Form N-300 Application to File Declaration of Intention

OMB No. 1615-0078; Expires 06/30/07

N-300, Application to File
Declaration of Intention

Department of Homeland Security
U.S. Citizenship and Immigration Services

Instructions
What Is the Purpose of This Form?

What Is the Fee?

This form is for a permanent resident to apply for a
Declaration of Intention to become a citizen of the
United States. A Declaration of Intention is not
required for naturalization, but may be required by some
States if you wish to engage in certain occupations or
professions, or obtain various licenses.

The fee for this application is $120.00. The fee must be
submitted in the exact amount.

Who May File?
If you are a lawful permanent resident over the age of
18 years, you may apply for a Declaration of Intention.
You must be in the United States when you file this
application.

What Initial Evidence Must Be Submitted?
After ensuring that the personal information required on
all 3 pages of the application is complete, you must file
your application with:
A copy of your Permanent Resident Card (Form
I-551) or other evidence that you are a lawful
permanent resident.
Photos. You must submit two identical, natural
color passport-style photographs of yourself taken
within 30 days of filing this application. The photos
must have a white background, be unmounted
printed on thin paper and be glossy and unretouched
face, with your head bare (unless you are wearing a
headdress as required by a religious order of which
you are a member). The photographs should be no
larger than 2 x 2 inches, with the distance from the
top of the head to just below the chin about 1 and 1/4
inches. Lightly print your Alien Registration
Number (A#) on the back of each photo with a
pencil. Using a pen, sign your full name in English
on the front of each photograph in such a manner as
not to obscure your features.

The fee cannot be refunded. Do not mail cash. All
checks and money orders must be drawn on a bank or
other institution located in the United States and must be
payable in United States currency. The check or money
order should be made payable to the Department of
Homeland Security, unless:
If you live in Guam and are filing this application
there, make your check or money order payable to
the "Treasurer, Guam."
If you live in the U.S. Virgin Islands and are filing
this application there, make your check or money
order payable to the "Commissioner of Finance of
the Virgin Islands."
Checks are accepted subject to collection. An
uncollected check will render the application and any
document issued invalid. A charge of $30.00 will be
imposed if a check in payment of a fee is not honored by
the bank on which it is drawn.
How to Check If the Fee Is Correct.

The fee on this form is current as of the edition date
appearing in the lower right corner of this page. However,
because USCIS fees change periodically, you can verify if
the fee is correct by following one of the steps below:
Visit our website at www.uscis.gov and scroll down to
"Forms and E-Filing" to check the appropriate fee, or
Review the Fee Schedule included in your form
package, if you called us to request the form, or
Telephone our National Customer Service Center at
1-800-375-5283 and ask for the fee information.

Where Must You File the Application?
File this application at the local office of the U.S.
Citizenship and Immigration Services (USCIS) having
jurisdiction over your place of residence.

Form N-300 Instructions (Rev. 10/26/05)Y

How Will the Application Be Processed?
Acceptance. Any application that is not signed or
accompanied by the correct fee will be rejected with
a notice that the application is deficient. You may
correct the deficiency and resubmit the application.
However, an application is not considered properly
filed until accepted by USCIS.
Initial Processing. Once the application has been
accepted, it will be checked for completeness,
including submission of the required initial evidence.
If you do not completely fill out the form or file it
without the required initial evidence, you will not
establish a basis for eligibility and we may deny your
application.

Use InfoPass to Make an Appointment.
As an alternative to waiting in line for assistance at your
local USCIS office, you can now schedule an
appointment through our internet-based system,
InfoPass. To access the system, visit our website at
www.uscis.gov. Use the InfoPass appointment
scheduler and follow the screen prompts to set up your
appointment. InfoPass generates an electronic
appointment notice that appears on the screen. Print the
notice and take it with you to your appointment. The
notice gives the time and date of your appointment,
along with the address of the USCIS office.

Privacy Act Notice.

Requests for More Information. We may request
more information or evidence, or we may request
that you appear at a USCIS office for an interview.
We may also request that you submit the originals of
any copy. We will return these originals when they
are no longer needed.

We ask for the information on this form, and associated
evidence to determine if you have established eligibility
for the immigration benefit. Our legal right to ask for
this information is noted in 8 U.S.C. 1445. We may
provide this information to other government agencies.
Failure to provide this information and any requested
evidence may delay a final decision or result in denial of
your request.

Decision. You will be notified in writing of the
decision on your application. If your application is
approved, the Declaration of Intention will be issued.

Paperwork Reduction Act Notice.

What Are the Penalties for Fraud or
Misrepresentation?

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.

If you knowingly and willfully falsify or conceal a
material fact or submit a false document with this
request, we will deny the benefit you are filing for and
may deny any other immigration benefit. In addition,
you will face severe penalties provided by law and may
be subject to criminal prosecution.

We try to create forms and instructions that are accurate,
can be easily understood and that impose the least
possible burden on you to provide us with information.
Often this is difficult because some immigration laws
are very complex.

