Form N-4 11/12/19 Page 2 of 2
This form is to be submitted monthly by the clerk of any court conducting naturalization activities in conformity with Section 339 of
the Immigration and Nationality Act (8 USC 1450), and Title 8, Code of Federal Regulations, Part 339. The completed form, with a
copy and all attachments, should be submitted to the District Office of U.S. Citizenship and Immigration Services (USCIS) having
jurisdiction over the location of the court.
Our authority for collecting the information reported on Form N-4 is contained in Section 339 of the Immigration and Nationality Act
(INA) (8 USC 145D). The information contained in this form will be used by USCIS to finalize the record process regarding persons
naturalized and to determine payments to the courts as provided in Section 344(f) of the INA (8 USC 1455).
An agency may not conduct or sponsor an information collection and a person is not required to respond to a collection of information
unless it displays a currently valid OMB control number. The public reporting burden for this collection of information is estimated at
30 minutes per response, including the time for reviewing instructions and completing and submitting the form. Send comments
regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to:
U.S. Citizenship and Immigration Services, Regulatory Coordination Division, 20 Massachusetts Avenue, N.W., Washington, DC
20529-2140. OMB No. 1615-0051. Do not mail your completed Form N-4 to this address.
Authority to Collect Information
The USCIS office receiving the form shall retain the original, duplicate, and all attachments.
Paperwork Reduction Act
Instructions
