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Get USCIS G-639 2012

Number and Name) Apt. Number City State Date of Birth (mm/dd/yyyy) Zip Code Place of Birth The Subject of Record must provide a signature under either a Notarized Affidavit of Identity or a Sworn Declaration Under Penalty of Perjury: Notarized Affidavit of Identity Signature of Subject of Record Subscribed and sworn to before me this Date (mm/dd/yyyy) day of Signature of Notary Telephone No. My Commission Expires on Sworn Declaration Under Penalty of Perjury Executed outside the Unit.

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