Electronic intake questions

N400 ONLINE FORM: QUESTIONS WITH INSTRUCTIONAL AND HELP TEXT
Instructional text: Text that appears directly below a question and provides instructions for answering the question. (In some cases, like in the Crimes and Offenses section, instructional text may appear above a set of questions.) Help text: Text that appears below or next to an input field, partially hidden. Users can click to expand. Provides additional contextual or clarifying information about a question.							The OMB Control #, along with burden stmt and Privacy stmt will be on form
New form questions (from Feb. 2016 N-400) and updated form copy are highlighted in blue
Step	Section	Question	Sub-Question	Field Type	Instructional Text	Help Text	Response to OMB
Getting Started	Your Basis for Eligibility	What is your basis for eligibility?	I am at least 18 years of age and have been a lawful permanent resident of the United States for at least 5 years.	Radio
			I am at least 18 years of age and have been a lawful permanent resident of the United States for at least 3 years. In addition, I have been married to and living with a U.S. citizen spouse for the last 3 years, and my spouse has been a U.S. citizen for the last 3 years at the time I filed my Form N-400.	Radio
			I am at least 18 years of age, I am a lawful permanent resident of the United States, and I am the spouse of a U.S. citizen and my U.S. citizen spouse is regularly engaged in specified employment abroad.	Radio
			I am at least 18 years of age and am applying on the basis of qualifying military service.	Radio
			Other	Radio
	Your interpreter and/or preparer information	Is anyone helping you fill out this application?	Yes/No	Radio
			Someone assisted me in completing the application	Checkbox
		What is your preparer's full name	Given name (first name)	Text
			Family name (last name)	Text
		What is your preparer's business or organization name (if any)?		Text
			My preparer is not part of a business or organization.	Checkbox
		What is your preparer's mailing address?	Country	Text
			Street number and name	Text
			Apt/Ste/Flr	Dropdown
			Number	Text
			City or town	Text
			State	Dropdown
			ZIP code + 4	Text
			County	Text
		What is your preparer's contact information?	Daytime phone number	Text
			Mobile phone number (if any)	Text
			Email address (if any)	Text
			The preparer does not have an email address.	Checkbox
		What is your interpreter's full name	Given name (first name)	Text
			Family name (last name)	Text
		What is your interpreter's business or organization name (if any)?		Text
			My preparer is not part of a business or organization.	Checkbox
		What is your interpreter's mailing address?	Country	Text
			Street number and name	Text
			Apt/Ste/Flr	Dropdown
			Number	Text
			City or town	Text
			State	Dropdown
			ZIP code + 4	Text
			County	Text
		What is your interpreter's contact information?	Daytime phone number	Text
			Mobile phone number (if any)	Text
			Fax number	Text
			Email address	Text
			The interpreter does not have an email address.	Checkbox
		Other than English, what language is your interpreter using to interpret this application for you?		Text
	Your name	What is your current legal name?	Given name (first name)	Text	Your current legal name is the name on your birth certificate, unless it changed after birth by a legal action such as marriage or court order. Do not provide any nicknames here.
			Middle name (if applicable)	Text
			Family name (last name)	Text
		Have you used any other names since birth?	Yes/No	Radio	Provide any other names you have used, including nicknames, aliases, and maiden names.
		(If yes)	Given name (first name)	Text
			Middle name (if applicable)	Text
			Family name (last name)	Text
		Would you like to legally change your name?	Yes/No	Radio	Provide the new full name you would like to use. Any name change you request here will not be final until you are naturalized. You do not need to request a name change if you legally changed your name because of marriage or divorce. A court can allow you to change your name when you are naturalized. If you want the court to change your name at your naturalization oath ceremony, provide the new name you would like to use. We cannot process name change requests for members of the military or their spouses who are naturalizing overseas.
		(If yes)	Given name (first name)	Text
			Middle name (if applicable)	Text
			Family name (last name)	Text
	Your contact information	How can we contact you?	Mobile phone number (if any)	Text
			Daytime phone number	Text
			This is the same as my mobile phone number.	Checkbox
			Evening phone number	Text
			This is the same as my mobile phone number.	Checkbox
			Work telephone number (if any)	Text
			Email address (if any)	Text
		What is your current mailing address?	Country	Dropdown	We will send a letter to your mailing address to contact you throughout the naturalization process. We may not be able to contact you if you do not provide a complete and valid mailing address.	Instructions for P.O. Box numbers, students, spouses of U.S. citizens employed abroad, and applicants receiving benefits under the Violence Against Women Act (VAWA): Post Office (P.O.) Box numbers: Do not provide a P.O. Box number unless it is your only address. Students: If you are still financially dependent on your parents, you may apply for naturalization either where you go to school or where your family lives. Spouses of U.S. citizens employed abroad: If you are residing outside of the United States, are filing under INA section 319(b), and want us to collect your biometrics in the United States, then you must provide an address in the United States. We will send a letter to that mailing address notifying you when and where to go for biometrics services. Applicants receiving benefits under the Violence Against Women Act (VAWA): If you received benefits under VAWA, you are not required to disclose the confidential address of a shelter. If you are residing at a shelter at the time of filing this application, you may provide a "safe address" where you are able to receive mail. If you are not currently residing in a shelter, but have resided in a shelter for part of the reporting period, you may provide the city and state of residence alone.
