Fillable Form I-600A Approval: Petition to Classify Orphan as (USCIS)

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Form I-600A Approval: Petition to Classify Orphan as (USCIS)

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U.S. Citizenship and Immigration Services (USCIS) is an office of the U.S. Branch of Homeland Security (DHS) that oversees the nation's naturalization and migration framework. It is a successor to the Immigration and Naturalization Service (INS), which was disintegrated by the Homeland Security Act of 2002 and supplanted by three segments inside the DHS: USCIS, Immigration and Customs Enforcement (ICE), and Customs and Border Protection (CBP).

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Page 1 of 17Form I-600 Edition 12/21/19

Petition to

Classify Orphan as an Immediate Relative

Department of Homeland Security

U.S. Citizenship and Immigration Services

USCIS

Form I-600

OMB No. 1615-0028

Expires 12/31/2021

START HERE - Type or print in black ink. Complete a separate petition for each child. This petition is made to classify an

orphan as your immediate relative.

Part 1. Information About You (Petitioner)

Family Name (Last Name)

Middle Name (if applicable)Given Name (First Name)Family Name (Last Name)

Given Name (First Name) Middle Name (if applicable)

Other Names Used (if any)

►

You must be a U.S. citizen in order to file this petition. See the What Are the Eligibility Requirements section of the Form

I-600 Instructions for more information.

Married Unmarried

For U.S. Government Use Only

The petitioner is:

Action Block

Provide all other names you have ever used, including aliases, maiden name, and nicknames. If you need extra space to complete

this section, use the space provided in Part 10. Additional Information.

Receipt/Fee Stamp

Approved

Department of State Actions:

Transfer to USCIS as Not Clearly

Approvable

Transfer to USCIS as Consular Return

Form I-600A Approval

The petitioner is approved to adopt an

orphan from (if specified):

Approval Valid Until (mm/dd/yyyy):

PAIR Letter Issued Date (if applicable)

(mm/dd/yyyy):

(Name of non-Hague Convention Country)

Final Adjudicating Office/Post:

Officer Signature and Date:

Child's Legal Name after Adoption:

Your Contact Information

City or Town State ZIP Code

Street Number and Name Apt. Flr. NumberSte.

3. U.S. Mailing Address (if any)

In Care Of Name (if any)

Select this box if

Form G-28 or G-28I

is attached.

Attorney State Bar Number

(if applicable)

Attorney or Accredited Representative

USCIS Online Account Number (if any)

To be Completed By

an Attorney or

Accredited

Representative (if any)

Page 2 of 17Form I-600 Edition 12/21/19

Part 1. Information About You (Petitioner) (continued)

Is your current U.S. mailing address the same as your U.S. physical address?

If you answered "No," provide your U.S. physical address in Item Number 5. or your address abroad in Item Number 6., as

appropriate.

4. NoYes

Number

Address Abroad (if any)

Street Number and Name

City or Town State

Apt. Flr.Ste.

Postal CodeProvince Country

Number

U.S. Physical Address (if any)

Street Number and Name

City or Town State ZIP Code

Apt. Flr.Ste.

Daytime Telephone Number7.

Mobile Telephone Number (if any)8.

Email Address (if any)9.

Information About Your U.S. Citizenship

10. USCIS Online Account Number (if any)

►

11. Date of Birth (mm/dd/yyyy)

City/Town/Village of Birth 12. State or Province of Birth13.

Country of Birth14.

How did you obtain your U.S. citizenship?

Your Name On the Certificate of Citizenship

If you answered "Yes," provide the following information about your Certificate of Citizenship:

If you obtained your citizenship through your parents, have you obtained a Certificate of Citizenship in

your own name?

15.

