DHS Form 7001, Request for Case Assistance

OMB 1601-0004 Case Assistance (DHS Form 7001)

The Office of the Citizenship and Immigration Services Ombudsman (CIS Ombudsman) assists individuals and employers in resolving difficulties they are experiencing with U.S. Citizenship and Immigration Services (USCIS). If you have already tried to resolve your issue directly with USCIS, you may submit DHS Form 7001 to request case assistance from the CIS Ombudsman. You can submit this form online below.

The CIS Ombudsman is an independent office within the Department of Homeland Security and is not part of USCIS. We cannot provide legal advice.

Before You Submit a Request

Before asking us for help, you should:

Try to resolve your issue directly with USCIS.
Review the types of cases we can and cannot help with.

Go to our How to Submit a Case Assistance Request page for more information on both steps.

Please see our CIS Ombudsman Web Alerts page for information that could affect your case assistance request. We have alerts on:

How we are prioritizing case assistance requests
Healthcare and childcare workers may request expedited processing for Employment Authorization Documents
Temporary suspension of biometrics for H-4, L-2, and E nonimmigrants
Application Support Center (ASC) appointments

Submit DHS Form 7001 Online

You can submit the DHS Form 7001 online to receive case assistance. To do so, complete the form sections below and select the “Submit” button. Make sure to complete every section that applies to you and to check your information before submitting.

- The CIS Ombudsman’s Office does not accept fees.
- If a particular item does not apply to your case assistance request, please leave blank.
- Please attach scanned copies of any documents you received from or sent to USCIS or any other government entity that are related to your request for assistance. Additionally, you may submit other information or documentation that will help the CIS Ombudsman’s Office review your request for assistance.
- This form is not required. However, a properly completed form ensures that the Ombudsman’s Office receives the necessary information to assist with your case. If you do not properly complete the form, you may experience a delay in the process of your request for assistance.
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) If you are an Attorney/Accredited Representative, a copy of the Form G-28 filed with the application/petition; and (5) Other information or documentation that is important to the case.

--NOTICE--

Please note that while the CIS Ombudsman's Office provides impartial and independent recommendations to USCIS on how to resolve problems, the CIS Ombudsman's Office does not have the statutory authority to make or change USCIS decisions.

DHS Form 7001 - Privacy Act Statement:

Authority: 6 U.S.C. Section 272 authorizes the collection of this information.

Purpose: The CIS Ombudsman’s Office will use the information provided to assist an individual or employer with his or her Case Assistance Request.

Routine Use: The information will be used by and disclosed to DHS personnel and contractors or other agents who need the information to assist in activities related to your Case Assistance Request. DHS may also share the information provided in accordance with the routine uses listed in DHS/CISOMB-001 Virtual CIS Ombudsman System of Records Notice, 75 FR 18857 (April 13, 2010).

Disclosure: Furnishing this information is voluntary. However, failure to provide the requested information may delay or prevent the CIS Ombudsman’s Office from providing assistance with your case.

Paperwork Reduction Act Notice:

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: cisombudsman@hq.dhs.gov; Mailing Address: Citizenship and Immigration Services Ombudsman, U.S. Department of Homeland Security, Mail Stop 0180, Washington, D.C. 20528-0180), ATTN: PRA OMB 1601-0004.

* Indicates required field

1. Name: Please identify the name of the individual or employer (applicant/beneficiary/petitioner) encountering difficulties with USCIS. Do not enter the attorney/law firm’s name here.

Individual

Petitioning Company/Organization

Prefix

First Name

Middle Name

Last Name

Organization Name

Street Address

Apartment/Suite

City

State/Province

Zip/Postal Code

Country

Phone Number

Email Address

Email Address

Confirm Email

Phone Number

Fax

Please send any future correspondence through the U.S. Postal Service

Please send any future correspondence through the U.S. Postal Service

Birthdate

Birthdate: Year

Birthdate: Month

Birthdate: Day

Country of Citizenship

Hold down the Ctrl key (PC) or CMD key (Mac) for multiple selections.

Country of Birth

A-Number
A-
Please provide your A-Number, if applicable, to assist with the review of your request.

NOTE: Most A-Numbers are 9 digits and follow the following format: A012-345-678. If yours is 8 digits, please add a zero ("0") before the first number. If USCIS did not assign an A-Number to you, leave this section blank. While this is not a required field, the information provided will assist with our review.

Application/Petition Information (Sections 5 and 6)

5. Applications/Petitions Filed

List all applications and/or petitions pending with USCIS related to your request for assistance. Please provide the USCIS Receipt Date, USCIS Form Number, and Receipt Numbers in the three columns below. List all available receipt numbers. The receipt number is located in the top left corner of your Notice of Action (USCIS Form I-797). Receipt number format: EAC1012345678; MSC0944556677. Do not include dashes between the characters.

USCIS Receipt Date	Receipt Numbers	USCIS Form Number	Operations
USCIS Receipt Date USCIS Receipt Date: Year USCIS Receipt Date: Month USCIS Receipt Date: Day	Receipt Numbers	USCIS Form Number

more items

6. Type of Immigration Benefit Sought: Please provide the type of immigration benefit sought from USCIS. Check all that apply.

Nonimmigrant Status (ex. Student)

Immigrant Status (ex. Permanent Residency)

Citizenship or Naturalization

Asylum or Refugee Status

Interim Benefits (ex. Employment Authorization)

Waiver (ex. Waiver of Grounds of Inadmissibility)

Other

Please Specify: Limited to 200 characters

7. Reason for Inquiry/Case Assistance Request: Check all that apply. Provide a description in Section 8 and add documentation related to your inquiry in Section 12.
I am facing or am about to face an immediate adverse action or impact, an emergency or any other type of significant hardship, caused by an action/inaction/delay in processing by USCIS.

