G 845 Form Fillable PDF Details

In the intricate tapestry of U.S. immigration and citizenship procedures, various documents play critical roles in ensuring that individuals and agencies navigate these processes efficiently and accurately. Among these, the Form G-845, or Document Verification Request, stands out as a vital tool used by registered agencies to request verification of an individual's immigration status from the U.S. Citizenship and Immigration Services (USCIS). Conceived under the umbrella of the Department of Homeland Security, this form facilitates the Systematic Alien Verification for Entitlements (SAVE) Program, aimed at aiding agencies in determining an applicant's eligibility for various public benefits including but not limited to Temporary Assistance for Needy Families (TANF), unemployment insurance, educational grants, and housing assistance. It requires detailed information about the applicant, including their immigration document number, name, nationality, date of birth, and the specific benefit for which eligibility verification is sought. Furthermore, the response segment from USCIS categorizes the individual's status, offering vital feedback on aspects such as lawful permanent residency, employment authorization, and more. Expiry dates, conditional aspects of residency, and other status nuances are addressed, highlighting the comprehensive nature of this verification process. The form not only underscores the intersection of immigration status with entitlement to public benefits but also reflects the broader commitment to maintaining the integrity and accountability of such programs.

QuestionAnswer
Form NameG 845 Form Fillable
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other names2011, I-94, OMB, entrant

Form Preview Example

Department of Homeland Security

OMB No. 1615-0101; Expires 01/31/2015

Form G-845, Document Verification Request

U.S. Citizenship and Immigration Services

 

 

 

 

 

 

Section A. To Be Completed by Registered Agency Only

To: U.S. Citizenship and Immigration Services (USCIS)

Attn: USCIS SAVE Program Status Verification Office

From: Type or Stamp Name and Address of Registered Agency

9.Check all that apply:

a. Photocopy of primary immigration document attached. Ensure copies are legible. If there is print on both sides of the immigration document, attach a copy of front and back.

b. Other Information Attached (specify documents):

Print clearly since USCIS may use above agency address with a No. 10 window envelope.

1.Immigration Document Number: Alien Registration Number (A-Number)

A-

I-94 (Arrival-Departure Record) Number

►

Other immigration number (if A-Number/I-94 Number not available):

Identify document containing the other immigration number:

2.Applicant's name as shown on the immigration document (Last, First, Middle)

3.Nationality

4. Date of Birth (mm/dd/yyyy):►

5. Social Security Number:

6.Student and Exchange Visitor Information System (SEVIS)

Number: ►

7.Case Verification Number

8.Registered Agency Case Number

10. Benefit

 

 

 

 

 

 

 

 

 

 

TANF

 

 

Unemployment Insurance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Education Grant/

 

 

Employment

 

 

 

 

 

 

Loan/ Work Study

 

 

Authorization

 

 

 

 

 

 

 

 

Food Stamps

 

 

Social Security Number

 

 

 

 

 

 

 

 

 

 

 

 

Housing Assistance

 

 

SSI or RSDI

 

 

 

 

 

 

 

 

 

 

 

 

Medicaid/Medical

 

 

Driver's License/ID

 

 

 

 

 

 

Assistance

 

 

 

 

 

 

 

 

 

 

 

Background Check

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other (specify below)

 

 

 

 

 

 

 

 

 

 

 

 

11. Name of Agency Official

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12. Title of Agency Official

 

 

 

 

 

 

 

 

13.Telephone Number (include area code)

(

 

 

 

)

 

 

 

-

14. Fax Number (include area code):

15. Date (mm/dd/yyyy): ►

Form G-845 01/08/12 N

Section A. To Be Completed by Registered Agency Only (CONTINUED)

Registered Agency Comments

Section B. To Be Completed by USCIS

USCIS RESPONSES: After review of the documents and/or information submitted, and/or of our records, we find that the document appears valid and relates to a/an:

1. Lawful Permanent Resident alien of the United States.

2. Conditional Resident alien of the United States.

3. Alien employment authorized in the United States as indicated:

a. No expiration (indefinite)

b. Expires on (mm/dd/yyyy):

c. Prior employment authorization date(s):

7. Alien paroled into the United States under section 212 of the Immigration and Nationality Act (INA).

a. No expiration (Indefinite)

b. Parole granted on (mm/dd/yyyy):

c. Parole expires on (mm/dd/yyyy):

8. Cuban/Haitian entrant of the United States.

9. Conditional entrant of the United States.

10. Nonimmigrant alien.

(Specify type or class below):

11. American Indian born in Canada to whom the provisions of section 289 of the INA apply. Date

4.Alien not employment authorized in the United States.