Birth Parents Naturalization

Yes No

Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)

Certificate of Citizenship Number

►

A-

Alien Registration Number (A-Number) (if any)

Place of IssuanceDate of Issuance

(mm/dd/yyyy)

Page 3 of 17Form I-600 Edition 12/21/19

Part 1. Information About You (Petitioner) (continued)

Middle Name (if applicable)Given Name (First Name)Family Name (Last Name)

A-Number (if any)

►

A-

Date of Naturalization Place of Naturalization

Certificate of Naturalization Number

Your Name On the Certificate of Naturalization

If you obtained your citizenship through naturalization, provide the following information about your Certificate of Naturalization:

Have you EVER renounced or lost U.S. citizenship or has anyone you obtained citizenship through (such as

your parent or grandparent) EVER lost U.S. citizenship?

16.

Yes No

NOTE: If you answered "Yes," provide a detailed explanation in the space provided in Part 10. Additional Information.

17. What is your marital status? DivorcedMarriedSingle WidowedSeparated

How many times have you been married (including your current marriage, if applicable)?18.

NOTE: If you are not currently married, skip to Item Number 30.

Information About Your Current Marriage

21.

Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)

Name of Your Current Spouse

Other Names Your Current Spouse Has Used (if any)

Given Name (First Name) Family Name (Last Name) Middle Name (if applicable)

Spouse's A-Number (if any)

►

A-

Spouse's Country of Birth

Spouse's State or Province of Birth

Spouse's Date of Birth (mm/dd/yyyy)

Spouse's City/Town/Village of Birth

Provide all other names your spouse has ever used, including aliases, maiden name, and nicknames. If you need extra space to

complete this section, use the space provided in Part 10. Additional Information.

Spouse's USCIS Online Account Number (if any)

►

22.

(mm/dd/yyyy)

19. Date of Current Marriage (mm/dd/yyyy)

20. Place Where Current Marriage Occurred

Information About Your Current Spouse23.

Page 4 of 17Form I-600 Edition 12/21/19

Part 1. Information About You (Petitioner) (continued)

Does your current spouse reside with you? 25.

24. How many times has your current spouse been married (including your current marriage, if applicable)?

If you answered "No," provide your current spouse's physical address in Item Number 26.

Yes No

Your Current Spouse's Physical Address (if applicable)

NumberStreet Number and Name Apt. Flr.Ste.

State ZIP Code

Province

City or Town

Postal Code Country

26.

Spouse's Daytime Telephone Number

Spouse's Email Address (if any)

Spouse's Mobile Telephone Number27. 28.

29.

Your Spouse's Contact Information

Additional Household Members

How many persons 18 years of age or older (other than your spouse, if married) reside with you?

If you answered "1" or more, you MUST complete Form I-600A/I-600 Supplement 1, Listing of Adult Member of the Household,

for each person.

30.

Name (First/Middle/Last)

Date of Birth

(mm/dd/yyyy)

Country of Birth A-Number (if any) Relationship to You

List all of your children who are under 18 years of age. Also include any other children under 18 years of age who reside in your

household, regardless of your relationship to those children. If you need extra space to complete this table, use the space provided

in Part 10. Additional Information.

31.

If you answered "No," provide your spouse's current U.S. immigration status:

Is your spouse a U.S. citizen? Yes No

If you answered "Yes," how did your spouse obtain U.S. citizenship? Birth Naturalization Parents

Page 5 of 17Form I-600 Edition 12/21/19

Part 1. Information About You (Petitioner) (continued)

Information About Prior Filings or Adoptions

If you need extra space to complete Item Numbers 32. - 37., use the space provided in Part 10. Additional Information.

Have you ever previously filed Form I-600, Form I-600A, Application for Advance Processing of an Orphan

Petition, Form I-800A, Application for Determination of Suitability to Adopt a Child From a Convention

Country, Form I-800, Petition to Classify Convention Adoptee as an Immediate Relative, or Form I-130,

Petition for Alien Relative, for an adopted child?

32.

Yes No

If you answered "Yes," provide the following information for EACH petition and/or application:

Type of Petition/Application Filed:

Form I-600A Form I-600 Form I-800A Form I-130 (for an adopted child)

Result: Approved Denied Withdrawn

Other (please explain):

Date (mm/dd/yyyy)

Revoked

Have you previously completed a domestic adoption of a child within the U.S.? 33. Yes No

If you answered "Yes," provide the following information for each completed domestic adoption of a child.

