Fillable N-600 Application for Certificate of Citizenship

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N-600 Application for Certificate of Citizenship

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The N-600 Application for Certificate of Citizenship form is 21 pages long and contains:

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  • 151 check-boxes
  • 272 other fields

Country of origin: US
File type: PDF

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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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For
USCIS
Use
Only
I am an ADOPTED child of a U.S. citizen parent.I am a BIOLOGICAL child of a U.S. citizen parent.
This application is being filed based on the fact that: (Select only one box)
Part 1. Information About Your Eligibility
Enter Your 9 Digit A-Number:
Date Stamp
Remarks
Current Legal Name (do not provide a nickname)
Family Name (Last Name) Given Name (First Name) Middle Name
1.
Part 2. Information About You
Family Name (Last Name) Given Name (First Name)
Your Name Exactly As It Appears on Your Permanent Resident Card (if different from above)
2.
Middle Name
START HERE - Type or print in black ink.
►
A-
Action BlockReceipt
Application for Certificate of Citizenship
Department of Homeland Security
U.S. Citizenship and Immigration Services
USCIS
Form N-600
OMB No. 1615-0057
Expires 12/31/2018
►
1.
Other (Explain fully):
Middle NameGiven Name (First Name)Family Name (Last Name)
Other Names You Have Used Since Birth
Provide all other names you have ever used, include nicknames, maiden name, and aliases.
3.
6.
Date of Birth (mm/dd/yyyy)
U.S. Social Security Number (if any)4.
Country of Birth
7.
►
5. USCIS Online Account Number (if any)
►
Select this box if
Form G-28 is
attached.
To be completed
by an Attorney
or Accredited
Representative (if any).
Attorney State Bar Number
(if applicable)
Attorney or Accredited Representative
USCIS Online Account Number (if any)
NOTE: 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.
NOTE: If you need extra space to complete this section, use the space provided in Part 11. Additional Information.
Gender
Male Female
9.
Country of Prior Citizenship or Nationality
8.
Page 1 of 15Form N-600 02/13/17 N
Part 2. Information About You (continued)
A-
11. Physical Address
City or Town
State ZIP Code + 4
NumberFlr.Ste.Apt.Street Number and Name (Do not provide a PO Box in this space unless it is your ONLY address.)
-
Postal Code (foreign address only)
Province (foreign address only)
Country (foreign address only)
10. Mailing Address
In Care Of Name (if any)
Current Marital Status
12.
Divorced
Single, Never Married
WidowedMarried
Separated
Other (Explain):
14. Information About Your Admission into the United States and Current Immigration Status
Marriage Annulled
I arrived in the following manner
Port-of-Entry
A.
City or Town State
Date of Entry (mm/dd/yyyy)
Exact Name Used at Time of Entry
Middle Name
Given Name (First Name)Family Name (Last Name)
City or Town
State ZIP Code + 4
NumberFlr.Ste.Apt.Street Number and Name
-
Postal Code (foreign address only)
Province (foreign address only)
Country (foreign address only)
U.S. Armed Forces
13.
NoYes
Are you a member or veteran of any branch of the U.S. Armed Forces?
I used the following travel document to be admitted to the United StatesB.
Travel Document
Passport
Passport Number
Travel Document Number
Country of Issuance for Passport or
Travel Document
Date Passport or Travel Document
Issued (mm/dd/yyyy)
Page 2 of 15Form N-600 02/13/17 N
A-
Part 2. Information About You (continued)
I obtained LPR status through adjustment of status in the United States or admission as a LPR (if applicable)D.
Date I became a LPR
(mm/dd/yyyy)
U.S. Citizenship and Immigration Services (USCIS) Office That Granted My LPR
Status or Location Where I Was Admitted
NoYes
Have you previously applied for a Certificate of Citizenship or U.S. Passport?15.
If you answered "Yes" to Item Number 15., provide an explanation below. If you need extra space to complete this section, use
the space provided in Part 11. Additional Information.
NoYes
16. Have you ever abandoned or lost your LPR status?
If you answered "Yes" to Item Number 16., provide an explanation below. If you need extra space to complete this section, use
the space provided in Part 11. Additional Information.
NoYes
Were you adopted?17.
If you answered "Yes" to Item Number 17., complete Items A. - D.
Place of Final AdoptionA.
NoYes
Did you have to be re-adopted in the United States?18.
If you answered "Yes" to Item Number 18., complete Items A. - D.
