Form I-600 Petition to Classify Orphan as an Immediate Relative

Petition to
Classify Orphan as an Immediate Relative
Department of Homeland Security
U.S. Citizenship and Immigration Services

USCIS
Form I-600
OMB No. 1615-0028
Expires 02/28/2026

For U.S. Government Use Only
Receipt/Fee Stamp

Action Block

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The petitioner is:

Married

Unmarried

Form I-600A Approval

Approval Valid Until (mm/dd/yyyy):

The petitioner is approved to adopt an
orphan from (if specified):

Department of State Actions:

Final Adjudicating Office/Post:

Approved

(Name of non-Hague Convention Country)

PAIR Letter Issued Date (if applicable)
(mm/dd/yyyy):

To be completed by
an Attorney or
Accredited
Representative (if any).

Transfer to USCIS as Not Clearly
Approvable

Officer Signature and Date:

Transfer to USCIS as Consular Return

Child's Legal Name after Adoption:

Select this box if
Form G-28 or G-28I
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. Complete a separate petition for each child. This petition is made to classify an
orphan as your immediate relative.
You must be a U.S. citizen in order to file this petition. See the What Are the Eligibility Requirements section of the Form
I-600 Instructions for more information.

Part 1. Basis of Filing
1.

Petition Filing Basis
Select the appropriate option below. See USCIS Form G-1055, Fee Schedule, available at www.uscis.gov/g-1055, for
information on filing fees.
You filed Form I-600A and it is pending or was approved and remains valid, and you are filing Form I-600 for:
One child
Multiple children who are birth siblings. This petition is for the first sibling.
Multiple children who are birth siblings. This petition is for an additional sibling.
Multiple children who are not birth siblings. This petition is for the first child.
Multiple children who are not birth siblings. This petition is for an additional child.
You do not have a valid Form I-600A approval (because you did not file a Form I-600A, your Form I-600A approval expired or
is no longer valid, etc.). You are requesting a suitability and eligibility determination as part of your Form I-600 (combination
filing), and you are filing Form I-600 for:
One child
Multiple children who are birth siblings. This petition is for the first sibling.
Multiple children who are birth siblings. This petition is for an additional sibling.
Multiple children who are not birth siblings. This petition is for the first child.
Multiple children who are not birth siblings. This petition is for an additional child.

Form I-600 Edition 04/01/24

Page 1 of 16

Part 1. Basis of Filing (continued)
2.

Any Change in Marital Status
Complete this section if you filed Form I-600A or a Form I-600 combination filing and have had a change in marital status since
you filed your application or petition.

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Your marital status changed while your Form I-600A or Form I-600 combination filing was pending, and you are
submitting a combination filing with a new basis marital status.

Your marital status changed after your Form I-600A or Form I-600 combination filing was approved, and you are
submitting a combination filing with a new basis marital status.

Part 2. Information About You (Petitioner)
1.

Family Name (Last Name)

2.

Other Names Used (if any)

Given Name (First Name)

Middle Name (if applicable)

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 12. Additional Information.
Family Name (Last Name)

Given Name (First Name)

Middle Name (if applicable)

Your Contact Information
3.

U.S. Mailing Address (if any)
In Care Of Name (if any)

4.

Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

ZIP Code

Yes

Is your current U.S. mailing address the same as your U.S. physical address?

No

If you answered "No," provide your U.S. physical address in Item Number 5. or your address abroad in Item Number 6., as
appropriate.
5.

U.S. Physical Address (if any)
In Care Of Name (if any)

Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

Form I-600 Edition 04/01/24

ZIP Code

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Part 2. Information About You (Petitioner) (continued)
6.

Address Abroad (if any)
Street Number and Name

Apt. Ste. Flr. Number

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City or Town

Province

7.

Daytime Telephone Number

9.

Email Address (if any)

State

Postal Code

Country

8. Mobile Telephone Number (if any)

Information About Your U.S. Citizenship
10.

USCIS Online Account Number (if any)
►

12.

City/Town/Village of Birth

11. Date of Birth (mm/dd/yyyy)

State or Province of Birth

Country of Birth

13.a. How did you obtain your U.S. citizenship?

Birth

Parents

Naturalization

13.b. If you obtained your citizenship through your parents, have you obtained a Certificate of Citizenship in your
own name?

