| myUSCIS Copydeck: Interactive Forms | ||
| Form Number and Name | N-565 Application for Replacement Naturalization/Citizenship Document | |
| OMB Number | 1615-0091 | |
| Form Edition Date: | 4/1/2024 | |
| Form Expiration Date: | 2/28/2027 | |
| PRA Project: | N-565-016 83C | |
| Revision Key | ||
| Description | ||
| • All original (old) text is black. • All revised (new) text is red. |
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| Example | Original | Revised |
| • All original text is black. • Any text that is removed from original column will be removed in the revision column with the words on either side indicated with red. |
1. Oranges 2. Bananas 3. Apple 4. Pineapple |
1. Oranges 2. Bananas 3. Pineapple 4. Pear |
| I want to eat a watermelon for lunch and go hiking today. | I want to go hiking today. | |
| FILE A FORM: N-565 | |||||
| Column Header Descriptions Header: If needed, a header is located directly under the dropdown menu and above the body text. Body Text: Based on the purpose of the form found in the paper form instructions. Link: A reference column to include any URLs that appear as hyperlinks in the body text. CTA: Copy to include for a button. Notes: Internal notes for the myUSCIS teams to provide insight and explanations. Page breaks are indicated by a bold horizontal line. |
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| Heading | Body Text | Alert | Link | CTA | Notes |
| Select the form you want to file online | Use this form to request a replacement of a Certificate of Naturalization, Certificate of Citizenship, Declaration of Intention, Repatriation Certificate, or to apply for a special certificate of naturalization to be recognized as a U.S. citizen by a foreign country. | Start form | |||
| APPLICATION OVERVIEW: N-565 | |||||||||
| Column Header Descriptions Heading: The primary heading on a page, typically the first part of a section of the page. Sub-Heading: The secondary header, typically directly underneath the Heading. Primary Navigation: A section of the form that contains several pages. Secondary Navigation: A single page within a section. Body Text: Based on the questions from the paper form. Link: A reference column to include any URLs that appear as hyperlinks in the Instructional text. CTA: Copy to include for a button. Notes: Internal notes for the myUSCIS teams to provide insight and explanations. Page breaks are indicated by a bold horizontal line. |
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| Heading | Sub-Heading | Conditional Logic | Body Text | Revision - Body Text | Alert | Required? | Links | CTA | Notes |
| N-565, Application For Replacement Naturalization/Citizenship Document | The Application for Replacement Naturalization/Citizenship Document (N-565) is used to apply to U.S. Citizenship and Immigration Services (USCIS) for a replacement of a Certificate of Naturalization, Certificate of Citizenship, Declaration of Intention, or 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. Learn more about applying for a replacement document |
https://www.uscis.gov/n-565 | |||||||
| Before You Start Your Application | Eligibility | Your eligibility to apply for a replacement document depends on the reason for your request. You may apply for a replacement 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: • The document was lost, stolen, destroyed, or mutilated; • The document is incorrect due to a typographical or clerical error by USCIS; • Your name was changed by marriage, divorce, annulment, or court order, and you seek a document in your new name; or • You have a different gender than what is listed on your current document, and you seek a document reflecting the different 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. 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. |
Your eligibility to apply for a replacement document depends on the reason for your request. You may apply for a replacement 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: • The document was lost, stolen, destroyed, or mutilated; • The document is incorrect due to a typographical or clerical error by USCIS; • Your name was changed by marriage, divorce, annulment, or court order, and you seek a document in your new name; or • You have a different sex than what is listed on your current document, and you seek a document reflecting the different sex. 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. 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. |
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| Fee | We will automatically calculate the cost for you before you submit your application. For specific information about fees applicable to this form, see Form G-1055. Fee waiver: If you are requesting a fee waiver, you cannot file online. You must file a paper version of both the Form I-912, Request for Fee Waiver and the form for the specific benefit you are requesting. You can review the fee waiver guidance at www.uscis.gov/feewaiver. Refund policy: USCIS does not refund fees, regardless of any action we take on your application, petition, or request, or how long USCIS takes to reach a decision. By continuing this transaction, you acknowledge that you must submit fees in the exact amount and that you are paying the fees for a government service. Please refer to the instructions for the form(s) you are filing for additional information or you may call the USCIS Contact Center at 800-375-5283. For TTY (deaf or hard of hearing) 800-767-1833. |
https://www.uscis.gov/forms/filing-fees/additional-information-on-filing-a-fee-waiver | |||||||
| Documents you may need | Before starting the Application for Replacement Naturalization/Citizenship Document (N-565), you may want to gather the documents you will need to support your application. These include your original document, if you still have it, and a recent color photograph of yourself. The other documents you need will depend on the information you provide in the application, such as the reason you are requesting the replacement document. We will automatically determine which documents you should provide us as you fill out your application. At the time of filing, you must submit all evidence and supporting documentation listed. |
