N565-015-INS-FeeRule-OPSReview-FR-12212023

Instructions for Application for Replacement
Naturalization/Citizenship Document
Department of Homeland Security
U.S. Citizenship and Immigration Services

USCIS
Form N-565
OMB No. 1615-0091
Expires 12/31/2024

What Is the Purpose of Form N-565?

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Form N-565, Application for Replacement Naturalization/Citizenship Document, is used to apply to U.S. Citizenship and
Immigration Services (USCIS) for a replacement of a:
1. Certificate of Naturalization;
2. Certificate of Citizenship;

3. Declaration of Intention; or
4. Repatriation Certificate.

You can also use this application to apply for a special certificate of naturalization to have a foreign country recognize
you as a U.S. citizen.

Who May File Form N-565?

You may apply for a replacement document if you were issued a Certificate of Naturalization, Certificate of Citizenship,
Declaration of Intention, or Repatriation Certificate, and at least one of the following applies:
1. The document was lost, stolen, destroyed, or mutilated;

2. The document is incorrect due to a typographical or clerical error by USCIS;

3. Your name was changed by marriage, divorce, annulment, or court order, and you seek a document in your new name;
or
4. You obtained a court order, a government-issued document, or a letter from a licensed health care professional
recognizing that your gender is different from the gender listed on your current document, and you seek a document
reflecting the recognized gender.
In addition, you may apply for a replacement of your Certificate of Citizenship if you obtained a court order or a
document issued by the U.S. government or the government of any U.S. state that changes your date of birth, and you
seek a document with the new date of birth.
You may also file this application if you are a naturalized citizen seeking a special certificate of naturalization for the
purpose of a foreign country recognizing you as a U.S. citizen.
If the document was lost in the mail, please submit an online case service request for non-delivery of document prior to
submitting Form N-565.
NOTE: USCIS will not change your name without evidence such as a marriage certificate, divorce decree, or court order.
We will not change the date of birth on a Certificate of Citizenship without documentation such as a U.S. court order or
state-issued documents.
USCIS cannot make any changes to an incorrect date of birth or name on a Certificate of Naturalization if you provided
an incorrect date or name on your Form N-400, Application for Naturalization, and then later swore to the facts of your
application by signing Part 16. Signature at Interview. We can only change the name on your Certificate of
Naturalization if you changed your name after you naturalized.
http://get.adobe.com/reader/
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General Instructions
We provide free forms through the USCIS website. To view, print, or complete our forms, you should use the latest
version of Adobe Reader, which you can download for free at http://get.adobe.com/reader/.
Signature. You (or your signing authority) must properly complete your application. USCIS will not accept a stamped
or typewritten name in place of any signature on this application. If you are under 14 years of age, your parent or legal
guardian may sign the application on your behalf. A legal guardian may also sign for a mentally incompetent person. If
your application is not signed, or if the signature is not valid, we will reject your application. See 8 CFR 103.2(a)(7)(ii)
(A). If USCIS accepts a request for adjudication and determines that it has a deficient signature, USCIS may deny the
request.

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Validity of Signatures. USCIS will consider a photocopied, faxed, or scanned copy of an original handwritten signature
as valid for filing purposes. The photocopy, fax, or scan must be of the original document containing the handwritten ink
signature.
Filing Fee. See Form G-1055, available at www.uscis.gov/forms, for specific information about the fees applicable to
this form.
Evidence. When you file your application, you must submit all evidence and supporting documents listed in the Initial
Evidence section of these Instructions. For additional information, see the USCIS Policy Manual, Volume 12, Part K,
Certificates of Citizenship and Naturalization at www.uscis.gov/policymanual.
Biometric Services Appointment. USCIS may require you to appear for an interview or provide biometrics
(fingerprints, photograph, and/or signature) at any time to verify your identity, obtain additional information, and conduct
background and security checks, including a check of criminal history records maintained by the Federal Bureau of
Investigation (FBI), before making a decision on your application or petition. If we determine that a biometric services
appointment is necessary, we will send you an appointment notice with the date, time, and location of your appointment.
If you are currently overseas, your notice will instruct you to contact a U.S. Embassy, U.S. Consulate, or USCIS office
outside the United States to schedule an appointment.
At your biometrics appointment, you must sign an oath reaffirming that:
1. You provided or authorized all information in the application;

