I600A-015-FRM-TOC-FeeRule-OPSReview-FR-10232023

TABLE OF CHANGES – FORM

Form I-600A, Application for Advance Processing of an Orphan Petition

OMB Number: 1615-0028

10/23/2023

Reason for Revision: Final Fee Rule

Phase: OPS Review

Legend for Proposed Text:

• Black font = Current text

• Red font = Changes

Expires 07/31/2025

Edition Date 12/21/2019 E

Current Page Number and Section	Current Text	Proposed Text
	[new]	Part 1. Basis of Filing [ ] You are a U.S. citizen who plans to adopt or has adopted a child from a country that is not party to the Hague Adoption Convention. [ ] You previously filed a Form I-600A; AND your marital status changed while your Form I-600A application was pending.
Pages 1-6, Part 1. Information About You (Applicant)	[Page 1] Part 1. Information About You (Applicant) 1. Family Name (Last Name) Given Name (First Name) Middle Name (if applicable) 2. Other Names Used (if any) Provide all other names you have ever used, including aliases, maiden name, and nicknames. If you need extra space to complete this section, use the space provided in Part 9. Additional Information. … 16. Have you EVER renounced or lost U.S. citizenship or has anyone you obtained citizenship through (such as your parent or grandparent) EVER lost U.S. citizenship? Yes No NOTE: If you answered "Yes,” provide a detailed explanation in the space provided in Part 9. Additional Information. … 22. Other Names Your Current Spouse Has Used (if any) Provide all other names your spouse has ever used, including aliases, maiden name, and nicknames. If you need extra space to complete this section, use the space provided in Part 9. Additional Information. … 31. List all of your children who are under 18 years of age. Also include any other children under 18 years of age who reside in your household, regardless of your relationship to those children. If you need extra space to complete this table, use the space provided in Part 9. Additional Information. [Table 5 entries] Name (First/Middle/Last) Date of Birth (mm/dd/yyyy) Country of Birth A-Number (if any) Relationship to You (if any) [Page 5] Information About Prior Filings or Adoptions If you need extra space to complete Item Numbers 32. - 37., use the space provided in Part 9. Additional Information. … Duty of Disclosure You and your spouse (if married), must answer the following questions. See the Duty of Disclosure section in the Form I-600A Instructions concerning your ongoing duty to disclose information in response to these questions. If you or your spouse answer "Yes" to any of the questions in Item Numbers 38. and 39., provide a certified copy of the documentation showing the final disposition of each incident which resulted in arrest, indictment, conviction, and/or any other judicial or administrative action and a written statement giving details, including any mitigating circumstances about each arrest, signed by you and/or your spouse (if married) under penalty of perjury under U.S. law. The written statement must show the date of each incident; place incident occurred (city/town, state/province, country); name of police department or other law enforcement administration or other entity involved; date of incarceration and name of facility, if applicable. Provide a description of any type of counseling, rehabilitation, or other information that you and your spouse (if married) would like considered in light of this history in the space provided in Part 9. Additional Information. …	Part 2. Information About You (Applicant) [no change] Provide all other names you have ever used, including aliases, maiden name, and nicknames. If you need extra space to complete this section, use the space provided in Part 10. Additional Information. … 16. Have you EVER renounced or lost U.S. citizenship or has anyone you obtained citizenship through (such as your parent or grandparent) EVER lost U.S. citizenship? Yes No NOTE: If you answered "Yes,” provide a detailed explanation in the space provided in Part 10. Additional Information. … 22. Other Names Your Current Spouse Has Used (if any) Provide all other names your spouse has ever used, including aliases, maiden name, and nicknames. If you need extra space to complete this section, use the space provided in Part 10. Additional Information. … 31. List all of your children who are under 18 years of age. Also include any other children under 18 years of age who reside in your household, regardless of your relationship to those children. If you need extra space to complete this table, use the space provided in Part 10. Additional Information. [no change] Information About Prior Filings or Adoptions If you need extra space to complete Item Numbers 32. - 37., use the space provided in Part 10. Additional Information. … Duty of Disclosure You and your spouse (if married), must answer the following questions. See the Duty of Disclosure section in the Form I-600A Instructions concerning your ongoing duty to disclose information in response to these questions. If you or your spouse answer "Yes" to any of the questions in Item Numbers 38. and 39., provide a certified copy of the documentation showing the final disposition of each incident which resulted in arrest, indictment, conviction, and/or any other judicial or administrative action and a written statement giving details, including any mitigating circumstances about each arrest, signed by you and/or your spouse (if married) under penalty of perjury under U.S. law. The written statement must show the date of each incident; place incident occurred (city/town, state/province, country); name of police department or other law enforcement administration or other entity involved; date of incarceration and name of facility, if applicable. Provide a description of any type of counseling, rehabilitation, or other information that you and your spouse (if married) would like considered in light of this history in the space provided in Part 10. Additional Information. …
Pages 7-9, Part 2. Information About Your Home Study Preparer and/or Adoption Service Provider	[Page 7] Part 2. Information About Your Home Study Preparer and/or Adoption Service Provider 1. Your home study: …	Part 3. Information About Your Home Study Preparer and/or Adoption Service Provider [no change] …