State And County Where Adoption Was Finalized Date Adoption Was Finalized (mm/dd/yyyy)

Have you ever previously attempted to adopt a child internationally or domestically, but the adoption was

disrupted before it was finalized? An adoption is disrupted if you (or a custodian escorting the child on your

behalf) are granted legal custody or guardianship of the child, but the adoptive placement is interrupted before

the adoption was finalized.

34. Yes No

If you answered "Yes," provide a detailed description of the disruption.

Have you ever previously completed an adoption, either in the United States or abroad, that was later dissolved?

An adoption is dissolved if your parental rights over the adopted child are terminated at any time after the

adoption was finalized.

35. Yes No

If you answered "Yes," provide a detailed description of the dissolution.

Have you ever previously placed a child in the care of another person with the intent to transfer permanent

custody of the child?

36. Yes No

If you answered "Yes," provide a detailed description of the placement.

Have you ever received a child with the intent to gain permanent custody, but without involving child welfare

or other state/local authorities or following a the state/local process?

37. Yes No

If you answered "Yes," provide a detailed description of the custody transfer.

Page 6 of 17Form I-600 Edition 12/21/19

Part 1. Information About You (Petitioner) (continued)

You and your spouse (if married) must answer the following questions. See the Duty of Disclosure section in the Form I-600

Instructions concerning your ongoing duty to disclose information in response to these questions. If you or your spouse answer "Yes" to

any of the questions in Item Number 38. and 39., provide a certified copy of the documentation showing the final disposition of each

incident which resulted in arrest, indictment, conviction, and/or any other judicial or administrative action and a written statement giving

details, including any mitigating circumstances about each arrest, signed by you and/or your spouse (if married) under penalty of perjury

under U.S. law. The written statement must show the date of each incident; place incident occurred (city/town, state/province, country);

name of police department or other law enforcement administration or other entity involved; date of incarceration and name of facility, if

applicable. Provide a description of any type of counseling, rehabilitation, or other information that you and your spouse (if married)

would like considered in light of this history in the space provided in Part 10. Additional Information.

Duty of Disclosure

Have you EVER, whether in or outside the United States:38.

A. Been investigated, arrested, cited, charged, indicted, convicted, fined, or imprisoned for breaking or

violating any law or ordinance? (Answer "Yes," even if the record of the arrest, conviction, or other

adverse criminal history was expunged, sealed, pardoned, or the subject of any other amelioration. Do

not include traffic violations, except for violations for driving or operating a vehicle while intoxicated

or while impaired by or under the influence of alcohol or other intoxicant.)

Yes No

Received a pardon, amnesty, rehabilitation decree, other act of clemency, or similar action?B. NoYes

C. Received a suspended sentence, been placed on probation or parole, or been in an alternative

sentencing or rehabilitation program, such as diversion, deferred prosecution, deferred or withheld

adjudication, or expungement of a criminal charge?

Yes No

Been the subject of any investigation at any time, even if closed or unsubstantiated, by any child

welfare agency, court, or other official authority in any state or foreign country concerning the abuse or

neglect of any child?

NoYes

39. Has your spouse EVER, whether in or outside the United States:

A. Been investigated, arrested, cited, charged, indicted, convicted, fined, or imprisoned for breaking or

violating any law or ordinance? (Answer "Yes," even if the record of the arrest, conviction, or other

adverse criminal history was expunged, sealed, pardoned, or the subject of any other amelioration.

Do not include traffic violations, except for violations for driving or operating a vehicle while

intoxicated or while impaired by or under the influence of alcohol or other intoxicant.)

Yes No

Received a pardon, amnesty, rehabilitation decree, other act of clemency, or similar action?B. NoYes

C. Received a suspended sentence, been placed on probation or parole, or been in an alternative

sentencing or rehabilitation program, such as diversion, deferred prosecution, deferred or withheld

adjudication, or expungement of a criminal charge?

Yes No

Been the subject of any investigation at any time even if closed or unsubstantiated, by any child

welfare agency, court, or other official authority in any state or foreign country concerning the abuse

or neglect of any child?

