G-845 Supplement, Document Verification Request Supplement

Download G-845 Supplement

Purpose of Form:

This form reflects information that may be relevant to eligibility for Federal, State, and local public benefits under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Pub. L. 104-193.

Number of Pages:


Edition Date:

07/25/08. Previous editions accepted.

Where to File:

Submit this form in conjunction with Form G-845: it cannot be used alone.

Filing Fee:


Special Instructions:

This form should not be used alone, but only in conjunction with Form G-845 to request verification.

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