Date of Final Adoption
(mm/dd/yyyy)
B.
I am
C.
A Lawful Permanent Resident (LPR) A Nonimmigrant
Other (Explain):
A Refugee/Asylee
NOTE: If you select “Other” and you need extra space to complete this section, use the space provided in Part 11.
Additional Information.
StateCity or Town Country
CountryStateCity or Town
A.
Place of Final Adoption
Date Legal Custody Began
(mm/dd/yyyy)
C.
Date Physical Custody Began
(mm/dd/yyyy)
D.
Date Legal Custody Began
(mm/dd/yyyy)
C.
Date Physical Custody Began
(mm/dd/yyyy)
D.
Date of Adoption
(mm/dd/yyyy)
B.
NoYes
Were your parents married to each other when you were born (or adopted)?19.
NoYes
Did your parents marry after you were born?20.
NoYes
Do you regularly reside in the United States in the legal and physical custody of your U.S. citizen parents? 21.
Page 3 of 15Form N-600 02/13/17 N
A-
Part 2. Information About You (continued)
Date You Left the United States
(mm/dd/yyyy)
A.
Date You Returned to the
United States (mm/dd/yyyy)
B.
Date You Left the United States
(mm/dd/yyyy)
D.
Date You Returned to the
United States (mm/dd/yyyy)
E.
Part 3. Biographic Information
American Indian
or Alaska Native
Height Feet Inches
Race (Select all applicable boxes)2.
3.
Native Hawaiian or
Other Pacific Islander
Black or
African American
AsianWhite
Not Hispanic or LatinoHispanic or Latino
Ethnicity (Select only one box)
1.
4. Weight Pounds
5.
BrownBlue Green HazelGrayBlack PinkMaroon
Unknown/
Other
Eye color (Select only one box)
Bald
(No hair)
SandyRed WhiteGrayBlond BrownBlack
Hair color (Select only one box)
6.
Unknown/
Other
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. If you need extra spa
ce to complete this section, use the space provided in Part 11. Additional Information.
NoYes
Have you been absent from the United States since you first arrived?22.
StateCity or Town
F.
Place of Entry Upon Return to the United States
StateCity or Town
C.
Place of Entry Upon Return to the United States
Part 4. Information About Your U.S. Citizen Biological Father (or Adoptive Father)
NOTE: Complete this section if you are claiming citizenship through a U.S. biological father (of 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.
Current Legal Name of U.S. Citizen Father
Family Name (Last Name) Given Name (First Name) Middle Name
1.
Page 4 of 15Form N-600 02/13/17 N
A-
Part 4. Information About Your U.S. Citizen Biological Father
(or Adoptive Father) (continued)
My father is a U.S. citizen by6.
►
A-
Alien Registration Number (A-Number) (if any)Certificate of Citizenship Number
►
A-
A-Number (if any)Certificate of Naturalization Number
NoYes
Has your father ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship?7.
If you answered “Yes” to Item Number 7.,
provide an explanation in Part 11. Additional Information.
What is your U.S. citizen father's current marital status?
Divorced
Single, Never Married
WidowedMarried Marriage Annulled
Separated
Marital History8.
A. How many times has your U.S. citizen father been married (including annulled marriages and
marriages to the same person)?
B.
If you selected "Other," provide an explanation. If you need extra space to complete this section, use the space provided in
Part 11. Additional Information.
Other (Explain):
Birth in the United States Acquisition after birth through naturalization of alien parents
Birth abroad to U.S. citizen parents
Naturalization
5. Physical Address
City or Town
State ZIP Code + 4
NumberFlr.Ste.Apt.
Street Number and Name (Type or print "Deceased" and the date of death if your father has passed away.)
-
Postal Code (foreign address only)
Province (foreign address only)
Country (foreign address only)
StateCity or Town
Place of Naturalization (Name of Court or USCIS Office Location)
Date of Naturalization (mm/dd/yyyy)
2. Date of Birth (mm/dd/yyyy) Country of Birth 3. Country of Citizenship or Nationality4.
Page 5 of 15Form N-600 02/13/17 N
A-
Part 4. Information About Your U.S. Citizen Biological Father
(or Adoptive Father) (continued)
Date of Marriage (mm/dd/yyyy)
Spouse's Immigration Status
Lawful Permanent ResidentU.S. Citizen
F.
If you selected "Other,"
provide an explanation. If you need extra space to complete this section, use the space provided in
Part 11. Additional Information.