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| Biometric services appointment | Biometric Services Appointment. USCIS may require that you 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: • You provided or authorized all information in the application; • You reviewed and understood all of the information contained in, and submitted with, your application; and • All of this information was complete, true, and correct at the time of filing. |
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| Disability Accommodations/Modifications | To request a disability accommodation/modification, follow the instructions on your appointment notice or on the Disability Accommodations for the Public page. | www.uscis.gov/accommodationsinfo | |||||||
| After You Submit Your Application | Track your case online | After you submit your form, you can track its status through your USCIS account. Sign into your account often to check your case status and read any important messages from USCIS. | |||||||
| Mail in your original document | USCIS may require you to mail your original document. This is required if you are applying for a new document for one of the reasons below. • Current document is mutilated • Current document has a typographical/clerical error caused by USCIS • Name changed • Date of birth changed • Gender changed You should include your A-Number with your original document. Mail your original document to: USCIS Nebraska Service Center 850 S. Street Lincoln, NE 68508 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. |
USCIS may require you to mail your original document. This is required if you are applying for a new document for one of the reasons below. • Current document is mutilated • Current document has a typographical/clerical error caused by USCIS • Name changed • Date of birth changed • Current document reflects different sex You should include your A-Number with your original document. Mail your original document to: USCIS Nebraska Service Center 850 S. Street Lincoln, NE 68508 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. |
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| Respond to requests for information | If we need more information from you, we will send you a Request for Evidence (RFE) or Request for Information (RFI). You can respond to our request and upload your documents through your USCIS account. | Next | |||||||
| Completing Your Form Online | Filing online | Submitting your application online is the same as mailing in a completed paper form. They both gather the same information. | |||||||
| Complete the Getting Started section first | You should answer all questions in the Getting Started section first so we can best customize the rest of your online form experience. | ||||||||
| Provide as many responses as you can | You should provide as many responses as you can. Incomplete fields or sections and missing information can slow down the process after you submit your form. | ||||||||
| We will automatically save your responses | We will automatically save your information when you select next to go to a new page or navigate to another section of the form. We will save your information for 30 days from today, or from the last time you worked on the form. | ||||||||
| How to continue filling out your form | After you start your form, you can sign in to your account to continue where you left off. | ||||||||
| DHS Privacy Notice | AUTHORITIES: USCIS is collecting the information requested on this application, and the associated evidence, under the Immigration and Nationality Act (INA) 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 uses 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 USCIS denying your application. | |||||||||
| ROUTINE USES: DHS may, where allowable under relevant confidentiality provisions, 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 you can find at www.dhs.gov/privacy. DHS may also share this information, as appropriate, for law enforcement purposes or in the interest of national security. | www.dhs.gov/privacy | ||||||||
| 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 44 minutes 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. 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 Do not mail your completed Form N-565 to this address. OMB No. 1615-0091 Expires: 02/28/2027 |
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| Security Reminder | If you do not work on your application for more than 30 days, we will delete your data in order to prevent storing personal information indefinitely. | Start | |||||||
| GETTING STARTED: N-565 | |||||||||||||
| Column Header Descriptions Primary Navigation: A section of the form that contains several pages. Secondary Navigation: A single page within a section. Conditional Logic: Indicates whether the question or subquestion only applies if you meet certain criteria. Paper Form Question: The number in the paper form associated with the question. Question: Based on content from the paper form. Often re-written from a statement into a question. Sub-Question: Based on content from the paper form--the next level of information from the previous question. Often re-written from a statement into a question. Field Type: The interaction method for a user to select or input data (ex. Text field, Dropdown menu, Radio buttons). Instructional Text: Text that appears directly below a question and provides instructions for answering the question. Help Text: Text that appears below or next to an input field, partially hidden. Users can click to expand. Provides additional contextual or clarifying information about a question. Required: Indicates if an applicant is required to answer a question to compete the form. Most questions are required, conditional questions may not be required. Notes: Internal notes for the myUSCIS teams to provide insight and explanations. Page breaks are indicated by a bold horizontal line. |