			Street number and name	Text
			Apt/Ste/Flr	Dropdown
			Number	Text
			City or town	Text
			State	Text
			ZIP code	Text
			County	Text
			In care of name (if any)	Text
	When and where you were born	What is your date of birth?		Date
		What is your country of birth?		Text
	Your immigration information	What is your country of citizenship or nationality?		Text	Provide the name of the country as it currently exists, where you are currently a citizen or national. If the country no longer exists, use the current name of the country. If you are a citizen or national of more than one country, provide the name of the foreign country that issued your last passport. If you are stateless, enter the name of the current country where you were last a citizen or national.
		On what date did you become a lawful permanent resident?		Date		Provide the official date when your permanent residence began as shown on your Permanent Resident Card (formerly known as the Alien Registration or "Green Card"). [Image with sample green card and arrow to date]
			I am not a lawful permanent resident of the United States.	Checkbox
		What is your name exactly as it appears on your permanent residence card?	The name on my permanent resident card matches my full legal name.	Checkbox	Provide your name exactly as it appears on your permanent resident card even if it is misspelled.
			Given name (first name)	Text
			Middle name (if applicable)	Text
			Family name (last name)	Text
		What is your A-Number?		Text		Your A-Number is located on your Permanent Resident Card (formerly known as the Alien Registration or "Green Card"). [Image with sample green card and arrow to number] The A-Number on your card consists of a 7, 8, or 9-digit number, depending on when your card was issued.
		What is your U.S. Social Security Number?		Text
			I do not have a U.S. Social Security Number.	Checkbox
		What is your USCIS Online Account Number?		Text	The USCIS Online Account Number is not the same as an A-Number. If you previously filed an application, petition, or request using the USCIS online filing system, provide the USCIS Online Account Number you were issued. The USCIS Online Account Number was previously called the USCIS Electronic Immigration System, (USCIS ELIS). You can find your USCIS Online Account Number by logging in to your account and going to the profile page. If you previously filed certain applications, petitions, or requests on a paper form via a USCIS Lockbox facility, you may have received a USCIS Online Account Access Notice issuing you a USCIS Online Account Number. This number can be found on the top of the notice.
			I do not have a USCIS online account number.	Checkbox
About You	Describe yourself				We require you to complete the categories below to conduct background checks. Providing this information as part of your application may reduce the time you spend at your Biometric Services Appointment.
		What is your gender?	Male/Female	Radio
		What is your ethnicity?	Hispanic or Latino/Not Hispanic or Latino	Radio		Hispanic or Latino: Hispanic or Latino refers to a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.
		What is your race? (Select all that apply.)	White	Checkbox		White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
			Asian	Checkbox		Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
			Black or African American	Checkbox		Black or African American: A person having origins in any of the black racial groups of Africa.
			American Indian or Alaska Native	Checkbox		American Indian or Alaska Native: A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.
			Native Hawaiian or Other Pacific Islander	Checkbox		Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
		What is your height?	Feet/Inches	Text
		What is your weight?	Pounds	Text
		What is the color of your eyes?	Black/Blue/Brown/Gray/Green/Hazel/Maroon/Pink/ Unknown/Other	Dropdown
		What is the color of your hair?	Bald (No Hair)/Black/Blonde/Brown/Gray/Red/Sandy/White/ Unknown/Other	Dropdown
	Where you have lived	Where do you live now?	Country	Dropdown		Instructions for P.O. Box numbers, students, spouses of U.S. citizens employed abroad, and applicants receiving benefits under the Violence Against Women Act (VAWA): Post Office (P.O.) Box numbers: Do not provide a P.O. Box number unless it is your only address. Students: If you are still financially dependent on your parents, you may apply for naturalization either where you go to school or where your family lives. Spouses of U.S. citizens employed abroad: If you are residing outside of the United States, are filing under INA section 319(b), and want us to collect your biometrics in the United States, then you must provide an address in the United States. We will send a letter to that mailing address notifying you when and where to go for biometrics services. Victims of domestic violence: If you are a victim of domestic violence, you are not required to disclose the confidential address of a shelter or safe house. If you do not feel safe providing your current address, you may provide a "safe address" where you are able to receive mail. If you resided in a shelter or safe house for part of the reporting period, you may provide just the name of the city and state of residence for the shelter or safe house.
