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: you must include your complete mailing
address. Forms received without a mailing address will
not be processed.
Social Security Account Number: If you have a Social
Security Number, you must provide it. Also, if
you have ever used a different Social Security Account
Number, provide that as well.
of Birth: 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.
E-mail Address: If possible, provide your e-mail
address in case we need to contact you.
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
Incarcerated, institutionalized, hospitalized, or confined to
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 valid as proof of entry to the United States.
If you entered the United States as a valid non-immigrant alien,
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 document
s for this situation include copies of your I-20s or a letter
from the school you attended indicating your full time
as a non-immigrant alien). 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 alien.
You should provide as much information as possible. We will use
the information you provide to determine your registration
For individuals who have had a sex change. You must indicate
what gender you were born as, and attach documentation which
indicates this as well.
Reason why you failed to register with Selective Service upon
reaching age 18 and before reaching age 26:
Provide a written explanation for not registering with Selective
Sign and date the letter. Return this letter to the
address listed with copies of supporting documents showing
proof, and anything else
you may wish to include. Do not send original documents,
as they will not be returned. You should retain a copy
of all documents and correspondence submitted.
This form is designed to be printed for use, and cannot
be completed online. After printing, complete the form,
attach all appropriate documentation, and mail to: Selective
Service System, ATTN: SIL, PO Box 94638, Palatine, IL
form is for use only by men born after December 31, 1959,
who are not registered and are now 26 years old or older.
form is not a registration form, and by submitting it,
you will not be registered.
you feel that you have already registered, verify your
registration on our website (www.sss.gov), or call our
Registration Information Office at (847) 688-6888 to obtain
your Selective Service number.
will issue a Status Information Letter based on the information
you provide. This letter will clarify your status with
you are being denied a right, benefit, or privilege because
you are not registered, submit a copy of your Status Information
Letter and an explanation for your failure to register,
to the Agency administering the right, benefit, or privilege.
That Agency will make the final determination regarding
your eligibility. The Selective Service System does not
determine your eligibility for any right, benefit, or