NoYes
Is your U.S. citizen father's current spouse also your biological (or adopted) mother?
I.
H.
Part 5. Information About Your U.S. Citizen Biological Mother (or Adoptive Mother)
NOTE: 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.
Current Legal Name of U.S. Citizen Mother
Family Name (Last Name) Given Name (First Name) Middle Name
1.
2. Date of Birth (mm/dd/yyyy) Country of Birth 3. Country of Citizenship or Nationality4.
Other (Explain):
Country of Citizenship or Nationality
D.
Street Number and Name NumberFlr.Ste.Apt.
City or Town State ZIP Code + 4
-
Postal Code
(foreign address only)
Province
(foreign address only)
Spouse's Physical Address
Country
(foreign address only)
E.
CountryStateCity or Town
Place of MarriageG.
Date of Birth (mm/dd/yyyy) Country of Birth
B. C.
Information About U.S. Citizen Father's Current Spouse9.
A.
Middle Name
Given Name (First Name)Family Name (Last Name)
Page 6 of 15Form N-600 02/13/17 N
A-
Part 5. Information About Your U.S. Citizen Biological Mother
(or Adoptive Mother) (continued)
NoYes
Has your mother ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship?7.
If you answered “Yes” to Item Number 7.,
provide an explanation in Part 11. Additional Information.
What is your U.S. citizen mother's current marital status?
Divorced
Single, Never Married
WidowedMarried Marriage Annulled
Separated
Marital History8.
A.
How many times has your U.S. citizen mother been married (including annulled marriages and
marriages to the same person)?
B.
Other (Explain):
If you selected “Other,” provide an explanation. If you need extra space to complete this section, use the space provided in
Part 11. Additional Information.
Information About U.S. Citizen Mother's Current Spouse9.
A.
Middle Name
Given Name (First Name)Family Name (Last Name)
Place of Naturalization (Name of Court or USCIS Office Location)
►
A-
A-Number (if any)Certificate of Naturalization Number
Naturalization
My mother is a U.S. citizen by6.
►
A-
A-Number (if any)Certificate of Citizenship Number
Birth in the United States Acquisition after birth through naturalization of alien parents
Birth abroad to U.S. citizen parents
5. Physical Address
City or Town State ZIP Code + 4
NumberFlr.Ste.Apt.
Street Number and Name (Type or print "Deceased" and the date of death if your mother has passed away.)
-
Postal Code (foreign address only)
Province (foreign address only)
Country (foreign address only)
StateCity or Town
Date of Birth (mm/dd/yyyy) Country of Birth B. C.
Date of Naturalization (mm/dd/yyyy)
Page 7 of 15Form N-600 02/13/17 N
NoYes
Is your U.S. citizen mother's current spouse also your biological (or adopted) father?
I.
A-
Part 5. Information About Your U.S. Citizen Biological Mother
(or Adoptive Mother) (continued)
Part 6. Physical Presence in the United States From Birth Until Filing of Form N-600
NOTE: 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.
Indicate whether this information relates to your U.S. citizen
father or mother
U.S. Citizen Father U.S. Citizen Mother
Physical Presence in the United States
Spouse's Immigration Status
Lawful Permanent ResidentU.S. Citizen
H.
Other
If you selected “Other,” provide an explanation. If you need extra space to complete this section, use the space provided in
Part 11. Additional Information.
1.
2.
From (mm/dd/yyyy)A. To (mm/dd/yyyy) B. From (mm/dd/yyyy) To (mm/dd/yyyy)
From (mm/dd/yyyy)C. To (mm/dd/yyyy) D. From (mm/dd/yyyy) To (mm/dd/yyyy)
From (mm/dd/yyyy)E. To (mm/dd/yyyy) F. From (mm/dd/yyyy) To (mm/dd/yyyy)
From (mm/dd/yyyy)G. To (mm/dd/yyyy) H. From (mm/dd/yyyy) To (mm/dd/yyyy)
Date of Marriage (mm/dd/yyyy)F.
Street Number and Name NumberFlr.Ste.Apt.
City or Town State ZIP Code + 4
-
Postal Code
(foreign address only)
Province
(foreign address only)
Spouse's Physical Address
Country
(foreign address only)
E.
Country of Citizenship or NationalityD.
StateCity or Town
Place of Marriage
G.