			Street number and name	Text
			Apt/Ste/Flr	Dropdown
			Number	Text
			City or town	Text
			State	Text
			ZIP code	Text
			County	Text
			I live at my current mailing address.	Checkbox
		When did you move here?	From	Date
		Where else have you lived during the last 5 years?	Country	Dropdown
			Street number and name	Text
			Apt/Ste/Flr	Dropdown
			Number	Text
			City or town	Text
			State	Text
			ZIP code	Text
			County	Text
		When did you live here?	FROM/TO
		In which USCIS field office would you like to have your naturalization interview?		Dropdown
	School and employment	Where have you worked and/or attended school (full time or part time) during the last 5 years?	School Employer Unemployed Self-employed		Provide where and when you have worked or attended school full-time or part-time during the last 5 years. Include all military, police, and/or intelligence service and provide information for the complete time period.
		Add a school
		What is the name of the school?		Text
		What was your occupation?		Text
		On what dates did you attend this school?	FROM/TO	Date
			I am currently attending this school.	Checkbox
		What is the school address?	Country	Text
			Street number and name	Text
			Apt/Ste/Flr	Dropdown
			Number	Text
			City or town	Text
			State	Dropdown
			ZIP code + 4	Text
			County	Text
		Add an employer
		What is the name of your employer?		Text
		What was your occupation?		Text
		On what dates were you employed here?	FROM/TO	Date
			I am currently working here.	Checkbox
		What is the employer's address?	Country	Text
			Street number and name	Text
			Apt/Ste/Flr	Dropdown
			Number	Text
			City or town	Text
			State	Dropdown
			ZIP code + 4	Text
			County	Text
		Add a period of unemployment		Text
		On what dates were you unemployed?	FROM/TO	Date
			I am currently unemployed.	Checkbox
		Add a period of self-employment
		What is the name of your employer?		Text
		What was your occupation?		Text
		On what dates were you employed here?	FROM/TO	Date
			I am currently working here.	Checkbox
		What is the employer's address?	Country	Text
			Street number and name	Text
			Apt/Ste/Flr	Dropdown
			Number	Text
			City or town	Text
			State	Dropdown
			ZIP code + 4	Text
			County	Text
	Military service	Have you EVER served in the U.S. armed services?	Yes/No	Radio
		Are you currently a member of the U.S. armed forces?	Yes/No	Radio
		Are you scheduled to deploy overseas, including to a vessel, within the next three months?	Yes/No	Radio
		Are you currently stationed overseas?	Yes/No	Radio
	Selective service	Are you a male who lived in the United States at any time between your 18th and 26th birthdays?	Yes/No	Radio
		Did you register for the Selective Service?	Yes/No	Radio
		(IF YES) On what date did you register for the Selective Service?		Text
		(IF YES) What is your Selective Service Number?		Text
		(IF NO & ≥ 18 < 26) On what date did you register for the Selective Service?		Text
		(IF NO & ≥ 18 < 26) What is your Selective Service Number		Text
		(IF NO & ≥ 26) Why did you not register with the Selective Service?		Text area
	Travel outside the U.S.	List all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years.	Date you left the United States.	Date	Provide information for all trips you have taken outside the United States, including short trips that lasted longer than 24 hours and visits to Canada and Mexico. We count the day you depart from the United States and the day you return as days in the United States.
			Date you returned to the United States.	Date
			Countries to which you traveled.	Text area
		I have not left the country in the last 5 years.		Checkbox
	Request for accommodations	You are eligible for an exemption from the English language test.	You are 50 years old or older and have lived in the United States as a lawful permanent resident for periods at least 20 years. You do not have to take the English language test, but you do have to take the civics test in the language of your choice.	Alert
			You are 55 years old or older and have lived in the United States as a lawful permanent resident for periods at least 15 years. You do not have to take the English language test, but you do have to take the civics test in the language of your choice.	Alert
		You are eligible for an exemption from the English language test. You may also take a simplified version of the civics test.	You are 65 years old or older and have lived in the United States as a lawful permanent resident for periods at least 20 years. You may not have to take the English language test.	Alert
		Do you have a physical or developmental disability or mental impairment that prevents you from demonstrating your knowledge and understanding of the English language and/or civics requirements for naturalization?	Yes/No	Radio	In order to request a disability exemption, your disability or impairment must affect your ability to read, write, or speak the English language or learn U.S. civics, even with accommodations. Your disability must have affected you for at least 1 year or be expected to last longer than 1 year. If you qualify for a disability exception, an interpreter who is fluent in English and the language of your choice must come with you to your interview. You cannot qualify for a disability exception based on: • Illiteracy
		Are you requesting an accommodation because of your disabilities and/or impairments?	Yes/No	Radio	We will make every effort to make reasonable accommodations for applicants with disabilities who need modifications to the naturalization process in order to demonstrate their eligibility. • If you use a wheelchair, we will make sure you can be fingerprinted, interviewed, and sworn in at a location that is wheelchair accessible, and all domestic USCIS facilities meet the Accessibility Guidelines of the Americans with Disabilities Act • If you are unable to travel to a designated USCIS location for an interview, USCIS may visit you at your home or a hospital to conduct the naturalization interview • If you use a service animal such as a guide dog, your animal may come with you to your interview, oath ceremony, or any other immigration benefit-related appointment • If you are blind or have low vision, USCIS may permit you to take a test orally rather than in writing • If you are hearing impaired, the officer conducting your interview will speak loudly and slowly, or we will work with you to arrange for an American Sign Language interpreter. If you require an American Sign Language interpreter at the oath ceremony, your interview, or any other immigration benefit-related appointment, please indicate that here.