Yes

No

If you answered "Yes," provide the following information about your Certificate of Citizenship:
Your Name On the Certificate of Citizenship
Family Name (Last Name)

Given Name (First Name)

Middle Name (if applicable)

Alien Registration Number (A-Number) (if any) Certificate of Citizenship Number
► ADate of Issuance (mm/dd/yyyy)

Place of Issuance

13.c. If you obtained your citizenship through naturalization, provide the following information about your Certificate of Naturalization:
Your Name On the Certificate of Naturalization
Family Name (Last Name)

Given Name (First Name)

A-Number (if any)

Certificate of Naturalization Number

Middle Name (if applicable)

► ADate of Naturalization (mm/dd/yyyy)

Form I-600 Edition 04/01/24

Place of Naturalization

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Part 2. Information About You (Petitioner) (continued)
14.

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 12. Additional Information.

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15.

What is your marital status?

Single

Married

Divorced

Widowed

16.

How many times have you been married (including your current marriage, if applicable)?

Separated

NOTE: If you are not currently married, skip to Item Number 28.

Information About Your Current Marriage
17.

Date of Current Marriage (mm/dd/yyyy)

19.

Name of Your Current Spouse

18.

Family Name (Last Name)

20.

Place Where Current Marriage Occurred

Given Name (First Name)

Middle Name (if applicable)

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 12. Additional Information.
Family Name (Last Name)

21.

Given Name (First Name)

Middle Name (if applicable)

Information About Your Current Spouse
Spouse's Date of Birth (mm/dd/yyyy)

Spouse's City/Town/Village of Birth

Spouse's A-Number (if any)

Spouse's USCIS Online Account Number (if any)

► A-

►

Spouse's State or Province of Birth

Spouse's Country of Birth

Is your spouse a U.S. citizen?
If you answered "Yes," how did your spouse obtain U.S. citizenship?

Yes
Birth

Naturalization

No
Parents

If you answered "No," provide your spouse's current U.S. immigration status:

22.

How many times has your current spouse been married (including your current marriage, if applicable)?

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Part 2. Information About You (Petitioner) (continued)
Your Spouse's Contact Information
23.

Does your current spouse reside with you?

Yes

No

If you answered "No," provide your current spouse's physical address in Item Number 24.
24.

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Your Current Spouse's Physical Address (if applicable)
Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

Province

25.

Spouse's Daytime Telephone Number

27.

Spouse's Email Address (if any)

Postal Code

ZIP Code

Country

26.

Spouse's Mobile Telephone Number

Additional Household Members
28.

How many persons 18 years of age or older (other than your spouse, if married) reside with you?

If you answered "1" or more, you MUST complete Form I-600A/I-600 Supplement 1, Listing of Adult Member of the
Household, for each person.
29.

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 12. Additional Information.
Name (First/Middle/Last)

Form I-600 Edition 04/01/24

Date of Birth
(mm/dd/yyyy)

Country of Birth

A-Number (if any)

Relationship to You

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Part 2. Information About You (Petitioner) (continued)
Information About Prior Filings or Adoptions
If you need extra space to complete Item Numbers 30. - 35., use the space provided in Part 12. Additional Information.
30.

Have you ever previously filed Form I-600, Form I-600A, Application for Advance Processing of an Orphan
Petition, Form I-800A, Application for Determination of Suitability to Adopt a Child From a Convention
Country, Form I-800, Petition to Classify Convention Adoptee as an Immediate Relative, or Form I-130,
Petition for Alien Relative, for an adopted child?

Yes

No

Yes

No

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If you answered "Yes," provide the following information for EACH petition and/or application:
Type of Petition/Application Filed:
Form I-600A

Result:

Form I-600

Approved

Form I-800A

Denied

Form I-130 (for an adopted child)

Withdrawn

Revoked

Other (please explain):

Date (mm/dd/yyyy)

31.

Have you previously completed a domestic adoption of a child within the U.S.?

If you answered "Yes," provide the following information for each completed domestic adoption of a child.
State And County Where Adoption Was Finalized

32.

Date Adoption Was Finalized (mm/dd/yyyy)

Have you ever previously attempted to adopt a child internationally or domestically, but the adoption was
disrupted before it was finalized? An adoption is disrupted if you (or a custodian escorting the child on your
behalf) are granted legal custody or guardianship of the child, but the adoptive placement is interrupted
before the adoption was finalized.

Yes

No

Yes

No

Yes

No

Yes

No

If you answered "Yes," provide a detailed description of the disruption.

33.

Have you ever previously completed an adoption, either in the United States or abroad, that was later dissolved?
An adoption is dissolved if your parental rights over the adopted child are terminated at any time after the
adoption was finalized.
If you answered "Yes," provide a detailed description of the dissolution.