Country
Page 8 of 15Form N-600 02/13/17 N
A-
Part 7. Information About Military Service of U. S. Citizen Parents
NOTE: Complete this only if you are an applicant claiming U.S. citizenship at time of birth abroad.
NoYes
Has your U.S. citizen parent served in the U.S. Armed Forces?1.
If you answered "Yes" to Item Number 1., which parent served in the U.S. Armed Forces?
U.S. Citizen Father U.S. Citizen Mother
2.
Dates of Service (mm/dd/yyyy) (If time of service fulfills any of the required physical presence, submit evidence of the service.)3.
Type of Discharge
4.
Other than HonorableHonorable
Dishonorable
A.
To (mm/dd/yyyy)From (mm/dd/yyyy) To (mm/dd/yyyy)From (mm/dd/yyyy)
B.
Part 8.
Applicant's Statement, Contact Information, Certification, and Signature
NOTE: Read the Penalties section of the Form N-600 Instructions before completing this part.
1.
I can read and understand English, and I have read and understand every question and instruction on this application
and my answer to every question.
A.
Applicant's Statement Regarding the Interpreter
understood everything.
every question, in
The interpreter named in Part 9. read to me every question and instruction on this application and my answer to
, a language in which I am fluent and I
B.
NOTE: Select the box for either Item A. or B. in Item Number 1. If applicable, select the box for Item Number 2.
Applicant's Statement
At my request, the preparer named in Part 10., ,
2. Applicant's Statement Regarding the Preparer
prepared this application for me based only upon information I provided or authorized.
Applicant's Contact Information
Applicant's Daytime Telephone Number Applicant's Mobile Telephone Number (if any)
Applicant's Email Address (if any)
3.
5.
4.
I further authorize release of information contained in this application, in supporting documents, and in my USCIS records to other
entities and persons where necessary for the administration and enforcement of U.S. immigration laws.
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 of
my records that USCIS may need to determine my eligibility for the immigration benefit I seek.
Applicant's Certification
Page 9 of 15Form N-600 02/13/17 N
A-
Part 8. Applicant's Statement, Contact Information, Certification,
and Signature (continued)
I understand that USCIS may require me to appear for an appointment to take my biometrics (fingerprints, photograph, and/or
signature) and, at that time, if I am required to provide biometrics, I will be required to sign an oath reaffirming that:
Applicant's Signature
Applicant's Signature (sign in ink) Date of Signature (mm/dd/yyyy)6.
NOTE TO ALL APPLICANTS: If you do not completely fill out this application or fail to submit required documents listed in the
Instructions, USCIS may deny your application.
3) All of this information was complete, true, and correct at the time of filing.
2) I understood all of the information contained in, and submitted with, my application; and
1) I reviewed and provided or authorized all of the information in my application;
I certify, under penalty of perjury, that I provided or authorized all of the information in my application, I understand all of the
information contained in, and submitted with, my application, and that all of this information is complete, true, and correct.
Interpreter's Business or Organization Name (if any)2.
Interpreter's Given Name (First Name)Interpreter's Family Name (Last Name)1.
Provide the following information about the interpreter.
Interpreter's Full Name
Part 9. Interpreter's Contact Information, Certification, and Signature
City or Town State
Postal CodeProvince
Street Number and Name Apt. Flr. NumberSte.
Country
Interpreter's Mailing Address
3.
ZIP Code + 4
-
Interpreter's Contact Information
4. Interpreter's Daytime Telephone Number
Interpreter's Email Address (if any)
6.
Interpreter's Mobile Telephone Number (if any)
5.
Page 10 of 15Form N-600 02/13/17 N
A-
Part 9. Interpreter's Contact Information, Certification, and Signature
(continued)
Interpreter's Certification
I certify, under penalty of perjury, that:
I am fluent in English and
, which is the same language specified in Part 8.,
Item B. in Item Number 1., and I have read to this applicant in the identified language every question and instruction on this
application and his or her answer to every question. The applicant informed me that he or she understands every instruction, question,
and answer on the application, including the Applicant's Certification, and has verified the accuracy of every answer.
Date of Signature (mm/dd/yyyy)Interpreter's Signature (sign in ink)
Interpreter's Signature
7.
Part 10. Contact Information, Declaration, and Signature of the Person Preparing this Application, if
Other Than the Applicant
Provide the following information about the preparer.
Preparer's Full Name
Preparer's Given Name (First Name)Preparer's Family Name (Last Name)1.
Preparer's Business or Organization Name (if any)
2.