		(IF YES) Select any applicable box.	I am deaf or hard of hearing. Please explain the accommodation that you are requesting. If you are requesting a sign-language interpreter, indicate for which language (for example, American Sign Language).	Checkbox
			I am blind or have low vision. Please explain the accommodation that you are requesting.	Checkbox
			I have another type of disability and/or impairment. Please explain the accommodation that you are requesting. Describe the nature of your disability and/or impairment and the accommodation you are requesting.	Checkbox
Your Family	Marital status	What is your current marital status?	Single, never married/Married/Divorced/Widowed/Separated/Marriage annulled	Radio	Your marital status includes annulled marriages, marriages to other persons, and previous marriages to the same person.
	About your current spouse	What is your current spouse's legal name?	Given name (first name)	Text	Your spouse's legal name is the name on his or her birth certificate, unless it changed after birth by a legal action such as marriage or court order. Do not provide a nickname here.
			Middle name (if applicable)	Text
			Family name (last name)	Text
		On what date did you marry [spouse name]?		Date
		What is [spouse name]'s date of birth?		Date
		Has [spouse name] ever changed his or her legal name?	Yes/No	Radio
		What is [spouse name]'s previous legal name ?	Given name (first name)	Text
			Middle name (if applicable)	Text
			Family name (last name)	Text
		Has your [spouse name] used any other names since birth?	Yes/No	Radio	Provide any other names your spouse has used, including nicknames, aliases, and maiden names.
			Given name (first name)	Text
			Middle name (if applicable)	Text
			Family name (last name)	Text
		What is [spouse name]'s present home address?
			My spouse's address is the same as my current address.	Checkbox
			Country	Text
			Street number and name	Text
			Apt/Ste/Flr	Dropdown
			Number	Text
			City or town	Text
			State	Dropdown
			ZIP code + 4	Text
			County	Text
		Is [spouse's name] a U.S. citizen?	Yes/No	Radio
		(IF YES) When did [spouse name] become a U.S. citizen?	At birth/Other	Dropdown
			Date [spouse name] became a U.S. citizen	Date
		(IF NO) What is [spouse name]'s country of citizenship or nationality?			Provide the name of the country as it currently exists, where your spouse is currently a citizen or national. If the country no longer exists, use the current name of the country. If your spouse is a citizen or national of more than one country, provide the name of the foreign country that issued his or her last passport. If your spouse is stateless, enter the name of the current country where he or she was last a citizen or national.
		(IF NO) What is [spouse name]'s current immigration status?	lawful permanent resident/Other	Dropbox
		(IF NO) What is [spouse name]'s A-Number?		Text
			[Spouse name] does not have an A-Number.	Checkbox
		Is your [spouse name] a current member of the U.S. armed forces?	Yes/No	Radio
		Where is [spouse name] currently employed?
			[Spouse name] is unemployed.	Checkbox
		How many times have you been married?		Text
	About your previous spouse	What is your prior spouse's legal name?	Given name (first name)	Text	Your prior spouse's legal name is the name on his or her birth certificate, unless it changed after birth by legal action such as marriage or court order. Do not provide a nickname here.
			Middle name (if applicable)	Text
			Family name (last name)	Text
		When were you married to [prior spouse name]	Date marriage began to date marriage ended	Date
		How did this marriage end?	Annulled/Divorced/Spouse deceased/Other	Radio
		What is [prior spouse name]'s date of birth?		Date
		What is [prior spouse name]'s country of birth?		Text	Provide the name of the country at the time of his or her birth, even if the name has changed.
		What is [prior spouse name]'s country of citizenship or nationality?		Dropdown	Provide the name of the country as it currently exists, where your prior spouse is currently a citizen or national. If the country no longer exists, use the current name of the country. If your prior spouse is a citizen or national of more than one country, provide the name of the foreign country that issued his or her last passport. If your prior spouse is stateless, enter the name of the current country where he or she was last a citizen or national.
		What was [prior spouse name]'s immigration status when your marriage ended?	U.S. citizen/lawful permanent resident/Other	Dropdown
			I do not know.	Checkbox
	Current spouse's marital history	What is [spouse name]'s prior spouse's legal name?	Given name (first name)	Text	Your spouse's prior spouse's legal name is the name on his or her birth certificate, unless it changed after birth by a legal action such as marriage or court order. Do not provide a nickname here.
