Fillable Ins Form N-600 (Visa Pro)

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Ins Form N-600 (Visa Pro)

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Form N-600 (Rev. 12/23/16) N
Department of Homeland Security
U. S. Citizenship and Immigration Services
Form N-600, Application for
Certificate of Citizenship
OMB No. 1615-0057; Expires 12/31/2018
Print or type all your answers fully and accurately in black ink. Write or type “N/A” if an item is not applicable. Write or type
“None” if the answer is none. Failure to answer all of the questions may delay processing your Form N-600.
1. I am a BIOLOGICAL child of a U.S. citizen parent(s).
This application is being filed based on the fact that:
2. I am an ADOPTED child of a U.S. citizen parent(s).
3. Other (explain fully):
Part 1. Information About Your Eligibility (Check only one box.
USCIS will reject your Form N-600 if you check more than one
box.)
Part 2. Information About You (Provide information about yourself if
you are a person applying for the Certificate of Citizenship.
Provide information about your child if you are a U.S. citizen
parent applying for a Certificate of Citizenship for your minor
child.)
Your A-Number if any:
A
--
Bar Code Date Stamp
Remarks
Action
2. Your name exactly as it appears on your Permanent Resident Card (if different
from above)
3. Other name(s) you have used since birth (if applicable. Include nicknames)
Family Name (last name) Given Name (first name) Middle Name (if applicable)
6.
1. Current Legal Name (do not provide a nickname)
Family Name (last name)
Given Name (first name) Middle Name (if applicable)
Family Name (last name)
Given Name (first name)
Middle Name (if applicable)
4.
5.
U.S. Social Security Number (if applicable)
Date of Birth (mm/dd/yyyy)
Country of Birth
Form N-600 (Rev. 12/23/16) N Page 2
Country (foreign address only)
7. 8. Gender 9. Height
Feet Inches
Male Female
14. Current Marital Status
Single, Never Married
Marriage Annulled
Married
Other (explain):
Divorced Widowed
15. Are you a member or veteran of any branch of the U.S. Armed Forces?
Yes No
A. I arrived in the following manner
16. Information about admission into the United States and current immigration status
Port of Entry (City/State) Exact Name Used at Time of Entry:Date of Entry (mm/dd/yyyy)
B. I used the following travel document to be admitted to the United States
Passport
Other (specify document name and issuance date(s))
Passport Number
Date Passport Issued (mm/dd/yyyy)
10. Home Address
Street Number and Name (do not provide a P.O. Box in this space unless it is your ONLY address) Apartment Number
City
Province (foreign address only)
Postal Code (foreign address only)
Zip Code
11. Mailing Address
Street Number and Name Apartment Number
C/O (in care of name, if applicable)
City
Province (foreign address only)
Postal Code (foreign address only)
Zip Code
Evening Phone Number12. Daytime Phone Number
( ) ( )( )
Mobile Phone Number (if any)
( )
Work Phone Number (if any)
E-Mail Address (if any)
13.
Part 2. Information About You (Continued)
A
--
State
Country (foreign address only)
State
Passport Issuing Country
Country of Prior Citizenship/Nationality
Form N-600 (Rev. 12/23/16) N Page 3
C. I am
A Permanent Resident
A Nonimmigrant
A Refugee/Asylee
Other (explain)
D. I obtained permanent resident status through adjustment of status in the United States or admission as a permanent resident (if
applicable)
USCIS office that granted my permanent resident status or
location where I was admitted
Date I became a permanent resident
(mm/dd/yyyy)
17. Have you previously applied for a Certificate of Citizenship or U.S. passport?
Yes (attach explanation) No
Yes (attach explanation) No
18. Have you ever abandoned or lost your permanent resident status?
19. Were you adopted?
Yes (complete the following information) No
Date of Adoption (mm/dd/yyyy)
Date Legal Custody Began (mm/dd/yyyy)
Date Physical Custody Began (mm/dd/yyyy)
Place of Final Adoption (City/State or Country)
20. Did you have to be re-adopted in the United States?
Yes (complete the following information) No
Date of Final Adoption (mm/dd/yyyy)
Date Legal Custody Began (mm/dd/yyyy)
Date Physical Custody Began (mm/dd/yyyy)
Place of Final Adoption (City/State)
21. Were your parents married to each other when you were born (or adopted)?
Yes No
23. Do you regularly reside in the United States in the legal and physical custody of your U.S. citizen
parent(s)?
