G-845, Document Verification Request
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2OMB No. 1615-0101; Expires 07/31/2011
Department of Homeland Security
G-845, Document Verification Request
U.S. Citizenship and Immigration Services
Section A. To Be Completed by the Submitting Agency
To:
U.S. Citizenship and Immigration Services (USCIS)
6.
Verification Number
7.
Photocopy of Document Attached
(If printed on both sides, attach a copy of the front and back.)
Other Information Attached (Specify documents)
From: Typed or Stamped Name and Address of Submitting Agency
8. Organization (Specify)
Attn:
Immigration Status Verification Unit
(USCIS may use above address with a No. 10 window envelope)
1. Alien Registration Number or Form I-94 Number
2. Applicant's Name (Last, First, Middle)
9.
Name of Submitting Official
3. Nationality
10. Title of Submitting Official
4. Date of Birth (mm/dd/yyyy)
11. Date (mm/dd/yyyy)
5. U.S. Social Security Number
12. Telephone Number
(
)
Section B. To Be Completed by USCIS
USCIS RESPONSES: From the documents or information submitted and/or a review of our records, we find that:
This document appears valid and relates to an alien who is a
1.
This document appears valid and relates to a Lawful
8.
conditional entrant.
Permanent Resident alien of the United States.
This document appears valid and relates to an alien who is a
This document appears valid and relates to a Conditional
9.
2.
nonimmigrant.
Resident alien of the United States.
(Specify type or class below)
This document appears valid and relates to an alien authorized
3.
employment as indicated below:
a. Full-Time
This document appears valid and relates to an alien not
10.
authorized employment in the United States.
b. Part-Time
Continue to process as legal alien. USCIS is searching indices
11.
for further information.
c. No Expiration (Indefinite)
This document is not valid because it appears to be:
d. Expires on (Specify mm/dd/yyyy below):
12.
(Check all that apply)
a. Expired
This document appears valid and relates to an alien who has an
b. Altered
4.
application pending for:
c. Counterfeit
(Specify USCIS benefit below)
USCIS Stamp
This document relates to an alien having been granted asylum/
5.
refugee status in the United States.
This document appears valid and relates to an alien paroled
6.
into the United States pursuant to Section 212 of the I&N Act.
This document appears valid and relates to an alien who is a
7.
Cuban/Haitian entrant.
Form G-845 (Rev.07/25/08)Y
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