			Middle name (if applicable)	Text
			Family name (last name)	Text
		When was [spouse name] married to [current spouse's prior spouse]?	Date marriage began to date marriage ended	Date
		How did this marriage end?	Annulled/Divorced/Spouse deceased/Other	Radio
		What is [current spouse's prior spouse name]'s date of birth?		Date
		What is [current spouse's prior spouse name]'s country of birth?		Dropdown	Provide the name of the country at the time of his or her birth, even if the name has changed.
		What is [current spouse's prior spouse name]'s country of citizenship or nationality?		Dropdown	Provide the name of the country as it currently exists, where your spouse's prior spouse is currently a citizen or national. If the country no longer exists, use the current name of the country. If your spouse's prior spouse is a citizen or national of more than one country, provide the name of the foreign country that issued his or her last passport. If your spouse's prior spouse is stateless, enter the name of the current country where he or she was last a citizen or national.
		What is [current spouse's prior spouse name]'s immigration status?	U.S. citizen/lawful permanent resident/Other	Dropdown
			I do not know.	Checkbox
		How many times has [current spouse name] been married?		Text	Your spouse's marital history includes annulled marriages, marriages to other persons, and previous marriages to the same person. If your spouse was married to the same person more than one time, provide the requested information about each marriage separately.
	Children	What is your total number of children?		Text	Your children include those who: • are legally adopted children • are current stepchildren • were born in the United States or in other countries • are under or over 18 years of age • are currently married or unmarried • are living with you or elsewhere • were born when you were not married You should also include children who are missing or deceased.
		What is your child's current legal name?		Text	Your child's legal name is the name on his or her birth certificate, unless it changed after birth by legal action such as marriage or court order. Do not provide a nickname here.
		What is [child name]'s relationship to you?		Text	Your child's relationship to you includes biological child, stepchild, or legally adopted child.
			My child is missing.	Checkbox
			My child is deceased.	Checkbox
		What is [child name]'s date of birth?		Date
		What is [child name]'s country of birth?		Text	Provide the name of the country at the time of your child's birth, even if the name has changed.
		What is [child name]'s current address?
			This child lives with me.	Checkbox
			Country	Text
			Street number and name	Text
			Apt/Ste/Flr	Dropdown
			Number	Text
			City or town	Text
			State	Dropdown
			ZIP code + 4	Text
			County	Text
		What is [child name]'s A-Number?		Text
			This child does not have an A-Number.	Checkbox
	About your parents	Is your mother a U.S. citizen?	Yes/No	Radio	Your relationship to your mother may be biological or as a legally adoptive parent.
		What is your mother's current legal name?		Text	Your mother's legal name is the name on her birth certificate, unless it changed after birth by legal action such as marriage or court order. Do not provide a nickname here.
		What is your mother's country of birth?			Provide the name of the country at the time of your mother's birth, even if the name has changed.
		What is your mother's date of birth?		Date
		When did your mother become a U.S. citizen?		Date
			My mother became a U.S. citizen at birth.	Checkbox
			I do not know.	Checkbox
		What is your mother's A-Number?		Text
			My mother does not have an A-Number.	Checkbox
		Is your father a U.S. citizen?	Yes/No	Radio	Your relationship to your father may be biological or as a legally adoptive parent.
		What is your father's current legal name?	Given name (first name)	Text	Your father's legal name is the name on his birth certificate, unless it changed after birth by legal action such as marriage or court order. Do not provide a nickname here.
			Middle name (if applicable)	Text
			Family name (last name)	Text
		What is your father's country of birth?		Date	Provide the name of the country at the time of your father's birth, even if the name has changed.
		What is your father's date of birth?		Date
		When did your father become a U.S. citizen?		Date
			My father became a U.S. citizen at birth.	Checkbox
			I do not know.	Checkbox
		What is your father's A-Number?	My father does not have an A-Number.	Checkbox
		Were your parents married before your 18th birthday?	Yes/No	Radio
Moral Character	Citizenship claims and voting				Answer each question by selecting “Yes” or “No,” where applicable. If any part of a question applies to you or has ever applied to you, you must answer “Yes.” Your answers, whether “Yes” or “No,” will not automatically cause your application to be denied.
