N-600 Frm Toc

TABLE OF CHANGES – FORM

Form N-600, Application for Certificate of Citizenship

OMB Number: 1615-0057

11/08/2018

Reason for Revision: Updates to standard language, and edits from SPC.

• Black font = Current text

• Purple font = Standard language

• Red font = Changes

Current Page Number and Section	Current Text	Proposed Text
Page 1, For USCIS Use Only	[Page 1] For USCIS Use Only Date Stamp Receipt Action Block Remarks To be completed by an Attorney or Accredited Representative (if any). Select this box if Form G-28 is attached. Attorney State Bar Number (if applicable) Attorney or Accredited Representative USCIS Online Account Number (if any)	[Page 1] [no change]
Page 1, Part 1. Information About Your Eligibility	[Page 1] START HERE - Type or print in black ink. Part 1. Information About Your Eligibility Enter Your 9-Digit A-Number: 1. This application is being filed based on the fact that: (Select only one box) [] I am a BIOLOGICAL child of a U.S. citizen parent. [] I am an ADOPTED child of a U.S. citizen parent. [] Other (Explain fully): [Fillable Field] NOTE: If you need extra space to complete this section, use the space provided in Part 11. Additional Information.	[Page 1] [no change]
Page 1, Part 2. Information About You	[Page 1] Part 2. Information About You NOTE: 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 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 3. Other Names You Have Used Since Birth Provide all other names you have ever used, include nicknames, maiden name, and aliases. Family Name (Last Name) Given Name (First Name) Middle Name Family Name (Last Name) Given Name (First Name) Middle Name 4. U.S. Social Security Number (if any) 5. USCIS Online Account Number (if any) 6. Date of Birth (mm/dd/yyyy) 7. Country of Birth 8. Country of Prior Citizenship or Nationality 9. Gender Male Female [Page 2] 10. Mailing Address In Care Of Name (if any) Street Number and Name Apt. Ste. Flr. Number City or Town State ZIP Code + 4 Province (foreign address only) Postal Code (foreign address only) Country (foreign address only) 11. Physical Address Street Number and Name (Do not provide a PO Box in this space unless it is your ONLY address.) Apt. Ste. Flr. Number City or Town State Province (foreign address only) Postal Code (foreign address only) Country (foreign address only) 12. Current Marital Status Single, Never Married Married Divorced Widowed Separated Marriage Annulled Other (Explain): 13. U.S. Armed Forces Are you a member or veteran of any branch of the U.S. Armed Forces? Yes No 14. Information About Your Admission into the United States and Current Immigration Status A. I arrived in the following manner Port-of-Entry City or Town State Date of Entry (mm/dd/yyyy) Exact Name Used at Time of Entry Family Name (Last Name) Given Name (First Name) Middle Name B. I used the following travel document to be admitted to the United States [] Passport Passport Number [] Travel Document Travel Document Number Country of Issuance for Passport or Travel Document Date Passport or Travel Document Issued (mm/dd/yyyy) [Page 3] C. I am A Lawful Permanent Resident (LPR) A Nonimmigrant A Refugee/Asylee Other (Explain): NOTE: If you select “Other” and you need extra space to complete this section, use the space provided in Part 11. Additional Information. D. I obtained LPR status through adjustment of status in the United States or admission as a LPR (if applicable) Date I became a LPR (mm/dd/yyyy) U.S. Citizen and Immigration Services (USCIS) Office That Granted my LPR Status or Location Where I Was Admitted 15. Have you previously applied for a Certificate of Citizenship or U.S. Passport? Yes No If you answered "Yes" to Item Number 15., provide an explanation below. If you need extra space to complete this section, use the space provided in Part 11. Additional Information. [Fillable Field] 16. Have you ever abandoned or lost your LPR status? Yes No If you answered "Yes" to Item Number 16., provide an explanation below. If you need extra space to complete this section, use the space provided in Part 11. Additional Information. [Fillable Field] 17. Were you adopted? Yes No If you answered “Yes” to Item Number 17., complete Items A. - D. A. Place of Final Adoption City or Town State Country B. Date of Adoption (mm/dd/yyyy) C. Date Legal Custody Began (mm/dd/yyyy) D. Date Physical Custody Began (mm/dd/yyyy) 18. Did you have to be re-adopted in the United States? Yes No If you answered “Yes” to Item Number 18., complete Items A. - D. A. Place of Final Adoption City or Town State Country B. Date of Adoption (mm/dd/yyyy) C. Date Legal Custody Began (mm/dd/yyyy) D. Date Physical Custody Began (mm/dd/yyyy) 19. Were your parents married to each other when you were born (or adopted)? Yes No 20. Did your parents marry after you were born? Yes No 21. Do you regularly reside in the United States in the legal and physical custody of your U.S. citizen parents? Yes No [Page 4] 22. 