I am facing a problem that was not resolved through the normal processes provided by USCIS.

I am experiencing a delay with a case that is beyond the anticipated processing time.

I am incurring or am about to incur significant and unusual costs (including fees for professional representation that are not normally incurred).

I have received an action or decision that involves clear errors of fact or gross and obvious misapplication of the relevant law by USCIS.

Other

Please Specify: Limited to 200 characters.

8. Description of Your Case Problem

Describe the difficulties experienced with USCIS, including all responses USCIS provided. In Section 12, attach relevant correspondence concerning actions taken to resolve the issue before submitting to the Ombudsman’s Office including: receipt notices; requests for evidence; decisions; notices and any other correspondence from USCIS about your case. Limited to 2000 characters.

9. Prior Actions Taken:
Check all that apply and provide the additional information requested for each selection in the "Please Describe" section provided below. Note that if selecting "Visited MyUSCIS Case Status" you must indicate what additional actions were taken to remedy the problem before submitting your inquiry to the Ombudsman.

Visited MyUSCIS Case Status

Contacted USCIS at its toll-free number 1-800-375-5283.

Provide Referral Number (also referred to as SRMT Number)

Attended appointment with USCIS.

Provide Confirmation Number

Sent an e-mail to USCIS.

Provide date email sent:

Provide date email sent:: Year

Provide date email sent:: Month

Provide date email sent:: Day

Provide USCIS email address:

Contacted a U.S. Government Department or Agency for assistance.

Provide Name and Contact Information

Contacted a U.S. Congressional Representative for assistance.

Provide Name and Contact Information

Please Describe:

10. Person Preparing this Form:
Please indicate who is completing this form. Important: If you are the beneficiary of a pending petition, the petitioner must provide consent to the release of information relating to your case.

I am:
The individual or employer encountering difficulties with USCIS

A representative of a company/organization

An attorney/accredited representative

Other

The individual or employer encountering difficulties with USCIS.

Please Specify:

First Name

Middle Name

Last Name

Law Firm / Organization

Street Address

Apartment/Suite

City

State/Province

Zip/Postal Code

Country

Email Address

Email Address

Confirm Email Address

Phone Number

Fax

I have submitted a Form G-28 to USCIS as the attorney/accredited representative regarding applications or petitions related to this inquiry. A copy of my Form G-28 is attached.

I am an accredited representative of a religious, charitable, social service or similar organization established in the United States and recognized by the Board of Immigration Appeals pursuant to 8 CFR 292.1. The name and address of my organization is provided above.

I am an attorney and a member in good standing of the highest court of the following state, territory, insular possession, or District of Columbia and am not under a court or administrative agency order suspending, enjoining, restraining, disbarring, or otherwise restricting me in practicing law.

State of Bar Admission

Name of Court

Other

Explain fully: Limited to 200 characters.

12. Supporting Documentation: Attach additional information related to your case, such as paperwork you submitted to USCIS, documents you received from USCIS, or other information or documentation you feel is important to your case.

Include up to 10 attachments (Such as scanned images, PDF files, TXT files, and Word
documents. Valid file extensions are: doc, docx, gif, jpg, jpeg, pdf, png, ppt, pptx,
rtf, txt, tif, xls, xlsx.). No more than 5 megabytes of data may be uploaded.

Please Note: Any files greater than 5MB in size will be rejected. In addition, the total size for all files for each request cannot exceed 5MB in size. File name may not exceed 80 characters.

Documents can also be faxed to 202-357-0042 or mailed to:

Citizenship and Immigration Services Ombudsman
U.S. Department of Homeland Security
Attention: Case Assistance
Mail Stop 0180
Washington, DC 20528-0180

Supporting Documentation

Maximum 10 files.
128 MB limit.
Allowed types: doc, docx, gif, jpg, jpeg, pdf, png, ppt, pptx, rtf, txt, tif, xls, xlsx.
10 MB limit per form.

Fax Attachments

Check this if supporting documentation is going to be faxed.

Email Attachments

Check this if supporting documentation is going to be e-mailed.

Mail Attachments

Check this if supporting documentation is going to be mailed. Do not mail original documents. Only mail copies of documents.

13. Consent

Please note that if you are the beneficiary of an immigration petition, consent of the individual or employer that submitted the petition on your behalf is required. The petitioner must sign.

I certify, under penalty of perjury under the laws of the United States of America, that the foregoing is true and correct, and that I am the person encountering difficulties with USCIS (applicant/beneficiary/petitioner) and I understand that any falsification of this statement is punishable under the provisions of 18 U.S.C § 1001 by a fine of not more than $10,000 or by imprisonment of not more than five years or both, and that requesting or obtaining any record(s) under false pretenses is punishable under the provisions of 5 U.S.C. § 522a(i)(3) by a fine of not more than $5,000.

Alternatively, I am the legal representative of record for the person encountering difficulties with USCIS (applicant/beneficiary/petitioner). I have included a copy of Form G-28 previously filed with USCIS.

Pursuant to 5 U.S.C § 522a(b), I authorize the Office of the Citizenship and Immigration Services Ombudsman to release any and all information relating to me to U.S. Citizenship and Immigration Services.

Signature:

Attorney/Accredited Representative Declaration Signature:

^{I declare that I have prepared this form at the request of the named party in Section 1 and all responses are true and correct.}

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DHS Form 7001, Request for Case Assistance

Before You Submit a Request

Submit DHS Form 7001 Online

Topics

News

In Focus

How Do I?

Get Involved

About DHS

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DHS Form 7001, Request for Case Assistance

Before You Submit a Request

Submit DHS Form 7001 Online