Department of Homeland Security
U.S. Citizenship and Immigration Services
G-845, Immigration Status/Document Verification Request
Section A. -
To be completed by the submitting agency.
To:
U.S. Citizenship and Immigration Services (USCIS)
From:
Typed or Stamped Name and Address of submitting Agency
(USCIS may use above address with a No. 20 window envelope.)
Attn:Status Verifier
5.6.
Photocopy of Document Attached.(If printed on both sides, attach a copy of the
front and back
.)Other Information Attached
(Specify documents.)
8.
(Benefit)
TANFEducation Grant/Loans/WorkstudyFood StampsHousing AssistanceMedicaid/Medical AssistanceUnemployment Insurance
Other
(specify)
(Your Case Number)
12.11.10.9.
OMB No. 1653-0032; Expires 06/30/08
1.
Alien Registration Number or I-94 Number
2.
Applicant's Name (Last, First, Middle)
3.
Citizenship/Nationality
For U.S. Department of Labor Use Only:
Provide 18-months of employment authorization document history data under
No. 19,
"Other" on
Page 2
.Date (mm/dd/yyyy)Telephone Number (
4.
Date of Birth (mm/dd/yyyy)
7.
Name of Submitting Official
Title of Submitting Official)Verification 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:
1.Lawful Permanent Resident alien
of the United States.
2.Conditional Resident alien
of the United States.
3.Refugee
under Section 207 of the INA.
4.Asylee
under Section 208 of the INA.
5.
Alien
paroled
into the United States pursuant to Section212(d)(5) of the INA as indicated below:
6.
Alien who is a
Cuban/Haitian
entrant as defined bySection 501(e) of the REAA of 1980.
7.
Alien who is a
conditional entrant
.
10.U. S.
citizen.11.
Alien
authorized employment
as indicated below:
a.
No Expiration (Indefinite).
b.
Expires on:
See Page 2 for additional comments.
Form G-845 (Rev. 01/06/06) YFor a period of one year or more.
a.b.
For a period of less than one year.(Specify USCIS benefit below.)Alien who has an
application pending
for:
9.
Alien who is a
nonimmigrant.
8.
USCIS Stamp
The person identified is a/an:
(mm/dd/yyyy)Alien not authorized employment in the United States.
12.
(Specify type or class and admitted to date.)
Search History:
Result 00 of 00
00 results for result for
p.
Notes
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