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. If you need extra space to complete this section, use the space provided in Part 11. Additional Information. A. Date You Left the United States (mm/dd/yyyy) B. Date You Returned to the United States (mm/dd/yyyy) C. Place of Entry Upon Return to the United States City or Town State D. Date You Left the United States (mm/dd/yyyy) E. Date You Returned to the United States (mm/dd/yyyy) F. Place of Entry Upon Return to the United States City or Town State	[Page 1] Part 2. Information About You NOTE: Provide information about yourself if you are an applicant 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. [no change] 12. Current Marital Status Single, Never Married Married Divorced Widowed Separated Marriage Annulled Other (Explain): 13. U.S. Armed Forces Are you a member or veteran of any branch of the U.S. Armed Forces? Yes No 14. Information About Your Admission into the United States and Current Immigration Status A. I arrived in the following manner: Port-of-Entry [Fillable field] Date of Entry (mm/dd/yyyy) Exact Name Used at Time of Entry Family Name (Last Name) Given Name (First Name) Middle Name B. I used the following travel document to be admitted to the United States [] Passport Passport Number [] Travel Document Travel Document Number Country of Issuance for Passport or Travel Document Date Passport or Travel Document Issued (mm/dd/yyyy) [Page 3] C. My most recent immigration status in the United States was: A Lawful Permanent Resident (LPR) A Nonimmigrant A Refugee/Asylee Other (Explain): NOTE: If you select “Other” and you need extra space to complete this section, use the space provided in Part 11. Additional Information. D. I obtained LPR status through adjustment of status in the United States or admission as a LPR (if applicable). Date I became a LPR (mm/dd/yyyy) U.S. Citizen and Immigration Services (USCIS) Office That Granted my LPR Status or Location Where I Was Admitted [no change] 21. Do you regularly reside in the United States in the legal and physical custody of your U.S. citizen parent(s), or, if over 18 years of age, did you regularly reside in the legal and physical custody of your U.S. citizen parent(s) before turning 18 years of age? Yes No [no change]
Page 4, Part 3. Biographic Information	[Page 4] Part 3. Biographic Information 1.  Ethnicity (Select only one box) Hispanic or Latino Not Hispanic or Latino 2.  Race (Select all applicable boxes) White Asian Black or African American American Indian or Alaska Native Native Hawaiian or Other Pacific Islander 3.  Height  Feet__ Inches __ 4.  Weight    Pounds _ ­_ _ 5.  Eye Color (Select only one box) Black Blue Brown Gray Green Hazel Maroon Pink Unknown/Other 6.  Hair Color (Select only one box) Bald (No hair) Black Blond Brown Gray Red Sandy White Unknown/Other	[Page 4] [no change] 2.  Race (Select all applicable boxes) American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White [no change]
Page 4, Part 4. Information About Your U.S. Citizen Biological Father (or Adoptive Father)	[Page 4] Part 4. Information About Your U.S. Citizen Biological Father (or Adoptive Father) NOTE: Complete this section if you are claiming citizenship through a U.S. biological father (of 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. 1. Current Legal Name of a U.S. Citizen Father Family Name (Last Name) Given Name (First Name) Middle Name [Page 5] 2. Date of Birth (mm/dd/yyyy) 3. Country of Birth 4. Country of Citizenship or Nationality 5. Physical Address Street Number and Name (Type or print "Deceased" and the date of death if your father has passed away.) Apt. Ste. Flr. Number City or Town State ZIP Code + 4 Province (foreign address only) Postal Code (foreign address only) Country (foreign address only) 6. My father is a U.S. citizen by [] Birth in the United States [] Acquisition after birth through naturalization of alien parents [] Birth abroad to U.S. citizen parents Certificate of Citizenship Number Alien Registration (A-Number) (if any) [] Naturalization Place of Naturalization (Name of Court or USCIS Office Location) City or Town State Certificate of Naturalization Number A-Number (if any) Date of Naturalization (mm/dd/yyyy) 7. Has your father ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship? Yes No If you answered “Yes” to Item Number 7., provide an explanation in Part 11. Additional Information. 