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| Primary Nav | Secondary Nav | Tertiary Nav | Conditional Logic | Paper Form Question | Question | Sub-Question | Revision - Sub-Question | Field Type | Instructional Text | Help Text | Alert | Required? | Notes |
| Getting Started | Type of application | 3.1.A | Which document are you applying for? | New Certificate of Citizenship | Radio | Yes | |||||||
| 3.1.B | New Certificate of Naturalization | Radio | Yes | ||||||||||
| 3.1.C | New Certificate of Repatriation | Radio | Yes | ||||||||||
| 3.1.D | New Declaration of Intention | Radio | Yes | ||||||||||
| 3.1.E | Special Certificate of Naturalization to obtain recognition of my U.S. citizenship by a foreign country | Radio | Yes | ||||||||||
| (If 3.1.A, 3.1.B, 3.1.C, or 3.1.D) | Why are you requesting a new document? | Select all that apply | |||||||||||
| 3.2A | My certificate or declaration was lost, stolen, or destroyed | Checkbox | |||||||||||
| 3.2B | My certificate or declaration is mutilated | Checkbox | |||||||||||
| 3.2C | My certificate or declaration is incorrect due to a typographical or clerical error by USCIS | Checkbox | |||||||||||
| 3.2D | My name has legally changed | Checkbox | |||||||||||
| 3.2E | My date of birth has legally changed through a court order or U.S. Government-issued document, and I am applying for a replacement Certificate of Citizenship | Checkbox | |||||||||||
| 3.2F | I am seeking to change the gender listed on my document | I am seeking to change the sex listed on my document | Checkbox | ||||||||||
| 3.2G | My reason for applying for a new document is not listed above. | Checkbox | |||||||||||
| (if 3.2G) | 3.2G(1) | Provide an explanation. | Textbox | ||||||||||
| (If 3.3; 3.4; 3.5; 3.6; or 3.7) [yellow alert] |
[YELLOW ALERT] [HEADER] You must mail your original document to USCIS [BODY] You must mail your original document to USCIS because of the reason you are requesting a new document. Review of your application may be delayed if you do not submit your original document. You should include your A-Number with your original document. Mail your original document to: USCIS Nebraska Service Center P.O. Box 82521 Lincoln, NE 68501 |
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| Preparer and interpreter information | Is someone assisting you with completing this application? | Yes/No | Radio | ||||||||||
| (IF YES) | Is a preparer assisting you with completing this application? | Yes/No | Radio | A preparer is anyone who completes or helps you complete all or part of your application using information and answers that you provide. | |||||||||
| (IF YES) | Is an interpreter assisting you with completing this declaration? | Yes/No | Radio | An interpreter is anyone who translates or helps you translate all or part of your application using information and answers that you provide. | |||||||||
| Preparer information | (IF YES TO PREPARER) | 11.1 | What is your preparer's full name? | Given name (first name) | Text | ||||||||
| Family name (last name) | Text | ||||||||||||
| 11.2 | What is your preparer's business or organization name? | Text | |||||||||||
| My preparer is not part of a business or organization. | Checkbox | ||||||||||||
| 11.3 | What is your preparer's contact information? | Daytime telephone number | Text | Provide a 10-digit phone number. | |||||||||
| 11.4 | Mobile telephone number | Text | Provide a 10-digit phone number. | ||||||||||
| My preparer does not have a mobile telephone number. | Checkbox | ||||||||||||
| 11.5 | Email address | Text | Example: [email protected] | ||||||||||
| My preparer does not have an email address. | Checkbox | ||||||||||||
| Interpreter information | (IF YES TO INTERPRETER) | 10.1 | What is your interpreter's full name? | Given name (first name) | Text | ||||||||
| Family name (last name) | Text | ||||||||||||
| 10.2 | What is your interpreter's business or organization name? | Text | |||||||||||
| My interpreter is not part of a business or organization. | Checkbox | ||||||||||||
| 10.3 | What is your interpreter's contact information? | Daytime telephone number | Text | Provide a 10-digit phone number. | |||||||||
| 10.4 | Mobile telephone number | Text | Provide a 10-digit phone number. | ||||||||||
| My interpreter does not have a mobile telephone number. | Checkbox | ||||||||||||
| 10.5 | Email address | Text | Example: [email protected] | ||||||||||
| My interpreter does not have an email address. | Checkbox | ||||||||||||
| 9.2.b | What language is your interpreter using to interpret this application for you? | Text | |||||||||||
| ABOUT YOU: N-565 | ||||||||||||
Column Header Descriptions Primary Navigation: A section of the form that contains several pages. Secondary Navigation: A single page within a section. Conditional Logic: Indicates whether the question or subquestion only applies if you meet certain criteria. Paper Form Question: The number in the paper form associated with the question. Question: Based on content from the paper form. Often re-written from a statement into a question. Sub-Question: Based on content from the paper form--the next level of information from the previous question. Often re-written from a statement into a question. Field Type: The interaction method for a user to select or input data (ex. Text field, Dropdown menu, Radio buttons). Instructional Text: Text that appears directly below a question and provides instructions for answering the question. Help Text: Text that appears below or next to an input field, partially hidden. Users can click to expand. Provides additional contextual or clarifying information about a question. Required: Indicates if an applicant is required to answer a question to compete the form. Most questions are required, conditional questions may not be required. Notes: Internal notes for the myUSCIS teams to provide insight and explanations. Page breaks are indicated by a bold horizontal line. |