NoYes

Part 2. Information About the Orphan Beneficiary

Name at Birth

Given Name (First Name) Family Name (Last Name) Middle Name (if applicable)

Current Name

Middle Name (if applicable)Family Name (Last Name) Given Name (First Name)

Page 7 of 17Form I-600 Edition 12/21/19

Given Name (First Name) Family Name (Last Name) Middle Name (if applicable)

Other Names the Orphan Has Used 3.

Provide all other names the orphan has ever used, including aliases and nicknames. If you need extra space to complete this

section, use the space provided in Part 10. Additional Information.

5. Date of Birth (mm/dd/yyyy)4. Gender

Male Female

City/Town/Village of Birth

7. Country of Birth8.State or Province of Birth

The beneficiary is an orphan because (select only one box):

He or she has a sole or surviving parent who is incapable of providing proper care and who has in writing irrevocably

released the child for emigration and adoption.

He or she has no parents due to the death or disappearance of, abandonment or desertion by, or separation or loss from

both parents.

If the orphan has a sole or surviving parent, answer the following:

A. What happened to the other birth or previous parent?

B. Is the remaining parent capable of providing proper care for the orphan?

10.

Has the remaining parent irrevocably released the orphan for emigration and adoption, in writing?C. Yes No

NoYes

11. Did you adopt the orphan abroad? Yes No

12. Did your spouse (if married) adopt the orphan abroad? Yes No

Part 2. Information About the Orphan Beneficiary (continued)

Did you or your spouse (if married) personally see and observe the child before or during the adoption

proceedings? (This does not include the visa interview and issuance.)

If you answered "Yes" to Item Number 11. or Item Number 12., provide the following information:13.

NoYes

B. C.Date of Adoption (mm/dd/yyyy) Place of Adoption

If you answered "No" to either Item Number 11., Item Number 12., or Item A. in Item Number 13., provide the following

information:

A. Do you and your spouse (if married) intend to adopt the orphan in the United States?

14.

Yes No

Provide a written description of all the pre-adoption requirements of the state of the orphan's proposed residence and cite any

relevant state statutes and regulations. If the state of the orphan's proposed residence does not have any pre-adoption

requirements, indicate "not applicable."

NOTE: If you need extra space to complete Items A. - D., use the space provided in Part 10. Additional Information.

Page 8 of 17Form I-600 Edition 12/21/19

Part 2. Information About the Orphan Beneficiary (continued)

Will any pre-adoption requirements be met at a later time?D. NoYes

Have any pre-adoption requirements of the orphan's proposed state of residence already been met? NoYes

If you answered "Yes," provide which requirements have been met.

If you answered "Yes," describe the steps you will take to comply with these requirements.

If you answered "No," provide each pre-adoption requirement that will not be met and explain why.

15. To your knowledge:

Does the orphan have any special need, disability, and/or impairment?

If you answered "Yes," name or describe the special need, disability, and/or impairment.

The orphan's legal custodian is (select only one box):16.

Yes No

An individual or entity other than the orphan's birth parents.

Both of the orphan's living birth parents.

One of the orphan's living birth parents. The living birth parent is the (select only one box): Mother Father

Name of the individual or entity:

Information About the Attorney Abroad Representing You and/or Your Spouse (if married) in this Case (if any)17.

Middle Name (if applicable)Family Name (Last Name)

Given Name (First Name)

Street Number and Name Apt. Flr.Ste. Number

Postal CodeProvince Country

City or Town State ZIP Code

Page 9 of 17Form I-600 Edition 12/21/19

Part 2. Information About the Orphan Beneficiary (continued)

19. Current Address of the Orphan

City or Town State ZIP Code

In Care Of Name

Street Number and Name

Apt. Flr. NumberSte.

Province Postal Code Country

20. If the orphan resides in an institution, provide the full name of the institution.

21. If the orphan does not reside in an institution, provide the full name of the person with whom the orphan is residing or the name

of the orphan's caretaker.

Middle Name (if applicable)Family Name (Last Name)

Given Name (First Name)

Provide any additional information necessary to locate the orphan, such as the name of a district, section, zone, or locality in

which the orphan resides:

22.