2. You reviewed and understood all of the information contained in, and submitted with, your application; and
3. All of this information was complete, true, and correct at the time of filing.
If you do not attend your biometric services appointment, we may deny your application.
Copies. You should submit legible photocopies of requested documents unless the Instructions specifically instruct you
to submit an original document. USCIS may request an original document at any time during our process. If we request
an original document from you, we will return it to you after USCIS determines it no longer needs the original.
NOTE: If you submit original documents when they are not required or requested, USCIS may destroy them after we
receive them.
Translations. If you submit a document with information in a foreign language, you must also submit a full English
translation. The translator must sign a certification that the English language translation is complete and accurate, and
that they are competent to translate from the foreign language into English. The certification must also include their
signature, printed name, the signature date, and their contact information.
USCIS Contact Center. For additional information on the application and Instructions about where to file, change of
address, and other questions, visit the USCIS Contact Center at www.uscis.gov/contactcenter or call at 800-375-5283
(TTY 800-767-1833). The USCIS Contact Center provides information in English and Spanish.

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Disability Accommodations/Modifications. To request a disability accommodation/modification, follow the
instructions on your appointment notice or at www.uscis.gov/accommodationsinfo.
How To Complete Form N-565
1. Type or print legibly in black ink.
2. If you need extra space to complete any item within this application, use the space provided in Part 12. Additional
Information or attach a separate sheet of paper. Type or print your name and Alien Registration Number (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.

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3. Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been
married and the question asks, “Provide the name of your current spouse”), type or print “N/A” unless otherwise
directed. If your answer to a question which requires a numeric response is zero or none (for example, “How many
children do you have” or “How many times have you departed the United States”), type or print “None” unless
otherwise directed.
4. USCIS Online Account Number. You will only have a USCIS Online Account Number (OAN) if you previously
filed a form that has a receipt number that begins with IOE. If you filed the form online, you can find your OAN in
your account profile. If you mailed us the form, you can find your OAN at the top of the Account Access Notice we
sent you. If you do not have a receipt number that begins with IOE, you do not have an OAN. The OAN is not the
same as an A-Number.
5. Country of Citizenship or Nationality. Provide the name of the country where you are a citizen and/or national.
This is not necessarily the country where you were born. If you do not have citizenship in any country, type or print
“stateless” and provide an explanation in Part 12. Additional Information.
6. Part 3. Biographic Information. Provide the biographic information requested. Providing this information as part of
your application may reduce the time you spend at your USCIS ASC appointment as described in the Biometric
Services Appointment section of these Instructions.
A. Ethnicity and Race. Select the boxes that best describe your ethnicity and race.
B. Categories and Definitions for Ethnicity and Race

(1) Hispanic or Latino. A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish
culture or origin, regardless of race. (NOTE: This category is only included under Ethnicity in Part 3., Item
Number 1.)
(2) 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.
(3) 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.
(4) Black or African American. A person having origins in any of the black racial groups of Africa.
(5) Native Hawaiian or Other Pacific Islander. A person having origins in any of the original peoples of
Hawaii, Guam, Samoa, or other Pacific Islands.
(6) White. A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
C. Height. Select the values that best match your height in feet and inches. For example, if you are five feet and nine
inches, select “5” for feet and “09” for inches. Do not enter your height in meters or centimeters.
D. Weight. Enter your weight in pounds. If you do not know your weight or need to enter a weight under 30 pounds
or over 699 pounds, enter “000.” Do not enter your weight in kilograms.
E. Eye Color. Select the box that best describes the color of your eyes.
F. Hair Color. Select the box that best describes the color of your hair.
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7. Part 9. Complete If Applying for a Special Certificate of Recognition as a Citizen of the United States to the
Government of a Foreign Country. Provide the information requested in Item Numbers 1. - 3. about the official of a
foreign country who has requested this certificate, if you know it.
NOTE: You do not need to complete Item Number 4. before you file Form N-565. The USCIS or consular official's
certification will be completed after USCIS adjudicates your Form N-565, if it is approved.
8. Part 10. Applicant's Statement, Contact Information, Certification, and Signature. Select the appropriate box to
indicate whether you read this application yourself or whether you had an interpreter assist you. If someone assisted
you in completing the application, select the box indicating that you used a preparer. Further, you must sign and date
your application and provide your daytime telephone number, mobile telephone number (if any), and email address (if
any). Every application MUST contain the signature of the applicant (or parent or legal guardian, if applicable). A
stamped or typewritten name in place of a signature is not acceptable.