8. Marital History A. How many times has your U.S. citizen father been married (including annulled marriages and marriages to the same person)? B. What is your U.S. citizen father’s current marital status? Single, Never Married Married Divorced Widowed Separated Marriage Annulled Other (Explain): If you selected "Other," provide an explanation. If you need extra space to complete this section, use the space provided in Part 11. Additional Information. [Page 6] 9. Information About U.S. Citizen Father's Current Spouse A. Family Name (Last Name) Given Name (First Name) Middle Name B. Date of Birth (mm/dd/yyyy) C. Country of Birth D. Country of Citizenship or Nationality E. Spouse’s Physical Address Street Number and Name Apt. Ste. Flr. Number City or Town State ZIP Code + 4 Province (foreign address only) Postal Code (foreign address only) Country (foreign address only) F. Date of Marriage (mm/dd/yyyy) G. Place of Marriage City or Town State Country H. Spouse’s Immigration Status U.S. Citizen Lawful Permanent Resident Other (Explain): If you selected "Other," provide an explanation. If you need extra space to complete this section, use the space provided in Part 11. Additional Information. I. Is your U.S. citizen father's current spouse also your biological (or adopted) mother? Yes No	[Page 4] Part 4. Information About Your U.S. Citizen Biological Father (or Adoptive Father) NOTE: Complete this section if you are claiming citizenship through a U.S. 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. [no change] 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 (if any) Alien Registration (A-Number) (if any) [] Naturalization Place of Naturalization (Name of Court or USCIS Office Location) City or Town State Certificate of Naturalization Number A-Number Date of Naturalization (mm/dd/yyyy) 7. Has your father ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship? Yes No If you answered “Yes” to Item Number 7., provide an explanation in Part 11. Additional Information. 8. Marital History A. How many times has your U.S. citizen father been married (including annulled marriages and marriages to the same person)? B. What is your U.S. citizen father’s current marital status? Single, Never Married Married Divorced Widowed Separated Marriage Annulled Other (Explain): [no change]
Page 6, Part 5. Information About Your U.S. Citizen Biological Mother (or Adoptive Mother)	[Page 6] Part 5. Information About Your U.S. Citizen Biological Mother (or Adoptive Mother) NOTE: 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 Family Name (Last Name) Given Name (First Name) Middle Name 2. Date of Birth (mm/dd/yyyy) 3. Country of Birth 4. Country of Citizenship or Nationality [Page 7] 5. Physical Address Street Number and Name (Type or print “Deceased” and the date of death if your mother has passed away.) Apt. Ste. Flr. Number City or Town State ZIP Code + 4 Province (foreign address only) Postal Code (foreign address only) Country (foreign address only) 6. My mother is a U.S. citizen by [] Birth in the United States [] Acquisition after birth through naturalization of alien parents [] Birth abroad to U.S. citizen parents Certificate of Citizenship Number Alien Registration (A-Number) (if any) [] Naturalization Place of Naturalization (Name of Court or USCIS Office Location) City or Town State Certificate of Naturalization Number A-Number (if any) Date of Naturalization (mm/dd/yyyy) 7. Has your mother ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship? Yes No If you answered “Yes” to Item Number 7., provide an explanation in Part 11. Additional Information. 8. Marital History A. How many times has your U.S. citizen mother been married (including annulled marriages and marriages to the same person)? B. What is your U.S. citizen mother’s current marital status? Single, Never Married Married Divorced Widowed Separated Marriage Annulled Other (Explain): If you selected "Other," provide an explanation. If you need extra space to complete this section, use the space provided in Part 11. Additional Information. 9. Information About U.S. Citizen Mother’s Current Spouse A. Family Name (Last Name) Given Name (First Name) Middle Name B. Date of Birth (mm/dd/yyyy) C. Country of Birth [Page 8] D. Country of Citizenship or Nationality E. Spouse’s Physical Address Street Number and Name Apt. Ste. Flr. Number City or Town State ZIP Code + 4 Province (foreign address only) Postal Code (foreign address only) Country (foreign address only) F. Date of Marriage (mm/dd/yyyy) G. Place of Marriage City or Town State Country H. Spouse’s Immigration Status U.S. Citizen Lawful Permanent Resident Other (Explain): If you selected "Other," provide an explanation. If you need extra space to complete this section, use the space provided in Part 11. Additional Information. I. Is your U.S. citizen mother’s current spouse also your biological (or adopted) father? Yes No	[Page 6] Part 5. Information About Your U.S. Citizen Biological Mother (or Adoptive Mother) [no change] 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 (if any) Alien Registration (A-Number) (if any) [] Naturalization Place of Naturalization (Name of Court or USCIS Office Location) City or Town State Certificate of Naturalization Number A-Number Date of Naturalization (mm/dd/yyyy) 7. Has your mother ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship? Yes No If you answered “Yes” to Item Number 7., provide an explanation in Part 11. Additional Information. 8. Marital History A. How many times has your U.S. citizen mother been married (including annulled marriages and marriages to the same person)? B. What is your U.S. citizen mother’s current marital status? Single, Never Married Married Divorced Widowed Separated Marriage Annulled Other (Explain): [no change]