34.

Have you ever previously placed a child in the care of another person with the intent to transfer permanent
custody of the child?
If you answered "Yes," provide a detailed description of the placement.

35.

Have you ever received a child with the intent to gain permanent custody, but without involving child
welfare or other state/local authorities or following a state/local process?
If you answered "Yes," provide a detailed description of the custody transfer.

Form I-600 Edition 04/01/24

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Part 2. Information About You (Petitioner) (continued)
Duty of Disclosure
You and your spouse (if married) must answer the following questions. See the Duty of Disclosure section in the Form I-600
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 36.a. - 37.d., 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 12. Additional Information.

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Have you EVER, whether in or outside the United States:

36.a. Been investigated, arrested, cited, charged, indicted, convicted, fined, or imprisoned for breaking or
violating any law or ordinance? (Answer "Yes," even if the record of the arrest, conviction, or other
adverse criminal history was expunged, sealed, pardoned, or the subject of any other amelioration. Do not
include traffic violations, except for violations for driving or operating a vehicle while intoxicated or
while impaired by or under the influence of alcohol or other intoxicant.)

Yes

No

36.b. Received a pardon, amnesty, rehabilitation decree, other act of clemency, or similar action?

Yes

No

36.c. Received a suspended sentence, been placed on probation or parole, or been in an alternative sentencing or
rehabilitation program, such as diversion, deferred prosecution, deferred or withheld adjudication, or
expungement of a criminal charge?

Yes

No

36.d. Been the subject of any investigation at any time, even if closed or unsubstantiated, by any child welfare
agency, court, or other official authority in any state or foreign country concerning the abuse or neglect of
any child?

Yes

No

37.a. Been investigated, arrested, cited, charged, indicted, convicted, fined, or imprisoned for breaking or
violating any law or ordinance? (Answer "Yes," even if the record of the arrest, conviction, or other
adverse criminal history was expunged, sealed, pardoned, or the subject of any other amelioration. Do
not include traffic violations, except for violations for driving or operating a vehicle while intoxicated or
while impaired by or under the influence of alcohol or other intoxicant.)

Yes

No

37.b. Received a pardon, amnesty, rehabilitation decree, other act of clemency, or similar action?

Yes

No

37.c. Received a suspended sentence, been placed on probation or parole, or been in an alternative sentencing
or rehabilitation program, such as diversion, deferred prosecution, deferred or withheld adjudication, or
expungement of a criminal charge?

Yes

No

37.d. Been the subject of any investigation at any time even if closed or unsubstantiated, by any child welfare
agency, court, or other official authority in any state or foreign country concerning the abuse or neglect
of any child?

Yes

No

Has your spouse EVER, whether in or outside the United States:

Part 3. Information About the Orphan Beneficiary
1.

Name at Birth
Family Name (Last Name)

2.

Given Name (First Name)

Middle Name (if applicable)

Given Name (First Name)

Middle Name (if applicable)

Current Name
Family Name (Last Name)

Form I-600 Edition 04/01/24

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Part 3. Information About the Orphan Beneficiary (continued)
3.

Other Names the Orphan Has Used
Provide all other names the orphan has ever used, including aliases and nicknames. If you need extra space to complete this
section, use the space provided in Part 12. Additional Information.

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Family Name (Last Name)

4.

Gender

Male
6.

5.

Given Name (First Name)

Middle Name (if applicable)

Date of Birth (mm/dd/yyyy)

Female

City/Town/Village of Birth

State or Province of Birth

Country of Birth

7.

The beneficiary is an orphan because (select only one box):

They have no parents due to the death or disappearance of, abandonment or desertion by, or separation or loss from both
parents.
They have a sole or surviving parent who is incapable of providing proper care and who has in writing irrevocably released
the child for emigration and adoption.

If the orphan has a sole or surviving parent, answer the following:
8.a. What happened to the other birth or previous parent?

8.b. Is the remaining parent capable of providing proper care for the orphan?

Yes

No

8.c. Has the remaining parent irrevocably released the orphan for emigration and adoption, in writing?

Yes

No

9.

Did you adopt the orphan abroad?

Yes

No

10.

Did your spouse (if married) adopt the orphan abroad?