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| Primary Nav | Secondary Nav | Tertiary Nav | Conditional Logic | Paper Form Question | Question | Sub-Question | Field Type | Instructional Text | Help Text | Alert | Required? | Notes |
| About You | Your name | 2.1 | What is your current legal name? | Given name (first name) | Text | Your current legal name is the name on your birth certificate, unless it changed after birth by a legal action such as marriage or court order. Do not provide any nicknames here. | ||||||
| Middle name (if applicable) | Text | |||||||||||
| Family name (last name) | Text | Yes | ||||||||||
| Have you used any other names since birth? | Yes/No | Radio | Other names used may include nicknames, aliases, and maiden names. | |||||||||
| (IF YES) | 2.2 | Given name (first name) | Text | Provide all other names you have ever used. | Simple Table CTA = + Add another name |
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| Middle name (if applicable) | Text | |||||||||||
| Family name (last name) | Text | |||||||||||
| Your contact information | 9.1 | How may we contact you? | Daytime telephone number | Text | Provide a 10-digit phone number. | |||||||
| 9.2 | Mobile telephone number (if any) | Text | Provide a 10-digit phone number. | |||||||||
| This is the same as my daytime telephone number. | Checkbox | |||||||||||
| 9.3 | Email address (if any) | Text | Example: [email protected] | |||||||||
| 2.3 | What is your current mailing address? | In care of name (if any) | Text | We will use your current mailing address to contact you throughout the application process. We may not be able to contact you if you do not provide a complete and valid address. | ||||||||
| Country | Dropdown | Yes | ||||||||||
| Address line 1 | Text | Street number and name | Yes | |||||||||
| Address line 2 | Text | Apartment, suite, unit, or floor | ||||||||||
| City or town | Text | Yes | ||||||||||
| (If non-USA use Province and text field) | State/Province | Text | Yes | |||||||||
| (If non-USA use Postal code and remove help text) | ZIP code/Postal code | Text | Provide a 5 or 9-digit ZIP code. | Yes | ||||||||
| Other information | 1.6 | What is your A-Number? (if any) | A- | Text | Provide a 7, 8, or 9-digit number. If your A-Number is fewer than 9 digits, the system will automatically add zero(s) after the "A" and before the first digit so there is a total of 9 digits, for example: A-001234567. | |||||||
| I do not have or know my A-Number. | Checkbox | |||||||||||
| 2.5 | Since becoming a U.S. citizen, have you lost or renounced your citizenship in any manner? | Yes/No | Radio | |||||||||
| (IF 2.5 = YES) | Provide an explanation. | Text field | ||||||||||
| 2.4 | What is your current marital status? | Single Married Divorced Widowed Marriage Annulled |
Radio | |||||||||
| EVIDENCE: N-565 | ||||||||||||||
| Column Header Descriptions Primary Navigation: A section of the form that contains several pages. Secondary Navigation: A single page within a section. Conditional Logic: Indicates whether the question or subquestion only applies if you meet certain criteria. Evidence Title: Name of the individual evidence. All evidence evidence titles should be "Title Case." Instructional Text: Text that appears directly below a question and provides instructions for answering the question. Document type: A dropdown list of examples of documents a user could select. Always include "Other documents" as an option Field Type: The interaction method for a user to select or input data (ex. Text field, Dropdown menu, Radio buttons). File Requirements: Exact requirements to successfully upload a file. Standard language provided by myUSCIS. Required: Indicates if an applicant is required to answer a question to compete the form. Most questions are required, conditional questions may not be required. Notes: Internal notes for the myUSCIS teams to provide insight and explanations. Page breaks are indicated by a bold horizontal line. |
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| Primary Nav | Secondary Nav | Tertiary Nav | Conditional Logic | Revision | Paper Form | Evidence Title | Field Type | Instructional Text | Document type | File Requirements | Alerts | Required? | Links | Notes |
| Evidence | 2" x 2" photo of you | 2" x 2" Photo Of You | Upload | 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. Upload a recent color photograph of yourself that measures 2 inches by 2 inches, with your face measuring 1 inch to 1 3/8 inch from your chin to the top of your head. Your eyes should be between 1 1/8 inch and 1 3/8 inch from the bottom of the photo. Make sure your whole face is visible, you are facing the camera directly, and the background is white or off-white. Your head must be bare, unless contrary to your religious beliefs. If you need help understanding the photo requirements or want to resize, rotate, or crop your photo, you can use to the Department of State's photo composition tools. |
2" x 2" photo | • Clear and readable • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF • No encrypted or password-protected files • If your documents are in a foreign language, upload a full English translation and the translator's certification with each original document. • Upload no more than five documents at a time • Accepted file name characters: English letters, numbers, spaces, periods, hyphens, underscores, and parentheses • Maximum size: 12MB per file |
https://travel.state.gov/content/travel/en/passports/how-apply/photos.html | |||||||
| U.S. government-issued photo identification | U.S. Government-Issued Photo Identification | Upload | Upload an image or copy of your U.S. Government-issued photo identification. | Government-issued photo identification | • Clear and readable • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF • No encrypted or password-protected files • If your documents are in a foreign language, upload a full English translation and the translator's certification with each original document. • Upload no more than five documents at a time • Accepted file name characters: English letters, numbers, spaces, periods, hyphens, underscores, and parentheses • Maximum size: 12MB per file |
