DATE
FILE NO.
NAME OF APPLICANT
CLERK,
NATIVE OF
APPROXIMATE DATE OF
NATURALIZATION
NAME OF ALLEGEDLY NATURALIZED PERSON
.
Sincerely,
DATE OF NATURALIZATION
NAME OF NATURALIZED PERSON AS SHOWN IN COURT RECORDS
COURT (Title and Location)
CERTIFICATE NUMBERPETITION NUMBER
DATE AND PLACE OF BIRTH (or age)
FORMER ALLEGIANCE
PLACE OF RESIDENCE OCCUPATION
DATE, PLACE AND MANNER OF ARRIVAL IN THE UNITED STATES
NAMES OF WITNESSES (if applicable)
NAME OF SPOUSEMARITAL STATUS
NAMES OF CHILDREN, DATES AND PLACES OF BIRTH
OTHER INFORMATION APPEARING ON RECORD
DECLARATION OF INTENTION FILED
(Date)
AGE OR DATE OF BIRTH
Date
U.S. Department of Justice
Immigration and Naturalization Service
Request for Verification of Naturalization
.
..
.
OMB No. 1115-0007
Signature and Title of person verifying Report
The person named above is alleged to have been naturalized in your court. If your records show that this person was naturalized,
please fill out the blocks as completely as your records permit. If no naturalization record is found, write "No Record" above your
signature. However, if a Declaration of Intention was filed, please fill in the lower block. If the subject's signature is available,
please make one tracing on thin paper and return it with this report. The information is requested for the official use of INS.
Form N-25 (Rev. 10/11/00)Y
Reporting Burden.
A person is not required to respond to a collection of information unless it displays a currently valid OMB control number. This
collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for reducing this burden to: Immigration and Naturalization Service, HQPDI, 425 I
Street, N.W., Room 4034, Washington, DC 20536; OMB No. 1115-0104.
DO NOT MAIL YOUR COMPLETED APPLICATION TO THIS
ADDRESS.