Yes No
24. Have you been absent from the United States since you first arrived?
Yes No
Date You Left the United States
(mm/dd/yyyy)
Date You Returned to the United States
(mm/dd/yyyy)
Place of Entry Upon Return to
the United States (City, State)
(complete the following information only if you are claiming U.S. citizenship at the time of birth if you were born before
October 10, 1952)
Yes No
22. Did your parents marry after you were born?
Part 2. Information About You (Continued)
A
--
Form N-600 (Rev. 12/23/16) N Page 4
Part 3. Information About Your U.S. Citizen Biological Father (or
Adoptive Father) (Complete this section if you are claiming
citizenship through a U.S. citizen biological father (or adoptive
father). Provide information about yourself if you are a U.S.
citizen father applying for a Certificate of Citizenship on behalf of
your minor biological or adopted child.)
5. Home Address
1. Current legal name of U.S. citizen father
3. 2.
Date of Birth (mm/dd/yyyy)
4.
Street Number and Name (write "Deceased" and date of death if your father has passed away)
Apartment Number
7. Has your father ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship?
6. My father is a U.S. citizen by
8. Marital History
Family Name (last name)
Given Name (first name)
Middle Name (if applicable)
City
Province (foreign address only)
Postal Code (foreign address only)
Zip Code
Certificate of Citizenship Number A-Number (if known)
Date of Naturalization (mm/dd/yyyy)
Place of Naturalization (name of court and City/State or USCIS office location)
Birth in the United States
Acquisition after birth through naturalization of alien parent(s)
Birth abroad to U.S. citizen parent(s)
Naturalization
Certificate of Naturalization Number
A-Number (if known)
B. What is your U.S. citizen father's current marital status?
A. How many times has your U.S. citizen father been married (including annulled marriages and marriage(s) to the same
person)?
Single, Never Married Married Separated Divorced Widowed
Marriage Annulled Other (explain):
A
--
Yes (provide full explanation on an additional sheet(s) of paper) No
State
Country (foreign address only)
Country of Birth
Country of Citizenship/Nationality
Form N-600 (Rev. 12/23/16) N Page 5
C. Information about U.S. citizen father's current spouse
Family Name (last name)
Given Name (first name)
Middle Name (if applicable)
Date of Birth (mm/dd/yyyy)
Part 3. Information About Your U.S. Citizen Biological Father (or
Adoptive Father) (Continued)
Spouse's Immigration Status
Date of Marriage (mm/dd/yyyy)
Place of Marriage (City/State or Country)
U.S. Citizen Permanent Resident Other (explain):
D. Is your U.S. citizen father's current spouse also your biological (or adopted) mother?
Yes No
Part 4. Information About Your U.S. Citizen Biological Mother (or Adoptive Mother) (Complete this
section if you are claiming citizenship through a U.S. citizen biological mother (or adoptive
mother). Provide information about yourself if you are a U.S. citizen mother applying for a
Certificate of Citizenship on behalf of your minor biological or adopted child.)
1. Current legal name of U.S. citizen mother
Spouse's Home Address
Street Number and Name
Apartment Number
City
Province (foreign address only)
Postal Code (foreign address only)
Zip Code
5. Home Address
Street Number and Name (write "Deceased" and date of death if your mother has passed away)
Apartment Number
City
Province (foreign address only)
Postal Code (foreign address only)
Zip Code
3. 2.
Date of Birth (mm/dd/yyyy)
4.
Family Name (last name)
Given Name (first name)
Middle Name (if applicable)
A
--
Country of Birth Country of Citizenship/Nationality
State
Country (foreign address only)
Country of Birth
State
Country (foreign address only)
Country of Citizenship/Nationality
Form N-600 (Rev. 12/23/16) N Page 6
6. My mother is a U.S. citizen by
Certificate of Citizenship Number A-Number (if known)
Date of Naturalization (mm/dd/yyyy)
Place of Naturalization (name of court and City/State or USCIS office location)
Birth in the United States
Acquisition after birth through naturalization of alien parent(s)
Birth abroad to U.S. citizen parent(s)
Naturalization
Certificate of Naturalization Number
A-Number (if known)
Part 4. Information About Your U.S. Citizen Biological Mother (or
Adoptive Mother) (Continued)
7. Has your mother ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship?
8. Marital History
C. Information about U.S. citizen mother's current spouse
A. How many times has your U.S. citizen mother been married (including annulled marriages and marriage(s) to the same
person)?
