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N-600, Application for Certificate of Citizenship (United States)

This form is to apply for a certificate of citizenship of the United States. The form provided here is simply a sample of what the actual Form N-600 looks like.

Department of Homeland Security
U.S Citizenship and Immigration Services

N-600, Application for Certificate of Citizenship

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If your child has an "A" Number, write it here: A ____________________

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For USCIS Use Only

Returned ____________________________

Resubmitted ____________________________

Reloc Sent ____________________________

Reloc Rec'd ____________________________

____ Applicant Interviewed ____________________________

____ Declaration of Intention verified by ____________________________

____ Citizenship verified by ____________________________

Receipt ____________________________

Remarks

Action Block

To Be Completed by Attorney or Representative, if any

____ Fill in box if G-28 is attached to represent the applicant

VOLAG# ____________________________

ATTY State License # ____________________________

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START HERE - Please type or print in black ink.

Part 1. Information about you. (Provide information about yourself, if you are a person applying for the Certificate of Citizenship. If you are a U.S. citizen parent applying for a Certificate of Citizenship for your minor child, provide information about your child).

Family Name (Last Name) ____________________________

Given Name (First Name) ____________________________

Full Middle Name (If applicable) ____________________________

B. Name exactly as it appears on your Permanent Resident Card (If applicable).

Family Name (Last Name) ____________________________

Given Name (First Name) ____________________________

Full Middle Name (If applicable) ____________________________

C. Other names used since birth

Family Name (Last Name) ____________________________

Given Name (First Name) ____________________________

Full Middle Name (If applicable) ____________________________


Family Name (Last Name) ____________________________

Given Name (First Name) ____________________________

Full Middle Name (If applicable) ____________________________

D. U.S. Social Security # (If applicable) ____________________________

E. Date of Birth (mm/dd/yyyy) ____________________________

F. Country of Birth ____________________________

G. Country of Prior Nationality ____________________________

H. Gender ____ Male ____ Female

I. Height ____________________________

Zip or Postal Code ____________________________

Date of Birth (mm/dd/yyyy) ____________________________

Country of Birth ____________________________

Certificate Number ____________________________

A # ____________________________

Telephone # (with area/country codes) ____________________________

E-Mail Address (if any) ____________________________

Part 2. Information About Your Eligibility. (Check only one).

A. I am claiming U.S. citizenship through:

____ A U.S. citizen father or a U.S. citizen mother.

____ Both U.S. citizen parents.

____ A U.S. citizen adoptive parent(s).

____ An alien parent(s) who naturalized.

B. ____ I am a U.S. citizen parent applying for a certificate of citizenship on behalf of my minor (under 18 years) BIOLOGICAL child.

C. ____ I am a U.S. citizen parent applying for a certificate of citizenship on behalf of my minor (under 18 years) ADOPTED child.

D. ____ Other (Please explain fully) ____________________________

Part 3. Additional Information About You.
(Provide additional information about yourself, if you are the person applying for the Certificate of Citizenship. If you are a U.S. citizen parent applying for a Certificate of Citizenship for your minor child, provide the additional information about your minor child).

A. Home Address - Street Number and Name (Do not write a P.O. Box in this space) ____________________________

Apartment Number ____________________________

City ____________________________

County ____________________________

State/Province ____________________________

Country ____________________________

Zip/Postal Code ____________________________

B. Mailing Address - Street Number and Name (If different from home address) ____________________________

Apartment Number ____________________________

City ____________________________

County ____________________________

State/Province ____________________________

Country ____________________________

Zip/Postal Code ____________________________

C. Daytime Phone Number (If any) ____________________________

Evening Phone Number (If any) ____________________________

E-Mail Address (If any) ____________________________

D. Marital Status

____ Single, Never Married ____ Married ____ Divorced ____ Widowed

____ Marriage Annulled or Other (Explain) ____________________________

E. Information about entry into the United States and current immigration status

1. I arrived in the following manner:

Port of Entry (City/State) ____________________________

Date (mm/dd/yyyy) ____________________________

Exact Name Used at Time of Entry: ____________________________

2. I used the following travel document to enter:

____ Passport

____ Passport Number ____________________________

Country Issuing Passport ____________________________

Date Passport Issued (mm/dd/yyyy) ____________________________

Other (Please Specify Name of Document and Dates of Issuance) ____________________________

3. I entered as:

____ An immigrant (lawful permanent resident) using an immigrant visa

____ A nonimmigrant

____ A refugee

____ Other (Explain) ____________________________

4. I obtained lawful permanent resident status through adjustment of status (If applicable)

Date you became a Permanent Resident (mm/dd/yyyy) ____________________________

USCIS (or former INS) Office where granted adjustment of status ____________________________

Have you previously applied for a certificate of citizenship or U.S. ____ No ____ Yes (Attach Explanation)

