Form DS-4194 "Request for Authentications Service"

What is Form DS-4194?

Form DS-4194, Request for Authentications Service, is necessary for documents submitted by U.S. citizens and foreign nationals to the U.S. Department of State. It is the responsibility of the Authentications Office to sign and issue certificates for these documents under the Seal of the U.S. Department of State. A DS-4194 Form needs to be completed for yourself or your company, along with a DS-4194 cover letter. This document was last updated in February 2012 by the U.S. Department of State.

Each separate request will require a new cover letter and failure to do so will result in rejection of your case and having your documents returned to you. All documents will be mailed back to a single location so accuracy is key.

A fillable DS-4194 PDF is available for download below.

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Download Form DS-4194 "Request for Authentications Service"

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U.S. Department of State
REQUEST FOR AUTHENTICATIONS SERVICE
SECTION 1: CUSTOMER CONTACT INFORMATION
Name (Last, First, MI)
Suffix/Prefix
E-mail
Home Phone
Extension
Cell Phone
Extension
Work Phone
Extension
Case Type (If Federal Agency Must Be Official Business)
Select
Specify
Country
Formal Mailing Address
Line 1
Line 2
City
State
ZIP Code
SECTION 2: COURIER/REPRESENTATIVE CONTACT INFORMATION
Are you submitting/retrieving this request on behalf of another individual?
Name (Last, First, MI)
Select
Company
Phone Number
Extension
SECTION 3: SHIPPING DETAILS (FOR MAILED IN REQUESTS ONLY)
Select
Delivery Method
Specify
Tracking Number
Shipping Address
Shipping Address
Same address as above
Line 1
Country
Line 2
City
State
ZIP Code
SECTION 4: DOCUMENT INFORMATION (CONTINUED ON NEXT PAGE)
Country
Number of Documents
Document Type
Document Label (Official Use Only)
Select
Select
Select
SECTION 5: PROJECTED COST
Total Number of Documents
Estimated Cost
DS-4194
Page 1 of 2
02-2012
U.S. Department of State
REQUEST FOR AUTHENTICATIONS SERVICE
SECTION 1: CUSTOMER CONTACT INFORMATION
Name (Last, First, MI)
Suffix/Prefix
E-mail
Home Phone
Extension
Cell Phone
Extension
Work Phone
Extension
Case Type (If Federal Agency Must Be Official Business)
Select
Specify
Country
Formal Mailing Address
Line 1
Line 2
City
State
ZIP Code
SECTION 2: COURIER/REPRESENTATIVE CONTACT INFORMATION
Are you submitting/retrieving this request on behalf of another individual?
Name (Last, First, MI)
Select
Company
Phone Number
Extension
SECTION 3: SHIPPING DETAILS (FOR MAILED IN REQUESTS ONLY)
Select
Delivery Method
Specify
Tracking Number
Shipping Address
Shipping Address
Same address as above
Line 1
Country
Line 2
City
State
ZIP Code
SECTION 4: DOCUMENT INFORMATION (CONTINUED ON NEXT PAGE)
Country
Number of Documents
Document Type
Document Label (Official Use Only)
Select
Select
Select
SECTION 5: PROJECTED COST
Total Number of Documents
Estimated Cost
DS-4194
Page 1 of 2
02-2012
Name (Last, First, MI)
Suffix/Prefix
E-mail
SECTION 4: ADDITIONAL DOCUMENTS (CONTINUED)
Country
Number of Documents
Document Type
Document Label (Official Use Only)
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
Select
DS-4194
Page 2 of 2
U.S. Department of State
REQUEST FOR AUTHENTICATIONS SERVICE
INSTRUCTIONS
PURPOSE
Form DS-4194 is used by the U. S. Department of State for documents submitted by U.S. citizens and foreign nationals. The Authentications Office is
responsible for signing and issuing certificates under the Seal of the U. S. Department of State for documents being submitted to foreign countries.
INSTRUCTIONS
Complete one copy of this form for yourself or your company to be submitted with your documents and payment. You must submit a new cover letter
for each request. Failure to do so will result in your case being rejected and documents being returned.
WARNING
Any false statement or concealment of a material fact may result in a delay or un-authenticated documentation.
FORM
DS-4194
SECTION 1: REQUESTOR'S CONTACT INFORMATION
Provide individual's full name or company's name (complete spelling). Indicate e-mail address; telephone number(s) home, work and/or cell.
If the document(s) were mailed or hand carried for a Federal Agency for Official Government business please indicate agency name, bureau
and/or office acronyms. Provide formal mailing address (include street address, city or town, zip code, province or country).
SECTION 2: SUBMITTER'S CONTACT INFORMATION
If you are submitting/or retrieving a request on behalf of someone other than yourself or a company, please provide specific and detailed information.
The full name of the individual's or company's name is required to properly search the database.
If you are retrieving document(s) your name must appear in section 2 of the intake form and State issued identification is required.
Provide individual's full name or company's name (complete spelling). Indicate e-mail address; telephone number(s) day time, evening or cell number.
SECTION 3: METHOD OF RETURN (MAIL-IN)
Indicate delivery method (type of mail service used to return the document). If this information is available, provide a tracking number and include all
letters and numbers (i.e., DOS, USPS, FED/EX, UPS, DHL & Others). Indicate the complete address that the document (s) will be returned to
for proper delivery.
It is imperative that the complete address is entered accurately! (i.e., street address, city, state, ZIP code & country). REVIEW INFORMATION FOR
ACCURACY!
Please note: All documents submitted will be returned to one location.
SECTION 4: DOCUMENT INFORMATION
Indicate the country (or countries) of use, the number of documents, and the document type. (A maximum of 15 documents are allowed per
customer/company person for walk-in services).
SECTION 5: METHOD OF PAYMENT
Please note: The authentication processing fee is $8.00 per document, not per page. This fee will be charged regardless of whether you receive an
authentication certification or a correspondence letter. This change in policy will take effect on April 1, 2012. Please pay the total amount shown in the
estimated cost field. (The exact amount is required.)
Allowable payment methods include U.S. Postal Money Orders, checks (personal, corporate, certified, cashiers, travelers) all payable to "U.S.
Department of State."
Walk-in service only: In addition to the payment methods noted above; Credit Cards and Debit/Check Cards (VISA, MasterCard, American Express,
Discover) are accepted.
DS-4194
Instructions Page 1 of 1
02-2012
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How to Fill Out Form DS-4194?