		Have you EVER claimed to be a U.S. citizen (in writing or any other way)?	Yes/No	Radio
		Please explain.		Text area
		Have you EVER registered to vote in any Federal, state, or local election in the United States?	Yes/No	Radio
		Please explain.		Text area
		Have you EVER voted in any Federal, state, or local election in the United States?	Yes/No	Radio
		Please explain.		Text area
		Do you now have, or did you EVER have, a hereditary title or an order of nobility in any foreign country?	Yes/No	Radio
		At your naturalization ceremony, are you willing to give up any inherited titles or orders of nobility that you have in a foreign country?	Yes/No	Radio
		Do you owe any overdue Federal, state, or local taxes?	Yes/No	Radio
		Please explain.		Text area
		Have you EVER not filed a Federal, state, or local tax return since you became a Lawful Permanent Resident?	Yes/No	Radio
		Please explain.		Text area
		Did you consider yourself to be a “non-U.S. resident”?	Yes/No	Radio
		Have you called yourself a "non-U.S. resident" on a Federal, state, or local tax return since you became a Lawful Permanent Resident?	Yes/No	Radio
		Please explain.		Text area
	Legal competency	Have you EVER been declared legally incompetent or been confined to a mental institution?	Yes/No	Radio
		Please explain.		Text area
	Party or group affiliation	Have you EVER been a member of, involved in, or in any way associated with any organization, association, fund, foundation, party, club, society, or similar group in the United States or in any other location in the world?	Yes/No	Radio
		What is the name of the group?		Text
		What is the purpose of the group?		Text
		On what dates were you a member?	From/To	Date
		I am currently a member.		Checkbox
		Have you EVER been a member of, or in any way associated (either directly or indirectly) with:
		The Communist Party?	Yes/No	Radio
		Please explain.		Text area
		Any other totalitarian party?	Yes/No	Radio
		Please explain.		Text area
		A terrorist organization?	Yes/No	Radio
		Please explain.		Text area
		Have you EVER advocated (either directly or indirectly) the overthrow of any government by force or violence?	Yes/No	Radio
		Please explain.		Text area
		Have you EVER persecuted (either directly or indirectly) any person because of race, religion, national origin, membership in a particular social group, or political opinion?	Yes/No	Radio
		Please explain.		Text area
		Between March 23, 1933 and May 8, 1945, did you work for or associate in any way (either directly or indirectly) with:
		The Nazi government of Germany?	Yes/No	Radio
		Please explain.		Text area
		Any government in any area occupied by, allied with, or established with the help of the Nazi government of Germany?	Yes/No	Radio
		Please explain.		Text area
		Any German, Nazi, or S.S. military unit, paramilitary unit, self-defense unit, vigilante unit, citizen unit, police unit, government agency or office, extermination camp, concentration camp, prisoner of war camp, prison, labor camp, or transit camp?	Yes/No	Radio
		Please explain.		Text area
		Were you EVER involved in any way with any of the following:
		Genocide?	Yes/No	Radio
		Please explain.		Text area
		Torture?	Yes/No	Radio
		Please explain.		Text area
		Killing, or trying to kill, someone?	Yes/No	Radio
		Please explain.		Text area
		Badly hurting, or trying to hurt, a person on purpose?	Yes/No	Radio
		Please explain.		Text area
		Forcing, or trying to force, someone to have any kind of sexual contact or relations?	Yes/No	Radio
		Please explain.		Text area
		Not letting someone practice his or her religion?	Yes/No	Radio
		Please explain.		Text area
		Were you EVER a member of, or did you EVER serve in, help, or otherwise participate in, any of the following groups:
		Military unit?	Yes/No	Radio
		Please explain.		Text area
		Paramilitary unit (a group of people who act like a military group but are not part of the official military)?	Yes/No	Radio
		Please explain.		Text area
		Police unit?	Yes/No	Radio
		Please explain.		Text area
		Self-defense unit?	Yes/No	Radio
		Please explain.		Text area
		Vigilante unit (a group of people who act like the police but are not part of the official police)?	Yes/No	Radio
		Please explain.		Text area
		Rebel group?	Yes/No	Radio
		Please explain.		Text area
		Guerrilla group (a group of people who use weapons against or otherwise physically attack the military, police, government, or other people)?	Yes/No	Radio
		Please explain.		Text area
		Militia (an army of people, not part of the official military)?	Yes/No	Radio
		Please explain.		Text area
		Insurgent organization (a group that uses weapons and fights against a government)?	Yes/No	Radio
		Please explain.		Text area
		Were you EVER a worker, volunteer, or soldier, or did you otherwise EVER serve in any of the following:
		Prison or jail?	Yes/No	Radio
		Please explain.		Text area
		Prison camp?	Yes/No	Radio
		Please explain.		Text area
		Detention facility (a place where people are forced to stay)?	Yes/No	Radio
		Please explain.		Text area
		Labor camp (a place where people are forced to work)?	Yes/No	Radio
		Please explain.		Text area
		Any other place where people were forced to stay?	Yes/No	Radio
		Please explain.		Text area
		Were you EVER a part of any group, or did you EVER help any group, unit, or organization that used a weapon against any person, or threatened to do so?	Yes/No	Radio
		(IF YES) When you were part of this group, or when you helped this group, did you ever use a weapon against another person?	Yes/No	Radio
		(IF YES) Please explain.		Text area
		(IF YES) When you were part of this group, or when you helped this group, did you ever tell another person that you would use a weapon against that person?	Yes/No	Radio
		(IF YES) Please explain.		Text area
		Did you EVER sell, give, or provide weapons to any person, or help another person sell, give, or provide weapons to any person?	Yes/No	Radio
		(IF YES) Did you know that this person was going to use the weapons against another person?	Yes/No	Radio
		(IF YES) Please explain.		Text area
		(IF YES) Did you know that this person was going to sell or give the weapons to someone who was going to use them against another person?	Yes/No	Radio
		(IF YES) Please explain.		Text area
		Did you EVER receive any type of military, paramilitary (a group of people who act like a military group but are not part of the official military), or weapons training?	Yes/No	Radio
		Please explain.		Text area
		Did you EVER recruit (ask), enlist (sign up), conscript (require), or use any person under 15 years of age to serve in or help an armed force or group?	Yes/No	Radio
		Please explain.		Text area
		Did you EVER use any person under 15 years of age to do anything that helped or supported people in combat?	Yes/No	Radio
		Please explain.		Text area
	Crimes and offenses				If any of the questions on this page apply to you, you must answer yes even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if anyone, including a judge, law enforcement officer, or attorney, told you that it no longer constitutes a record or told you that you do not have to disclose the information.