How Can You Get Information and USCIS
Forms?
To request USCIS forms, call our toll-free forms line at
1-800-870-3676. You may also get USCIS forms and
information about immigration laws and regulations by
calling our National Customer Service Center at
1-800-375-5283 or visiting the USCIS internet website
at www.uscis.gov.

Accordingly, the reporting burden for this collection of
information is computed as follows: (1) 5 minutes to
learn about the law and form; (2) 5 minutes to complete
the form; and (3) 35 minutes to assemble and file the
petition; for an estimated average of 45 minutes petition.
If you have comments regarding the accuracy of this
estimate, or suggestions for making this form simpler,
you may write to the: U.S. Citizenship and Immigration
Services, Regulatory Management Division, 111
Massachusetts Avenue, N.W., Washington, D.C. 20529;
OMB No. 1615-0078. Do not mail your completed
application to this address.

Form N-300 Instructions (Rev. 10/26/05)Y Page 2

OMB No. 1615-0078; Expires 06/30/07

N-300, Application to File
Declaration of Intention

Department of Homeland Security
U.S. Citizenship and Immigration Services

START HERE - Please type or print in black ink.
Part 1. Information about you. (NOTE: Applicant must complete

For USCIS Use Only
Receipt

Returned

all three pages of this form.)

Family Name

Given Name

Middle Name
Resubmitted

Address - C/O
Street Number and Name
City

Apt. #
State or Province

Country

Zip/Postal Code

Date of Birth (mm/dd/yyyy) Country of Birth

Country of Citizenship

U.S. Social Security # (If any)

A# (If any)

Telephone Number

E-Mail Address (If any)

(

Reloc Sent

)

Reloc Rec'd

Applicant
Interviewed

Part 2. Processing Information.
Date you became a permanent resident (mm/dd/yyyy)
Since you were admitted to the United States as a permanent resident, have you been absent for a
period of six months or longer?
No
Yes Attach a list of departure/arrival dates of all
absences.
Read
the
information
on
penalties in the instructions before
Part 3. Signature.
completing this section. You must be in the United States when you
file this application. You must sign your name below and also sign
your name in the appropriate places (Signature of Applicant on Pages
2 and 3) of this form.
I desire to declare my intention to become a citizen of the United States. I certify, under penalty
of perjury under the laws of the United States of America, that this application and the evidence
submitted with it is all true and correct. I authorize release of any information from my records
that the U.S. Citizenship and Immigration Services needs to determine eligibility for the benefit
I am seeking.
Date
Signature

Action Block

Part 4. Signature of person preparing form, if other than above.
(Sign below.)
I declare that I prepared this application at the request of the above person and it is based on all
information of which I have any knowledge.
Signature
Date
Print Your Name

To Be Completed by
Attorney or Representative, if any

Firm Name

Fill in box if G-28 is attached to
represent the applicant.

Firm Address

ATTY State License #
Telephone Number

(

)

E-Mail Address (If any)
Form N-300 (Rev. 10/26/05)Y

Original to be retained by USCIS - Duplicate to be given to:
Family Name

Given Name

Middle Name

Address - C/O
Street Number and Name

Apt. #

City

State or Province

Country

Photograph

Zip/Postal Code

Date of Birth (mm/dd/yyyy) Country of Birth
A# (If any)

Telephone Number

E-Mail Address (If any)

)

Here

Country of Citizenship

U.S. Social Security # (If any)

(

Affix

I am over the age of 18 years, have been lawfully admitted to the United States as a
permanent resident and am now residing in the United States pursuant to such
admission.

Not valid unless DHS Seal
applied below.

I hereby declare my intention in good faith to become a citizen of the United States and
I certify that the photographs affixed to the original and duplicate hereof are a likeness
of me and were signed by me.
I do swear (or affirm) that the statements I have made and the intentions I have
expressed in this declaration of intention subscribed by me are true to the best of my
knowledge and belief.

Signature of Applicant

Signature of Authorizing Official

Date

Date

Original Copy/Retained by USCIS

Form N-300 (Rev. 10/26/05)Y Page 2

Original to be retained by USCIS - Duplicate to be given to:
Family Name

Given Name

Middle Name

Address - C/O
Street Number and Name

Apt. #

City

State or Province

Country

Photograph

Zip/Postal Code

Date of Birth (mm/dd/yyyy) Country of Birth

Here

Country of Citizenship

U.S. Social Security # (If any)

A# (If any)

Telephone Number

E-Mail Address (If any)

(

Affix

)

I am over the age of 18 years, have been lawfully admitted to the United States as a
permanent resident and am now residing in the United States pursuant to such
admission.

Not valid unless DHS Seal
applied below.

I hereby declare my intention in good faith to become a citizen of the United States and
I certify that the photographs affixed to the original and duplicate hereof are a likeness
of me and were signed by me.
I do swear (or affirm) that the statements I have made and the intentions I have
expressed in this declaration of intention subscribed by me are true to the best of my
knowledge and belief.

Signature of Applicant

Signature of Authorizing Official

Date

Date

Duplicate Copy/Given to Applicant

Form N-300 (Rev. 10/26/05)Y Page 3