How to Fill Out and Submit Form DS-4240: Certification of Identity

Form DS-4240, the Certification of Identity, is the one-page form the U.S. Department of State uses to verify who you are before it releases records about you under the Freedom of Information Act or the Privacy Act. You fill it in, sign it under penalty of perjury (or in front of a notary), and send it together with a written request letter that describes the records you want. Without it, the Department will not process the request.¹

When You Need to File It

Two situations call for the form. The first is a request for your own records held by the Department, such as passport files, visa application materials, or consular reports. The second is a request that authorizes the Department to send your records to someone else, like an attorney or family member. Either way, the form satisfies the identity-verification requirement of the Privacy Act of 1974, which bars federal agencies from disclosing personal records without confirming who is asking.²

A parent or legal guardian can file on behalf of a U.S. citizen or lawful permanent resident minor who is unmarried and under 18, as long as they attach documentation of the relationship. Minors who are citizens or permanent residents may also file on their own.³

Filling In the Identity Section

Download the current version at foia.state.gov. The top of the form asks for the information the Department uses to locate your file: full legal name (last, first, middle initial), date of birth, current mailing address, and place of birth. The regulation is specific about place of birth — it must list city, state, and country, not the country alone.³

You also have to state your citizenship or lawful permanent resident status. This is a regulatory requirement for every Privacy Act access request directed to the Department, not an optional field.³

The form has spaces for a Social Security number, green card number, and passport number. None of these are mandatory. The form itself notes that providing them “will assist the Department in matching the individual’s information provided in this request with the records that pertain to that individual.”⁴ If you have a common name, or the records span many years, including at least one of these identifiers helps the search staff avoid pulling the wrong file.

If the Records Were Created Under a Former Name

Writing a maiden name, a prior married name, or an earlier legal name on the form is not enough on its own. The regulation requires a separate statement, signed under penalty of perjury, confirming that you also used that name.³ Attach that statement to your submission.

Signing: Penalty of Perjury or Notary

The bottom of the form contains a declaration in which you certify that everything you wrote is true. The pre-printed language works under 28 U.S.C. § 1746, which allows a legally binding unsworn statement without a notary as long as the required wording is present and you sign and date the form.⁵

You can also have your signature notarized instead. The regulation accepts either approach.³ Neither has an advantage in processing, so pick whichever is easier. If you use a notary, make sure the seal and signature are legible.

The declaration is enforceable. Knowingly giving false information on a form submitted to a federal agency is a federal crime carrying fines and up to five years in prison.⁶

Authorizing Release to a Third Party

If you want the Department to send your records to someone else — a lawyer, a relative, an employer — complete the third-party authorization block in the lower portion of the form. Enter the third party’s full legal name and complete mailing address, and use the checkbox to identify the type of third party, including an option for legal representation.² The pre-printed language references 5 U.S.C. § 552a(b) and authorizes the Department to release “any and all information relating to” you to the named party.

Skipping this section closes the door. Without your signed authorization on the form, the Department will not share your records with anyone else regardless of the relationship. If a lawyer or family member submits a request on your behalf without a completed DS-4240 bearing your signature, the agency can process the request but will typically refuse to confirm or deny that responsive records exist.¹

How to Submit It

The DS-4240 does not travel alone. It goes in with a FOIA or Privacy Act request letter that describes the records you want in enough detail for the agency to find them. Naming dates, countries, bureaus, or case numbers keeps the search focused and reduces back-and-forth. Two channels are available:

By mail, to the Office of Information Programs and Services (IPS), A/ISS/IPS/RL, U.S. Department of State, Washington, D.C. 20522-8100.
Online, through the Public Access Link (PAL) portal at pal.foia.state.gov, where you can file the request electronically and upload the signed DS-4240 as an attachment.

The portal also lets you check status after submission, which mailing a paper form does not.

What Happens Next

IPS uses the DS-4240 to verify your identity before searching for records. A missing field or an unsigned declaration stalls the request until you fix it. If you filed by mail, you can follow up with IPS by phone or email using the case reference in the agency’s acknowledgment; if you filed through PAL, the portal shows the current status.

Fees for individuals requesting their own records are modest. The first two hours of search time and the first 100 pages of duplication are free, so most personal requests cost nothing unless the file is unusually large or hard to locate.⁷ Fee waivers exist, but they are meant for requests that significantly contribute to public understanding of government operations, and personal-record requests rarely qualify. Inability to pay is not, on its own, a basis for a waiver.⁸

Processing times vary. A narrow request for a small set of clearly identified records moves faster than a broad request spanning years and multiple bureaus. Plan for months on complex matters.

Asking for Expedited Processing

If you need records urgently, you can ask for expedited handling, but you have to show a “compelling need.” Federal law recognizes two qualifying situations: the delay could reasonably be expected to threaten someone’s life or physical safety, or you are primarily engaged in disseminating information and there is urgency to inform the public about government activity.⁹

Include a certified statement explaining why your situation fits. The agency has ten calendar days to grant or deny expedited processing.⁹

1
Office of Inspector General. Before Making a FOIA/Privacy Act Request
2
U.S. Department of State. DS-4240 Certification of Identity Form
3
eCFR. 22 CFR 171.22 – Request for Access to Records
4
U.S. Department of State. DS-4240 Certification of Identity Form
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Office of the Law Revision Counsel. 28 USC 1746 – Unsworn Declarations Under Penalty of Perjury
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Office of the Law Revision Counsel. 18 USC 1001 – Statements or Entries Generally
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eCFR. 22 CFR Part 171 – Public Access to Information
8
FOIA.gov. Freedom of Information Act – Frequently Asked Questions
9
Department of Justice. Ensuring Timely Determinations on Requests for Expedited Processing