Application for naturalization uscis (1.06 MB)

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Summary

Application for Naturalization USCIS
Form N-400
Department of Homeland Security OMB No. 1615-0052
U.S. Citizenship and Immigration Services Expires 09/30/2022
Date Stamp Receipt Action Block
For
USCIS
Use
Only
Remarks
► START HERE - Type or print in black ink. Type or print "N/A" if an item is not applicable or the answer is none, unless
otherwise indicated. Failure to answer all of the questions may delay U.S. Citizenship and Immigration Services (USCIS) processing
your Form N-400. NOTE: You must complete Parts 1. - 15

If your biological or legal adoptive mother or father is a U.S. citizen by birth, or was naturalized before you reached your 18th
birthday, you may already be a U.S. citizen. Before you consider filing this application, please visit the USCIS Website at
www.uscis.gov for more information on this topic and to review the instructions for Form N-600, Application for Certificate of
Citizenship, and Form N-600K, Application for Citizenship and Issuance of Certificate Under Section 322

NOTE: Are either of your parents a United States citizen? If you answer “Yes,” then complete Part 6. Information About Your
Parents as part of this application. If you answer “No,” then skip Part 6. and go to Part 7. Biographic Information

Part 1. Information About Your Eligibility (Select only one box or your Enter Your 9 Digit A-Number:
Form N-400 may be delayed) ► A-
1. You are at least 18 years of age and:
A. Have been a lawful permanent resident of the United States for at least 5 years

B. Have been a lawful permanent resident of the United States for at least 3 years. In addition, you have been married to
and living with the same U.S. citizen spouse for the last 3 years, and your spouse has been a U.S. citizen for the last
3 years at the time you filed your Form N-400

C. Are a lawful permanent resident of the United States and you are the spouse of a U.S. citizen and your U.S. citizen
spouse is regularly engaged in specified employment abroad. (See the Immigration and Nationality Act (INA) section
319(b).) If your residential address is outside the United States and you are filing under Section 319(b), select the
USCIS Field Office from the list below where you would like to have your naturalization interview:
D. Are applying on the basis of qualifying military service

E. Other (Explain):
Part 2. Information About You (Person applying for naturalization)
1. Your Current Legal Name (do not provide a nickname)
Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)
2. Your Name Exactly As It Appears on Your Permanent Resident Card (if applicable)
Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)
Form N-400 Edition 09/17/19 Page 1 of 20
Part 2. Information About You (Person applying for naturalization) (continued) A-
3. Other Names You Have Used Since Birth (include nicknames, aliases, and maiden name, if applicable)
Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)
4. Name Change (Optional)
Read the Form N-400 Instructions before you decide whether or not you would like to legally change your name

Would you like to legally change your name? Yes No
If you answered ''Yes," type or print the new name you would like to use in the spaces provided below

Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)
5. U.S. Social Security Number (if applicable) 6. USCIS Online Account Number (if any)
► ►
7. Gender 8. Date of Birth 9. Date You Became a Lawful
Male Female (mm/dd/yyyy) Permanent Resident (mm/dd/yyyy)
10. Country of Birth 11. Country of Citizenship or Nationality
12. Do you have a physical or developmental disability or mental impairment that prevents you from Yes No
demonstrating your knowledge and understanding of the English language and/or civics requirements
for naturalization?
If you answered "Yes," submit a completed Form N-648, Medical Certification for Disability Exceptions, when you file your
Form N-400

13. Exemptions from the English Language Test
A. Are you 50 years of age or older and have you lived in the United States as a lawful permanent Yes No
resident for periods totaling at least 20 years at the time you file your Form N-400?
B. Are you 55 years of age or older and have you lived in the United States as a lawful permanent Yes No
resident for periods totaling at least 15 years at the time you file your Form N-400?
C. Are you 65 years of age or older and have you lived in the United States as a lawful permanent Yes No
resident for periods totaling at least 20 years at the time you file your Form N-400? (If you meet
this requirement, you will also be given a simplified version of the civics test.)
Part 3. Accommodations for Individuals With Disabilities and/or Impairments
NOTE: Read the information in the Form N-400 Instructions before completing this part