		Have you EVER committed, assisted in committing, or attempted to commit, a crime or offense for which you were NOT arrested?	Yes/No	Radio
		Have you EVER been arrested, cited, or detained by any law enforcement officer (including any immigration official or any official of the U.S. armed forces) for any reason?	Yes/No	Radio
		Have you EVER been charged with committing, attempting to commit, or assisting in committing a crime or offense?	Yes/No	Radio
		Have you EVER been convicted of a crime or offense?	Yes/No	Radio
		Have you EVER been placed in an alternative sentencing or a rehabilitative program (for example, diversion, deferred prosecution, withheld adjudication, deferred adjudication)?	Yes/No	Radio
		Have you EVER received a suspended sentence, been placed on probation, or been paroled?	Yes/No	Radio
		Have you EVER been in jail or prison?	Yes/No	Radio
		(IF YES) How long were you in jail or prison?	Years/Months/Days	Text
		Because you answered yes, you must answer additional questions on the next page.
		Answer the questions below to explain the following response(s). (Show the "yes" responses on the prior page)	One explanation may be enough to explain multiple responses. Add additional explanations as needed.
		(IF YES ALL BUT FIRST QUESTION) On what date were you arrested, cited, detained, or charged?	mm/dd/yyyy	Date
		(IF YES ALL BUT FIRST QUESTION) Where were you arrested, cited, detained, or charged?		Text
		(IF YES ALL BUT FIRST QUESTION)Why were you arrested, cited, detained, or charged?		Text area
		(IF YES ALL BUT FIRST QUESTION) What was the outcome or disposition of the arrest, citation, detention, or charge? (no charges filed, charges dismissed, jail, probation, etc.)		Text area
		Have you EVER:
		Been a habitual drunkard?	Yes/No	Radio
		Please explain.		Text area
		Been a prostitute or procured anyone for prostitution?	Yes/No	Radio
		Please explain.		Text area
		Sold or smuggled controlled substances, illegal drugs, or narcotics?	Yes/No	Radio
		Please explain.		Text area
		Been married to more than one person at the same time?	Yes/No	Radio
		Please explain.		Text area
		Married someone in order to obtain an immigration benefit?	Yes/No	Radio
		Please explain.		Text area
		Helped anyone to enter, or try to enter, the United States illegally?	Yes/No	Radio
		Please explain.		Text area
		Gambled illegally or received income from illegal gambling?	Yes/No	Radio
		Please explain.		Text area
		Failed to support your dependents or to pay alimony?	Yes/No	Radio
		Please explain.		Text area
		Made any misrepresentation to obtain any public benefit in the United States?	Yes/No	Radio
		Please explain.		Text area
		Have you EVER given any U.S. Government officials any information or documentation that was false, fraudulent, or misleading?	Yes/No	Radio
		Please explain.		Text area
		Have you EVER lied to any U.S. Government officials to gain entry or admission into the United States or to gain immigration benefits while in the United States?	Yes/No	Radio
		Please explain.		Text area
	Immigration proceedings	Have you EVER been removed, excluded, or deported from the United States?	Yes/No	Radio
		Please explain.		Text area
		Have you EVER been ordered removed, excluded, or deported from the United States?	Yes/No	Radio
		Please explain.		Text area
		Have you EVER been placed in removal, exclusion, rescission, or deportation proceedings?	Yes/No	Radio
		Please explain.		Text area
		Are removal, exclusion, rescission, or deportation proceedings (including administratively closed proceedings) currently pending against you?	Yes/No	Radio
		Please explain.		Text area
	Military	Have you EVER been court-martialed, administratively separated, or disciplined, or have you received an other than honorable discharge while in the U.S. armed forces?	Yes/No	Radio
		Please explain.		Text area
		Have you EVER been discharged from training or service in the U.S. armed forces because you were alien?	Yes/No	Radio
		Please explain.		Text area
		Have you EVER left the United States to avoid being drafted in the U.S. armed forces?	Yes/No	Radio
		Please explain.		Text area
		Have you EVER applied for any kind of exemption from military service in the U.S. armed forces?	Yes/No	Radio
		Please explain.		Text area
		Have you EVER deserted from the U.S. armed forces?	Yes/No	Radio
		Please explain.		Text area
	Attachment to the Constitution	Do you support the Constitution and form of Government of the United States?	Yes/No	Radio
		Please explain.		Text area
		Do you understand the full Oath of Allegiance to the United States?	Yes/No	Radio
		Please explain.		Text area
		Are you willing to take the full Oath of Allegiance to the United States?	Yes/No	Radio
		Please explain.		Text area
		If the law requires it, are you willing to bear arms on behalf of the United States?	Yes/No	Radio
		Please explain.		Text area
		If the law requires it, are you willing to perform noncombatant services in the U.S. armed forces?	Yes/No	Radio
		Please explain.		Text area
		If the law requires it, are you willing to perform work of national importance under civilian direction?	Yes/No	Radio
		Please explain.		Text area
Evidence
Review & Submit	Review your application				Before you submit, make sure you have answered all the questions that apply to you. Incomplete sections can slow down the application process.