Yes

No

Yes

No

If you answered “Yes” to Item Number 9. or Item Number 10., provide the following information:
11.a. Did you or your spouse (if married) personally see and observe the child before or during the
adoption proceedings? (This does not include the visa interview and issuance.)
11.b. Date of Adoption (mm/dd/yyyy)

11.c. Place of Adoption

If you answered "No" to either Item Number 9., Item Number 10., or Item Number 11.a., provide the following information:
NOTE: If you need extra space to complete Item Numbers 12.a. - 12.d., use the space provided in Part 12. Additional Information.
12.a. Do you and your spouse (if married) intend to adopt the orphan in the United States?

Yes

No

12.b. Provide a written description of all the pre-adoption requirements of the state of the orphan's proposed residence and cite any
relevant state statutes and regulations. If the state of the orphan's proposed residence does not have any pre-adoption
requirements, indicate "not applicable."

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Part 3. Information About the Orphan Beneficiary (continued)
12.c. Have any pre-adoption requirements of the orphan's proposed state of residence already been met?

Yes

No

If you answered "Yes," provide which requirements have been met.

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12.d. Will any pre-adoption requirements be met at a later time?

Yes

No

Yes

No

If you answered "Yes," describe the steps you will take to comply with these requirements.

If you answered "No," provide each pre-adoption requirement that will not be met and explain why.

To your knowledge:

13.a. Does the orphan have any special need, disability, and/or impairment?

13.b. If you answered "Yes," name or describe the special need, disability, and/or impairment.

14.

The orphan's legal custodian is (select only one box):

An individual or entity other than the orphan's birth parents.
Name of the individual or entity:
Both of the orphan's living birth parents.

One of the orphan's living birth parents. The living birth parent is the (select only one box):
15.

Mother

Father

Information About the Attorney Abroad Representing You and/or Your Spouse (if married) in this Case (if any)
Family Name (Last Name)

Given Name (First Name)

Middle Name (if applicable)

Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

Province

Form I-600 Edition 04/01/24

Postal Code

ZIP Code

Country

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Part 3. Information About the Orphan Beneficiary (continued)
16.

Address Where the Orphan Will Reside After the Adoption (or after you obtain legal custody)
Street Number and Name

Apt. Ste. Flr. Number

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City or Town

Province

17.

State

Postal Code

ZIP Code

Country

Current Address of the Orphan
In Care Of Name

Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

Province

Postal Code

ZIP Code

Country

18.

If the orphan resides in an institution, provide the full name of the institution.

19.

If the orphan does not reside in an institution, provide the full name of the person with whom the orphan is residing or the name
of the orphan's caretaker.
Family Name (Last Name)

20.

Given Name (First Name)

Middle Name (if applicable)

Provide any additional information necessary to locate the orphan, such as the name of a district, section, zone, or locality in
which the orphan resides:

After you obtain an adoption or legal custody of the orphan, do you intend to:
21.a. Seek an immigrant visa because the child will reside with you in the United States?

Yes

No

21.b. Seek a non-immigrant visa for the child to travel to the United States temporarily for the purpose of
naturalization, because you will continue to reside abroad with the child immediately following the adoption?

Yes

No

22.

Where do you wish to file your visa application (if applicable)?
The U.S. Embassy or U.S. Consulate located at:

Form I-600 Edition 04/01/24

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Part 4. Information About Your Home Study and Primary Adoption Service Provider
Your home study:
1.a.
1.b.
1.c.
1.d.
1.e.

Was previously submitted with your approved Form I-600A application (please attach a copy of your Form I-600A
approval notice).

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Was previously submitted with your pending Form I-600A application (please attach a copy of your Form I-600A receipt
notice).
Was previously submitted with a Form I-600A/I-600, Supplement 3 (please attach a copy of your Form I-600A/I-600,
Supplement 3 receipt notice).

IS attached to this Form I-600.

IS NOT attached to this Form I-600 because of state requirements necessitating review and documentation. The
appropriate state authority has indicated that it will submit the home study directly to U.S. Citizenship and Immigration
Services (USCIS). (Do not submit your Form I-600 to USCIS until the state authority is ready to send your home study to
USCIS.)

Information About Your Primary Adoption Service Provider

NOTE: A primary adoption service provider is the accredited agency or approved person who is responsible under 22 CFR 96 for
ensuring all six adoption services defined in 22 CFR 96.2 are provided according to the law, for supervising and being responsible for
supervised providers when used (see 22 CFR 96.14), and for developing and implementing a service plan in accordance with 22 CFR
96.44.
2.

Name of Primary Adoption Service Provider

3.

Point of Contact Within the Organization
Family Name (Last Name)

4.

Given Name (First Name)

Primary Adoption Service Provider's Mailing Address
Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

5.

Primary Adoption Service Provider's Daytime Telephone Number

7.

Primary Adoption Service Provider's Email Address (if any)

6.

ZIP Code

Primary Adoption Service Provider's Fax Number (if any)

The primary adoption service provider named above is one of the following:
8.a. An accredited agency in the United States.

Yes

No

8.b. An approved person in the United States.

Yes

No

Form I-600 Edition 04/01/24

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Part 5. Information About Fees, Expenses, and Other Compensation
If you need extra space to complete the tables in Item Numbers 1. or 2., use the space provided in Part 12. Additional Information.
1.

Information on payments already made. In the following table, provide all payments, including in-kind contributions that
you and your spouse (if married) have made in relation to the adoption of the child identified in this Form I-600. The
information you provide in this table must include all fees, expenses, in-kind contributions, and other compensation that you
and your spouse (if married) or anyone on behalf of you and your spouse, have directly or indirectly made, to any individual,
agency, entity, governmental authority, or other payee or recipient. The information below should include all payments made as
of the date of your signing this Form I-600.

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Date
(mm/dd/yyyy)

2.

Payee

Relationship to
Child (if any)

Purpose of Payment

Amount of Payment (or description
and value of in kind consideration)

Information on anticipated future payments. In the following table, provide all fees, expenses, in-kind contributions, and
other compensation that you and your spouse (if married) or anyone on behalf of you and your spouse, reasonably expect to pay
or make, either directly or indirectly, to any individual, agency, entity, governmental authority, or other payee or recipient.
Anticipated Date
of Payment
(mm/dd/yyyy)

Form I-600 Edition 04/01/24

Payee

Relationship to
Child (if any)

Purpose of Payment

Amount of Payment
(or description and value of in
kind consideration)

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Part 5. Information About Fees, Expenses, and Other Compensation (continued)
3.

Have you or your spouse (if married) or anyone on behalf of you and your spouse, given or arranged to
give money or other consideration either directly or indirectly to the orphan's parent(s), agent(s), other
individual(s), or entity to induce or encourage the release of the orphan?

Yes

No

If you answered "Yes," provide a detailed description to explain.

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Part 6. Request for Exemption From Submitting Affidavit of Support Under Section 213A of the INA on
behalf of Orphan Beneficiary
Select one of the below to indicate if you will submit an Affidavit of Support Under Section 213A of the INA (Form I-864 or Form
I-864EZ) with any visa application to the U.S. Department of State (DOS), or if you are requesting an exemption.
I am requesting an exemption from submitting an Affidavit of Support Under Section 213A of the INA on behalf of the orphan
beneficiary listed in Part 3. because:
1.a.

1.b.

The orphan beneficiary can receive credit for 40 qualifying quarters (credits) of work earned by the orphan beneficiary's
petitioning parent(s) in the United States (as defined by the Social Security Act). (Do not count any quarters for which a
means-tested public benefit was received.)
Upon admission as a lawful permanent resident, the orphan beneficiary will be under 18 years of age, unmarried, and the
child of a U.S. citizen, is not likely to become a public charge, and will automatically become a U.S. citizen under INA
section 320.

NOTE: For this to apply, the child will need an adoption that is considered final under U.S. immigration law.
2.

Neither of these exemptions apply, and I will submit Form I-864 or Form I-864EZ to DOS.

Part 7. Accommodations for Individuals With Disabilities and/or Impairments
NOTE: Read the information in the Form I-600 Instructions before completing this section.
1.

Are you requesting an accommodation because of disabilities and/or impairments?

2.

If you answered "Yes," select all applicable boxes below to indicate who has the disabilities and/or impairments.
Petitioner

Spouse

Yes

No

Other Adult Household Member

If you answered “Yes” to Item Number 1., select all applicable boxes in Item Numbers 3.a. - 3.b. and provide an answer for each
person with disabilities and/or impairments.
3.a.

Deaf or hard of hearing and request the following accommodation. (If requesting a sign-language interpreter, indicate for
which language (for example, American Sign Language).)

3.b.

Blind or have low vision and request the following accommodation:

3.c.

Another type of disability and/or impairment. (Describe the nature of the disability and/or impairment and the requested
accommodation.)

Form I-600 Edition 04/01/24

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Part 8. Petitioner's Certification, Duty of Disclosure, and Signature
NOTE: Read the Penalties section of the Form I-600 Instructions before completing this section.

Petitioner's Certification
I certify, under penalty of perjury, that I provided or authorized all of the responses and information contained in and submitted with
my petition, I read and understand or, if interpreted to me in a language in which I am fluent by the interpreter listed in Part 10.,
understood, all of the responses and information contained in, and submitted with, my petition, and that all of the responses and the
information are complete, true, and correct. Furthermore, I authorize the release of any information from any and all of my records
that USCIS may need to determine my eligibility for an immigration request and to other entities and persons where necessary for the
administration and enforcement of U.S. immigration law.

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Petitioner's Duty of Disclosure

I understand the ongoing duty to disclose information concerning my suitability and eligibility as an adoptive parent, as described in
the Form I-600 and/or Form I-600A Instructions, and I agree to notify my home study preparer and USCIS of any new information
that I am required to disclose.

Petitioner's Signature
1.

Petitioner's Signature

Date of Signature (mm/dd/yyyy)

Part 9. Your Spouse's Certification, Duty of Disclosure, and Signature

NOTE: Read the Penalties section of the Form I-600 Instructions before completing this section.

Your Spouse's Certification

I certify, under penalty of perjury, that I provided or authorized all of the responses and information contained in and submitted with
my petition, I read and understand or, if interpreted to me in a language in which I am fluent by the interpreter listed in Part 10.,
understood, all of the responses and information contained in, and submitted with, my petition, and that all of the responses and the
information are complete, true, and correct. Furthermore, I authorize the release of any information from any and all of my records
that USCIS may need to determine my eligibility for an immigration request and to other entities and persons where necessary for the
administration and enforcement of U.S. immigration law.

Your Spouse's Duty of Disclosure
I understand the ongoing duty to disclose information concerning my suitability and eligibility as an adoptive parent, as described in
the Form I-600 and/or Form I-600A Instructions, and I agree to notify the home study preparer and USCIS of any new information
that I am required to disclose.

Your Spouse's Signature
1.

Your Spouse's Signature

Date of Signature (mm/dd/yyyy)

Part 10. Interpreter's Contact Information, Certification, and Signature
Interpreter's Full Name
1.

Interpreter's Family Name (Last Name)

2.

Interpreter's Business or Organization Name

Form I-600 Edition 04/01/24

Interpreter's Given Name (First Name)

Page 14 of 16

Part 10. Interpreter's Contact Information, Certification, and Signature (continued)
Interpreter's Contact Information
3.

Interpreter's Daytime Telephone Number

5.

Interpreter's Email Address (if any)

4.

Interpreter's Mobile Telephone Number (if any)

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Interpreter's Certification and Signature

,
I certify, under penalty of perjury, that I am fluent in English and
and I have interpreted every question on the petition and Instructions and interpreted the petitioner's and/or petitioner's spouse's (if
married) answers to the questions in that language, and the petitioner and/or the petitioner's spouse informed me that they understood
every instruction, question, and answer on the petition.
6.

Interpreter's Signature

Date of Signature (mm/dd/yyyy)

Part 11. Contact Information, Declaration, and Signature of the Person Preparing this Petition, If Other
Than the Petitioner and Spouse
Preparer's Full Name
1.

Preparer's Family Name (Last Name)

2.

Preparer's Business or Organization Name

Preparer's Given Name (First Name)

Preparer's Contact Information
3.

Preparer's Daytime Telephone Number

5.

Preparer's Email Address (if any)

4.

Preparer's Mobile Telephone Number (if any)

Preparer's Certification and Signature
I certify, under penalty of perjury, that I prepared this petition for the petitioner and/or the petitioner's spouse (if married) at their
request and with express consent and that all of the responses and information contained in and submitted with the petition are
complete, true, and correct and reflects only information provided by the petitioner and/or the petitioner's spouse (if married). The
petitioner and/or the petitioner's spouse (if married) reviewed the responses and information and informed me that they understand the
responses and information in or submitted with the petition.
6.

Preparer's Signature

Form I-600 Edition 04/01/24

Date of Signature (mm/dd/yyyy)

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Part 12. Additional Information
If you need extra space to provide any additional information within this petition, 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 petition or attach a separate sheet of paper. Type or
print your name and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to
which your answer refers; and sign and date each sheet.

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1.

Family Name (Last Name)

2.

A-Number (if any) ► A-

3.

Page Number

Part Number

Item Number

4.

Page Number

Part Number

Item Number

5.

Page Number

Part Number

Item Number

6.

Page Number

Part Number

Item Number

Form I-600 Edition 04/01/24

Given Name (First Name)

Middle Name (if applicable)

Page 16 of 16