Form G-1450, Authorization for Credit Card Transactions Completed Form Examples and Samples
Find clear, filled examples of Form G-1450, Authorization for Credit Card Transactions. Our samples help you correctly pay USCIS fees by credit card and avoid common mistakes.
Form G-1450 Example – Paying for an I-485 Application
How this form was filled:
This sample shows how to fill out Form G-1450 to pay for a USCIS application, specifically the I-485, Application to Adjust Status. The cardholder is the same as the applicant, and all fields, including the payment amount, credit card details, and signature, are completed correctly for the year 2026.
Information used to fill out the document:
- Applicant/Cardholder First Name: Maria
- Applicant/Cardholder Last Name: Garcia
- Credit Card Billing Address: 1234 Apple St, Apt 5B, Anytown, CA 90210
- Cardholder Daytime Phone Number: (213) 555-1234
- Cardholder Email Address: [email protected]
- Credit Card Type: Visa
- Credit Card Number: 4111-1111-1111-1111
- Credit Card Expiration Date: 06/2028
- Card Security Code (CVV): 123
- Payment Amount: $1,140.00
- Name of Applicant/Petitioner: Maria Garcia
- Signature of Cardholder: Maria Garcia
- Date of Signature: 10/26/2026
What this filled form sample shows:
- Clear identification of the applicant and cardholder as the same individual.
- Accurate entry of all credit card details, including card type, number, expiration date, and CVV.
- Correctly specified payment amount corresponding to the associated USCIS application (Form I-485).
- Legible signature and a current date to validate the payment authorization.
Form specifications and details:
| Form: | G-1450, Authorization for Credit Card Transactions |
| Use Case: | Individual paying their own filing fee for Form I-485, Application to Adjust Status |
| Filing Agency: | U.S. Citizenship and Immigration Services (USCIS) |
| Categories: | authorization forms, CAR forms, credit forms |
| Created: | February 05, 2026 08:31 PM |