For filling out the “Request for Status Information Letter”
• Name (required): you must provide your complete name, and any other names you have ever
used. If you have more than one last name, you must provide both names.
• Address (required): you must include your complete mailing address. Forms received without a
mailing address will not be processed.
• Social Security Number (required, if you have one): If you have a social security number, you
must provide it. Also, if you have ever used a different social security number, provide it as well.
• Date of Birth (required): This form is only for men born after December 31, 1959, who are 26
years old or older. You must provide your complete date of birth.
• Daytime Telephone Number: If possible, provide a telephone number where you can be reached
during the day, in case we need to contact you.
• Email Address: If possible, provide your email address in case we need to contact you.
SECTION 2: (Requires dates and supporting documentation)
This section is for explaining and documenting why you did not register with Selective Service. This
section consists of five different parts. You must complete and submit documentation for any and all parts
that apply to you.
To obtain proof of military service (DD-214, Official Military Personnel File) write to: National Personnel
Records Center, GSA, Military Personnel Records Center, 9700 Page Blvd., St. Louis, MO, 63132.
Or visit http://www.archives.gov/veterans/military-service-records
Incarcerated, institutionalized, hospitalized, or home confined:
For each instance, provide type of confinement, dates of confinement, and supporting documentation.
Non-Citizen / Undocumented Immigrants:
If you entered the United States for the first time after your 26th birthday, you must provide
documentation to support your claim. Valid documentation includes: entry stamp in your passport, I-94
with entry stamp on it. If you entered the United States illegally after your 26th birthday, you must provide
proof that you were not living in the United States from age 18 to age 26. Please note: your Resident
Alien Card (Green Card) is not proof of entry to the United States.
If you entered the United States as a valid non-immigrant, and remained in that status to your 26th
birthday, you must provide documentation to support your claim. For example, if you entered the United
States as an F-1 student, and remained in that status until your 26th birthday, you would need to provide
documentation indicating that you were admitted on an F-1 visa and attended school full-time as
required. (Acceptable documents for this situation include copies of your I-20s or a letter from the school
you attended indicating your full time attendance as a non-immigrant). The same thing applies for all non-
immigrant statuses. You must explain, if at any point, you violated the terms of your visa, or overstayed
your visa and became an undocumented immigrant.
You should provide as much information as possible. We will use the information you provide to
determine your registration status.
Page 3 of 4