Download:
pdf |
pdfApplication for Certificate of Citizenship
USCIS
Form N-600
Department of Homeland Security
U.S. Citizenship and Immigration Services
OMB No. 1615-0057
Expires 11/30/2021
Receipt
Date Stamp
Action Block
For
USCIS
Use
Only
Remarks
To be completed by an
Attorney or Accredited
Representative.
Select this box if
Form G-28.
Attorney State Bar Number
Attorney or Accredited Representative
USCIS Online Account Number
DRAFT
Not for
Production
06/10/2020
► START HERE - Type or print in black ink.
Enter Your 9 Digit A-Number:
Part 1. Information About Your Eligibility
1.
► A-
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):
NOTE: If you need extra space to complete this section, use the space provided in Part 11. Additional Information.
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.
1.
Current Legal Name (do not provide a nickname)
Family Name (Last Name)
2.
Given Name (First Name)
Your Name Exactly As It Appears on Your Permanent Resident Card (if different from above)
Family Name (Last Name)
3.
Given Name (First Name)
Middle Name
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)
4.
Middle Name
U.S. Social Security Number
Given Name (First Name)
5.
USCIS Online Account Number
►
7.
Country of Birth
►
6.
Date of Birth (mm/dd/yyyy)
8.
Country of Prior Citizenship or Nationality
Middle Name
9.
Gender
Male
Form N-600 11/08/19
Female
Page 1 of 15
Part 2. Information About You (continued)
10.
Mailing Address
A-
(USPS ZIP Code Lookup)
In Care Of Name
Street Number and Name
Apt. Ste. Flr.
State
City or Town
Number
ZIP Code + 4
-
Postal Code (foreign address only) Country (foreign address only)
Province (foreign address only)
11.
Physical Address
DRAFT
Not for
Production
06/10/2020
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
-
Postal Code (foreign address only) Country (foreign address only)
Province (foreign address only)
12.
ZIP Code + 4
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?
14.
Yes
No
Information About Your Admission into the United States and Current Immigration Status
A. I arrived in the following manner:
Port-of-Entry
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
Form N-600 11/08/19
Date Passport or Travel Document Issued
(mm/dd/yyyy)
Page 2 of 15
Part 2. Information About You (continued)
A-
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.
Date I became a LPR
(mm/dd/yyyy)
15.
U.S. Citizenship and Immigration Services (USCIS) Office That Granted My LPR Status
or Location Where I Was Admitted
DRAFT
Not for
Production
06/10/2020
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.
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.
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
B. Date of Adoption
(mm/dd/yyyy)
18.
State
Country
C. Date Legal Custody Began
(mm/dd/yyyy)
D. Date Physical Custody Began
(mm/dd/yyyy)
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
B. Date of Final Adoption
(mm/dd/yyyy)
State
Country
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
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
Form N-600 11/08/19
Page 3 of 15
Part 2. Information About You (continued)
22.
A-
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
DRAFT
Not for
Production
06/10/2020
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
Part 3. Biographic Information
1.
Ethnicity (Select only one box)
Hispanic or Latino
2.
Not Hispanic or Latino
Race (Select all applicable boxes)
American Indian or Alaska Native
Asian
Black or African American
White
3.
Height Feet
5.
Eye color (Select only one box)
Black
6.
Inches
Blue
4.
Brown
Native Hawaiian or Other Pacific Islander
Weight
Pounds
Gray
Green
Hazel
Maroon
Pink
Unknown/
Other
Hair color (Select only one box)
Bald
(No hair)
Black
Blond
Brown
Gray
Red
Sandy
White
Unknown/
Other
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.
1.
Current Legal Name of U.S. Citizen Father
Family Name (Last Name)
Form N-600 11/08/19
Given Name (First Name)
Middle Name
Page 4 of 15
A-
Part 4. Information About Your U.S. Citizen Biological Father
(or Adoptive Father) (continued)
2.
Date of Birth (mm/dd/yyyy)
5.
Physical Address
3.
Country of Birth
4.
Country of Citizenship or Nationality
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
-
Postal Code (foreign address only) Country (foreign address only)
Province (foreign address only)
6.
DRAFT
Not for
Production
06/10/2020
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
Alien Registration Number (A-Number)
► A-
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)
► A-
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.
Form N-600 11/08/19
Page 5 of 15
A-
Part 4. Information About Your U.S. Citizen Biological Father
(or Adoptive Father) (continued)
9.
Information About U.S. Citizen Father's Current Spouse
A. Family Name (Last Name)
Given Name (First Name)
B. Date of Birth (mm/dd/yyyy)
Middle Name
C. Country of Birth
D. Country of Citizenship or Nationality
E. Spouse's Physical Address
DRAFT
Not for
Production
06/10/2020
Street Number and Name
City or Town
Apt. Ste. Flr. Number
State
Postal Code
(foreign address only)
Province
(foreign address only)
ZIP Code + 4
-
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
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)
2.
Date of Birth (mm/dd/yyyy)
Form N-600 11/08/19
Given Name (First Name)
3.
Country of Birth
Middle Name
4.
Country of Citizenship or Nationality
Page 6 of 15
A-
Part 5. Information About Your U.S. Citizen Biological Mother
(or Adoptive Mother) (continued)
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
-
Postal Code (foreign address only) Country (foreign address only)
Province (foreign address only)
6.
