Instructions For Form G-845 - Verification Request (Page 2 of 4) in pdf

3. Complete Item Numbers 1. - 16.

Item Numbers 1a. - 1.d. Immigration Document Numbers. Enter the Alien Registration Number (A-Number) or

Form I-94 Number in the space provided or both the A-Number and Form I-94 Number if both numbers are listed on the

provided document. The A-Number is the letter "A" followed by a 7, 8, or 9-digit number. The Form I-94 Number is

found on Form I-94, Arrival-Departure Record, and is 11 digits. (Check the front and back of the Form I-94. If you

received a paper Form I-94, check the front and back of the Form I-94. If the A-Number appears, record that number

when requesting information because the A-Number refers to the most integral record available.)

Enter any other immigration numbers, such as the applicant's foreign passport number or Certificate of Citizenship document

number, in the data collection box entitled "Other Immigration Number." Provide the name or form numbers of the

documents that contain these immigration numbers in the next data collection box. If it is a foreign passport, include the

name of the country of issuance. These numbers can be included with the A-Number and Form I-94 Number.

If you are requesting immigration status verification based on a VAWA self-petition, submit copies of the self-petitioner's

documents relating to the VAWA self-petition. These immigration documents may include a Form I-797 Receipt notice,

or a Form I-797 Notice of Determination of a Prima Facie case and/or a Form I-797 Notice of Approval.

Item Numbers 2.a. - 2.c. Full Name. Enter the applicant's last name, first name, and middle name exactly as printed on

the immigration document.

Item Number 3. Case Verification Number. Enter the 15-digit case verification number if a query was initiated in the

SAVE online system. If the SAVE online system was not used, leave this blank.

Item Number 4. Date of Birth. Enter the applicant's date of birth in the mm/dd/yyyy format.

Item Number 5. U.S. Social Security Number. Enter the applicant's U.S. Social Security Number, if applicable.

Item Number 6. Student and Exchange Visitor Information System (SEVIS) Number. Enter the applicant's SEVIS

number, if applicable.

Item Number 7. Citizenship or Nationality. Enter the applicant's citizenship or nationality.

Item Numbers 8.a - 8.b. Documents Attached. Select all applicable boxes to indicate information attached. If an

immigration document is printed on both sides, you must attach a copy of both the front and back of the document.

Ensure copies are legible. If you are attaching other information, ensure that it is only another immigration document or

numeric identifier. A state issued driver's license or identification card or a Social Security Card is not acceptable.

Item Numbers 9.a - 9.l. Benefits Sought. Select the boxes corresponding to the benefits that the applicant is seeking

from the submitting agency.

Item Numbers 10. - 14. Registered Agency Information. Enter the Registered Agency case number, if applicable, and

the submitting official's first and last name, title, daytime telephone number, extension number, and fax number in the

spaces provided.

Item Number 15. Date Request Completed. Enter the date that the submitting official completed the Form G-845.

Item Number 16. Registered Agency Comments (if any). The Registered Agency may enter additional information

about the immigration verification request. Use this box for providing additional information or comments such as:

Aliases;

Date of entry into the United States;

Previous receipt numbers; and

Special requests from the Registered Agency.

Form G-845 Instructions 05/20/15 N

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Instructions For Form G-845 - Verification Request Page 2