File Name: n-400.pdf
File Size: 1.06 MB
File Type: Application/pdf
Last Modified: 2 years
Status: Available
Last checked: 4 hours ago!
This Document Has Been Certified by a Professional
100% customizable
Language: English
We recommend downloading this file onto your computer
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 ForUSCIS 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, unlessotherwise indicated. Failure to answer all of the questions may delay U.S. Citizenship and Immigration Services (USCIS) processingyour 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 18thbirthday, you may already be a U.S. citizen. Before you consider filing this application, please visit the USCIS Website atwww.uscis.gov for more information on this topic and to review the instructions for Form N-600, Application for Certificate ofCitizenship, 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 YourParents 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 Nationality12. 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 ImpairmentsNOTE: 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 You1. 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 Residence1. 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) ResidencePart 6. Information About Your ParentsIf 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 NoInformation About Your Mother2. 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 Father3. 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 InformationNOTE: USCIS requires you to complete the categories below to conduct background checks. (See the Form N-400 Instructions formore information.)1. Ethnicity (Select only one box) Hispanic or Latino Not Hispanic or Latino2. Race (Select all applicable boxes) White Asian Black or American Indian Native Hawaiian or African American or Alaska Native Other Pacific Islander3. Height Feet Inches 4. Weight Pounds5. Eye color (Select only one box) Black Blue Brown Gray Green Hazel Maroon Pink Unknown/ Other6. Hair color (Select only one box) Bald Black Blond Brown Gray Red Sandy White Unknown/ (No hair) OtherForm 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 timeperiod. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or currentemployment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, wereunemployed, 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 Occupation2. 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 Occupation3. 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 OccupationForm 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? days2. How many trips of 24 hours or longer have you taken outside the United States during the last 5 years? trips3. 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 NoPart 10. Information About Your Marital History1. 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 No3. 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 Company5. 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 SpouseForm 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 Children1. 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 additionalsheets of paper
1. Have you EVER claimed to be a U.S. citizen (in writing or any other way)? Yes No2. Have you EVER registered to vote in any Federal, state, or local election in the United States? Yes No3. Have you EVER voted in any Federal, state, or local election in the United States? Yes No4. 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 NoForm 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 No7. 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 No8. 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 No11. 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 …