Instructions For Form G-639 - Freedom Of Information Act/privacy Act Request (Page 2 of 7) in pdf

General Instructions

USCIS provides forms free of charge through the USCIS website. In order to view, print, or fill out our forms, you should

use the latest version of Adobe Reader, which you can download for free at If you do not

have Internet access, you may call the USCIS National Customer Service Center at 1-800-375-5283 and ask that we mail

a form to you. For TTY (deaf or hard of hearing) call: 1-800-767-1833.

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 5. Additional

Information or attach a separate sheet of paper; type or print your 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 type or print “N/A,” unless otherwise

directed. If your answer to a question which requires a numeric response is zero or none type or print “None,” unless

otherwise directed.

Specific Instructions

Form G-639 is divided into five parts. The following information will help you complete the request.

NOTE: Providing the information requested on this request 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.c. 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. Select the appropriate box to indicate whether you are the Subject of Record. If you answer “No,”

indicating you are requesting access to another individual’s records, complete all information in 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. - 2.c. Requestor’s Full Name. Provide your full legal name in the spaces provided.

Item Numbers 3.a. - 3.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 4. - 6. Requestor’s Contact Information. Provide your daytime telephone number, mobile telephone

number (if any), and email address (if any).

Form G-639 Instructions 04/17/17 N

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