TABLE OF CHANGES – FORM
Form N-600K, Application for Citizenship and Issuance of Certificate Under Section 322
OMB Number: 1615-0087
10/30/2018
Reason for Revision: Minor revisions, including updates to standard language.
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Current Page Number and Section |
Current Text |
Proposed Text |
Page 1, For USCIS Use Only |
[Page 1]
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)
START HERE - Type or print in black ink.
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[Page 1]
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)
START HERE - Type or print in black ink.
NOTE: The applicant on this form is the child’s parent, grandparent, or legal guardian. |
Page 1, Part 1. Information About the Child’s Eligibility |
[Page 1]
Part 1. Information About the Child’s Eligibility
1. The application is being filed for a child. The child is under 18 years of age and (Select only one box):
The BIOLOGICAL child of a qualifying U.S. citizen (USC) parent filing this application.
The ADOPTED child of a qualifying USC parent filing this application.
The grandchild of a qualifying USC grandparent or the child ward of a USC legal guardian filing this application within five years of the death of the USC parent.
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[Page 1]
Part 1. Information About the Child’s Eligibility
1. The application is being filed for a child. The child is under 18 years of age and (select only one box):
The BIOLOGICAL child of a qualifying U.S. citizen (USC) parent filing this application.
The ADOPTED child of a qualifying USC parent filing this application.
The grandchild of a qualifying USC grandparent or the child ward of a USC legal guardian filing this application within five years of the death of the USC parent.
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Page 1, Part 2. Information About the Child |
[Page 1]
Part 2. Information About the Child (for whom this application being filed)
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 the Permanent Resident Card (if applicable) Family Name (Last Name) Given Name (First Name) Middle Name
3. Other Names Used (if applicable)
Provide all other names you have ever used, including nicknames, maiden name, and aliases. Family Name (Last Name) Given Name (First Name) Middle Name
4. U.S. Social Security Number (if applicable) 5. USCIS Online Account Number (if any) 6. Date of Birth (mm/dd/yyyy) 7. Country of Birth
[Page 2]
8. Prior Country of Citizenship or Nationality 9. Gender Male/Female 10. Height Feet/Inches
11. Mailing Address In Care Of Name (if any) Street Number and Name Apt. Ste. Flr. Number City or Town State ZIP Code Province Postal Code Country
12. Physical Address (Do not provide a PO Box in this space unless it is the ONLY address.) Street Number and Name Apt. Ste. Flr. Number City or Town State ZIP Code Province Postal Code Country
13. Marital Status Single, Never Married Married Divorced Widowed Separated Marriage Annulled Other (Explain): _______
14. Information About the Admission Into the United States and Current Immigration Status
NOTE: Do NOT complete this section. The USCIS officer will complete it during the interview.
A. 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. Current Immigration Status
15. Was there any prior application for citizenship or for a U.S. passport? Y/N
[Page 3]
16. Was the child adopted? Y/N
A. Date of Adoption (mm/dd/yyyy) B. Date Legal Custody Began (mm/dd/yyyy) C. Date Physical Custody Began (mm/dd/yyyy)
17. Were the child's parents married to each other when the child was born (or adopted)? Y/N
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[Page 1]
Part 2. Information About the Child (for whom this application being filed)
1. Current Legal Name (do not provide a nickname) Family Name (Last Name) Given Name (First Name) Middle Name
2. Name Exactly As It Appears on the Permanent Resident Card (if applicable) Family Name (Last Name) Given Name (First Name) Middle Name
3. Other Names Used (if applicable)
Provide all other names ever used, including nicknames, maiden name, and aliases. Family Name (Last Name) Given Name (First Name) Middle Name
4. U.S. Social Security Number (if applicable) 5. USCIS Online Account Number (if any) 6. Date of Birth (mm/dd/yyyy) 7. Country of Birth
[Page 2]
8. Country of Citizenship or Nationality 9. Gender Male/Female 10. Height Feet/Inches
11. Mailing Address In Care Of Name (if any) Street Number and Name Apt. Ste. Flr. Number City or Town State ZIP Code Province Postal Code Country
12. Physical Address (Do not provide a PO Box in this space unless it is the ONLY address.) Street Number and Name Apt. Ste. Flr. Number City or Town State ZIP Code Province Postal Code Country
13. Marital Status Single, Never Married Married Divorced Widowed Separated Marriage Annulled Other (Explain): _______
14. Information About the Child’s Admission Into the United States and Current Immigration Status
NOTE: Do NOT complete this section. The USCIS officer will complete it during the interview.
