Form G-1256 08/10/15
Page 1 of 2
Declaration for Interpreted USCIS Interview
Department of Homeland Security
U.S. Citizenship and Immigration Services
Form G-1256
Internal Use
Interviewee's Name
Interviewee's Alien Registration Number
Interviewee's Native Language(s)
Interpreter's Name
Interpreter's Address
Copy of Interpreter's Identity Document Attached
Languages Used by Interpreter
Yes No
I authorize the interpreter named above to act on my behalf as my interpreter during my interview with U.S. Citizenship and
Immigration Services (USCIS).
I fully understand that this interpreter's participation in the interview may result in him/her learning of my personal information
related to my benefit request, and I consent to this disclosure.
I have communicated with this interpreter, and I am satisfied that the interpreter has the ability to speak and understand a
language that I speak.
I understand that my interpreter must be fluent in English and a language I understand, competent to interpret in accordance with
USCIS guidance, and impartial and unbiased throughout the interview.
I understand that USCIS, at its discretion, may determine at any point before or during my interview that this interpreter may no
longer serve as an interpreter for the entire interview or portions of the interview.
My interpreter is at least 18 years of age and is not a witness in my case. If my interpreter is 14 through 17 years of age or is a
witness in my case, I understand I must show good cause for an exception to USCIS policy in order for my interpreter to serve.
I understand that my attorney or accredited representative cannot serve simultaneously as my interpreter during the interview.G.
The interpreter has interpreted this entire form to me and I fully understand the contents of this document.H.
Interviewee's Signature
I am appearing today at the request of the individual whose name and Alien-number appear above (“the interviewee”).A.
I speak and understand both English and the non-English language indicated above fluently, and know from speaking with the
individual that we understand each other.
I agree to interpret accurately, literally and fully the questions asked by the officer and the answers given by the interviewee
during the interview.
I understand that I must be fluent in both English and a language that the interviewee named above understands, competent to
interpret in accordance with the guidance provided by the USCIS officer, and impartial and unbiased throughout the interview.
Interpreter's Telephone Number
I agree not to disclose any personal information about the interviewee or any other information that I may learn in the interview.E.
Interviewee's Declaration
Interpreter's Declaration
I understand that USCIS may choose to collect, retain, and verify the identity information I have provided.F.
Form G-1256 08/10/15
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The applicant/interviewee and the interpreter both signed this document in my presence on . Date (mm/dd/yyyy)
USCIS Officer's Signature
USCIS Officer's Typed or Printed Name
The interpreter was disqualified for the following reasons:
I, , the applicant/interviewee, understand that my interpreter has been
disqualified by USCIS. I understand that I may request that my interview be rescheduled for the purposes of finding a qualified
I request that USCIS reschedule my interview so that I may retain the services of a qualified interpreter. Yes No
USCIS Officer's Signature
USCIS Officer's Typed or Printed Name
Supervisory USCIS Officer's Signature
Supervisory USCIS Officer's Typed or Printed Name
The applicant/interviewee has opted to continue the interview without the assistance of his/her chosen interpreter.
USCIS Officer's Signature
USCIS Officer's Typed or Printed Name
Interviewee's Signature
Interviewee's Typed or Printed Name
Withdrawal of Interpreter
Interpreter's Disqualification
USCIS Officer's Declaration
I certify that I am qualified to act as an interpreter and that I have interpreted the contents of this form to the interviewee. He or
she has stated that he or she understood me.
Interpreter's Signature
Date (mm/dd/yyyy)
I understand that USCIS, in its discretion, may determine before or at any point during the interview that I may no longer serve as
an interpreter for the entire interview or for certain portions of the interview.
Field Office Location