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Інструкція по формуванню G-1041

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Instructions for Genealogy Index Search Request  
Form G-1041  
OMB No. 1615-0096  
Expires 08/31/2025  
Department of Homeland Security  
U.S. Citizenship and Immigration Services  
What Is the Purpose of Form G-1041?  
You should use Form G-1041 to request a search of U.S. Citizenship and Immigration Services (USCIS) historical  
databases. To obtain copies of USCIS historical records, use Form G-1041A, Genealogy Records Request.  
Requests for searches of USCIS historical databases are used to determine whether any USCIS records exist on the  
immigrant and, if such records exist, to capture the file number and/or other identifier of each record.  
Who Should Use Form G-1041?  
You should use this Form G-1041 if you are a:  
1. Researcher seeking records of your ancestors for genealogical or family history purposes;  
2. Historian or social scientist seeking historical records of persons you can identify by name, date of birth, and place of  
birth; or  
NOTE: For information about the Index Search process, visit Searching The Index at www.uscis.gov/genealogy.  
When Should Form G-1041 Not Be Used?  
You should not use Form G-1041 to request:  
1. Records of naturalization prior to September 27, 1906. Consult Federal records stored at the National Archives and  
Records Administration (NARA) Record Group 21, at www.archives.gov/research/guide-fed-records/groups/021.  
html or contact the clerk of the court where the naturalization occurred;  
2. Sea, land, or air passenger manifest lists recording arrivals prior to December 1982. For these documents, contact  
3. Certification of Nonexistence of a Naturalization Record. All these requests must be submitted to the USCIS Records  
4. Information related to living persons. This information must be requested from the Freedom of Information Act  
5. Deportation records.  
NOTE: For any records not specifically mentioned in Form G-1041 or not available through any other USCIS program,  
use Form G-639, Freedom of Information/Privacy Act Request.  
What Information Is Required To Begin an Index Search?  
The following information is required to initiate a search of USCIS historical indices:  
1. Required Information:  
A. Immigrant’s full name (last, first, and middle);  
B. Alias names or variant spellings, if any;  
Form G-1041 Instructions 08/10/22  
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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 www.uscis.gov/genealogy.  
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 www.get.adobe.com/reader/. 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.)  
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Evidence. At the time of filing, you must submit all evidence and supporting documentation listed in the What  
Information Is Required To Begin an Index Search section of these Instructions.  
Copies. You may submit legible photocopies of documents requested, unless the Instructions specifically state that you  
must submit an original document. USCIS may request an original document at the time of filing or at any time during  
processing of an application, petition, or request. If you submit original documents when not required, the documents  
may remain a part of the record, and USCIS will not automatically return them to you.  
Translations. If you submit a document with information in a foreign language, you must also submit a full English  
translation. The translator must sign a certification that the English language translation is complete and accurate, and that  
he or she is competent to translate from the foreign language into English. The certification should also include the date,  
the translator’s signature and printed name, and may contain the translator’s contact information.  
How To Fill Out Form G-1041  
1. Type or print legibly in black ink.  
2. If you need extra space to complete any item within this request, use the space provided in Part 4. Additional  
Information or attach a separate sheet of paper; type or print your name and Alien Registration Number (A-Number)  
(if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer  
refers; and sign and date each sheet.  
3. Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been  
married and the question asks “Provide the name of your current spouse”), type or print “N/A,” unless otherwise  
directed. If your answer to a question which requires a numeric response is zero or none (for example, “How many  
children do you have” or “How many times have you departed the United States”), type or print “None,” unless  
otherwise directed.  
We recommend that you print or save a copy of your completed request to review in the  
future and for your records.  
What Evidence Must You Submit?  
You must submit all evidence requested in these Instructions with your request. If you fail to submit required evidence,  
USCIS may reject or deny your request for failure to submit requested evidence or supporting documents in accordance  
with 8 CFR 103.2(b)(1) and these Instructions.  
What Is the Filing Fee?  
The filing fee for Form G-1041 is $65.  
NOTE: The filing fee is not refundable, regardless of any action USCIS takes on this request. DO NOT MAIL CASH.  
You must submit all fees in the exact amounts.  
Use the following guidelines when you prepare your check or money order for the Form G-1041 filing fee:  
1. The check or money order must be drawn on a bank or other financial institution located in the United States and must  
be payable in U.S. currency; and  
2. Make the check or money order payable to U.S. Department of Homeland Security.  
NOTE: Spell out U.S. Department of Homeland Security; do not use the initials “USDHS” or “DHS.”  
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Notice to Those Making Payment by Check. If you send us a check, USCIS will convert it into an electronic funds  
transfer (EFT). This means we will copy your check and use the account information on it to electronically debit your  
account for the amount of the check. The debit from your account will usually take 24 hours and your bank will show it  
on your regular account statement.  
You will not receive your original check back. We will destroy your original check, but will keep a copy of it. If USCIS  
cannot process the EFT for technical reasons, you authorize us to process the copy in place of your original check. If your  
check is returned as unpayable, USCIS will re-submit the payment to the financial institution one time. If the check is  
returned as unpayable a second time, we will reject your request and charge you a returned check fee.  
How To Check If the Fees Are Correct  
Form G-1041’s filing fee is current as of the edition date in the lower left corner of this page. However, because USCIS  
fees change periodically, you can verify that the fees are correct by following one of the steps below.  
1. Visit the USCIS website at www.uscis.gov, select “FORMS,” and check the appropriate fee; or  
2. Call the USCIS National Customer Service Center at 1-800-375-5283 and ask for fee information. For TTY (deaf or  
hard of hearing) call: 1-800-767-1833.  
Where To File?  
Please see our website at www.uscis.gov/G-1041 or call our National Customer Service Center at 1-800-375-5283 for the  
most current information about where to file this request. For TTY (deaf or hard of hearing) call: 1-800-767-1833.  
Processing Information  
Initial Processing. Once USCIS accepts your request we will check it for completeness. If you do not completely fill out  
this request, you will not establish a basis for your eligibility and USCIS may reject or deny your request.  
Requests for More Information. We may request that you provide more information or evidence to support your  
request. We may also request that you provide the originals of any copies you submit. USCIS will return any requested  
originals when they are no longer needed.  
DHS Privacy Notice  
AUTHORITIES: The information requested on this historical records request, and the associated evidence, is collected  
under 8 CFR parts 103.38 through 103.41.  
PURPOSE: The primary purpose for providing the requested information on this request form is to assist USCIS with  
identifying and obtaining copies of the requested USCIS historical records.  
DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and  
any requested evidence, prevents USCIS from processing your request.  
ROUTINE USES: DHS may share the information you provide on this form with other Federal, state, local, and foreign  
government agencies and authorized organizations. DHS follows approved routine uses, as described in the associated  
published system of records notice [DHS/USCIS/ICE/CBP-001 Alien File, Index, and National File Tracking System of  
Records] and as described in the published privacy impact assessment [DHS/USCIS/PIA-017(a) Microfilm Digitization  
Application System], which you can find at www.dhs.gov/privacy. DHS may also share the information, as appropriate,  
for law enforcement purposes or in the interest of national security.  
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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 Office of Management and Budget (OMB) control number. The  
public reporting burden for this collection of information is estimated at 30 minutes per response, including the time for  
reviewing instructions, gathering the required documentation and information, completing the request, attaching necessary  
documentation, 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. 1615-0096. Do not mail your completed Form G-1041 to this address.  
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