Form Table of changes

TABLE OF CHANGES – FORM

Form N-426, Request for Certification of Military or Naval Services

OMB Number: 1615-0053

02/24/2015

Reason for Revision: FOD is requesting that the form instructions for Form N-426 follow the same format at the Form N-400 instructions. We are requesting that the instructions be in a full-page format, with standardized headings. This standardization is in accordance with the customer-friendly full-page format of the N-400 instructions.

FOD is also requesting clarifying verbiage in the form instructions. The Nebraska Service Center (NSC) reviews Form N-426 submitted by a military member, and issues a Request for Evidence (RFE) if the Form N-426 is incomplete. NSC has informed FOD that the main reason for issuing an RFE is when the Certifying Official either fails to select the boxes for honorable service or fails to complete the Certification section at the bottom. The revised instructions clarify this requirement. In addition, NSC rejects a number of forms that are certified by military recruiters, who are not authorized to act as certifiers. The revised instruction includes this prohibition.

Current Page Number and Section	Current Text	Proposed Text
Page 1, For USCIS Use Only	[Page 1] For USICS Use Only Date Returned: To: Initials: Comments:	[Delete] [Delete] [Delete] [Delete] [Delete]
Page 1, Instructions	[Page 1] 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. For further assistance, contact the Military Help Line, 1-877-CIS-4MIL (1-877-247-4645) or visit www.uscis.gov/military.	[Page 1] Persons who are serving or have served under specified conditions in the U.S. Armed Forces 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. USCIS requests certification of the service member's military service. Recruiters are not authorized to certify this request. Submit this request with Form N-400, Application for Naturalization. Instructions: Requestors must complete Parts 1. - 4. Certifying officials must complete Parts 5. - 8.
Page 1	[Page 1] Alien Registration Number Military Service Number Name Used During Military Service (Last, First, Middle) U.S. Social Security Number Date of Birth Place of Birth (Country and City) Present Address:	[Page 1] Part 1. Information About You 1. Alien Registration Number (A-Number) (if any) 2. Military Service Number 3. Names Used During Military Service List all names you have used, including your maiden name (if any). If you need extra space to complete this section, use the space provided in Part 9. Additional Information. [2 spaces for names] Family Name (Last Name) Given Name (First Name) Middle Name 4. U.S. Social Security Number (if any) 5. USCIS ELIS Account Number (if any) 6. Date of Birth (mm/dd/yyyy) 7. Place of Birth (city and country) 8. Physical Address Street Number and Name Apt. Ste. Flr. Number City or Town State Zip Code Province or Region (foreign address only) Postal Code Country
NEW	[Page 1] 1. Where did the applicant enlist (Country, State, and City where the applicant entered service)? 2. Has the applicant reenlisted? Y/N 3. Where did the applicant reenlist?	[Page 1] Part 2. Enlistment Information 1. Where did you enlist? City *add data collection boxes* State Country 2. Have you reenlisted? Y/N 3. Where did you reenlist? City *add data collection boxes* State Country
Page 1, Military Service	[Page 1] Military Service List all periods of service. (attach an additional sheet(s) if you need to provide more information.) TO BE COMPLETED BY APPLICANT OR CERTIFYING OFFICIAL [Table with 5 columns] Branch of Service Date Service Began Date Service Ended Type of Service (includes all active, reserve, and National Guard Service) [ ] Active Duty [ ] Selected Reserve of the Ready Reserve* * 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 a 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)	[Page 2] Part 3. Periods of Military Service (To be completed by requestor) Provide all periods of service. If you need extra space to complete this section, use the space provided in Part 9. Additional Information. [Delete] [Table with 5 columns and 4 rows] Military Service [No change] Date Service Began (mm/dd/yyyy) Date Service Ended (mm/dd/yyyy) Type of Service (include all active, reserve, and National Guard Service) [Row 2: Military Service 1/Blank/Blank/Blank/ [ ] Active Duty/[ ] Selected Reserve of the Ready Reserve*] [Row 3: Military Service 2/Blank/Blank/Blank/ [ ] Active Duty/[ ] Selected Reserve of the Ready Reserve*] [Row 4: Military Service 3/Blank/Blank/Blank/ [ ] Active Duty/[ ] Selected Reserve of the Ready Reserve*] * 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 a 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)