Page 8, Part 6. Physical Presence in the United States From Birth Until Filing of Form N-600	[Page 8] Part 6. Physical Presence in the United States From Birth Until Filing of Form N-600 NOTE: 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. 1. Indicate whether this information relates to your U.S. citizen father or mother U.S. Citizen Father U.S. Citizen Mother 2. Physical Presence in the United States A. From (mm/dd/yyyy) To (mm/dd/yyyy) B. From (mm/dd/yyyy) To (mm/dd/yyyy) C. From (mm/dd/yyyy) To (mm/dd/yyyy) D. From (mm/dd/yyyy) To (mm/dd/yyyy) E. From (mm/dd/yyyy) To (mm/dd/yyyy) F. From (mm/dd/yyyy) To (mm/dd/yyyy) G. From (mm/dd/yyyy) To (mm/dd/yyyy) H. From (mm/dd/yyyy) To (mm/dd/yyyy)	[Page 8] [no change]
Page 9, Part 7. Information About Military Service of U.S. Citizen Parents	[Page 9] Part 7. Information About Military Service of U.S. Citizen Parents NOTE: Complete this only if you are an applicant claiming U.S. citizenship at time of birth abroad. 1. Has your U.S. citizen parent served in the U.S. Armed Forces? Yes No 2. If you answered “Yes” to Item Number 1., which parent served in the U.S. Armed Forces? U.S. Citizen Father U.S. Citizen Mother 3. Dates of Service (mm/dd/yyyy) (if time of service fulfills any of the required physical presence, submit evidence of the service.) A. From (mm/dd/yyyy) To (mm/dd/yyyy) B. From (mm/dd/yyyy) To (mm/dd/yyyy) 4. Type of Discharge Honorable Other than Honorable Dishonorable	[Page 9] [no change]
Page 9, Part 8. Applicant’s Statement, Contact Information, Certification, and Signature	[Page 9] Part 8. Applicant’s Statement, Contact Information, Certification, and Signature NOTE: Read the Penalties section of the Form N-600 Instructions before completing this part. Applicant’s Statement [new] 1. Applicant’s Statement Regarding the Interpreter A. 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. B. The interpreter named in Part 9. read to me every question and instruction on this application and my answer to every question in [Fillable Field], a language in which I am fluent, and I understood everything. 2. Applicant’s Statement Regarding the Preparer At my request, the preparer named in Part 10., [Fillable field], prepared this application for me based only upon information I provided or authorized. Applicant’s Contact Information 3. Applicant’s Daytime Telephone Number 4. Applicant’s Mobile Telephone Number (if any) 5. Applicant’s Email Address (if any) 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 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. [Page 10] I understand that USCIS may require me to appear for an appointment to take my biometrics (fingerprints, photograph, and/or signature) and, at that time, if I am required to provide biometrics, 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 6. Applicant’s Signature (sign in ink) Date of Signature (mm/dd/yyyy) NOTE TO ALL APPLICANTS: If you do not completely fill out this application or fail to submit required documents listed in the Instructions, USCIS may deny your application.	[Page 9] Part 8. Applicant’s Statement, Contact Information, Certification, and Signature NOTE: Read the Penalties section of the Form N-600 Instructions before completing this section. Applicant’s Statement NOTE: Select the box for either Item A. or B. in Item Number 1. If applicable, select the box for Item Number 2. [no change] 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 and all of my records that USCIS may need to determine my eligibility for the immigration benefit that I seek. I furthermore 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 law. [Page 10] [no change] 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. [no change]
Page 10, Part 9. Interpreter’s Contact Information, Certification, and Signature	[Page 10] Part 9. Interpreter’s Contact Information, Certification, and Signature Provide the following information about the interpreter. Interpreter’s Full Name 1. Interpreter’s Family Name (Last Name) Interpreter’s Given Name (First Name) 2. Interpreter’s Business or Organization Name (if any) Interpreter’s Mailing Address 3. Street Number and Name Apt./Ste./Flr. Number City or Town State ZIP Code + 4 Province Postal Code Country Interpreter’s Contact Information 4. Interpreter’s Daytime Telephone Number 5. Interpreter’s Mobile Telephone Number (if any) 6. Interpreter’s Email Address (if any) [Page 11] Interpreter’s Certification I certify, under penalty of perjury, that: I am fluent in English and [Fillable Field], which is the same language specified in Part 8., Item B. in Item Number 1., and I have read to this applicant in the identified language every question and instruction on this application and his or her answer to every question. 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 7. Interpreter’s Signature Date of Signature (mm/dd/yyyy)	[Page 10] [no change] [Page 11] Interpreter’s Certification I certify, under penalty of perjury, that: I am fluent in English and [Fillable Field], which is the same language specified in Part 8., Item B. in Item Number 1., and I have read to this applicant in the identified language every question and instruction on this application and his or her answer to every question. 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 7. Interpreter’s Signature Date of Signature (mm/dd/yyyy)