1. Are you requesting an accommodation because of your disabilities and/or impairments? Yes No
If you answered "Yes," select any applicable box

A. I am deaf or hard of hearing and request the following accommodation. (If you are requesting a sign-language
interpreter, indicate for which language (for example, American Sign Language).)
B. I am blind or have low vision and request the following accommodation:
Form N-400 Edition 09/17/19 Page 2 of 20
Part 3. Accommodations for Individuals With Disabilities and/or A-
Impairments (continued)
C. I have another type of disability and/or impairment (for example, use a wheelchair). (Describe the nature of your
disability and/or impairment and the accommodation you are requesting.)
Part 4. Information to Contact You
1. Daytime Telephone Number 2. Work Telephone Number (if any)
3. Evening Telephone Number 4. Mobile Telephone Number (if any)
5. Email Address (if any)
Part 5. Information About Your Residence
1. Where have you lived during the last five years? Provide your most recent residence and then list every location where you
have lived during the last five years. If you need extra space, use additional sheets of paper

A. Current Physical Address
Street Number and Name Apt. Ste. Flr. Number
City or Town County State ZIP Code + 4
-
(USPS ZIP Code Lookup)
Province or Region Postal Code Country
(foreign address only) (foreign address only) (foreign address only)
Dates of From (mm/dd/yyyy) To (mm/dd/yyyy)
Residence
B. Current Mailing Address (if different from the address above)
In Care Of Name (if any)
Street Number and Name Apt. Ste. Flr. Number
City or Town County State ZIP Code + 4
-
Province or Region Postal Code Country
(foreign address only) (foreign address only) (foreign address only)
Form N-400 Edition 09/17/19 Page 3 of 20
Part 5. Information About Your Residence (continued) A-
C. Physical Address 2
Street Number and Name Apt. Ste. Flr. Number
City or Town County State ZIP Code + 4
-
Province or Region Postal Code Country
(foreign address only) (foreign address only) (foreign address only)
Dates of From (mm/dd/yyyy) To (mm/dd/yyyy)
Residence
D. Physical Address 3
Street Number and Name Apt. Ste. Flr. Number
City or Town County State ZIP Code + 4
-
Province or Region Postal Code Country
(foreign address only) (foreign address only) (foreign address only)
Dates of From (mm/dd/yyyy) To (mm/dd/yyyy)
Residence
E. Physical Address 4
Street Number and Name Apt. Ste. Flr. Number
City or Town County State ZIP Code + 4
-
Province or Region Postal Code Country
(foreign address only) (foreign address only) (foreign address only)
Dates of From (mm/dd/yyyy) To (mm/dd/yyyy)
Residence
Part 6. Information About Your Parents
If neither one of your parents is a United States citizen, then skip this part and go to Part 7

1. Were your parents married before your 18th birthday? Yes No
Information About Your Mother
2. Is your mother a U.S. citizen? Yes No
If you answered "Yes," complete the following information. If you answered "No," go to Item Number 3

Form N-400 Edition 09/17/19 Page 4 of 20
Part 6. Information About Your Parents (continued) A-
A. Current Legal Name of U.S. Citizen Mother
Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)
B. Mother's Country of Birth C. Mother's Date of Birth (mm/dd/yyyy)
D. Date Mother Became a U.S. Citizen E. Mother's A-Number
(if known) (mm/dd/yyyy) (if any)
► A-
Information About Your Father
3. Is your father a U.S. citizen? Yes No
If you answered ''Yes," complete the information below. If you answered "No," go to Part 7