5.Alien has an application pending for (specify USCIS benefit):

6.Alien granted asylum or refugee status in the United States.

status recognized (mm/dd/yyyy):

12. U.S. Citizen.

OTHER USCIS RESPONSES:

13. USCIS is searching indices for further information.

14. This document is not valid because it appears to be: (Check all that apply)

a. Expired

b. Altered

c. Counterfeit

Form G-845 01/08/12 N Page 2

Section C. USCIS Comments

1.Unable to process request without an original consent of disclosure statement signed by the applicant. Resubmit request.

2.No determination can be made from the information submitted. Obtain copy of the original alien registration document. Resubmit request.

3.No determination can be made without seeing both sides of the documents submitted. Resubmit request.

4.Cannot read document copy. Resubmit request.

5.Other:

USCIS Stamp

Form G-845 01/08/12 N Page 3

How to Edit G 845 Form Fillable Online for Free

Dealing with PDF files online can be very easy with our PDF tool. Anyone can fill in 2011 here effortlessly. Our editor is constantly evolving to give the very best user experience achievable, and that's due to our resolve for constant enhancement and listening closely to feedback from customers. Here is what you'd want to do to begin:

Step 1: Click on the orange "Get Form" button above. It will open our editor so that you could start filling in your form.

Step 2: As soon as you open the file editor, you will notice the document all set to be filled out. Besides filling out different fields, you may as well do other sorts of actions with the file, specifically writing any words, modifying the original text, inserting images, affixing your signature to the PDF, and more.

Be attentive while filling in this form. Ensure every single field is done accurately.

1. The 2011 will require particular information to be entered. Ensure that the following fields are complete:

Part # 1 for filling out Massachusetts

2. The next stage is usually to fill in all of the following fields: available, Identify document containing the, number, Housing Assistance, SSI or RSDI, MedicaidMedical Assistance, Drivers LicenseID, Applicants name as shown on the, Background Check, Last First Middle, Nationality, Other specify below, Date of Birth mmddyyyy, Name of Agency Official, and Social Security Number.

A way to fill out Massachusetts step 2

3. This next section is considered fairly straightforward, Registered Agency Case Number, Date mmddyyyy, and Form G N - every one of these form fields has to be completed here.

Date mmddyyyy, Form G N, and Registered Agency Case Number in Massachusetts

4. The fourth part arrives with the next few fields to consider: Registered Agency Comments, Section B To Be Completed by USCIS, USCIS RESPONSES After review of, Alien paroled into the United, and section of the Immigration and.

Filling out segment 4 of Massachusetts

5. Last of all, the following final portion is what you will have to wrap up prior to finalizing the PDF. The blanks at issue are the following: USCIS RESPONSES After review of, section of the Immigration and, Lawful Permanent Resident alien, Conditional Resident alien of the, Alien employment authorized in, indicated, a No expiration indefinite, b Expires on mmddyyyy, c Prior employment authorization, a No expiration Indefinite, b Parole granted on mmddyyyy, c Parole expires on mmddyyyy, CubanHaitian entrant of the, Conditional entrant of the United, and Nonimmigrant alien.

a No expiration indefinite, c Parole expires on mmddyyyy, and a No expiration Indefinite of Massachusetts

Be really mindful while filling in a No expiration indefinite and c Parole expires on mmddyyyy, as this is where most people make some mistakes.

Step 3: Make sure that your details are correct and then click "Done" to continue further. Join us right now and instantly gain access to 2011, ready for downloading. Every last edit you make is conveniently preserved , helping you to change the document later when required. FormsPal ensures your data confidentiality via a protected method that in no way records or distributes any private data provided. You can relax knowing your files are kept safe whenever you work with our editor!

G 845 Form Fillable isn’t the one you’re looking for?

Related Documents