Page 11, Part 10. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant	[Page 11] Part 10. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant Provide the following information about the preparer. Preparer’s Full Name 1. Preparer’s Family Name (Last Name) Preparer’s Given Name (First Name) 2. Preparer’s Business or Organization Name (if any) Preparer’s Mailing Address 3. Street Number and Name Apt./Ste./Flr. Number City or Town State ZIP Code Province Postal Code Country Preparer’s Contact Information 4. Preparer’s Daytime Telephone Number 5. Preparer’s Mobile Telephone Number (if any) 6. Preparer’s Email Address (if any) [Page 12] Preparer’s Statement 7. A. I am not an attorney or accredited representative but have prepared this application on behalf of the applicant and with the applicant’s consent. B. I am an attorney or accredited representative and my representation of the applicant in this case extends/does not extend beyond the preparation of this application. NOTE: If you are an attorney or accredited representative, 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 this 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 8. Preparer’s Signature (sign in ink) Date of Signature (mm/dd/yyyy)	[Page 11] [no change] NOTE: If you are an attorney or accredited representative, you may need to submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative, with this application. Members of the Armed Forces applying outside the United States for a Certificate of Citizenship under INA section 320 may file Form G-28I, Notice of Entry of Appearance as Attorney In Matters Outside the Geographical Confines of the United States with this application, if applicable. 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 this 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. [no change]
Page 13, Part 11. Additional Information	[Page 13] Part 11. Additional Information If you need extra space to provide any additional information within this application, 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 application or attach a separate sheet of paper. Type or print 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. [Fillable field] 4. A. Page Number B. Part Number C. Item Number D. [Fillable field] 5. A. Page Number B. Part Number C. Item Number D. [Fillable field] 6. A. Page Number B. Part Number C. Item Number D. [Fillable field]	[Page 13] [no change]
Page 14, Part 12. Affidavit	[Page 14] Part 12. Affidavit (do NOT complete this part unless instructed to do so AT THE INTERVIEW) I, the (applicant, parent, or legal guardian) [Field] 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 [Field] to [Field] inclusive, that the same are true and correct to the best of my knowledge, and that corrections number [Field] to [Field] were made by me or at my request. Applicant’s, Parent’s, or Legal Guardian’s Signature (Sign in ink) Date of Signature (mm/dd/yyyy) Subscribed and sworn or affirmed before me upon examination of the applicant (parent, legal, guardian) on [Date (mm/dd/yyyy)] at [(Location)]. USCIS Officer’s Printed Name USCIS Officer’s Title USCIS Officer’s Signature (Sign in ink) Date of Signature (mm/dd/yyyy)	[Page 14] [no change] Subscribed and sworn or affirmed before me upon examination of the applicant (parent or legal guardian) on [Date (mm/dd/yyyy)] at [(Location)]. [no change]
Page 14, Part 13. Office Report and Recommendation on Application for Certificate of Citizenship	[Page 14] Part 13. Officer Report and Recommendation on Application for Certificate of Citizenship (for USCIS use ONLY) On the basis of the documents, records, the testimony of persons 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 [Date (mm/dd/yyyy)] 3. The applicant derived or acquired U.S. citizenship through (Select the box next to the appropriate section of law, or if the section of law is not reflected, type or print the applicable section of law in the space next to “Other.”) A. INA Section 301 B. INA Section 309 C. INA Section 320 D. INA Section 321 E. Other 4. The applicant has not been expatriated since that time [Page 15] I recommend that this Form N-600 be: Approved Denied Issue Certificate of Citizenship in the name of: Family Name (Last Name) Given Name (First Name) Middle Name USCIS Officer’s Printed Name USCIS Officer’s Title USCIS Officer’s Signature (Sign in ink) Date of Signature (mm/dd/yyyy) [] I do [] do not concur with the USCIS Officer’s recommendation of Form N-600. USCIS District Director’s or Field Office Director’s Signature (Sign in ink) Date of Signature (mm/dd/yyyy)	[Page 14] [no change]

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