Where do you wish to file your visa application (if applicable)?

The U.S. Embassy or U.S. Consulate located at:

23.

Address Where the Orphan Will Reside After the Adoption (or after you obtain legal custody)

Ste. Flr.Apt. NumberStreet Number and Name

StateCity or Town ZIP Code

18.

Province Postal Code Country

24.

After you obtain an adoption or legal custody of the orphan, do you intend to:

A. Seek an immigrant visa because the child will reside with you in the United States? Yes No

B. Seek a non-immigrant visa for the child to travel to the United States temporarily for the purpose of

naturalization, because you will continue to reside abroad with the child immediately following the

adoption?

Yes No

Page 10 of 17Form I-600 Edition 12/21/19

NOTE: A primary adoption service provider is the accredited agency or approved person who is responsible under 22 CFR 96 for

ensuring all six adoption services defined in 22 CFR 96.2 are provided according to the law, for supervising and being responsible for

supervised providers when used (see 22 CFR 96.14), and for developing and implementing a service plan in accordance with 22 CFR

96.44.

Name of Primary Adoption Service Provider

Primary Adoption Service Provider's Mailing Address

Street Number and Name

City or Town State ZIP Code

Apt. Flr.Ste.

Number

Point of Contact Within the Organization

Family Name (Last Name) Given Name (First Name)

Primary Adoption Service Provider's Daytime Telephone Number

Primary Adoption Service Provider's Fax Number (if any)

Primary Adoption Service Provider's Email Address (if any)

B. An approved person in the United States.

NoYes

The primary adoption service provider named above is one of the following:

An accredited agency in the United States. Yes No

5. 6.

Information About Your Primary Adoption Service Provider

Part 3. Information About Your Home Study and Primary Adoption Service Provider

Your home study:1.

IS NOT attached to this Form I-600 because of state requirements necessitating review and documentation. The

appropriate state authority has indicated that it will submit the home study directly to U.S. Citizenship and Immigration

Services (USCIS). (Do not submit your Form I-600 to USCIS until the state authority is ready to send your home study

to USCIS.)

IS attached to this Form I-600.

Was previously submitted with your pending Form I-600A application (please attach a copy of your Form I-600A fee

receipt notice).

Was previously submitted with your approved Form I-600A application (please attach a copy of your Form I-600A

approval notice).

Page 11 of 17Form I-600 Edition 12/21/19

Date

(mm/dd/yyyy)

Payee

Relationship to

Child (if any)

Purpose of Payment

Amount of Payment (or description

and value of in kind consideration)

Information on payments already made. In the following table, provide all payments, including in-kind contributions that you

and your spouse (if married) have made in relation to the adoption of the child identified in this Form I-600. The information

you provide in this table must include all fees, expenses, in-kind contributions, and other compensation that you and your spouse

(if married) or anyone on behalf of you and your spouse, have directly or indirectly made, to any individual, agency, entity,

governmental authority, or other payee or recipient. The information below should include all payments made as of the date of

your signing this Form I-600.

Part 4. Information About Fees, Expenses, and Other Compensation

If you need extra space to complete the tables in Item Numbers 1. or 2., use the space provided in Part 10. Additional Information.

Information on anticipated future payments. In the following table, provide all fees, expenses, in-kind contributions, and other

compensation that you and your spouse (if married) or anyone on behalf of you and your spouse, reasonably expect to pay or

make, either directly or indirectly, to any individual, agency, entity, governmental authority, or other payee or recipient.

Anticipated Date

of Payment

(mm/dd/yyyy)

Payee Relationship to

Child (if any)

Purpose of Payment

Amount of Payment

(or description and value of in

kind consideration)

Page 12 of 17Form I-600 Edition 12/21/19

Part 4. Information About Fees, Expenses, and Other Compensation (continued)

Have you or your spouse (if married) or anyone on behalf of you and your spouse, given or arranged to

give money or other consideration either directly or indirectly to the orphan's parent(s), agent(s), other

individual(s), or entity to induce or encourage the release of the orphan?

