Instructions For Genealogy Index Search Request (Form G-1041) (Page 2 of 5) in pdf

C. Date of birth (provide whether date given is exact or an estimated year); and

D. Country or place of birth.

2. Additional data will help identify a certain immigrant from others with the same name, such as:

A. Date of the immigrant’s arrival in the United States (provide whether the date is actual or estimated); and

B. The immigrant’s residences in the United States including exact street address, city, and/or state. (For example,

you could type or print, “in Pennsylvania until 1938, then lived in Madison, Wisconsin.”)

3. If the immigrant’s date of birth is less than 100 years before today’s date, you must attach documentary proof of death

to this request. Examples of acceptable documentary proof of death include:

A. Death certificate (uncertified copy);

B. Printed obituaries, funeral programs, or photographs of gravestones;

C. Bible, church, or other religious records;

D. U.S. Social Security Death Index records (individual records only, not lists);

E. Records relating to the payment of death benefits; and

F. Other documents demonstrating that the immigrant of the request is deceased.

Submit a copy of one of these items with this request. Do not include original records because USCIS will not return

such documents.

What If the Required Information Is Not Provided?

USCIS cannot make any search without at least the immigrant’s name, year of birth, and country of birth. If the

immigrant appears in USCIS records under a name other than that provided, we will return no matching records. We will

search alternative names only if you provide the names, spellings, and aliases. Similarly, if multiple immigrants with the

same name appear having the identical birth year and country, we will return no matching records (for example, actual

or estimated date of arrival or naturalization, or place of residence when naturalized.) USCIS can identify an immigrant

from among others with the same name only if you provide additional information.

NOTE: We will consider foreign versions of names as the same (for example, Giuseppe and Joseph, which are different

spellings of the same name.)

To learn about various foreign spellings of common names and about alternate sources for some USCIS record file

numbers, visit the USCIS Genealogy Program website at

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.

Signature. Each request must be properly signed and filed. For all signatures on this request, USCIS will not accept a

stamped or typewritten name in place of a signature. If you are under 14 years of age, your parent or legal guardian may

sign the request on your behalf. A legal guardian may also sign for a mentally incompetent person.

Filing Fee. Each request must be accompanied by the appropriate filing fee. (See the What Is the Filing Fee section of

these Instructions.)

Form G-1041 Instructions 12/23/16 N

Page 2 of 5

Instructions For Genealogy Index Search Request (Form G-1041) Page 2