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9. Part 11. Interpreter's Contact Information, Certification, and Signature. If you used anyone as an interpreter to
read the Instructions and questions on this application to you in a language in which you are fluent, the interpreter must
fill out this section; provide his or her name, the name and address of his or her business or organization (if any), his or
her daytime telephone number, his or her mobile telephone number (if any), and his or her email address (if any). The
interpreter must sign and date the application.
10. Part 12. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other
Than the Applicant. This section must contain the signature of the person who completed your application, if other
than you, the applicant. If the same individual acted as your interpreter and your preparer, that person should
complete both Part 11. and Part 12. If the person who completed this application is associated with a business or
organization, that person should complete the business or organization name and address information. Anyone who
helped you complete this application MUST sign and date the application. A stamped or typewritten name in place of
a signature is not acceptable. If the person who helped you prepare your application is an attorney or accredited
representative, he or she may also need to submit a completed Form G-28, Notice of Entry of Appearance as Attorney
or Accredited Representative, along with your application.
We recommend that you review your copy of your completed application before you go to your biometric services
appointment at a USCIS ASC. At your appointment, USCIS will allow you to complete the application process only if
you are able to confirm, under penalty of perjury, that all of the information in your application is complete, true, and
correct. If you are not able to make that attestation in good faith at that time, we will require you to return for another
appointment.
Initial Evidence
1. Photographs. If you reside in the United States, USCIS may request that you attend an appointment at an ASC to have
your photograph taken. If you reside outside the United States, you must submit two identical color passport-style
photographs of yourself taken recently. The photos must have a white to off-white background, be printed on thin
paper with a glossy finish, and be unmounted and unretouched.
The photos must be 2 by 2 inches with a full face, frontal view. Head height should measure 1 to 1 3/8 inches from the
top of your hair to the bottom of your chin, and eye height should measure between 1 1/8 to 1 3/8 inches from the top
of your eyes to the bottom of the photo. Your head must be bare unless you are wearing headwear as required by your
religious denomination. Use a pencil or felt pen to lightly print your name and A-Number (if any) on the back of the
photos.
2. You must submit a copy of your U.S. Government-issued photo identification.
3. If your marital status has changed since your original document was issued, you must submit a copy of the document
establishing your change in marital status (such as your marriage certificate, divorce decree, annulment decree, or
spouse's death certificate).
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4. If your document was lost, stolen, or destroyed, you must attach a copy of the document (if available), a police report,
and/or a sworn statement explaining what happened to the document and any attempts to retrieve the document.
5. If you are applying for replacement of a mutilated document, you must attach the original mutilated document.
6. If you are applying for replacement of a document that is incorrect due to a typographical or clerical error by USCIS,
you must attach the original incorrect document and complete Part 4. of Form N-565.
7. If you are applying for a new document because your name was changed, you must submit the original USCIS
document and a copy of either the original or certified document establishing the name change (such as a marriage
certificate, divorce decree, annulment decree, or court order), and complete Part 5. of Form N-565.

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8. If you are applying for a new Certificate of Citizenship because your date of birth has legally changed, you must
submit the original USCIS document you are seeking to replace. You must also submit a copy of either the original or
certified document establishing the date of birth change (for example, a court order or vital record document issued by
the U.S. Government or the government of any U.S. state (“U.S. Government documents”)) and complete Part 6. of
Form N-565. U.S. Government documents may include a birth certificate, a certificate recognizing foreign birth, a
certificate of birth abroad, or other similar vital records issued by the U.S. state where you resided when the document
was issued. Only applicants applying for a new Certificate of Citizenship may select this option.
9. If you are applying for a new document that reflects a different gender than is shown on your current document, you
must submit the original USCIS document along with one of the forms of evidence listed below supporting the
requested official change in gender designation and complete Part 7. of Form N-565.
Submit one of the following forms of evidence supporting your requested official change in gender designation:
A. A court order granting change of sex or gender;