NoYes

If you answered "Yes," provide a detailed description to explain.

Part 5. Accommodations for Individuals With Disabilities and/or Impairments

1. Are you requesting an accommodation because of disabilities and/or impairments?

If you answered "Yes," select all applicable boxes below to indicate who has the disabilities and/or impairments.2.

Petitioner Spouse Other Adult Household Member

If you answered "Yes" to Item Number 1., select all applicable boxes in Items A. - C. and provide an answer for each person

with disabilities and/or impairments.

Deaf or hard of hearing and request the following accommodation. (If requesting a sign-language interpreter, indicate

for which language (for example, American Sign Language).):

Yes No

Blind or have low vision and request the following accommodation:

Another type of disability and/or impairment. (Describe the nature of the disability and/or impairment and the requested

accommodation.):

NOTE: Read the information in the Form I-600 Instructions before completing this section.

Part 6. Petitioner's Statement, Certification, Duty of Disclosure, and Signature

Petitioner's Statement

NOTE: Read the Penalties section of the Form I-600 Instructions before completing this section.

every question in

The interpreter named in Part 8. read to me every question and instruction on this petition and my answer to

Petitioner's Statement Regarding the Interpreter (Select the box for either Item A. or B.)1.

I can read and understand English, and I have read and understand every question and instruction on this petition and my

answer to every question.

I understood everything.

, a language in which I am fluent, and

Petitioner's Statement Regarding the Preparer (if applicable)2.

At my request, the preparer named in Part 9.,

prepared this application for me based only upon information I provided or authorized.

Page 13 of 17Form I-600 Edition 12/21/19

Part 6. Petitioner's Statement, Certification, Duty of Disclosure, and Signature (continued)

Petitioner's Certification

Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS may

require that I submit original documents to USCIS at a later date. Furthermore, I authorize the release of any information from any

and all of my records that USCIS may need to determine my suitability and eligibility as an adoptive parent and whether the child I am

petitioning for is eligible to be classified as my immediate relative.

I furthermore authorize release of information contained in this petition, in supporting documents, and in my USCIS records, to other

entities and persons where necessary for the administration and enforcement of U.S. immigration law.

I understand that USCIS will require me to appear for an appointment to take my biometrics (for example, fingerprints, photograph,

and/or signature) and, at that time, I will be required to sign an oath reaffirming that:

2) I understood all of the information contained in, and submitted with, my petition; and

1) I reviewed and provided or authorized all of the information in my petition;

I certify, under penalty of perjury, that I provided or authorized all of the information in my petition, I understand all of the

information contained in and submitted with my petition, and that all of this information is complete, true, and correct.

3) All of this information was complete, true, and correct at the time of filing.

Petitioner's Signature Date of Signature (mm/dd/yyyy) 3.

Petitioner's Signature

NOTE TO ALL PETITIONERS: If you do not completely fill out this petition or fail to submit required documents listed in the

Instructions, USCIS may deny your petition.

Part 7. Your Spouse's Statement, Certification, Duty of Disclosure, and Signature

NOTE: Read the Penalties section of the Form I-600 Instructions before completing this section.

Petitioner's Duty of Disclosure

I understand the ongoing duty to disclose information concerning my suitability and eligibility as an adoptive parent, as described in

the Form I-600 and/or Form I-600A Instructions, and I agree to notify my home study preparer and USCIS of any new information

that I am required to disclose.

Your Spouse's Statement

every question in

The interpreter named in Part 8. read to me every question and instruction on this petition and my answer to

Spouse's Statement Regarding the Interpreter (Select the box for either Item A. or B.)1.

I can read and understand English, and have read and understand every question and instruction on this petition and my

answer to every question.

and I understood everything.

, a language in which I am fluent,

Spouse's Statement Regarding the Preparer (if applicable)2.

At my request, the preparer named in Part 9.,

prepared this petition for me based only upon information I provided or authorized.

Page 14 of 17Form I-600 Edition 12/21/19

Part 7. Your Spouse's Statement, Certification, Duty of Disclosure, and Signature (continued)