A. Current Legal Name of U.S. Citizen Father
Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)
B. Father's Country of Birth C. Father's Date of Birth (mm/dd/yyyy)
D. Date Father Became a U.S. Citizen E. Father's A-Number
(if known) (mm/dd/yyyy) (if any)
► A-
Part 7. Biographic Information
NOTE: USCIS requires you to complete the categories below to conduct background checks. (See the Form N-400 Instructions for
more information.)
1. Ethnicity (Select only one box)
Hispanic or Latino Not Hispanic or Latino
2. Race (Select all applicable boxes)
White Asian Black or American Indian Native Hawaiian or
African American or Alaska Native Other Pacific Islander
3. Height Feet Inches 4. Weight Pounds
5. Eye color (Select only one box)
Black Blue Brown Gray Green Hazel Maroon Pink Unknown/
Other
6. Hair color (Select only one box)
Bald Black Blond Brown Gray Red Sandy White Unknown/
(No hair) Other
Form N-400 Edition 09/17/19 Page 5 of 20
Part 8. Information About Your Employment and Schools You Attended A-
List where you have worked or attended school full time or part time during the last five years. Provide information for the complete time
period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current
employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were
unemployed, or have studied for the last five years. If you worked for yourself, type or print "self-employed." If you were unemployed,
type or print "unemployed." If you need extra space, use additional sheets of paper

1. Employer or School Name
Street Number and Name Apt. Ste. Flr. Number
City or Town State ZIP Code + 4
-
Province or Region Postal Code Country
(foreign address only) (foreign address only) (foreign address only)
Date From (mm/dd/yyyy) Date To (mm/dd/yyyy) Your Occupation
2. Employer or School Name
Street Number and Name Apt. Ste. Flr. Number
City or Town State ZIP Code + 4
-
Province or Region Postal Code Country
(foreign address only) (foreign address only) (foreign address only)
Date From (mm/dd/yyyy) Date To (mm/dd/yyyy) Your Occupation
3. Employer or School Name
Street Number and Name Apt. Ste. Flr. Number
City or Town State ZIP Code + 4
-
Province or Region Postal Code Country
(foreign address only) (foreign address only) (foreign address only)
Date From (mm/dd/yyyy) Date To (mm/dd/yyyy) Your Occupation
Form N-400 Edition 09/17/19 Page 6 of 20
Part 9. Time Outside the United States A-
1. How many total days (24 hours or longer) did you spend outside the United States during the last 5 years? days
2. How many trips of 24 hours or longer have you taken outside the United States during the last 5 years? trips
3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Start with
your most recent trip and work backwards. If you need extra space, use additional sheets of paper

Date You Left the Date You Returned Did Trip Last Countries to Total Days
United States to the United States 6 Months or Which You Outside the
(mm/dd/yyyy) (mm/dd/yyyy) More? Traveled United States
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Part 10. Information About Your Marital History
1. What is your current marital status?
Single, Never Married Married Divorced Widowed Separated Marriage Annulled
If you are single and have never married, go to Part 11

2. If you are married, is your spouse a current member of the U.S. armed forces? Yes No
3. How many times have you been married (including annulled marriages, marriages to other people, and
marriages to the same person)?
4. If you are married now, provide the following information about your current spouse

A. Current Spouse's Legal Name
Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)
B. Current Spouse's Previous Legal Name
Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)
C. Other Names Used by Current Spouse (include nicknames, aliases, and maiden name, if applicable)
Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)
D. Current Spouse's Date of Birth E. Date You Entered into Marriage
(mm/dd/yyyy) with Current Spouse (mm/dd/yyyy)
Form N-400 Edition 09/17/19 Page 7 of 20
Part 10. Information About Your Marital History (continued) A-
F. Current Spouse's Present Home Address
Street Number and Name Apt. Ste. Flr. Number
City or Town County State ZIP Code + 4
-
Province or Region Postal Code Country
(foreign address only) (foreign address only) (foreign address only)
G. Current Spouse's Current Employer or Company
5. Is your current spouse a U.S. citizen? Yes No
If you answered ''Yes," answer Item Number 6. If you answered ''No," go to Item Number 7