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| Evidence of change in marital status | Evidence Of Change In Marital Status | Upload | If your marital status has changed since your original document was issued, you must upload an image or copy of the document establishing your change in marital status. Such documents may include your marriage certificate, divorce decree, annulment decree, or husband's or wife's death certificate. | Marriage certificate Divorce decree Annulment decree Husband's or wife's death certificate |
• Clear and readable • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF • No encrypted or password-protected files • If your documents are in a foreign language, upload a full English translation and the translator's certification with each original document. • Upload no more than five documents at a time • Accepted file name characters: English letters, numbers, spaces, periods, hyphens, underscores, and parentheses • Maximum size: 12MB per file |
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| Evidence of your lost, stolen, or destroyed document | (IF 3.2A, LOST, STOLEN, OR DESTROYED) |
Evidence Of Your Lost, Stolen, Or Destroyed Document | Upload | Upload an image or copy of your original document if you have one. You can also upload a copy of a police report and/or a sworn statement explaining what happened to the document and any attempts to retrieve the document. |
Certificate of Naturalization Certificate of Citizenship Declaration of Intention Repatriation Certificate |
• Clear and readable • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF • No encrypted or password-protected files • If your documents are in a foreign language, upload a full English translation and the translator's certification with each original document. • Upload no more than five documents at a time • Accepted file name characters: English letters, numbers, spaces, periods, hyphens, underscores, and parentheses • Maximum size: 12MB per file |
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| Evidence of your mutilated document | (IF 3.2B, MUTILATED) | Evidence Of Your Mutilated Document | Upload | Upload an image or copy of your original mutilated document. You also must mail your original mutilated document to USCIS to complete your application. You should include your A-Number with your original document. Mail your original document to: USCIS Nebraska Service Center P.O. Box 82521 Lincoln, NE 68501 |
Certificate of Naturalization Certificate of Citizenship Declaration of Intention Repatriation Certificate |
• Clear and readable • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF • No encrypted or password-protected files • If your documents are in a foreign language, upload a full English translation and the translator's certification with each original document. • Upload no more than five documents at a time • Accepted file name characters: English letters, numbers, spaces, periods, hyphens, underscores, and parentheses • Maximum size: 12MB per file |
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| Evidence of clerical or typographical error | (IF 3.2C, CLERICAL/TYPO ERROR) | Evidence Of Clerical Or Typographical Error | Upload | Upload images or copies of documents supporting your explanation of the error and request for a new document. You also must mail your incorrect original document to USCIS to complete your application. You should include your A-Number with your original document. Mail your original document to: USCIS Nebraska Service Center P.O. Box 82521 Lincoln, NE 68501 |
Certificate of Naturalization Certificate of Citizenship Declaration of Intention Repatriation Certificate |
• Clear and readable • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF • No encrypted or password-protected files • If your documents are in a foreign language, upload a full English translation and the translator's certification with each original document. • Upload no more than five documents at a time • Accepted file name characters: English letters, numbers, spaces, periods, hyphens, underscores, and parentheses • Maximum size: 12MB per file |
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| Evidence of your name change by marriage | (IF 3.2D, NAME CHANGE BY MARRIAGE, DIVORCE, OR ANNULMENT) | Evidence Of Your Name Change By Marriage | Upload | Upload an image or copy of the original certified marriage certificate, divorce certificate or annulment decree that shows your legally changed name. You also must mail your original or certified document to USCIS to complete your application. You should include your A-Number with your original document. Mail your original document to: USCIS Nebraska Service Center P.O. Box 82521 Lincoln, NE 68501 |
Certificate of Naturalization Certificate of Citizenship Declaration of Intention Repatriation Certificate Original certified marriage certificate Original divorce certificate Original annulment decree |
• Clear and readable • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF • No encrypted or password-protected files • If your documents are in a foreign language, upload a full English translation and the translator's certification with each original document. • Upload no more than five documents at a time • Accepted file name characters: English letters, numbers, spaces, periods, hyphens, underscores, and parentheses • Maximum size: 12MB per file |
