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Instructions pour le formulaire G-845, Demande de vérification

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Instructions for Form G-845, Verification Request  
Form G-845  
OMB No. 1615-0101  
Expires 04/30/2024  
Department of Homeland Security  
U.S. Citizenship and Immigration Services  
What Is the Purpose of This Form?  
An agency that is registered with the U.S. Citizenship and Immigration Services’ (USCIS) Systematic Alien Verification for  
Entitlements (SAVE) Program may file this form to request immigration status verification information for an applicant.  
Who May File This Form?  
Any agency that has executed a Memorandum of Agreement with the USCIS SAVE Program.  
General Instructions  
For each applicant you must complete a separate Form G-845, Verification Request, and include copies of documents only  
for that individual. If a family unit applies for a benefit, submit a separate Form G-845 for each family member.  
If you do not follow the instructions, USCIS’ SAVE Program may return this form without a verification response, which  
may delay processing.  
USCIS provides forms free of charge through the USCIS Web site. 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  
Copies. Submit copies (front and back) of the applicant’s most recently issued immigration documentation. In addition  
to the most recently issued immigration documentation, you may also submit any relevant documents bearing on the  
applicant’s immigration status or admission. Ensure that copies are legible and made from an original document.  
How To Fill Out Form G-845  
1. Type or print legibly in black ink.  
2. If you need extra space to complete any item within this request, attach a separate sheet of paper; type or print  
applicant’s last name, first name, and Case Verification Number at the top of each sheet; and indicate the Page  
Number, Part Number, and Item Number to which the information refers.  
3. If you are filling the form out manually, type or print the applicant’s last and first name and Case Verification Number  
at the top of each page. For example: Smith, John, 123456789123456.  
Specific Instructions  
Part 1. Information From the Registered Agency  
NOTE: Only the Registered Agency should complete the information in this part of the request.  
1. In the Tosection, stamp, type, or print the mailing address of the Registered Agency’s assigned Status Verification  
Office; you can find this address at  
2. In the “From” section, stamp, type, or print the Registered Agency’s name and mailing address with ZIP Code.  
NOTE: You MUST enter a complete return address with ZIP code into the “From” portion of the form. You also  
MUST complete ALL items in Part 1. (SAVE may use this portion of the form to display your address in a number  
10 window envelope.)  
Form G-845 Instructions 04/08/21  
Page 1 of 4  
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:  
1. Aliases;  
2. Date of entry into the United States;  
3. Previous receipt numbers; and  
4. Special requests from the Registered Agency.  
Form G-845 Instructions 04/08/21  
Page 2 of 4  
Part 2. USCIS Responses  
Only USCIS should complete the information in this part of the request.  
Part 3. USCIS Comments  
Only USCIS should complete the information in this part of the request.  
Processing Information  
Upon receipt, the SAVE Program Status Verification Office will review the form for completeness, including submission  
of any attached documents. If the Form G-845 is not completely filled out, USCIS will return the request to you with  
no verification response.  
If the Form G-845 is submitted without a copy of the applicant’s most recently issued immigration documentation, USCIS  
will return it to you with no verification response.  
If USCIS responds to the verification request by selecting Item Number 19. in Part 2., USCIS Responses, Additional  
USCIS Responses, “USCIS is searching indices for further information,” this indicates that USCIS cannot find the  
requested immigration status information immediately. In such a case, USCIS will conduct further records research.  
While this search is pending, USCIS will return a copy of the unprocessed Form G-845 and Form G-1120, Status  
Verification Return Checklist, to notify you that the case is pending. USCIS will return the original Form G-845 to you  
when we have completed our research and prepared a final response. The applicant may still be in lawful immigration  
status, or have employment authorization, even if USCIS does not provide an immediate response.  
USCIS Forms and Information  
To ensure you are using the latest version of this form, visit the USCIS Web site at where you can obtain  
the latest USCIS forms and immigration-related information. If you do not have Internet access, you may order USCIS  
forms by calling our toll-free number at 1-800-375-5283. You may also obtain forms and information by calling the  
USCIS Contact Center at 1-800-375-5283. For TTY (deaf or hard of hearing) call: 1-800-767-1833.  
USCIS Privacy Act Statement  
USCIS AUTHORITIES: The information requested on this form, and the associated evidence, is collected under the  
Immigration and Nationality Act, sections 101, et seq.  
PURPOSE: The primary purpose for providing the information on this form is to verify the status of the applicant.  
DISCLOSURE: Failure to provide the requested information, and any requested evidence, may delay a response to your  
ROUTINE USES: DHS may share the information you provide on this form with other Federal, state, local, and foreign  
government agencies and authorized organizations under approved routine uses described in the associated published  
system of records notices [DHS/USCIS-004 - Systematic Alien Verification for Entitlements Program System of Records,  
September 21, 2011, 76 FR 58525], which you can find at DHS may also make the information  
available, as appropriate, for law enforcement purposes or in the interest of national security.  
Form G-845 Instructions 04/08/21  
Page 3 of 4  
Paperwork Reduction Act  
An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection  
of information, unless it displays a currently valid OMB control number. The public reporting burden for this collection  
of information is estimated at 5 minutes per response, including the time for reviewing instructions and completing  
and submitting the request. Send comments regarding this burden estimate or any other aspect of this collection of  
information, including suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services, Office of  
Policy and Strategy, Regulatory Coordination Division, 5900 Capital Gateway Drive, Mail Stop #2140, Camp Springs,  
MD 20588-0009; OMB No. 1615-0101. Do not mail your completed Form G-845 to this address.  
Form G-845 Instructions 04/08/21  
Page 4 of 4