3. Street Number and Name Apt. Flr. NumberSte.
City or Town
State
Postal CodeProvince Country
Preparer's Mailing Address
ZIP Code + 4
-
Preparer's Contact Information
Preparer's Daytime Telephone Number Preparer's Mobile Telephone Number (if any)
Preparer's Email Address (if any)
4.
6.
5.
Page 11 of 15Form N-600 02/13/17 N
A-
Part 10. Contact Information. Declaration, and Signature of the Person
Preparing this Application, if Other Than the Applicant (continued)
I am not an attorney or accredited representative but have prepared this application on behalf of
the applicant and with the applicant's consent.
I am an attorney or accredited representative and my representation of the applicant in this case
does not extend beyond the preparation of this application.
7.
Preparer's Statement
A.
B.
extends
NOTE: If you are an attorney or accredited representative whose representation extends beyond preparation of this
application, you may be obliged to submit a completed Form G-28, Notice of Entry of Appearance as Attorney or
Accredited Representative, with this application.
Preparer's Certification
By my signature, I certify, under penalty of perjury, that I prepared this application at the request of the applicant. The applicant then
reviewed this completed application and informed me that he or she understands all of the information contained in, and submitted
with, his or her application, including the Applicant's Certification, and that all of this information is complete, true, and correct. I
completed this application based only on information that the applicant provided to me or authorized me to obtain or use.
Preparer's Signature (sign in ink)
Date of Signature (mm/dd/yyyy)
Preparer's Signature
8.
Page 12 of 15Form N-600 02/13/17 N
A-
Part 11. Additional Information
5.
Page Number
Part Number Item Number6.
Item NumberPart NumberPage Number B.
B.
C.
C.
D.
D.
A.
A.
If you need extra space to provide any additional information within this application, use the space below. If you need more space
than what is provided, you may make copies of this page to complete and file with this application or attach a separate sheet of paper.
Type or print your name and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item
Number to which your answer refers; and sign and date each sheet.
A-Number (if any) ►
A-
3.
2.
Page Number B. Part Number C. Item Number
1. Family Name (Last Name) Given Name (First Name) Middle Name
D.
A.
Page Number
Part Number Item Number
D.
4. B. C.A.
Page 13 of 15Form N-600 02/13/17 N
A-
Part 12. Affidavit (do NOT complete this part unless instructed to do so
AT THE INTERVIEW)
NOTE: Do not complete Parts 12. and 13. unless the USCIS officer instructs you to do so at the interview.
do swear or affirm, underI, the (applicant, parent, or legal guardian)
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.
Applicant's, Parent's, or Legal Guardian's Signature (Sign in ink)
Date of Signature (mm/dd/yyyy)
Subscribed and sworn or affirmed before me upon examination of the applicant (parent, legal, guardian) on
USCIS Officer's Printed Name
USCIS Officer's Signature (Sign in ink)
USCIS Officer's Title
Date of Signature (mm/dd/yyyy)
On the basis of the documents, records, the testimony of persons 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:
True and correct
1.
The applicant derived or acquired U.S. citizenship on
2.
Date (mm/dd/yyyy)
The applicant derived or acquired U.S. citizenship through (Select the box next to the appropriate section of law, or if the
section of law is not reflected, type or print the applicable section of law in the space next to “Other.”)
3.
INA Section 301
A.
INA Section 309
B.
INA Section 320
C.
INA Section 321
D.
Other
E.
The applicant has not been expatriated since that time4.
Part 13. Officer Report and Recommendation on Application for Certificate of Citizenship
(for USCIS use ONLY)
at
(Location)
Date (mm/dd/yyyy)
.
Page 14 of 15Form N-600 02/13/17 N
A-
Part 13. Officer Report and Recommendation on Application for
Certificate of Citizenship (for USCIS use ONLY) (continued)
DeniedApprovedI recommend that this Form N-600 be:
Issue Certificate of Citizenship in the name of
Family Name (Last Name) Given Name (First Name) Middle Name
USCIS Officer's Printed Name
USCIS Officer's Signature (Sign in ink)
USCIS Officer's Title
Date of Signature (mm/dd/yyyy)
USCIS District Director's or Field Office Director's Signature (Sign in ink)
Date of Signature (mm/dd/yyyy)
do not
concur with the USCIS Officer's recommendation of Form N-600.
I do
Page 15 of 15Form N-600 02/13/17 N
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N-600 Application for Certificate of Citizenship

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Completed 17 November 2019

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