	Preparer and interpreter signature	Preparer's statement	I am not an attorney or accredited representative but have prepared this application on behalf of the applicant and with the applicant's consent.	Checkbox
			I am an attorney or accredited representative and my representation of the applicant in this case does not extend beyond the preparation of this application.	Checkbox	If you are an attorney or accredited representative whose representation extends beyond preparation of this application, you may need to submit a completed Form G-28 Notice of Entry of Appearance as Attorney or Accredited Representative with this application.
		Preparer's certification			By my signature, I certify, under penalty of perjury, that I prepared this application at the request of the applicant. The applicant then reviewed the completed application and informed me that he or she understands all of the information contained in, and submitted with, his or her application, including the Applicant's Certification, and that all of this information is complete, true, and correct. I completed this application based only on information that the applicant provided to me or authorized me to obtain or use.
		Preparer's signature			You must sign on paper by viewing and printing the Preparer Signature page. Sign and date this page before returning it to the applicant. Once the applicant receives the signed page from you, they will scan the page and attach it here. Applicant: Once your preparer signs and returns the Preparer Signature page to you, scan and attach the document here.
		Interpreter's certification			I certify, under penalty of perjury, that: I am fluent in English and [language specified in [Part 13., Item B. in Item Number 1.], and I have read every question and instruction on this application and the applicant's answer to every question to the applicant in the identified language. The applicant informed me that he or she understands every instruction, question and answer on the application, including the Applicant's Certification, and has verified the accuracy of every answer.
		Interpreter's signature			You must sign on paper by viewing and printing the Interpreter Signature page. Sign and date this page before returning it to the applicant. Once the applicant receives the signed page from you, they will scan the page and attach it here. Applicant: Once your interpreter signs and returns the Interpreter Signature page to you, scan and attach the document here.
	Your signature	Applicant's statement regarding the preparer	At my request, [preparer name] prepared this application for me based only upon information I provided or authorized.	Checkbox
		Applicant's statement regarding the interpreter	I can read and understand English, and I have read and understand every question and instruction on this application and my answer to every question.	Checkbox
			[Interpreter name] read to me every question and instruction on this application and my answer to every question in [language], a language in which I am fluent, and I understood everything.	Checkbox
		Applicant's certification			Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS may require that I submit original documents to USCIS at a later date. Furthermore, I authorize the release of any information from any of my records that USCIS may need to determine my eligibility for the immigration benefit that I seek. I further authorize release of information contained in this application, 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 understand that USCIS will require me to appear for an appointment to take my biometrics (fingerprints, photograph, and/or signature) and, at that time, I will be required to sign an oath reaffirming that: 1) I reviewed and provided or authorized all of the information in my application; 2) I understood all of the information contained in, and submitted with, my application; and 3) All of this information was complete, true, and correct at the time of filing. I certify, under penalty of perjury, that I provided or authorized all of the information in my application, I understand all of the information contained in, and submitted with, my application, and that all of this information is complete, true, and correct.
		Applicant's signature			We may deny your application if you do not completely fill out this application or fail to submit required documents.
	Pay and submit				We will send you to pay.gov — our safe, secure payment website — to make your payment and submit your application online. Here are the steps in the payment and submission process: 1. Provide your billing information on Pay.gov 2. Provide your information for one of two biling options: credit card or bank account 3. Submit your payment 4. Pay.gov will redirect you to USCIS to an application confirmation screen, which will include your application receipt number Once your payment is confirmed, your application will be submitted. Your payment and application submission may take 1-3 days to be fully processed. You can track the status of your application in your USCIS account dashboard.