G-1041A-2016 FeeRule-83C-FRM-09062016

G1041A-TOC-2016 FeeRule-83C-FRM-09212016.docx

Genealogy Index Search Request and Genealogy Records Request

G-1041A-2016 FeeRule-83C-FRM-09062016

OMB: 1615-0096

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1615-0096 can be found here:

Document [docx]

Download: docx | pdf

TABLE OF CHANGES – FORM

Form G-1041A, Genealogy Records Request

OMB Number: 1615-0096

Date: 10/01/2016

Reason for Revision: Updates are required for Form G-1041A due to a Fee Increase.

Current Page Number and Section

Current Text

Proposed Text

Page 1,

Part 1. Information About You (Requestor)

Requestor’s Certification

By my signature, I consent to pay all costs incurred for search, duplication, and review of documents up to $35. (See Form G-1041A Instructions for more information.)

6.a. Requestor’s Signature

6.b. Date of Signature (mm/dd/yyyy)

Requestor’s Certification

By my signature, I consent to pay all costs incurred for search, duplication, and review of documents up to $65. (See Form G-1041A Instructions for more information.)

6.a. Requestor’s Signature

6.b. Date of Signature (mm/dd/yyyy)

Page 2,

Part 3. Identification of Requested Record

NOTE (C-file numbered C650000 and below): The fee for a copy of a microfilm record is $20 per request.

NOTE (C-file numbered C650000 and below): The fee for a copy of a textual hard copy file is $35 per request.

NOTE: If you are a researcher providing a C-file number below C-6500000 obtained from any source other than the USCIS Geneology Program, you may not know the format of the file (microfilm or hard copy). Therefore, you will be unable to determine the fee. In this case, submit the $20 fee. If the C-file is found in hard copy format, we will notify you to remit the additional $15.

Naturalization Certificate File (1906-1956)

1.a. Certificate Number C

1.b. Date of Naturalization (mm/dd/yyyy)

1.c. Court

1.d. City

1.e. Country

1.f. Fee (Select all appropriate boxes)

__ $20 (Microfilm)

__$35 (Hard Copy)

Non-standard C-Files (B, D, OM, OS, A, AA, OL)

2.a. Number as Shown on Certificate

2.b. Date of Issuance (mm/dd/yyyy)

Alien Registration Record (AR-2) (1940-1944)

3.a. Alien Registration Number (A-Number) A or AR

3.b. Fee $20 (Copy Format-Microfilm)

A-File numbered below 8 million

4.a. A-File Number A

4.b. Fee $35 (Copy Format-Hard Copy)

Visa File (1924-1944)

5.a. Visa Number

5.b. Date of Entry (mm/dd/yyyy)

5.c. Port-of-Entry

5.d. Ship (seaport arrivals only)

5.e. Fee __$35 (Copy Format-Hard Copy)

Registry File (1929-1944)

6.a. Registry File Number R

6.b. Fee __$35 (Copy Format- Hard Copy)

Total Fees Due/Attached

NOTE (C-file numbered C650000 and below): The fee for a copy of a microfilm record is $65 per request.

NOTE (C-file numbered C650000 and below): The fee for a copy of a textual hard copy file is $65 per request.

NOTE: If you are a researcher providing a C-file number below C-650000 obtained from any source other than the USCIS Geneology Program, you may not know the format of the file (microfilm or hard copy).

[Deleted]