The Request for Authentications Service Form DS-4194 is comprised of five sections.

  • The first section asks for the applicant's contact information, including a formal mailing address (use your personal address if this is for you or the company address if it is for a company).
  • The second section asks for courier or representative contact information and will also ask if the person completing this form is submitting or retrieving this request on behalf of another individual. If this is the case, the request must have the entire name of the person or company submitting the DSW-4194 Form to properly search the database.
  • The third section asks for shipping details for only mailed in requests and is similar to the first section, except for an additional question for the delivery method.
  • Section four asks for document information, including the number of documents, document type, and contains an additional page on the next page if additional boxes are needed to complete the form. A maximum of 15 documents are allowed for walk-ins on a per person or company basis.
  • The fifth section is the projected cost and asks for the total number of documents, estimated cost, name, and email. There is an eight dollar processing fee per document (not per page). The fee will be applied whether or not an application certification or a correspondence letter is sent. This change went into effect April 1, 2012.

The exact total will need to be listed on the form in the section provided. Acceptable payment methods include U.S. Postal Service Money Orders, checks (corporate, certified, cashiers, personal, or travel) and can be made payable to "U.S. Department of State." Walk-ins are also allowed to pay by credit or debit/check cards (accepted cards are VISA, American Express, Discover, and MasterCard).

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