G. Were you adopted? ____ No ____Yes (Please complete the following information):

Date of Adoption (mm/dd/yyyy) ____________________________

Place of Final Adoption (City/State) ____________________________

Date Legal Custody Began (mm/dd/yyyy) ____________________________

Date Physical Custody Began (mm/dd/yyyy) ____________________________

H. Did you have to be re-adopted in the United States?

____ No ____ Yes (Please complete the following information):

Date of Final Adoption (mm/dd/yyyy) ____________________________

Place of Final Adoption (City/State or Country) _______________________

Date Legal Custody Began (mm/dd/yyyy) _______________________

Date Physical Custody Began (mm/dd/yyyy) _______________________

I. Were your parents married to each other when you were born (or adopted)?

J. Have you been absent from the United States since you first arrived?
(Only for persons born before October 10, 1952, who are claiming U.S. citizenship at time of birth; otherwise, do not complete this section.)

If yes, complete the following information about all absences, beginning with your most recent trip. If you need more space, use a separate sheet of paper.

Date You Left the United States (mm/dd/yyyy) _______________________

Date You Returned to the United States (mm/dd/yyyy) _______________________

Place of Entry Upon Return to the United States _______________________

Part 4. Information About U.S. Citizen Father (or Adoptive Father).
(Complete this section if you are claiming citizenship through a U.S. citizen father. If you are a U.S. citizen father applying for a Certificate of Citizenship on behalf of your minor biological or adopted child, provide information about yourself below.)

A. Current legal name of U.S. citizen father.

Family Name (Last Name) ____________________________

Given Name (First Name) ____________________________

Full Middle Name (If applicable) ____________________________

B. Date of Birth (mm/dd/yyyy) ____________________________

C. Country of Birth ____________________________

D. Country of Nationality ____________________________

E. Home Address - Street Number and Name (If deceased, so state and enter date of death) ____________________________

Apartment Number ____________________________

City ____________________________

State/Province ____________________________

Country ____________________________

Zip/Postal Code ____________________________

F. U.S. citizen by:

____ Birth in the United States

____ Birth abroad to U.S. citizen parent(s)

____ Acquisition after birth through naturalization of alien parent(s)

____ Naturalization

Date of Naturalization (mm/dd/yyyy) ____________________________

Place of Naturalization (Name of Court and City/State or USCIS or Former INS Office Location) ____________________________

Certificate of Naturalization Number ____________________________

Former "A" Number (If known) ____________________________

G. Has your father ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship?

____ No ____ Yes (Provide full explanation on a separate sheet(s) of paper.)

H. Dates of Residence and/or Physical Presence in the United States
(Complete this only if you are an applicant claiming U.S. citizenship at time of birth abroad)

Provide the dates your U.S. citizen father resided in or was physically present in the United States. If you need more space, use a separate sheet(s) of paper.

From (mm/dd/yyyy) ____________________________

To (mm/dd/yyyy) ____________________________


From (mm/dd/yyyy) ____________________________

To (mm/dd/yyyy) ____________________________

I. Marital History

1. How many times has your U.S. citizen father been married (including annulled marriages)?

2. Information about U.S. citizen father's current spouse:

Family Name (Last Name) ____________________________

Given Name (First Name) ____________________________

Full Middle Name (If applicable) ____________________________

Date of Birth (mm/dd/yyyy) ____________________________

Country of Birth ____________________________

Country of Nationality ____________________________

Home Address - Street Number and Name ____________________________

Apartment Number ____________________________

City ____________________________

State/Province ____________________________

Country ____________________________

Zip/Postal Code ____________________________

Date of Marriage (mm/dd/yyyy) ____________________________

Place of Marriage (City/State or country) ____________________________

Spouse's Immigration Status:

____ U.S. Citizen ____ Lawful Permanent Resident ____ Other (Explain) ____________________________

3. Is your U.S. citizen father's current spouse also your mother? ____ No ____ Yes

Part 5. Information About U.S. Citizen Mother (or Adoptive Mother).
(Complete this section if you are claiming citizenship through a U.S. citizen mother. If you are a U.S. citizen mother applying for a Certificate of Citizenship on behalf of your minor biological or adopted child, provide information about yourself below.)

A. Current legal name of U.S. citizen mother.

Family Name (Last Name) ____________________________

Given Name (First Name) ____________________________

Full Middle Name (If applicable) ____________________________

B. Date of Birth (mm/dd/yyyy) ____________________________

C. Country of Birth ____________________________

D. Country of Nationality ____________________________

E. Home Address - Street Number and Name
(If deceased, so state and enter date of death) ____________________________

Apartment Number ____________________________

City ____________________________

State/Province ____________________________

Country ____________________________

Zip/Postal Code ____________________________

F. U.S. citizen by:

____ Birth in the United States

____ Birth abroad to U.S. citizen parent(s)

____ Acquisition after birth through naturalization of alien parent(s)

____ Naturalization

Date of Naturalization (mm/dd/yyyy) ____________________________

Place of Naturalization (Name of Court and City/State or USCIS or Former INS Office Location) ____________________________

Certificate of Naturalization Number ____________________________

Former "A" Number (If known) ____________________________

G. Has your mother ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship?

____ No ____ Yes (Provide full explanation on a separate sheet(s) of paper.)

H. Dates of Residence and/or Physical Presence in the United States
(Complete this only if you are an applicant claiming U.S. citizenship at time of birth abroad)

Provide the dates your U.S. citizen mother resided in or was physically present in the United States. If you need more space, use a separate sheet(s) of paper.