Family Name (last name) Given Name (first name) Middle Name (if applicable)
Date of Birth (mm/dd/yyyy)
Spouse's Immigration Status
Date of Marriage (mm/dd/yyyy)
Place of Marriage (City/State or Country)
U.S. Citizen Permanent Resident Other (explain):
Spouse's Home Address
Street Number and Name
Apartment Number
City
Province (foreign address only)
Postal Code (foreign address only)
Zip Code
B. What is your U.S. citizen mother's current marital status?
Single, Never Married
Marriage Annulled
Married
Other (explain):
Separated Divorced Widowed
D. Is your U.S. citizen mother's current spouse also your biological (or adopted) father?
Yes No
A
--
Yes (provide full explanation on an additional sheet(s) of paper) No
Country of Birth
Country of Citizenship/Nationality
State
Country (foreign address only)
Form N-600 (Rev. 12/23/16) N Page 7
Indicate whether this information relates to your U.S. citizen
(USC) father or mother
USC Father
USC Mother
Physical Presence in the United States (mm/dd/yyyy)
From Until From Until
From Until From Until
From Until From Until
From Until From Until
Part 5. Physical Presence in the United States From Birth Until Filing
of Form N-600 (Only applicants born outside the United States
claiming to have been born U.S. citizens are required to provide all
the dates when your U.S. citizen biological father or U.S. citizen
biological mother resided in the United States. Include all dates
from your birth until the date you file your Form N-600.)
4. Type of discharge
Honorable Other than Honorable Dishonorable
3. Dates of Service (if time of service fulfills any of required physical presence, submit evidence of service)
From (mm/dd/yyyy) To (mm/dd/yyyy)
From (mm/dd/yyyy)
To (mm/dd/yyyy)
I certify, under penalty of perjury under the laws of the United States, that this application and the evidence submitted with it is all true
and correct. I authorize the release of any information from my records, or my minor child's records, that U.S. Citizenship and
Immigration Services needs to determine eligibility for the benefit I am seeking.
Part 7. Your Signature (USCIS will reject your Form N-600 if it is not signed.)
Your Signature (parent may sign on behalf of a minor child)
Date (mm/dd/yyyy)
Part 6. Information About Military Service of U. S. Citizen Parent(s) (Complete this only if you are an
applicant claiming U.S. citizenship at time of birth abroad.)
1. Has your U.S. citizen parent(s) served in the U.S. Armed Forces?
Yes No
2. If "Yes," which parent?
U.S. Citizen Father U.S. Citizen Mother
Part 8. Signature of Person Who Prepared This Form N-600 For You (if applicable)
I declare that I prepared this application at the request of the above person. The answers provided are based on information of which I
have personal knowledge and/or were provided to me by the above-named person in response to the questions contained on this form.
Preparer's Printed Name
Preparer's Signature
Date (mm/dd/yyyy)
A
--
Form N-600 (Rev. 12/23/16) N Page 8
NOTE: Do not complete the next part unless the USCIS officer instructs you to do so at the interview.
Preparer's Address
Street Number and Name
City
Zip Code
Province (foreign address only)
Postal Code (foreign address only)
Preparer's E-Mail Address
Preparer's Fax Number
( )
Preparer's Firm or Organization Name (if applicable)
Part 8. Signature of Person Who Prepared This Form N-600 For You
(if applicable)
Preparer's Daytime Phone Number
( )
A
--
State
Country (foreign address only)
Form N-600 (Rev. 12/23/16) N Page 9
I, the (applicant, parent, or legal guardian) do swear or affirm, under penalty of perjury
under the laws of the United States, that I know and understand the contents of this application signed by me, and the attached
supplementary pages number ( ) to ( ) inclusive, that the same are true and correct to the best of my knowledge, and that
corrections number ( ) to ( ) were made by me or at my request.
Part 10. Officer Report and Recommendation on Application for Certificate of Citizenship (for USCIS
use ONLY)
On the basis of the documents, records, the testimony of person(s) examined, and the identification upon personal appearance of the
underage beneficiary, I find that all the facts and conclusions set forth under oath in this application are:
1. True and correct
2. The applicant derived or acquired U.S. citizenship on
(mm/dd/yyyy)
3. The applicant derived or acquired U.S. citizenship through (mark “X” next to the appropriate section of law, or if the section of
law is not reflected, write the applicable section of law in the space next to “Other”)
4. The applicant has not been expatriated since that time
I recommend that this Form N-600 application be Approved Denied
Issue Certificate of Citizenship in the name of
Subscribed and sworn or affirmed before me upon examination of the applicant (parent, legal guardian) on
at
.
Applicant's, Parent's, or Legal Guardian's Signature
Date (mm/dd/yyyy)
USCIS Officer's Name and Title
USCIS Officer's Signature
I do concur with the USCIS Officer's recommendation of the Form N-600.do not
USCIS Officer's Name and Title
USCIS Officer's Signature Date (mm/dd/yyyy)
USCIS District Director's or Field Office Director's Signature
Date (mm/dd/yyyy)
(mm/dd/yyyy)
(Location)
Section 301 of the INA
Other:
Section 320 of the INA
Section 321 of the INA
Section 309 of the INA
Last Name
First Name Middle Name
Part 9. Affidavit (do NOT complete this part unless instructed to do so AT
THE INTERVIEW)
A
--
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