A. 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. Current Immigration Status
15. Was there any prior application for citizenship or for a U.S. passport? Y/N
[Page 3]
16. Was the child adopted? Y/N
A. Date of Adoption (mm/dd/yyyy) B. Date Legal Custody Began (mm/dd/yyyy) C. Date Physical Custody Began (mm/dd/yyyy)
17. Were the child's parents married to each other when the child was born (or adopted)? Y/N
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Page 3, Part 3. Information About the Child’s U.S. Citizen Biological or Adoptive Parent |
[Page 3]
Part 3. Information About the Child’s U.S. Citizen Biological or Adoptive Parent
NOTE: Provide information about the U.S. citizen father or mother applying on behalf of the eligible child. Provide information about the child's U.S. citizen parent in the sections noted if the U.S. citizen grandparent or legal guardian is filing this form.
1. Current Legal Name of U.S. Citizen Parent Family Name (Last Name) Given Name (First Name) Middle Name
2. Date of Birth (mm/dd/yyyy) 3. Country of Birth 4. U.S. Social Security Number (if applicable)
5. 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 ZIP Code Province Postal Code Country
6. Daytime Telephone Number 7. Work Telephone Number (if any) 8. Evening Telephone Number 9. Mobile Telephone Number (if any) 10. Email Address (if any)
[Page 4]
11. The parent 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 Number (A-Number) (if known)
Naturalization
Place of Naturalization Name of Court or USCIS Office Location City or Town State Certificate of Naturalization Number A-Number (if known) Date of Naturalization (mm/dd/yyyy)
12. Has the U.S. citizen father or mother ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship? Y/N
If the answer is “Yes” to Item Number 12., provide a full explanation in the space provided in Part 11. Additional Information.
13. Marital History
A. How many times has the U.S. citizen father or mother been married (including annulled marriages and marriages to the same person)?
B. What is the U.S. citizen father or mother's current marital status?
Single, Never Married Married Divorced Widowed Separated Marriage Annulled Other (Explain): _______
C. Information About the U.S. Citizen Father's or Mother's Current Spouse Family Name (Last Name) Given Name (First Name) Middle Name
Date of Birth (mm/dd/yyyy) Country of Birth Country of Citizenship or Nationality
Spouse's Physical Address Street Number and Name (Do not provide a PO Box in this space unless it is your spouse's ONLY address.) Apt. Ste. Flr. Number City or Town State ZIP Code Province Postal Code Country
[Page 5]
Date of Marriage (mm/dd/yyyy)
Place of Marriage City or Town State Country
Spouse's Immigration Status U.S. Citizen Lawful Permanent Resident Other (Explain): ____________
D. Is the U.S. citizen father's or mother's current spouse also the child's biological (or adoptive) parent? Y/N
14. Member of U.S. Armed Forces
A. Is the sponsoring U.S. citizen parent a member of the U.S. Armed Forces? Y/N
B. If the answer is “Yes,” then are there official orders authorizing the child to accompany and reside with the sponsoring U.S. citizen parent who is a member of the U.S. Armed Forces? Y/N
NOTE: If the U.S. citizen biological or adoptive parent is filing this application AND has the required physical presence in the United States, skip Part 4. and go directly to Part 5.
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[Page 3]
[no change]
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 Number (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)
12. Has the U.S. citizen father or mother ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship? Y/N
If you answered “Yes” to Item Number 12., provide a full explanation in the space provided in Part 11. Additional Information.
13. Marital History
A. How many times has the U.S. citizen father or mother been married (including annulled marriages and marriages to the same person)?
B. What is the U.S. citizen father or mother's current marital status?
Single, Never Married Married Divorced Widowed Separated Marriage Annulled Other (Explain): _______
[no change]
14. Member of U.S. Armed Forces
A. Is the sponsoring U.S. citizen parent a member of the U.S. Armed Forces? Y/N
B. If you answered “Yes” to Item A., then are there official orders authorizing the child to accompany and reside with the sponsoring U.S. citizen parent who is a member of the U.S. Armed Forces? Y/N
NOTE: If the U.S. citizen biological or adoptive parent is filing this application AND has the required physical presence in the United States, skip Part 4. and go directly to Part 5.
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Page 5, Part 4. Information About the Child’s Qualifying U.S. Citizen Grandparent |
[Page 5]
Part 4. Information About the Child’s Qualifying U.S. Citizen Grandparent
NOTE: Complete this part only if the U.S. citizen parent (or adoptive parent), grandparent, or legal guardian is applying for citizenship for the child, and the U.S. citizen parent has not been physically present in the United States for five years; two years of which were after 14 years of age.)
1. Current Legal Name of U.S. Citizen Grandparent Family Name (Last Name) Given Name (First Name) Middle Name
2. Date of Birth (mm/dd/yyyy) 3. Country of Birth 4. U.S. Social Security Number (if applicable)
5. 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 ZIP Code Province Postal Code Country
6. Daytime Telephone Number 7. Work Telephone Number (if any)
[Page 6]
8. Evening Telephone Number 9. Mobile Telephone Number (if any) 10. Email Address (if any)
11. The grandparent 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 A-Number (if known)
Naturalization
Place of Naturalization Name of Court or USCIS Office Location City or Town State
Certificate of Naturalization Number A-Number (if known) Date of Naturalization (mm/dd/yyyy
12. Has the grandparent ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship? Y/N
If the answer is “Yes” to Item Number 12., provide a full explanation in the space provided in Part 11. Additional Information.
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[Page 5]
[no change]
11. The grandparent 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) 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)
12. Has the grandparent ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship? Y/N
If you answered “Yes” to Item Number 12., provide a full explanation in the space provided in Part 11. Additional Information.
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Page 6, Part 5. Physical Presence in the United States From Birth Until Filing of Form N-600K |
[Page 6]
Part 5. Physical Presence in the United States From Birth Until Filing of Form N-600K
NOTE: Provide the dates that the U.S. citizen parent or grandparent was present in the United States. If the U.S. citizen parent has not been physically present in the United States for five years, two years of which were after 14 years of age, then the child must use the physical presence of the U.S. citizen grandparent.
1. Indicate whether this information relates to the U.S. citizen parent or to the qualifying grandparent. U.S. Citizen Parent U.S. Citizen Grandparent
2. Physical Presence in the United States
A. From (mm/dd/yyyy) Until (mm/dd/yyyy) B. From (mm/dd/yyyy) Until (mm/dd/yyyy) C. From (mm/dd/yyyy) Until (mm/dd/yyyy) D. From (mm/dd/yyyy) Until (mm/dd/yyyy) E. From (mm/dd/yyyy) Until (mm/dd/yyyy) F. From (mm/dd/yyyy) Until (mm/dd/yyyy) G. From (mm/dd/yyyy) Until (mm/dd/yyyy) H. From (mm/dd/yyyy) Until (mm/dd/yyyy)
NOTE: If the U.S. citizen biological/adoptive parent is filing this application, skip Part 6. and go directly to Part 7.
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[Page 6]
[no change] |
Page 7, Part 6. Information About the Legal Guardian |
[Page 7]
Part 6. Information About the Legal Guardian
NOTE: Complete this part only if your legal guardian is filing this application in lieu of a deceased U.S. citizen parent.
1. Current Legal Name of U.S. Citizen Grandparent
Family Name (Last Name) Given Name (First Name) Middle Name
2. Date of Birth (mm/dd/yyyy) 3. Country of Birth 4. U.S. Social Security Number (if applicable)
5. 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 ZIP Code Province Postal Code Country
6. Daytime Telephone Number 7. Work Telephone Number (if any) 8. Evening Telephone Number 9. Mobile Telephone Number (if any) 10. Email Address (if any)
11. The legal guardian 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 A-Number (if known)
Naturalization
Place of Naturalization Name of Court or USCIS Office Location City or Town State
Certificate of Naturalization Number A-Number (if known) Date of Naturalization (mm/dd/yyyy
[Page 8]
12. Date of Legal Guardianship (mm/dd/yyyy) 13. Name of Authority that Granted Legal Guardianship
14. Address of Authority that Granted Legal Guardianship 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 ZIP Code Province Postal Code Country
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[Page 7]
Part 6. Information About the Legal Guardian
NOTE: Complete this part only if the legal guardian is filing this application on behalf of a deceased U.S. citizen parent.
[no change]
11. The legal guardian 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) 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)
[no change] |
Page 8, Part 7. Preferred Location and Date for Interview |
[Page 8]
Part 7. Preferred Location and Date for Interview
1. USCIS Office Location City or Town State
2. Preferred Date (mm/dd/yyyy)
USCIS will attempt to accommodate the requested preferences.
NOTE: Interview date should be at least 90 days after filing Form N-600K and before the child's 18th birthday.
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[Page 8]
Part 7. Preferred Location and Date for Interview
1. USCIS Office Location City or Town State
2. Preferred Date (mm/dd/yyyy)
USCIS will attempt to accommodate the requested preferences.
NOTE: The interview date should be at least 90 days after filing Form N-600K and before the child's 18th birthday.
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Page 8, Part 8. Applicant’s Statement, Contact Information, Certification, and Signature |
[Page 8]
Part 8. Applicant’s Statement, Contact Information, Certification, and Signature
NOTE: Read the Penalties section of the Form N-600K Instructions before completing this part.
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.
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 ___________, 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., _________, prepared this application for me based only upon information I provided or authorized.
[Page 9]
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.
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.
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[Page 8]
Part 8. Applicant’s Statement, Certification, and Signature
NOTE: Read the Penalties section of the Form N-600K 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.
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 ___________, 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., _________, prepared this application for me based only upon information I provided or authorized.
[Page 9]
[deleted]
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 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 law.
[deleted]
I certify, under penalty of perjury, that all of the information in my application, and any document submitted with it were provided or authorized by me, that I reviewed and 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 3. 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.
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Page 9, Part 9. Interpreter’s Contact Information, Certification, and Signature |
[Page 9]
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)
[Page 10]
Interpreter’s Mailing Address
3. Street Number and Name Apt. Ste. Flr. Number City or Town State ZIP Code 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)
Interpreter’s Certification I certify, under penalty of perjury, that:
I am fluent in English and ________, 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 (sign in ink) Date of Signature (mm/dd/yyyy)
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[Page 9]
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)
[Page 10]
Interpreter’s Mailing Address
3. Street Number and Name Apt. Ste. Flr. Number City or Town State ZIP Code 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)
Interpreter’s Certification I certify, under penalty of perjury, that:
I am fluent in English and ________, 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 (sign in ink) Date of Signature (mm/dd/yyyy)
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Page 10, Part 10. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant |
[Page 10]
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)
[Page 11]
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)
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 whose representation extends beyond preparation of this application, you may be obliged 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 7. Preparer’s Signature (sign in ink) Date of Signature (mm/dd/yyyy)
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[Page 10]
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)
[Page 11]
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)
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, or Form G-28I, Notice of Entry of Appearance as Attorney In Matters Outside the Geographical Confines of the United States, 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)
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Page 12, Part 11. Additional Information |
[Page 12]
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, make copies of this page to complete and file with this application or attach a separate sheet of paper. Type or print the applicant's name and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which the answer refers; and sign and date each sheet.
1. Family Name (Last Name) Given Name (First Name) Middle Name
2. A-Number (if any)
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. A. Page Number B. Part Number C. Item Number D. __________________
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[Page 12]
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, make copies of this page to complete and file with this application or attach a separate sheet of paper. Type or print the child’s name and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which the answer refers; and sign and date each sheet.
1. Family Name (Last Name) Given Name (First Name) Middle Name
2. A-Number (if any)
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. A. Page Number B. Part Number C. Item Number D. __________________
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Page 13, Part 12. Affidavit |
[Page 13]
Part 12. Affidavit (At the time of Interview)
I, the parent/grandparent/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 Grandparent'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 (U.S. citizen parent, grandparent, or legal guardian) on (Date (mm/dd/yyyy)) _______ at (Location).
Interviewing USCIS Officer’s Name Interviewing USCIS Officer’s Title Interviewing USCIS Officer’s Signature (sign in ink) Date of Signature (mm/dd/yyyy)
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Part 12. Affidavit (At the time of Interview)
I, the parent/grandparent/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.
Parent’s, Grandparent’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 (U.S. citizen parent, grandparent, or legal guardian) on (Date (mm/dd/yyyy)) _______ at (Location).
Interviewing USCIS Officer’s Name Interviewing USCIS Officer’s Title Interviewing USCIS Officer’s Signature (sign in ink) Date of Signature (mm/dd/yyyy)
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Part 13. USCIS Officer Report and Recommendation
On the basis of the documents, records and the testimony of person 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 322(a)(2)(A) of the (Parent residence); B. INA Section 322(a)(2)(B) of the (Grandparent residence); or C. Other
I recommend that this Form N-600K 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 the Form N-600K.
USCIS Field Office Director’s Signature (sign in ink) Date of Signature (mm/dd/yyyy)
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Kim, Andrew I |
| File Modified | 0000-00-00 |
| File Created | 2021-01-15 |