I have been previously married ___________ time(s).
If acquired through parentage, have you obtained a certificate in your
own name based on that acquisition?
If acquired through naturalization, give name under which naturalized,
number of naturalization certificate, and date and place of naturalization.
Department of Homeland Security
U.S. Citizenship and Immigration Services
Do not write in this block. For USCIS Use Only.
It has been determined that the:
preadoptive requirements in the State of the child's proposed
residence.
The following is a description of the preadoption requirements, if any,
of the State of the child's proposed residence:
File number of applicant, if applicable.
The preadoption requirements, if any,:
BLOCK I - Information about the prospective adoptive parent.
Date and place of present marriage
6. My telephone number is: (Include Area Code)
Name of present spouse (include maiden name of wife)
Number of prior marriages of spouse
If not, submit evidence of citizenship. See Instruction 2.a(2).
Have you or any person through whom you claimed citizenship ever lost
United States citizenship?
I have never been married.
4. Address abroad (If any):
prospective adoptive parent will furnish proper care to
a beneficiary orphan if admitted to the United States.
Yes (If Yes, attach detailed explanation.)
2. Other names used (including maiden name if appropriate):
3. I reside in the U.S. at:
8. If you are now married, give the following information:
9. I am a citizen of the United States through:
Please type or print legibly in black ink.
This application is made by the named prospective adoptive parent for advance processing of an orphan petition.
OMB No. 1615-0028; Expires 08/31/08
I-600A, Application for Advance
Processing of Orphan Petition
Form I-600A (Rev. 07-30-07) Y