Document Verification Request (United States)
This form is to verify documentation for the United States Citizenship and Immigration Services. The form provided here is simply a sample of what the actual Form G-845 looks like.
Department of Homeland Security
U.S. Citizenship and Immigration Services
G-845, Document Verification Request
Section A - To be completed by the submitting agency.
___________________________________ From: Typed or Stamped Name and Address of Submitting Agency
Attn: Status Verifier
1. Alien Registration Number or Form I-94 Number ___________________________________
2. Applicant's Name (Last, First, Middle) ___________________________________
3. Nationality ___________________________________
4. Date of Birth (mm/dd/yyyy) ___________________________________
5. U.S. Social Security Number ___________________________________
6. Verification Number ___________________________________
7. Photocopy of Document Attached.
(If printed on both sides, attach a copy of the front and back.)
Other Information Attached (Specify documents). ___________________________________
8. Organization (specify) ___________________________________
9. Name of Submitting Official ___________________________________
10. Title of Submitting Official ___________________________________
11. Date ___________________________________
12. Telephone Number ___________________________________
Section B-To be completed by USCIS
USCIS RESPONSE: From the documents or information submitted and/or a review of our records we find that:
1. This document appears valid and relates to a Lawful Permanent Resident alien of the United States.
2. This document appears valid and relates to a Conditional Resident alien of the United States.
3. This document appears valid and relates to an alien authorized employment as indicated below:
c. No Expiration (Indefinite)
d. Expires on: (Specify mm/dd/yyyy below)
4. This document appears valid and relates to an alien who has an application pending for: (Specify USCIS benefit below)
5. This document relates to an alien having been granted asylum/refugee status in the United States.
6. This document appears valid and relates to an alien paroled into the United States pursuant to Section 212 of the I&N Act.
7. This document appears valid and relates to an alien who is a Cuban/Haitian entrant.
8. This document appears valid and relates to an alien who is a conditional entrant.
9. This document appears valid and relates to an alien who is a nonimmigrant. (Specify type or class below)
10. This document appears valid and relates to an alien not authorized employment in the United States.
11. Continue to process as legal alien. USCIS is searching indices for further information.
12. This document is not valid because it appears to be: (Check all that apply)
a. ____ Expired
b. ____ Altered
c. ____ Counterfeit
13. No determination can be made from the information submitted. Please obtain a copy of the original alien registration documentation and resubmit.
14. No determination can be made without seeing both sides of the document submitted. (Please resubmit request.)
15. Copy of document is not readable. (Please resubmit request.)
For Purposes of Determining Only If Alien Is Permanently Residing Under Color of Law!
16. USCIS is actively pursuing the removal of an alien in this class/category.
17. USCIS is not actively pursuing the removal of an alien in this class/category at this time.