From (mm/dd/yyyy) ____________________________

To (mm/dd/yyyy) ____________________________

From (mm/dd/yyyy) ____________________________

To (mm/dd/yyyy) ____________________________

I. Marital History

1. How many times has your U.S. citizen mother been married (including annulled marriages)?

2. Information about U.S. citizen mother's current spouse:

Family Name (Last Name) ____________________________

Given Name (First Name) ____________________________

Full Middle Name (If applicable) ____________________________

Date of Birth (mm/dd/yyyy) ____________________________

Country of Birth ____________________________

Country of Nationality ____________________________

Home Address - Street Number and Name ____________________________

Apartment Number ____________________________

City ____________________________

State/Province ____________________________

Country ____________________________

Zip/Postal Code ____________________________

Date of Marriage (mm/dd/yyyy) ____________________________

Place of Marriage (City/State or country) ____________________________

Spouse's Immigration Status:

____ U.S. Citizen ____ Lawful Permanent Resident ____ Other (Explain) ____________________________

3. Is your U.S. citizen mother's current spouse also your mother? ____ No ____ Yes

Part 6. Information About Military Service of U.S. citizen Parent(s). (Complete this only if you are an applicant claiming U.S. citizenship at time of birth abroad)

1. Has your U.S. citizen parent(s) served in the armed forces? _

___ No ____ Yes

2. If "Yes," which parent?

____ U.S. Citizen Father ____ U.S. Citizen Mother

3. Dates of Service. (If time of service fulfills any of required physical presence, submit evidence of service).

From (mm/dd/yyyy) ____________________________

To (mm/dd/yyyy) ____________________________


From (mm/dd/yyyy) ____________________________

To (mm/dd/yyyy) ____________________________

4. Type of discharge. ____ Honorable ____ Other than Honorable ____ Dishonorable

Part 7. Signature.

I certify, under penalty of perjury under the laws of the United States, that this application and the evidence submitted with it is all true and correct. I authorize the release of any information from my records, or my minor child's records, that U.S. Citizenship and Immigration Services needs to determine eligibility for the benefit I am seeking.

Applicant's Signature ____________________________

Printed Name ____________________________

Date (mm/dd/yyyy) ____________________________

Part 8. Signature of person preparing form, if other than applicant.

I declare that I prepared this application at the request of the above person. The answers provided are based on information of which I have personal knowledge and/or were provided to me by the above-named person in response to the questions contained on this form.

Preparer's Signature ____________________________

Preparer's Printed Name ____________________________

Date (mm/dd/yyyy) ____________________________

Name of Business/Organization (If applicable) ____________________________

Preparer's Daytime Phone Number ____________________________

Preparer's Address - Street Number and Name ____________________________

City ____________________________

County ____________________________

State ____________________________

Zip Code ____________________________

NOTE: Do not complete the following parts unless a USCIS officer instructs you to do so at the interview.

Part 9. Affidavit.

I, the (applicant, parent or legal guardian) do swear or affirm, under penalty of perjury laws of the United States, that I know and understand the contents of this application signed by me, and the attached supplementary pages number (____) to (____) inclusive, that the same are true and correct to the best of my knowledge, and that corrections number (____) to (____) were made by me or at my request.

Signature of parent, guardian or applicant ____________________________

Date (mm/dd/yyyy) ____________________________

Subscribed and sworn or affirmed before me upon examination of the applicant (parent, guardian) on at Title Signature of Interviewing Officer.

District Adjudication Officer's Name and Title ____________________________

District Adjudication Officer's Signature ____________________________

Part 10. Officer Report and Recommendation on Application for Certificate of Citizenship.

On the basis of the documents, records and the testimony of persons examined, and the identification upon personal appearance of the underage beneficiary, I find that all the facts and conclusions set forth under oath in this application

are ____ true and correct; that the applicant did ____ derive or acquire U.S. citizenship

on ____________________________ (mm/dd/yyyy), through (mark "X" in appropriate section of law or, if section of law not reflected, insert applicable section of law in "Other" block):

____ section 301 of the INA
____ section 309 of the INA
____ section 320 of the INA
____ section 321 of the INA
____ Other ____________________________

and that (s)he ____ has ____ has not been expatriated since that time.

I recommend that this application be ____ granted ____ denied and that

____ A or ____ AA Certificate of Citizenship be issued in the name of ____________________________.

I do ____ do not concur in recommendation of the application.

District Director or Officer-in-Charge Signature ____________________________

Date (mm/dd/yyyy) ____________________________

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