Page 9, Part 3. Information About Your Intended Adoption(s)	[Page 9] Part 3. Information About Your Intended Adoption(s) 1. What country do you intend to adopt from (if known)? 2. Do you or your spouse (if married) plan to travel abroad to locate or adopt a child? Yes No 3. If you answered "Yes" to Item Number 2., provide the following information (if available): A. Your Intended Departure Date (mm/dd/yyyy) B. Your Spouse's Intended Departure Date (mm/dd/yyyy) C. Place to Which You or Your Spouse (if married) Are Traveling City or Town Province Country 4. Will you and your spouse (if married) adopt the child abroad after either you or your spouse (if married) have personally seen and observed the child before or during the adoption proceedings? Yes No 5. If you know that the child will be adopted in the United States, provide a written description of all the pre-adoption requirements of the state of the child's proposed residence. Cite any relevant state statutes and regulations, and describe the steps you have already taken or will take to comply with these requirements. Identify and explain any pre-adoption requirements that you cannot meet at this time as a result of state law. If you need extra space to complete this Item Number., use the space provided in Part 9. Additional Information. …	Part 4. Information About Your Intended Adoption(s) [no change] 5. If you know that the child will be adopted in the United States, provide a written description of all the pre-adoption requirements of the state of the child's proposed residence. Cite any relevant state statutes and regulations, and describe the steps you have already taken or will take to comply with these requirements. Identify and explain any pre-adoption requirements that you cannot meet at this time as a result of state law. If you need extra space to complete this Item Number., use the space provided in Part 10. Additional Information. …
Page 10, Part 4. Accommodations for Individuals With Disabilities and/or Impairments	[Page 10] Part 4. Accommodations for Individuals With Disabilities and/or Impairments NOTE: Read the information in the Form I-600A Instructions before completing this section. …	Part 5. Accommodations for Individuals With Disabilities and/or Impairments [no change] …
Pages 10-11, Part 5. Applicant’s Statement, Certification, Duty of Disclosure, and Signature	[Page 10] Part 5. Applicant’s Statement, Certification, Duty of Disclosure, and Signature NOTE: Read the Penalties section of the Form I-600A Instructions before completing this section. Applicant’s Statement 1. Applicant’s Statement Regarding the Interpreter (Select the box for either Item A. or B.) 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 7. 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 (if applicable) At my request, the preparer named in Part 8., [Fillable field], prepared this application for me based only upon information I provided or authorized. …	Part 6. Applicant’s Statement, Certification, Duty of Disclosure, and Signature [no change] B. The interpreter named in Part 8. 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 (if applicable) At my request, the preparer named in Part 9., [Fillable field], prepared this application for me based only upon information I provided or authorized. …
Pages 11-12, Part 6. Your Spouse’s Statement, Certification, Duty of Disclosure, and Signature	[Page 11] Part 6. Your Spouse’s Statement, Certification, Duty of Disclosure, and Signature Your Spouse’s Statement 1. Spouse’s Statement Regarding the Interpreter (select the box for either Item A. or B.) A. I can read and understand English, and have read and understand every question and instruction on this application and my answer to every question. B. The interpreter named in Part 7. 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. Spouse’s Statement Regarding the Preparer (if applicable) At my request, the preparer named in Part 8., [Fillable field], prepared this application for me based only upon information I provided or authorized. …	Part 7. Your Spouse’s Statement, Certification, Duty of Disclosure, and Signature [no change] B. The interpreter named in Part 8. 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. Spouse’s Statement Regarding the Preparer (if applicable) At my request, the preparer named in Part 9., [Fillable field], prepared this application for me based only upon information I provided or authorized. …
Pages 12-13, Part 7. Interpreter’s Contact Information, Certification, and Signature	[Page 12] Part 7. Interpreter’s Contact Information, Certification, and Signature If you and/or your spouse (if married) used an interpreter to read and complete this application, 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 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 13] 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 Parts 5. and 6., Item B in Item Number 1., and I have read to this applicant and/or the applicant’s spouse in the identified language every question and instruction on this application and their answer to every question. The applicant and/or the applicant’s spouse informed me that he or she understands every instruction, question, and answer on the application, including the Applicant’s Certification and the Your Spouse’s Certification, and has verified the accuracy of every answer. Interpreter’s Signature 7. Interpreter's Signature Date of Signature (mm/dd/yyyy)	Part 8. Interpreter’s Contact Information, Certification, and Signature [no change] 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 Parts 6. and 7., Item B in Item Number 1., and I have read to this applicant and/or the applicant’s spouse in the identified language every question and instruction on this application and their answer to every question. The applicant and/or the applicant’s spouse informed me that he or she understands every instruction, question, and answer on the application, including the Applicant’s Certification and the Your Spouse’s Certification, and has verified the accuracy of every answer. [no change]
Pages 13-14, Part 8. Contact Information, Declaration, and Signature of the Person Preparing this Application, If Other Than the Applicant and Spouse	[Page 13] Part 8. Contact Information, Declaration, and Signature of the Person Preparing this Application, If Other Than the Applicant and Spouse If you and/or your spouse (if married) used a preparer to complete this application, provide the following information about the preparer. …	Part 9. Contact Information, Declaration, and Signature of the Person Preparing this Application, If Other Than the Applicant and Spouse [no change] …
Page 15, Part 9. Additional Information	[Page 15] Part 9. 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. If you attach a separate sheet of paper, type or print your full 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]	Part 10. Additional Information [no change]

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