OMB 1601-0004; Exp. 12/31/2014
USCIS may be able to provide the answer to many frequently asked questions such as:
Before asking the Ombudsman's Office for help with your application or petition, you should first try to resolve the problem with USCIS by using the following methods:
While there is no time limit to complete this form, this form cannot be saved. Your session will time out after 20 minutes of inactivity.
You will need to have the following information available in order to complete this form, if applicable: (1) A-Number;
(2) All USCIS receipt numbers related to each application or petition; (3) Documents submitted to or received from USCIS;
(4) Attorney/Accredited Representative information, if represented; and (5) Other information or documentation that is important to the case.
Please note that while the Ombudsman's Office provides impartial and independent recommendations to USCIS on how to resolve problems,
the Ombudsman's Office does not have the statutory authority to make or change USCIS decisions.
All information submitted to the Citizenship and Immigration Services Ombudsman is collected and protected under the provisions of the Privacy Act.
By submitting this information to the Citizenship and Immigration Services Ombudsman,
you consent to our review of your information and allow us to contact USCIS on your behalf.
Your consent allows the Citizenship and Immigration Services Ombudsman to resolve your case inquiry and identify systemic immigration issues.
The public reporting burden to complete this information collection is estimated at one hour per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the necessary data,
and completing and reviewing the collected information. An agency may not conduct or sponsor,
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 and expiration date.
Send comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden to the Office of the Citizenship and Immigration Services Ombudsman,
[E-mail: firstname.lastname@example.org; Mailing Address: Citizenship and Immigration Services Ombudsman,
U.S. Department of Homeland Security, Washington, D.C. 20528-0180], ATTN: PRA OMB 1601-0004.