Form N-600 Application for Certificate of Citizenship

OMB No. 1615-0057; Expires 12/31/2014

Form N-600, Application for
Certificate of Citizenship

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

Print or type all your answers fully and accurately in black ink. Write or type “N/A” if an item is not applicable. Write or type
“None” if the answer is none. Failure to answer all of the questions may delay processing your Form N-600.

Part 1. Information About Your Eligibility (Check only one box.
USCIS will reject your Form N-600 if you check more than one
box.)
This application is being filed based on the fact that:
1.

I am a BIOLOGICAL child of a U.S. citizen parent(s).

2.

I am an ADOPTED child of a U.S. citizen parent(s).

3.

Other (explain fully):

Your A-Number if any:

A

-

-

Bar Code

Date Stamp

Remarks

Part 2. Information About You (Provide information about yourself if
you are a person applying for the Certificate of Citizenship.
Provide information about your child if you are a U.S. citizen
parent applying for a Certificate of Citizenship for your minor
child.)
1. Current Legal Name (do not provide a nickname)
Family Name (last name)
Given Name (first name)

Middle Name (if applicable)

Action

2. Your name exactly as it appears on your Permanent Resident Card (if different
from above)
Family Name (last name)
Given Name (first name)

Middle Name (if applicable)

3. Other name(s) you have used since birth (if applicable. Include nicknames)
Family Name (last name)
Given Name (first name)

4. U.S. Social Security Number (if applicable) 5. Date of Birth (mm/dd/yyyy)

Middle Name (if applicable)

6. Country of Birth

Form N-600 (Rev. 12/16/12) N

Part 2. Information About You (Continued)
7.

Country of Prior Citizenship/Nationality

-

A
8. Gender
Male

-

9. Height
Female

Feet

Inches

10. Home Address
Street Number and Name (do not provide a P.O. Box in this space unless it is your ONLY address)

Apartment Number

City

State

Zip Code

Province (foreign address only)

Country (foreign address only)

Postal Code (foreign address only)

11. Mailing Address
C/O (in care of name, if applicable)

Street Number and Name

Apartment Number

City

State

Zip Code

Province (foreign address only)

Country (foreign address only)

Postal Code (foreign address only)

Work Phone Number (if any)

Evening Phone Number

(

(

12. Daytime Phone Number

(

)

Mobile Phone Number (if any)

(

)

)

13. E-Mail Address (if any)

)

14. Current Marital Status
Single, Never Married
Marriage Annulled

Married

Divorced

Widowed

Other (explain):
Yes

15. Are you a member or veteran of any branch of the U.S. Armed Forces?

No

16. Information about admission into the United States and current immigration status
A. I arrived in the following manner
Port of Entry (City/State)

Date of Entry (mm/dd/yyyy) Exact Name Used at Time of Entry:

B. I used the following travel document to be admitted to the United States
Passport Issuing Country
Passport Number
Passport

Date Passport Issued (mm/dd/yyyy)

Other (specify document name and issuance date(s))

Form N-600 (Rev. 12/16/12) N Page 2

Part 2. Information About You (Continued)

-

A

-

C. I am
A Permanent Resident
A Nonimmigrant
A Refugee/Asylee
Other (explain)
D. I obtained permanent resident status through adjustment of status in the United States or admission as a permanent resident (if
applicable)
USCIS office that granted my permanent resident status or
Date I became a permanent resident
location where I was admitted
(mm/dd/yyyy)

17. Have you previously applied for a Certificate of Citizenship or U.S. passport?

Yes (attach explanation)

No

18. Have you ever abandoned or lost your permanent resident status?

Yes (attach explanation)

No

19. Were you adopted?

Yes (complete the following information)

Date of Adoption (mm/dd/yyyy)

Place of Final Adoption (City/State or Country)

Date Legal Custody Began (mm/dd/yyyy)

Date Physical Custody Began (mm/dd/yyyy)

20. Did you have to be re-adopted in the United States?

Yes (complete the following information)

Date of Final Adoption (mm/dd/yyyy)

Place of Final Adoption (City/State)

Date Legal Custody Began (mm/dd/yyyy)

Date Physical Custody Began (mm/dd/yyyy)

No

No

21. Were your parents married to each other when you were born (or adopted)?

Yes

No

22. Did your parents marry after you were born?

Yes

No

23. Do you regularly reside in the United States in the legal and physical custody of your U.S. citizen
parent(s)?

Yes

No

24. Have you been absent from the United States since you first arrived?

Yes

No

(complete the following information only if you are claiming U.S. citizenship at the time of birth if you were born before
October 10, 1952)
Date You Left the United States
(mm/dd/yyyy)

Date You Returned to the United States
(mm/dd/yyyy)

Place of Entry Upon Return to
the United States (City, State)

Form N-600 (Rev. 12/16/12) N Page 3

Part 3. Information About Your U.S. Citizen Biological Father (or
Adoptive Father) (Complete this section if you are claiming
citizenship through a U.S. citizen biological father (or adoptive
father). Provide information about yourself if you are a U.S.
citizen father applying for a Certificate of Citizenship on behalf of
your minor biological or adopted child.)

