I-600A Petition to Classify Orphan as an Immediate Relative and

OMB No. 1615-0028; Expires 08/31/08

I-600A, Application for Advance
Processing of Orphan Petition

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

Do not write in this block.

For USCIS Use Only.

It has been determined that the:
Married

Fee Stamp

Unmarried

prospective adoptive parent will furnish proper care to
a beneficiary orphan if admitted to the United States.
There:
are
are not
preadoptive requirements in the State of the child's proposed
residence.
The following is a description of the preadoption requirements, if any,
of the State of the child's proposed residence:

DATE OF FAVORABLE
DETERMINATION
DD
DISTRICT

The preadoption requirements, if any,:
have been met.

File number of applicant, if applicable.
have not been met.

Please type or print legibly in black ink.
This application is made by the named prospective adoptive parent for advance processing of an orphan petition.

BLOCK I - Information about the prospective adoptive parent. 8. If you are now married, give the following information:
1. My name is: (Last)

(First)

(Middle)

Date and place of present marriage (mm/dd/yyyy)

2. Other names used (including maiden name if appropriate):

Name of present spouse (include maiden name of wife)

3. I reside in the U.S. at:

(Apt. No.)

Date of birth of spouse (mm/dd/yyyy) Place of birth of spouse

(Zip Code)

Number of prior marriages of spouse

(Number and Street)

(Apt. No.)

My spouse resides

(Province)

(Country)

(Apt. No.)

(Number and Street)
4. Address abroad (If any):
(Town or City)

(C/O if appropriate)
(Town or City)

(State)

5. I was born on: (mm/dd/yyyy)
In:

(Town or City)

6. My telephone number is:

(State or Province)

(Country)

(City)

(State)

(Country)

If acquired through naturalization, give name under which naturalized,
number of naturalization certificate, and date and place of naturalization.

(Include Area Code)

I have been previously married ___________ time(s).

Trans. In

(No. and Street)

Apart from me
(provide address below)

9. I am a citizen of the United States through:
Birth
Parents
Naturalization

7. My marital status is:
Married
Widowed
Divorced
Single
I have never been married.

Received

With me

Ret'd Trans. Out

If not, submit evidence of citizenship. See Instruction 2.a(2).
If acquired through parentage, have you obtained a certificate in your
own name based on that acquisition?
Yes
No
Have you or any person through whom you claimed citizenship ever lost
United States citizenship?
No
Yes (If Yes, attach detailed explanation.)

Completed

Form I-600A (Rev. 07/30/07) Y

BLOCK II - General information.
10. Name and address of organization or individual assisting you in
locating or identifying an orphan
(Name)

No
Yes
15. If the answer to Question 14 is "No," will the child be adopted abroad
after having been personally seen and observed by you and your
spouse, if married?

(Address)
11. Do you plan to travel abroad to locate or adopt a child?
Yes

14. Will the child come to the United States for adoption after compliance
with the preadoption requirements, if any, of the State of proposed
residence?

No

12. Does your spouse, if any, plan to travel abroad to locate or adopt a
child?
Yes
No
13. If the answer to Question 11 or 12 is "Yes," give the
following information:
a. Your date of intended departure
b. Your spouse's date of intended departure

Yes
No
16. Where do you wish to file your orphan petition?
The USCIS office located at
The American Embassy or Consulate at
17. Do you plan to adopt more than one child?
No
Yes
If "Yes," how many children do you plan to adopt?

c. City, province

Certification of prospective adoptive parent.

Certification of married prospective adoptive parent spouse.

(Signature of Prospective Adoptive Parent)

(Signature of Prospective Adoptive Parent Spouse)

Executed on (Date)

Executed on (Date)

I certify, under penalty of perjury under the laws of the United States
of America, that the foregoing is true and correct and that I will care
for an orphan/orphans properly if admitted to the United States.

I certify, under penalty of perjury under the laws of the United States of
America, that the foregoing is true and correct and that my spouse and I
will care for an orphan/orphans properly if admitted to the United States.

Signature of person preparing form, if other than petitioner.
I declare that this document was prepared by me at the request of the
petitioner and is based entirely on information of which I have knowledge.

(Signature)
Street Address and Room or Suite No./City/State/Zip Code
Executed on (Date)

Form I-600A (Rev. 07/30/07) Y Page 2