on active duty), etc. If you attended a service academy or military school, provide a letter from the
school or a transcript showing the dates.

To obtain proof of military service (DD Form 214, Official Military Personnel File), visit this
website Proof of military service (DD Form 214, Official Military Personnel file.
Have you ever served in the U.S. military or attended a military service academy/school?
Yes (Please Continue)
US Army

No (SKIP to Section 3)

US Navy

US Marine Corps

US Air Force

List dates of active duty service:

US Coast Guard

to

List dates of reserve duty service:

to

Did you attend a military service academy?
The United States Military Academy (USMA)
The United States Naval Academy (USNA)
The United States Air Force Academy (USAFA)
The United States Coast Guard Academy (USCGA)
List dates of attendance:

to

Were you enrolled in an officer procurement program at a military school or university?
The Citadel
University of North Georgia
Norwich University
Virginia Military Institute
Texas A&M
University of Virginia Polytechnic and State University
List dates of attendance:

to

SECTION 3 - INCARCERATED / INSTITUTIONALIZED / HOSPITALIZED
Please attach proof if you were CONTINUOUSLY incarcerated, institutionalized, hospitalized, or home confined for the
entire period from your 18th through 26th birthdays. If you were released, escaped, or otherwise out of custody for 30 days or
more, you do not need to complete this form. Call us at (888) 655-1825.
Were you CONTINUOUSLY incarcerated, institutionalized, hospitalized, or home confined for the entire period of time between
your 18th and 26th birthdays?
Yes (Please Continue)

No (SKIP to Section 4)

Please indicate the type of confinement and provide start and release dates. (Attach separate sheet if necessary)
Institutionalized

Incarcerated

Hospitalized

Home Confined

to

to

to

to

to

to

SECTION 4 - TRANSGENDER
The Military Selective Service Act, including the requirement to register, applies to all individuals who were designated male at
birth. If you were born female and have transitioned to male, you must provide a copy of your female birth certificate (or medical
documentation to show that a transition has taken place) and legal documentation to show any changes to your name.
My sex at birth was:
Male

Female (I have or will transition to male)

SECTION 5 - US CITIZENSHIP & IMMIGRATION STATUS
The Selective Service System does not share any information about an individual’s immigration status with outside
agencies such as U.S. Immigration and Customs Enforcement (ICE).
Are you a citizen of the United States by birth (born in the US, or overseas to qualifying US parents)?
Yes (SKIP to Section 6)

No (Please continue)

Did you become a Naturalized Citizen more than 30 days before your 26th birthday?
Yes

(SKIP to Section 6)

Naturalization Date

No (Please continue)

Did you become a Permanent Resident (Green Card Holder) more than 30 days before your 26th birthday?
Yes

(SKIP to Section 6)

Resident Since Date

No (Please continue)

You must provide documentation to support your claim. Valid documentation includes the date of entry stamp in your passport or
visa, I-94, or I-20 with date of entry stamp, or any other official document that was accepted, stamped, or signed by USCIS and
clearly states your arrival date. If you submit the electronic version of the I-94, you must include the accompanying travel history.
Please note, your Permanent Resident Card (Green Card) cannot be used to document the date you arrived in the
United States, even if the dates are the same.
If you entered the United States illegally, undocumented, without inspection, or for any other reason you cannot show proof of
your arrival date, you must provide documentation that shows you were living outside of the United States for each year between
your 18th and 26th birthdays. This could include school records, employment records, rent and utility receipts, participation in a
health insurance plan, tax returns, etc.
When did you first enter the United States and what was your immigration status?

Arrival Date

USCIS Status

Was the above date later than 30-days before your 26th birthday?
Yes, I was never in the United States (at any time, in any status) prior to this date. (Skip to Section 6)
No (Please continue)
Was the above arrival date earlier than your 18th birthday AND you left the country prior to your 18th birthday AND you did not
return to the United States (at any time in any status) until after the date that was 30 days before your 26th birthday?
Yes, I was never in the United States (at any time, in any status) between my 18th birthday and 30 days before my 26th birthday.