-

A

-

1. Current legal name of U.S. citizen father
Family Name (last name)

2. Date of Birth (mm/dd/yyyy)

5.

Given Name (first name)

Middle Name (if applicable)

3. Country of Birth

4. Country of Citizenship/Nationality

Home Address
Street Number and Name (write "Deceased" and date of death if your father has passed away)

Apartment Number

City

State

Zip Code

Province (foreign address only)

Country (foreign address only)

Postal Code (foreign address only)

6. My father is a U.S. citizen by
Birth in the United States
Acquisition after birth through naturalization of alien parent(s)
Birth abroad to U.S. citizen parent(s)
Certificate of Citizenship Number
A-Number (if known)
Naturalization
Date of Naturalization (mm/dd/yyyy)

Place of Naturalization (name of court and City/State or USCIS office location)

Certificate of Naturalization Number

A-Number (if known)

7. Has your father ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship?
Yes (provide full explanation on an additional sheet(s) of paper)

No

8. Marital History
A. How many times has your U.S. citizen father been married (including annulled marriages and marriage(s) to the same
person)?
B. What is your U.S. citizen father's current marital status?
Single, Never Married
Married
Marriage Annulled

Separated

Divorced

Widowed

Other (explain):

Form N-600 (Rev. 12/16/12) N Page 4

Part 3. Information About Your U.S. Citizen Biological Father (or
Adoptive Father) (Continued)

A

-

-

C. Information about U.S. citizen father's current spouse
Family Name (last name)

Given Name (first name)

Middle Name (if applicable)

Date of Birth (mm/dd/yyyy)

Country of Birth

Country of Citizenship/Nationality

Spouse's Home Address
Apartment Number

Street Number and Name
City

State

Zip Code

Province (foreign address only)

Country (foreign address only)

Postal Code (foreign address only)

Date of Marriage (mm/dd/yyyy)

Place of Marriage (City/State or Country)

Spouse's Immigration Status
U.S. Citizen

Permanent Resident

Other (explain):
Yes

D. Is your U.S. citizen father's current spouse also your biological (or adopted) mother?

No

Part 4. Information About Your U.S. Citizen Biological Mother (or Adoptive Mother) (Complete this
section if you are claiming citizenship through a U.S. citizen biological mother (or adoptive
mother). Provide information about yourself if you are a U.S. citizen mother applying for a
Certificate of Citizenship on behalf of your minor biological or adopted child.)
1. Current legal name of U.S. citizen mother
Given Name (first name)
Family Name (last name)

2. Date of Birth (mm/dd/yyyy)

5.

3. Country of Birth

Middle Name (if applicable)

4. Country of Citizenship/Nationality

Home Address
Street Number and Name (write "Deceased" and date of death if your mother has passed away)

Apartment Number

City

State

Zip Code

Province (foreign address only)

Country (foreign address only)

Postal Code (foreign address only)

Form N-600 (Rev. 12/16/12) N Page 5

Part 4. Information About Your U.S. Citizen Biological Mother (or
Adoptive Mother) (Continued)

-

A

-

6. My mother is a U.S. citizen by
Birth in the United States
Acquisition after birth through naturalization of alien parent(s)
Birth abroad to U.S. citizen parent(s)
Certificate of Citizenship Number
A-Number (if known)

Naturalization
Date of Naturalization (mm/dd/yyyy)

Place of Naturalization (name of court and City/State or USCIS office location)

Certificate of Naturalization Number

A-Number (if known)

7. Has your mother ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship?
Yes (provide full explanation on an additional sheet(s) of paper)

No

8. Marital History
A. How many times has your U.S. citizen mother been married (including annulled marriages and marriage(s) to the same
person)?
B. What is your U.S. citizen mother's current marital status?
Single, Never Married

Married

Marriage Annulled

Separated

Divorced

Widowed

Other (explain):

C. Information about U.S. citizen mother's current spouse
Family Name (last name)

Given Name (first name)

Middle Name (if applicable)

Date of Birth (mm/dd/yyyy)

Country of Birth

Country of Citizenship/Nationality

Spouse's Home Address
Street Number and Name

Apartment Number

City

State

Zip Code

Province (foreign address only)

Country (foreign address only)

Postal Code (foreign address only)

Date of Marriage (mm/dd/yyyy)

Place of Marriage (City/State or Country)

Spouse's Immigration Status
U.S. Citizen

Permanent Resident

Other (explain):

