Form N-426 Request for Certification of Military or Naval Service

OMB No. 1615-0053; Expires 09/30/2010

N-426, Request for Certification
of Military or Naval Service

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

Instructions
NOTE: Type or print clearly with black ink. Be sure this form and the complete return address are legible. Do not leave
any questions unanswered. When appropriate, insert "None," "Not Applicable," or "N/A." For further assistance, contact
the Military Help Line, 1-877-CIS-4MIL (1-877-247-4645) or visit www.uscis.gov/military.

What Is the Purpose of This Form?
This form is for current or former members of the U.S.
Armed Forces who are applying for naturalization under
the Immigration and Nationality Act. Completion and
certification of this form by the applicant and certifying
official will serve as an authenticated certification of
military service. Submit all pages of the form.
Failure to provide the information requested, with the
exception of your U.S. Social Security Number (SSN),
may delay a final decision or result in denial of your
Form N-400, Application for Naturalization. Your
application will not be denied for failure to provide your
SSN; however, it may prove difficult to verify your
military service if you do not provide it since military
records are indexed by SSN.

All or part of the information solicited may as a matter of
routine use be disclosed to courts exercising
naturalization jurisdiction and to other Federal, State,
local, and foreign law enforcement and regulatory
agencies, the Department of Defense, including any
component thereof, Selective Service System,
Department of State, Department of the Treasury, Central
Intelligence Agency, Interpol, and individuals and
organizations that process the application for
naturalization, or during the courses of investigations, to
elicit further information required by USCIS to carry out
its functions.
Failure to provide any or all of the solicited information
may delay the naturalization process or result in a failure
to locate military records or prove qualifying military
service.

DRAFT - Not For Production

How to File

If you are applying for naturalization under section 328
or 329 of the Immigration and Nationality Act, submit
this form along with:
1. Form N-400, Application for Naturalization;
2. Copy of Form DD-214, Certificate of Release or
Discharge from Active Duty; and
3. Form G-325B, Biographic Information.
Refer to "Where to File?" of the filing instructions for
Form N-400.

Authority for Collecting This Information
Our authority for collecting the information requested
on this form is contained in sections 328 and 329 of the
Immigration and Nationality Act (8 U.S.C. 1439
and 1440).

Paperwork Reduction Act

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 20
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
Management Division, 111 Massachusetts Avenue, N.
W., 3rd Floor, Suite 3008, Washington, DC 20529-2210.
OMB No. 1615-0053. Do not mail your application to
this address.

Information solicited that indicates a violation or
potential violation of law, whether civil, criminal, or
regulatory in nature, may be referred as a routine use to
the appropriate agency, whether Federal, State, local, or
foreign, charged with the responsibility of investigating,
enforcing, or prosecuting such violations.
Form N-426 Instructions (Rev. 03/24/09))Y

OMB No. 1615-0053; Expires 09/30/2010

N-426, Request for Certification
of Military or Naval Service

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

Persons who are serving or have served under specified conditions in the Armed Forces of the United States are granted certain exemptions
from the general requirements for naturalization. To establish eligibility, the law requires the department with custody of the service record
to certify whether the service member served honorably, and whether each separation from the service was under honorable conditions.
Certification of the service member's military service listed on this form is required. Submit this form with Form N-400, Application for
Naturalization. If the service member was issued Form DD 214, Certificate of Release or Discharge from Active Duty, attach a photocopy.
For further assistance, contact the Military Help Line, 1-877-CIS-4MIL (1-877-247-4645) or visit www.uscis.gov/military.

A

Alien Registration Number

Military Service Number

Name Used During Active Service (Last, First, Middle)

U.S. Social Security Number

For USCIS Use Only
Date Returned:
To:
Initials:
Comments:

Date of Request

Date of Birth

Place of Birth (Country and City)

Present Address:
Phone Number(s):

E-Mail Address(es):

Military Service
List all periods of service. (Use a blank sheet if more space is needed.)
TO BE COMPLETED BY
APPLICANT OR CERTIFYING OFFICIAL
Branch of Service

Date Service Began

Date Service Ended

TO BE COMPLETED BY
CERTIFYING OFFICIAL
Applicant served honorably or
is currently serving honorably?

Type of Service (includes all active, reserve,
and National Guard Service)
Active Duty
Selected Reserve of the Ready Reserve*
Other _________________________

Yes

No (give details in Remarks)

Active Duty
Selected Reserve of the Ready Reserve*
Other _________________________

Yes

No (give details in Remarks)

DRAFT - Not For Production
Active Duty
Selected Reserve of the Ready Reserve*
Other _________________________

Yes

No (give details in Remarks)

*Selected Reserve of the Ready Reserve members: (1) participate in at least 48 scheduled drills or training periods during each year and serve on active duty for
training at least 14 days each year; or (2) participate in training at encampments, maneuvers, outdoor target practice, or other exercises at least 15 days each year.
(10 U.S.C. 10143)

Where did the applicant enlist (Country, State, and City where the applicant entered service)?
Has the applicant reenlisted?

Yes

No

Where did the applicant reenlist?

Signature of Applicant
Separation Information
Is the applicant separated ?

Yes

No

If separated, select discharge type:

Honorable

Other (give details in Remarks section)

Was the applicant discharged on account of alienage?

Yes

No (if "Yes," give details in Remarks section)

Remarks
Use for continuation of any of the above items. You should also list in the space below any derogatory information in your records relating to the service member's
character, loyalty to the United States, disciplinary actions, convictions, or other matters concerning his or her fitness for citizenship. (Use a blank sheet if more
space is needed.)

Certification
TO BE COMPLETED BY CERTIFYING OFFICIAL
I am authorized to certify that the information given here concerning the service of the person named on this form is correct according to the records of the
________________________________________________________________ Official Signature _____________________________________________________
Name of Department
Name and Title _______________________________________________________
[SEAL, if available]
(No State-issued notary
Phone Number and E-Mail Address _______________________________________
Date _______________, ______________
Public seals accepted.)
Form N-426 (Rev. 03/24/09)Y