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| Evidence of your name change by court order | (IF 3.2D, NAME CHANGE BY COURT ORDER) | Evidence Of Your Name Change By Court Order | Upload | Upload an image or copy of the original or certified court order that shows your legally changed name. You also must mail your original or certified document to USCIS to complete your application. You should include your A-Number with your original document. Mail your original document to: USCIS Nebraska Service Center P.O. Box 82521 Lincoln, NE 68501 |
Certificate of Naturalization Certificate of Citizenship Declaration of Intention Repatriation Certificate Original or certified court order that shows legally changed name |
• Clear and readable • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF • No encrypted or password-protected files • If your documents are in a foreign language, upload a full English translation and the translator's certification with each original document. • Upload no more than five documents at a time • Accepted file name characters: English letters, numbers, spaces, periods, hyphens, underscores, and parentheses • Maximum size: 12MB per file |
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| Evidence of your date of birth change | (IF 3.2E, DOB CHANGE) | Evidence Of Your Date Of Birth Change | Upload | Upload an image or copy of the original or certified U.S. Government-issued document, court order, or a vital record document establishing the date of birth change. A U.S. Government document may include: • Birth certificate • Certificate recognizing foreign birth • Certificate of birth abroad • Other similar vital records issued by the U.S. state where you resided when the document was issued You also must mail your original document to USCIS to complete your application. You should include your A-Number with your original document. Mail your original document to: USCIS Nebraska Service Center P.O. Box 82521 Lincoln, NE 68501 |
Birth certificate Certificate recognizing foreign birth Certificate of birth abroad Other similar vital records issued by U.S. state where you resided when the document was issued |
• Clear and readable • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF • No encrypted or password-protected files • If your documents are in a foreign language, upload a full English translation and the translator's certification with each original document. • Upload no more than five documents at a time • Accepted file name characters: English letters, numbers, spaces, periods, hyphens, underscores, and parentheses • Maximum size: 12MB per file |
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| Your naturalization certificate | (IF 3.1E, SPECIAL CERTIFICATE OF NATURALIZATION TO OBTAIN RECOGNITION OF MY U.S. CITIZENSHIP BY A FOREIGN COUNTRY) | Your Naturalization Certificate | Upload | Upload an image or 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. |
Naturalization certificate | • Clear and readable • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF • No encrypted or password-protected files • If your documents are in a foreign language, upload a full English translation and the translator's certification with each original document. • Upload no more than five documents at a time • Accepted file name characters: English letters, numbers, spaces, periods, hyphens, underscores, and parentheses • Maximum size: 12MB per file |
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| Loss of citizenship | D14:D15 | (IF 2.5 = yes, RENOUNCED U.S. CITIZENSHIP) | Loss Of Citizenship | Upload | Upload an image or copy of a document explaining how and why you lost or renounced your United States citizenship. | Written statement | • Clear and readable • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF • No encrypted or password-protected files • If your documents are in a foreign language, upload a full English translation and the translator's certification with each original document. • Upload no more than five documents at a time • Accepted file name characters: English letters, numbers, spaces, periods, hyphens, underscores, and parentheses • Maximum size: 12MB per file |
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| Evidence of incorrect document | (IF 3.2G, REASON NOT LISTED ABOVE) | Evidence Of Incorrect Document | Upload | Upload images or copies of any documents supporting your explanation of the error and request for a replacement document. You also must mail your incorrect original document to USCIS to complete your application. You should include your A-Number with your original document. Mail your original document to: USCIS Nebraska Service Center P.O. Box 82521 Lincoln, NE 68501 |
Certificate of Naturalization Certificate of Citizenship Declaration of Intention Repatriation Certificate Other supporting documents |
• Clear and readable • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF • No encrypted or password-protected files • If your documents are in a foreign language, upload a full English translation and the translator's certification with each original document. • Upload no more than five documents at a time • Accepted file name characters: English letters, numbers, spaces, periods, hyphens, underscores, and parentheses • Maximum size: 12MB per file |
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| Original document from USCIS | (IF 3.2C, TYPOGRAPHICAL/CLERICAL ERROR, 3.2D, NAME CHANGE, 3.2E, DOB CHANGE, 3.2F, GENDER CHANGE) | (IF 3.2C, TYPOGRAPHICAL/CLERICAL ERROR, 3.2D, NAME CHANGE, 3.2E, DOB CHANGE, 3.2F, SEX CHANGED) | Original Document From USCIS | Upload | Upload an image or copy of your original document. You also must mail your original document to USCIS to complete your application. You should include your A-Number with your original document. Mail your original document to: USCIS Nebraska Service Center P.O. Box 82521 Lincoln, NE 68501 |
Certificate of Naturalization Certificate of Citizenship Declaration of Intention Repatriation Certificate |
• Clear and readable • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF • No encrypted or password-protected files • If your documents are in a foreign language, upload a full English translation and the translator's certification with each original document. • Upload no more than five documents at a time • Accepted file name characters: English letters, numbers, spaces, periods, hyphens, underscores, and parentheses • Maximum size: 12MB per file |