D. Is your U.S. citizen mother's current spouse also your biological (or adopted) father?

Yes

No

Form N-600 (Rev. 12/16/12) N Page 6

Part 5. Physical Presence in the United States From Birth Until Filing
of Form N-600 (Only applicants born outside the United States
claiming to have been born U.S. citizens are required to provide all
the dates when your U.S. citizen biological father or U.S. citizen
biological mother resided in the United States. Include all dates
from your birth until the date you file your Form N-600.)
Indicate whether this information relates to your U.S. citizen
(USC) father or mother

-

A

-

USC Mother

USC Father

Physical Presence in the United States (mm/dd/yyyy)
From

Until

From

Until

From

Until

From

Until

From

Until

From

Until

From

Until

From

Until

Part 6. Information About Military Service of U. S. Citizen Parent(s) (Complete this only if you are an
applicant claiming U.S. citizenship at time of birth abroad.)
Yes

1. Has your U.S. citizen parent(s) served in the U.S. Armed Forces?
U.S. Citizen Father

2. If "Yes," which parent?

No

U.S. Citizen Mother

3. Dates of Service (if time of service fulfills any of required physical presence, submit evidence of service)
From (mm/dd/yyyy)

4. Type of discharge

From (mm/dd/yyyy)

To (mm/dd/yyyy)

Honorable

To (mm/dd/yyyy)

Other than Honorable

Dishonorable

Part 7. Your Signature (USCIS will reject your Form N-600 if it is not signed.)
I certify, under penalty of perjury under the laws of the United States, that this application and the evidence submitted with it is all true
and correct. I authorize the release of any information from my records, or my minor child's records, that U.S. Citizenship and
Immigration Services needs to determine eligibility for the benefit I am seeking.
Your Signature (parent may sign on behalf of a minor child)

Date (mm/dd/yyyy)

Part 8. Signature of Person Who Prepared This Form N-600 For You (if applicable)
I declare that I prepared this application at the request of the above person. The answers provided are based on information of which I
have personal knowledge and/or were provided to me by the above-named person in response to the questions contained on this form.
Preparer's Printed Name

Preparer's Signature

Date (mm/dd/yyyy)

Form N-600 (Rev. 12/16/12) N Page 7

Part 8. Signature of Person Who Prepared This Form N-600 For You
(if applicable)
Preparer's Firm or Organization Name (if applicable)

-

A

-

Preparer's Daytime Phone Number

(

)

Preparer's Address
Street Number and Name

City

State

Zip Code

Province (foreign address only)

Country (foreign address only)

Postal Code (foreign address only)

Preparer's E-Mail Address

Preparer's Fax Number

(

)

NOTE: Do not complete the next part unless the USCIS officer instructs you to do so at the interview.

Form N-600 (Rev. 12/16/12) N Page 8

Part 9. Affidavit (do NOT complete this part unless instructed to do so AT
THE INTERVIEW)

-

A

-

I, the (applicant, parent, or legal guardian)
do swear or affirm, under penalty of perjury
under the laws of the United States, that I know and understand the contents of this application signed by me, and the attached
supplementary pages number (
) to (
) inclusive, that the same are true and correct to the best of my knowledge, and that
corrections number (
) to (
) were made by me or at my request.
Applicant's, Parent's, or Legal Guardian's Signature

Date (mm/dd/yyyy)

Subscribed and sworn or affirmed before me upon examination of the applicant (parent, legal guardian) on

at

(mm/dd/yyyy)

.
(Location)
USCIS Officer's Signature

USCIS Officer's Name and Title

Part 10. Officer Report and Recommendation on Application for Certificate of Citizenship (for USCIS
use ONLY)
On the basis of the documents, records, the testimony of person(s) examined, and the identification upon personal appearance of the
underage beneficiary, I find that all the facts and conclusions set forth under oath in this application are:
1.

True and correct

2.

The applicant derived or acquired U.S. citizenship on
(mm/dd/yyyy)

3.

The applicant derived or acquired U.S. citizenship through (mark “X” next to the appropriate section of law, or if the section of
law is not reflected, write the applicable section of law in the space next to “Other”)
Section 301 of the INA
Section 309 of the INA
Section 320 of the INA
Section 321 of the INA
Other:

4.

The applicant has not been expatriated since that time

I recommend that this Form N-600 application be

Approved

Denied

Issue Certificate of Citizenship in the name of
Last Name

First Name

Middle Name

USCIS Officer's Name and Title

USCIS Officer's Signature

Date (mm/dd/yyyy)

I do

do not

concur with the USCIS Officer's recommendation of the Form N-600.

USCIS District Director's or Field Office Director's Signature

Date (mm/dd/yyyy)

Form N-600 (Rev. 12/16/12) N Page 9