Arrival Date

USCIS Status

(Skip to Section 6)

No (Please continue)
For each period shown, you must provide documentation that shows you entered the United States as a valid non-immigrant
and that you adhered to the terms of your visa. For example, if you entered the United States as an international student and
remained in that status until your 26th birthday, you would need to provide documentation indicating that you were admitted
on an F-1 visa, attended school full-time as required, and either left the country or changed status when required. Acceptable
documents may include copies of your I-20s, visa, and transcripts, or a letter from the school stating the dates you attended there
as a full time international student. If OPT is authorized, the copy of the I-20 must reflect this. If you were on an H-1 visa, you
must provide documentation of your arrival/start date and a copy of the approved “Notice of Action”, an official company letter
showing your authorized dates of employment, or a W2 form showing you worked for the company that sponsored your visa.
The same applies for all non-immigrant statuses held. You must show your arrival/start date and documentation that shows you
remained in good status for the entire period. If you left the country, send a copy of the date stamp showing your arrival back

into your country. If you remained in the US and requested a change of status, send a copy of the approved “Notice of Action”
you received from USCIS.
You must include any times that you entered the United States illegally or without inspection, (no documentation is necessary).
Likewise, you must list any times when you violated the terms of your visa, overstayed your visa, or for any other reason became
an undocumented immigrant.
You should provide as much information as possible. We will use the information you send to determine your registration status.
For a list of acceptable documents, please see our List of acceptable documents.
Please list your immigration history showing all arrivals, departures and other changes in status, starting with the date
of arrival that first put you in the United States between your 18th and 26th birthdays and continuing until you were past
your 26th birthday. Use a separate sheet if necessary.

Arrival / Start Date

Good Until Date

Departure / End Date

USCIS Status

Arrival / Start Date

Good Until Date

Departure / End Date

USCIS Status

Arrival / Start Date

Good Until Date

Departure / End Date

USCIS Status

SECTION 6 - REASON FOR FAILURE TO REGISTER BEFORE AGE 26
Provide a written explanation for not registering with the Selective Service System. If you believe you did register, please provide
a detailed explanation in the space provided below stating when, where, and how you registered. Include all addresses you may
have used at that time.

SECTION 7 - YOUR SIGNATURE
Sign, date, and return this form to the address listed below with copies of ALL supporting documents showing proof of your
claim. You may include any other supporting information you would like us to consider. IMPORTANT: Do not send original
documents. The Selective Service System may not return original documents. You should retain a copy of all documents and
correspondence submitted.

Signature

Month / Day / Year

Selective Service System
ATTN: SIL
PO Box 94638
Palatine, IL 60094-4638

HELPFUL INFORMATION
•

Please print this form. This form cannot be submitted online. Please type all requested information on the form before
printing. ATTACH A COPY of all supporting documentation (DO NOT submit originals), and mail them to the address
provided.

•

This form is for use only by men born after December 31, 1959, who are not registered and are now 26 years and older or
transgender who were born females.

•

This form is not a registration form. Submitting this form will not register you with the Selective Service System.

•

We will issue a Status Information Letter based on the information you provide. KEEP the original copy in your permanent
files for future reference.

•

If you are denied a right, benefit, or privilege because you are not registered, submit a copy of your Status Information Letter
from the Selective Service System, and a separate letter in which you explain, to the best of your ability, the reasons for your
failure to register to the agency administering the right, benefit, or privilege. That agency, NOT the Selective Service System,
will make the final determination regarding your eligibility. The Selective Service System does not approve, disapprove, or
make any recommendations to determine your eligibility for any right, benefit, or privilege you are seeking.

•

Immigrant men over the age of 31 who are seeking naturalization and who did not register are no longer required to provide
a “status information letter” or documentation of their status from the Selective Service System to USCIS. If asked for a
status information letter, these men may print a form letter concerning their request for a letter for use with USCIS from
http://www.sss.gov.