B. A government-issued document reflecting the requested gender designation. Acceptable government-issued
documents include an amended birth certificate, a passport, a driver's license, or other official document showing
identity issued by the U.S. Government, a state or local government in the United States, or a foreign government;
C. A letter from a licensed health care professional certifying the requested gender designation is consistent with your
gender identity. Licensed health care professionals include licensed counselors, nurse practitioners, physicians
(Medical Doctors or Doctors of Osteopathy), physician assistants, psychologists, social workers, and therapists.
The health care certification must include the following information:
(1) A court order granting change of sex or gender;
(2) The health care professional's license number and issuing state, country, or other jurisdiction of the
professional license;
(3) Language stating the health care professional has treated or evaluated you in relation to your gender identity;
and
(4) The health care professional's assessment of your gender identity.
10. If you are applying for a special certificate of naturalization to obtain recognition as a citizen of the United States by a
foreign country, you must attach a copy of your naturalization certificate.
NOTE: USCIS regulations require this special certificate when a foreign state requires proof of your citizenship for
any legitimate purpose, except for admission to the foreign country or in processing their own immigration benefit
requests.
11. If you are filing from overseas and provide a foreign mailing address, USCIS will send your new document (if
approved) to the nearest U.S. Embassy, U.S. Consulate, or USCIS field office. You will receive notification by mail
where to pick up your new document.
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Where to File?
Please see our website at www.uscis.gov/N-565 for the most current information about where to file this application.

Processing Information
Rejection. USCIS will reject any application that is not signed or accompanied by the correct fee and will send you a
notice that the application is deficient. You may correct the deficiency and resubmit the application. An application is
not considered properly filed until the date that USCIS accepts it.

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Initial Processing. Once USCIS accepts your application, we will check it for completeness. If you do not properly
complete this application, you will not establish a basis for your eligibility and we may reject or deny your application.
Requests for More Information. USCIS may request that you provide more information or evidence to support your
application. We may also request that you provide the originals of any copies you submit. If we request an original
document from you, we will return it to you after USCIS determines it is no longer needed.
Decision. The decision on Form N-565 involves a determination of whether you have established eligibility for the
document you are requesting. If you establish eligibility for the document, USCIS will approve your application and issue
the document. Where appropriate, USCIS will forward a special Certificate of Naturalization to the U.S. Department of
State for delivery to a foreign government official. If your application is denied, USCIS will notify you of the decision in
writing.

USCIS Forms and Information

To ensure you are using the latest version of this application, visit www.uscis.gov.

Penalties

If you knowingly and willfully falsify or conceal a material fact or submit a false document with your Form N-565, we
will deny your application and may deny any other immigration benefit. In addition, you will face severe penalties
provided by law and may be subject to criminal prosecution.

DHS Privacy Notice
AUTHORITIES: The information requested on this application, and the associated evidence, is collected pursuant to
Immigration and Nationality Act Section 343(a).
PURPOSE: The primary purpose for providing the information on this application is to request a replacement of your
Declaration of Intention, Certificate of Naturalization, Certificate of Citizenship, Repatriation Certificate, or to apply for a
special certificate of naturalization as a U.S. citizen to be recognized by a foreign country. DHS will use the information
you provide to grant or deny the replacement document you are seeking.
DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information,
including your Social Security number (if applicable), and any requested evidence, may delay a final decision or result in
denial of your application.

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ROUTINE USES: DHS may share the information you provide on this application and any additional requested
evidence with other Federal, state, local, and foreign government agencies and authorized organizations. DHS follows
approved routine uses described in the associated published system of records notices [DHS/USCIS/ICE/CBP-001 Alien
File, Index, and National File Tracking System, DHS/USCIS-007 Benefits Information System, and DHS/USCIS-018
Immigration Biometric and Background Check] and published privacy impact assessments [DHS/USCIS/PIA-016(a)
Computer Linked Application Information Management System and Associated Systems, and DHS/USCIS/PIA-056
USCIS Electronic Information System, and DHS/USCIS/PIA-071 myUSCIS Account Experience], which can be found at
www.dhs.gov/privacy. DHS may also share this information, as appropriate, for law enforcement purposes or in the
interest of national security.

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Paperwork Reduction Act

USCIS may not conduct or sponsor an information collection, and you are not required to respond to a collection of
information, unless it displays a currently valid Office of Management and Budget (OMB) control number. The public
reporting burden for this collection of information is estimated at 1.147 hour per response, including the time for
reviewing instructions, gathering the required documentation and information, completing the application, preparing
statements, attaching necessary documentation, and submitting the application. The collection of biometrics is estimated
to require 1 hour and 10 minutes. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services, Office of
Policy and Strategy, Regulatory Coordination Division, 5900 Capital Gateway Drive, Mail Stop #2140, Camp Springs,
MD 20588-0009; OMB No. 1615-0091. Do not mail your completed Form N-565 to this address.

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