6. If your current spouse is a U.S. citizen, complete the following information

A. When did your current spouse become a U.S. citizen?
At Birth - Go to Item Number 8. Other - Complete the following information

B. Date Your Current Spouse Became
a U.S. Citizen (mm/dd/yyyy)
7. If your current spouse is not a U.S. citizen, complete the following information

A. Current Spouse's Country of Citizenship or Nationality B. Current Spouse's A-Number (if any)
► A-
C. Current Spouse's Immigration Status
Lawful Permanent Resident Other (Explain):
8. How many times has your current spouse been married (including annulled marriages, marriages to
other people, and marriages to the same person)? If your current spouse has been married before,
provide the following information about your current spouse's prior spouse

If your current spouse has had more than one previous marriage, provide that information on additional sheets of paper

A. Legal Name of My Current Spouse's Prior Spouse
Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)
B. Immigration Status of My Current Spouse's Prior Spouse (if known)
U.S. Citizen Lawful Permanent Resident Other (Explain):
C. Date of Birth of My Current Spouse's D. Country of Birth of My Current Spouse's
Prior Spouse (mm/dd/yyyy) Prior Spouse
E. Country of Citizenship or Nationality of My Current
Spouse's Prior Spouse
Form N-400 Edition 09/17/19 Page 8 of 20
Part 10. Information About Your Marital History (continued) A-
F. My Current Spouse's Date of Marriage G. Date My Current Spouse's Marriage Ended
with Prior Spouse (mm/dd/yyyy) with Prior Spouse (mm/dd/yyyy)
H. How My Current Spouse's Marriage Ended with Prior Spouse
Annulled Divorced Spouse Deceased Other (Explain):
9. If you were married before, provide the following information about your prior spouse. If you have more than one previous
marriage, provide that information on additional sheets of paper

A. My Prior Spouse's Legal Name
Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)
B. My Prior Spouse's Immigration Status When My Marriage Ended (if known)
U.S. Citizen Lawful Permanent Resident Other (Explain):
C. My Prior Spouse's Date of Birth D. My Prior Spouse's Country
(mm/dd/yyyy) of Birth
E. My Prior Spouse's Country of F. Date of Marriage with My Prior
Citizenship or Nationality Spouse (mm/dd/yyyy)
G. Date Marriage Ended with My
Prior Spouse (mm/dd/yyyy)
H. How Marriage Ended with My Prior Spouse
Annulled Divorced Spouse Deceased Other (Explain):
Part 11. Information About Your Children
1. Indicate your total number of children. (You must indicate ALL children, including: children who are alive,
missing, or deceased; children born in the United States or in other countries; children under 18 years of age or
older; children who are currently married or unmarried; children living with you or elsewhere; current
stepchildren; legally adopted children; and children born when you were not married.)
2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age