My mother is a U.S. citizen by
DRAFT
Not for
Production
06/10/2020
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
Alien Registration Number (A-Number)
► A-
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)
► A-
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)
B. Date of Birth (mm/dd/yyyy)
Form N-600 11/08/19
Given Name (First Name)
Middle Name
C. Country of Birth
Page 7 of 15
A-
Part 5. Information About Your U.S. Citizen Biological Mother
(or Adoptive Mother) (continued)
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
-
Postal Code
(foreign address only)
Province
(foreign address only)
Country
(foreign address only)
DRAFT
Not for
Production
06/10/2020
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
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
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
2.
U.S. Citizen Mother
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)
Form N-600 11/08/19
Page 8 of 15
Part 7. Information About Military Service of U. S. Citizen Parents
A-
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?
2.
If you answered "Yes" to Item Number 1., which parent served in the U.S. Armed Forces?
U.S. Citizen Father
3.
No
U.S. Citizen Mother
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)
4.
Yes
To (mm/dd/yyyy)
B. From (mm/dd/yyyy)
To (mm/dd/yyyy)
Type of Discharge
Honorable
DRAFT
Not for
Production
06/10/2020
Other than Honorable
Dishonorable
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.
1.
2.
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.
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.
Applicant's Contact Information
3.
Applicant's Daytime Telephone Number
5.
Applicant's Email Address (if any)
4.
Applicant's Mobile Telephone Number (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
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.
Form N-600 11/08/19
Page 9 of 15
A-
Part 8. Applicant's Statement, Contact Information, Certification, and
Signature (continued)
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.
DRAFT
Not for
Production
06/10/2020
Applicant's Signature
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.
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
6.
Interpreter's Email Address (if any)
Form N-600 11/08/19
5.
Interpreter's Mobile Telephone Number (if any)
Page 10 of 15
A-
Part 9. Interpreter's Contact Information, Certification, and Signature
(continued)
Interpreter's Certification
I certify, under penalty of perjury, that:
, which is the same language specified in Part 8.,
I am fluent in English and
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)
DRAFT
Not for
Production
06/10/2020
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.
City or Town
State
Province
Postal Code
Number
ZIP Code + 4
-
Country
Preparer's Contact Information
4.
Preparer's Daytime Telephone Number
6.
Preparer's Email Address (if any)
Form N-600 11/08/19
5.
Preparer's Mobile Telephone Number (if any)
Page 11 of 15
Part 10. Contact Information. Declaration, and Signature of the Person
Preparing this Application, if Other Than the Applicant (continued)
A-
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. 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.
DRAFT
Not for
Production
06/10/2020
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
Form N-600 11/08/19
Date of Signature (mm/dd/yyyy)
Page 12 of 15
Part 11. Additional Information
A-
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 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)
2.
A-Number
3.
A. Page Number
D.
4.
A. Page Number
D.
5.
A. Page Number
D.
6.
A. Page Number
Given Name (First Name)
Middle Name
► AB. Part Number
C. Item Number
DRAFT
Not for
Production
06/10/2020
B. Part Number
C. Item Number
B. Part Number
C. Item Number
B. Part Number
C. Item Number
D.
Form N-600 11/08/19
Page 13 of 15
NOTE: Do not complete Parts 12. and 13. unless the USCIS officer instructs you to do so at the interview.
Part 12. Affidavit (do NOT complete this part unless instructed to do so
AT THE INTERVIEW)
A-
I, the (applicant, parent, or legal guardian)
do swear or affirm, under
penalty of perjury under the laws of the United States, that I know and understand the contents of this application signed by me, and
the attached supplementary pages number
to
inclusive, that the same are true and correct to the best of my knowledge,
and that corrections number
to
were made by me or at my request.
Date of Signature (mm/dd/yyyy)
Applicant's, Parent's, or Legal Guardian's Signature
Subscribed and sworn or affirmed before me upon examination of the applicant (parent, or legal guardian) on
DRAFT
Not for
Production
06/10/2020
at
.
Date (mm/dd/yyyy)
(Location)
USCIS Officer's Printed Name
USCIS Officer's Title
USCIS Officer's Signature
Date of Signature (mm/dd/yyyy)
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)
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.”)
3.
4.
A.
INA Section 301
B.
INA Section 309
C.
INA Section 320
D.
INA Section 321
E.
Other
The applicant has not been expatriated since that time
Form N-600 11/08/19
Page 14 of 15
Part 13. Officer Report and Recommendation on Application for
Certificate of Citizenship (for USCIS use ONLY) (continued)
I recommend that this Form N-600 be:
Approved
A-
Denied
Issue Certificate of Citizenship in the name of
Family Name (Last Name)
Given Name (First Name)
USCIS Officer's Printed Name
USCIS Officer's Title
USCIS Officer's Signature
I do
Middle Name
Date of Signature (mm/dd/yyyy)
DRAFT
Not for
Production
06/10/2020
do not concur with the USCIS Officer's recommendation of Form N-600.
USCIS District Director's or Field Office Director's Signature
Form N-600 11/08/19
Date of Signature (mm/dd/yyyy)
Page 15 of 15
File Type | application/pdf |
File Title | N-600, Application for Certificate of Citizenship |
Subject | Application for Certificate of Citizenship |
Author | USCIS |
File Modified | 2020-06-10 |
File Created | 2020-06-10 |