Form G-884 - Request For The Return Of Original Documents
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2OMB No. 1615-0100; Expires 12/31/2012
G-884, Request for the
Department of Homeland Security
Return of Original Documents
U.S. Citizenship and Immigration Services
START HERE - Type or print in black ink
For USCIS Use Only
Part 1. Information About You
(Person requesting the return of original
Remarks
documents)
Given Name
Middle Name
Family Name
Mailing Address - Street Number and Name
Apt./SuiteNumber
File No.
Date
City
Zip Code
A-Number (if any)
State
Daytime Phone Number
Date of Birth
City/Town/Village of Birth
Country of Birth
(with area code)
(mm/dd/yyyy)
Specific information about desired document(s) or record(s) (e.g., marriage license, birth certificate, death certificate, etc.)
Part 2. Data for Identification of Personal Record
(Person requesting the return of original documents)
Family Name
Given Name
Middle Name
Other Names Used (if any)
Date of Birth
Place of Birth
Date of Entry
Port of Entry
Type of Entry
A-Number (if any)
(mm/dd/yyyy)
(mm/dd/yyyy)
(visitor, student, etc.)
Name on Certificate of Naturalization
Certificate of
Certificate of Naturalization
Naturalization Number
Date (mm/dd/yyyy)
Name on Certificate of Citizenship
Certificate of
Certificate of Citizenship
Citizenship Number
Date (mm/dd/yyyy)
Naturalization Court/USCIS Office and Location
Verification of Identity
In person with
Legible photocopies
identification
Form G-884 (12/11/11)Y
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