To list any additional children, use additional sheets of paper

A. Child 1
Current Legal Name
Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)
A-Number (if any) Date of Birth (mm/dd/yyyy) Country of Birth
► A-
Form N-400 Edition 09/17/19 Page 9 of 20
Part 11. Information About Your Children (continued) A-
Current Address
Street Number and Name Apt. Ste. Flr. Number
City or Town County State ZIP Code + 4
-
Province or Region Postal Code Country
(foreign address only) (foreign address only) (foreign address only)
What is your child's relationship to you? (for example, biological child,
stepchild, legally adopted child)
B. Child 2
Current Legal Name
Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)
A-Number (if any) Date of Birth (mm/dd/yyyy) Country of Birth
► A-
Current Address
Street Number and Name Apt. Ste. Flr. Number
City or Town County State ZIP Code + 4
-
Province or Region Postal Code Country
(foreign address only) (foreign address only) (foreign address only)
What is your child's relationship to you? (for example, biological child,
stepchild, legally adopted child)
C. Child 3
Current Legal Name
Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)
A-Number (if any) Date of Birth (mm/dd/yyyy) Country of Birth
► A-
Form N-400 Edition 09/17/19 Page 10 of 20
Part 11. Information About Your Children (continued) A-
Current Address
Street Number and Name Apt. Ste. Flr. Number
City or Town County State ZIP Code + 4
-
Province or Region Postal Code Country
(foreign address only) (foreign address only) (foreign address only)
What is your child's relationship to you? (for example, biological child,
stepchild, legally adopted child)
D. Child 4
Current Legal Name
Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)
A-Number (if any) Date of Birth (mm/dd/yyyy) Country of Birth
► A-
Current Address
Street Number and Name Apt. Ste. Flr. Number
City or Town County State ZIP Code + 4
-
Province or Region Postal Code Country
(foreign address only) (foreign address only) (foreign address only)
What is your child's relationship to you? (for example, biological child,
stepchild, legally adopted child)
Part 12. Additional Information About You (Person Applying for Naturalization)
Answer Item Numbers 1. - 21. If you answer "Yes" to any of these questions, include a typed or printed explanation on additional
sheets of paper

1. Have you EVER claimed to be a U.S. citizen (in writing or any other way)? Yes No
2. Have you EVER registered to vote in any Federal, state, or local election in the United States? Yes No
3. Have you EVER voted in any Federal, state, or local election in the United States? Yes No
4. A. Do you now have, or did you EVER have, a hereditary title or an order of nobility in any foreign Yes No
country?
B. If you answered "Yes," are you willing to give up any inherited titles or orders of nobility that you Yes No
have in a foreign country at your naturalization ceremony?
5. Have you EVER been declared legally incompetent or been confined to a mental institution? Yes No
Form N-400 Edition 09/17/19 Page 11 of 20
Part 12. Additional Information About You (Person Applying for A-
Naturalization) (continued)
6. Do you owe any overdue Federal, state, or local taxes? Yes No
7. A. Have you EVER not filed a Federal, state, or local tax return since you became a lawful permanent Yes No
resident?
B. If you answered "Yes," did you consider yourself to be a "non-U.S. resident"? Yes No
8. Have you called yourself a "non-U.S. resident" on a Federal, state, or local tax return since you became a Yes No
lawful permanent resident?
9. A. Have you EVER been a member of, involved in, or in any way associated with, any organization, Yes No
association, fund, foundation, party, club, society, or similar group in the United States or in any other
location in the world?
B. If you answered "Yes," provide the information below. If you need extra space, attach the names of the other groups on
additional sheets of paper and provide any evidence to support your answers

Name Purpose Dates of Membership
of the of the From To
Group Group (mm/dd/yyyy) (mm/dd/yyyy)
10. Have you EVER been a member of, or in any way associated (either directly or indirectly) with:
A. The Communist Party? Yes No
B. Any other totalitarian party? Yes No
C. A terrorist organization? Yes No
11. Have you EVER advocated (either directly or indirectly) the overthrow of any government by force or Yes No
violence?
12. Have you EVER persecuted (either directly or indirectly) any person because of race, religion, national Yes No
origin, membership in a particular social group, or political opinion?
13. Between March 23, 1933 and May 8, 1945, did you work for or associate in any way (either directly or
indirectly) with:
A. The Nazi government of Germany? Yes No
B. Any government in any area occupied by, allied with, or established with the help of the Nazi Yes No
government of Germany?
C. Any German, Nazi, or S.S. military unit, paramilitary unit, self-defense unit, vigilante unit, citizen unit, Yes No
police unit, government agency or office, extermination camp, concentration camp, prisoner of war
camp, prison, labor camp, or transit camp?
Form N-400 Edition 09/17/19 Page 12 of 20

If you answered ''Yes," type or print the new name you would like to use in the spaces provided below. Would you like to legally change your name? Yes. No. Read the Form N-400 …