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| ADDITIONAL INFORMATION: N-565 | ||||||||||||
Column Header Descriptions Primary Navigation: A section of the form that contains several pages. Secondary Navigation: A single page within a section. Paper Form Question: The number in the paper form associated with the question. Question: Based on content from the paper form. Often re-written from a statement into a question. Sub-Question: Based on content from the paper form--the next level of information from the previous question. Often re-written from a statement into a question. Field Type: The interaction method for a user to select or input data (ex. Text field, Dropdown menu, Radio buttons). Instructional Text: Text that appears directly below a question and provides instructions for answering the question. Help Text: Text that appears below or next to an input field, partially hidden. Users can click to expand. Provides additional contextual or clarifying information about a question. Required: Indicates if an applicant is required to answer a question to compete the form. Most questions are required, conditional questions may not be required. Notes: Internal notes for the myUSCIS teams to provide insight and explanations. Page breaks are indicated by a bold horizontal line. |
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| Primary Nav | Secondary Nav | Tertiary Nav | Conditional Logic | Paper Form Question | Question | Sub-Question | Field Type | Instructional Text | Help Text | Alert | Required? | Notes |
| Additional Information | Additional information | Additional Information | If you need to provide any additional information for any of your answers to the questions in this form, enter it into the space below. You should include the questions that you are referencing. If you do not need to provide any additional information, you may leave this section blank. |
No | Large Table Pattern Ghost Sub Nav |
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| REVIEW AND SUBMIT: N-565 | ||||||||||||
| Column Header Descriptions Primary Navigation: A section of the form that contains several pages. Secondary Navigation: A single page within a section. Conditional Logic: A column used to indicate whether the question or subquestion only applies if you meet certain criteria. Paper Form Question: The number in the paper form associated with the question. Question: Based on content from the paper form. Often re-written from a statement into a question. Sub-Question: Based on content from the paper form--the next level of information from the previous question. Often re-written from a statement into a question. Field Type: The interaction method for a user to select or input data (ex. Text field, Dropdown menu, Radio buttons). Instructional Text: Text that appears directly below a question and provides instructions for answering the question. Help Text: Text that appears below or next to an input field, partially hidden. Users can click to expand. Provides additional contextual or clarifying information about a question. Required: Indicates if an applicant is required to answer a question to compete the form. Most questions are required, conditional questions may not be required. CTA: Copy to include for a button Notes: Internal notes for the myUSCIS teams to provide insight and explanations. Page breaks are indicated by a bold horizontal line. |
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| Primary Nav | Secondary Nav | Conditional Logic | Paper form question | Question | Sub-Question | Field Type | Instructional Text | Help Text | Alert | Required? | CTA | Notes |
| Review and Submit | Review your application | Check your application before you submit | Please review your ${formType} and check it for accuracy and completeness before you submit it. We encourage you to provide as many responses as you can throughout the ${formType}. Missing or incomplete information may slow down the review process after you submit your ${formType}. You can return to this page to review your ${formType} as many times as you want before you submit it. |
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| Your fee | Your form filing fee is: $0 Refund policy: USCIS does not refund fees, regardless of any action we take on your application, petition or request, or how long USCIS takes to reach a decision. By continuing this transaction, you acknowledge that you must submit fees in the exact amount and that you are paying the fees for a government service. |
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| Different copy based on if the user did not answer a required question | Alerts and warnings | You have one or more alerts and warnings based on the information you provided in your application. A red alert means you have incomplete responses or inconsistent data. You cannot submit your application with any alerts. A yellow warning means you may be missing information or may need to follow-up with us about your responses. You can still submit your application, but some warnings may slow down the review process after you submit your application. A green alert means you have completed all required fields and responses. |
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| Your application summary | Review the N-565 form information | Here is a summary of all the information you provided in your application. Make sure you have provided responses for everything that applies to you before you submit your application. You can edit your responses by going to each application section using the site navigation. We also prepared a draft case snapshot with your responses, which you can download below. View draft snapshot |