NEW And Page 1	[Page 1] Phone Numbers(s): E-Mail Address(es): Date of Request	[Page 2] Part 4. Requestor’s Contact Information, Certification, and Signature Requestor’s Contact Information [Sub-header] 1. Requestor’s Daytime Telephone Number 2. Requestor’s Mobile Telephone Number (if any) 3. Requestor’s Email Address (if any) Requestor’s Certification [Sub-header] I authorize release of information contained in this request, in supporting documents, and in my USCIS records to other entities and persons where necessary for the administration and enforcement of U.S. immigration laws. I certify, under penalty of perjury, that the information in my request and any document submitted with my request were provided by me and are complete, true, and correct. Requestor’s Signature [Sub-header] 4. Requestor’s Signature Date of Signature (mm/dd/yyyy) NOTE TO ALL REQUESTORS: USCIS may deny your request if you do not completely fill out this request or fail to submit required documents listed in the instructions.
Page 1, TO BE COMPLETED BY CERTIFYING OFFICIAL	[Page 1] TO BE COMPLETED BY CERTIFYING OFFICIAL Applicant served honorably or is currently serving honorably? Yes/No (give details in Remarks) Yes/No (give details in Remarks) Yes/No (give details in Remarks) Where did the Applicant enlist (Country, State, and City where the applicant entered service)? Where did the Applicant enlist (Country, State, and City where the applicant entered service)? Where did the applicant reenlist?	[Page 3] Part 5. Character of Service (To be completed by Certifying Official) State whether the requestor served honorably or is currently serving honorably for each period of military service the requestor served (refer to Part 3. Periods of Military Service). If you answer “No,” provide details in Part 7. Remarks. 1. Honorable Period of Military Service 1 Yes/No 2. Honorable Period of Military Service 2 Yes/No 3. Honorable Period of Military Service 3 Yes/No [Delete] [Delete] [Delete]
Page 1, Separation Information	[Page 1] Separation Information Is the applicant separated? Y/N If separated, select discharge type: Honorable/Other (give details in Remarks section) Was the applicant discharged on account of alienage? If you answer “Yes,” provide details in the Remarks section. Y/N	[Page 3] Part 6. Separation Information 1. Is the requestor separated? Y/N 2. If separated, select discharge type: Honorable/Other (provide details in Part 7. Remarks) 3. Was the requestor discharged on account of alienage? If you answer “Yes,” provide details in Part 7. Remarks. Y/N
Page 1, Remarks	[Page 1] 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 action, convictions, or other matters concerning his or her fitness for citizenship. (Use a blank sheet if more space is needed.)	[Page 3] Part 7. Remarks Provide any derogatory information in your records relating to the service member’s character, loyalty to the United States, disciplinary action, convictions, other than honorable discharges, or other matters concerning his or her fitness for citizenship. If you need extra space to complete this section, use the space provided in Part 9. Additional Information.
Page 1, Certification	[Page 1] 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 _________________ Name of Department Official Signature Name and Title Phone Number and E-Mail Address [SEAL, if available] (No State-issued notary Public seals accepted.) Date _________ , ______________	[Page 3] Part 8. 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 request is correct according to the records of the ________________. Name of Department [No change] [No change] Daytime Telephone Number Email Address (if any) Seal, if available (No state-issued notary public seals accepted.) Date _____________
NEW		[Page 4] Part 9. Additional Information If you need extra space to provide any additional information within this request, use the space below. If you need more space than what is provided, you may make copies of this page to complete and file with this request or attach a separate sheet of paper. Include your name and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet. 1. Family Name (Last Name) [Auto-populated field] Given Name (First Name) [Auto-populated field] Middle Name [Auto-populated field] 2. A-Number (if any) [Auto-populated field] 3.A. Page Number B. Part Number C. Item Number D. ________________________________ 4.A. Page Number B. Part Number C. Item Number D. ________________________________ 5.A. Page Number B. Part Number C. Item Number D. ________________________________ 6.A. Page Number B. Part Number C. Item Number D. ________________________________ 7. Requestor’s Signature Date of Signature (mm/dd/yyyy)

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