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| Preparer’s certification | (IF PREPARER) | 11 | Preparer's certification and signature | I certify, under penalty of perjury, that I prepared this application for the applicant at his or her request and with express consent and that all of the responses and information contained in and submitted with the application are complete, true, and correct and reflects only information provided by the applicant. The applicant reviewed the responses and information and informed me that he or she understands the responses and information in or submitted with the application. | Your preparer must read and agree to the certification below. | |||||||
| As the applicant's preparer, you must sign on paper and provide your signature page to the applicant. Follow these steps: 1. Download the Preparer Signature page 2. Print the Preparer Signature page 3. Read and sign the Preparer Signature page 4. Give the signed Preparer Signature page to the applicant The applicant will need to scan and upload your completed signature page on the next screen. |
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| Preparer signature | (IF PREPARER) | 11.6 | Preparer's Signature Upload | Upload | Scan and upload your preparer's completed signature page below. | Next | ||||||
| Interpreter certification | (IF INTERPRETER) | 10 | Interpreter's certification and signature | I certify, under penalty of perjury, that I am fluent in English and the language provided in the Getting Started section of this application, and I have interpreted every question on the application and Instructions and interpreted the applicant’s answers to the questions in that language, and the applicant informed me that he or she understood every instruction, question, and answer on the application. | Your interpreter must read and agree to the certification below. | |||||||
| As the applicant's interpreter, you must sign on paper and provide your signature page to the applicant. Follow these steps: 1. Download the Interpreter Signature page 2. Print the Interpreter Signature page 3. Read and sign the Interpreter Signature page 4. Give the signed Interpreter Signature page to the applicant The applicant will need to scan and upload your completed signature page on the next screen. |
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| Interpreter signature | (IF INTERPRETER) | 10.6 | Interpreter's Signature Upload | Upload | Scan and upload your interpreter's completed signature page below. | Next | ||||||
| Your certification and signature | 9 | Applicant's certification and signature | I certify, under penalty of perjury, that I provided or authorized all of the information contained in and submitted with my application, I read and understand or, if interpreted to me in a language in which I am fluent by the interpreter listed in the Getting Started section, understood, all of the responses and information contained in, and submitted with, my application, and that all of the responses and 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. | You must read and agree to the certification below. If you knowingly and willfully falsify or conceal a material fact or submit a false document with your application, we can deny your application and may deny any other immigration benefit. You may also face criminal prosecution and penalties provided by the law. | ||||||||
| I have read and agree to the applicant's statement | Checkbox | |||||||||||
| 9.4 | Applicant's signature | Text | You must provide your digital signature below by typing your full legal name. If you do not completely fill out this application, or if you do not submit the required documents listed in the Instructions, we may deny your application. We will record the date of your signature with your application. | Yes | Next | |||||||
| Pay and submit | (If "Your signature" is complete) | Pay for and submit your application | The final step to submit your Form N-565, Application for Replacement Naturalization/Citizenship Document, is to pay the required fee. Your application fee is: $[xxx]. Refund policy: By continuing this transaction, you agree that you are paying for a government service and that the filing fee, biometric services fee and all related financial transactions are final and not refundable, regardless of any action USCIS takes on an application, petition or request, or how long USCIS takes to reach a decision. You must submit all fees in the exact amounts. |
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| We will send you to Pay.gov — our safe, secure payment website — to pay your fees and submit your form online. Here are the steps in the payment and submission process: 1. Provide your billing information on Pay.gov 2. Provide your credit card or U.S. bank account information 3. Submit your payment When you have paid your fee, your application will be submitted. Pay.gov will redirect you to a uscis.gov confirmation screen, which will include your receipt number. Please keep a copy of your receipt number for your records. You can track the status of your application through your USCIS online account. |
Pay and submit | |||||||||||
| (Successful submission) (No nav) | You successfully submitted your N-565 | We will contact you if we have any questions or need additional information. You can track the status of your application through your USCIS online account. | Go to my cases | |||||||||
| (Unsuccessful card declined) (No nav) | You did not submit your N-565 | Your payment failed because your credit or debit card was declined. You can try again now to sign and submit your declaration or save and exit. |
Sign and submit | |||||||||
| (Unsuccessful submission) (No nav) | You did not submit your N-565 | Your payment failed or was canceled before it could be processed on Pay.gov. You can try again now to sign and submit your petition or save your petition and exit. We will save your petition for 30 days from when you started it. |
Sign and submit | |||||||||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |