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I-600, Petition to Classify Orphan as an Immediate Relative (United States)

This form is a petition to classify an orphan as a relative of a person of the United States. The form provided here is simply a sample of what the actual Form I-600 looks like.

Department of Homeland Security
U.S. Citizenship and Immigration Services

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

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Do not write in this block. (For USCIS Use Only.)

TO THE SECRETARY OF STATE:

The petition was filed by:

____ Married petitioner ____ Unmarried petitioner

The petition is approved for orphan:

____ Adopted abroad ____ Coming to U.S. for adoption. Preadoption requirements have been met.

Remarks:


Fee Stamp


File number ___________________________

DATE OF ACTION ___________________________

DD ___________________________

DISTRICT ___________________________


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Type or print legibly in black ink. Complete a separate petition for each child.


Petition is being made to classify the named orphan as an immediate relative


Block I - Information about petitioner.

1. My name is: (Last) ___________________________

(First) ___________________________

(Middle) ___________________________

2. Other names used (including maiden name if appropriate): ___________________________

3. I reside in the U.S. at: (C/O if appropriate) ___________________________

(Number and Street) ___________________________

(Town or City) ___________________________

(State) ___________________________

(Zip Code) ___________________________

4. Address Abroad (if any):

(Number and Street) ___________________________

(Town or city) ___________________________

(Province) ___________________________

(Country) ___________________________

5. I was born on: (mm/dd/yyyy) ___________________________

In: (Town or City) ___________________________

(State or Province) ___________________________

(Country) ___________________________

6. My telephone number is: (Include Area Code) ___________________________

7. My marital status is:

____ Married

____ Widowed

____ Divorced

____ Single

____ I have never been married.

____ I have been previously married _________ time(s).

8. If you are now married, give the following information:

Date and place of present marriage (mm/dd/yyyy) ___________________________

Name of present spouse (include maiden name of wife) ___________________________

Date of birth of spouse ___________________________

Place of birth of spouse ___________________________

Number of prior marriages of spouse ___________________________

My spouse resides ____ With me ____ Apart from me (provide address below)

(Apt. No.) ___________________________

(No. and Street) ___________________________

(City) ___________________________

(Country) ___________________________

9. I am a citizen of the United States through:

____ Birth ____ Parents ____ Naturalization

If acquired through naturalization, give name under which naturalized, number of naturalization certificate, and date and place of naturalization: ___________________________

If not, submit evidence of citizenship. See Instruction 2.a(2).

If acquired through parentage, have you obtained a certificate in your own name based on that acquisition?

____ No ____ Yes

Have you or any person through whom you claimed citizenship ever lost U.S. citizenship?

____ No ____ Yes (If Yes, attach detailed explanation.)

Block II - Information about orphan beneficiary.

10. Name at Birth

(First) ___________________________

(Middle) ___________________________

(Last) ___________________________

11. Name at Present

(First) ___________________________

(Middle) ___________________________

(Last) ___________________________

12. Any other names by which orphan is or was known. ___________________________

13. Gender ____ Male ____ Female

14. Date of birth (mm/dd/yyyy) ___________________________

15. Place of Birth (City) ___________________________

(State or Province) ___________________________

(Country) ___________________________

16. The beneficiary is an orphan because (check one):

____ He or she has no parents.

____ He or she has only one parent who is the sole or surviving parent.

17. If the orphan has only one parent, answer the following:

a. State what has become of the other parent: ___________________________

b. Is the remaining parent capable of providing for the orphan's support? ____ Yes ____ No

c. Has the remaining parent in writing irrevocably released the orphan for emigration and adoption? ____ Yes ____ No

18. Has the orphan been adopted abroad by the petitioner and spouse jointly or the unmarried petitioner? ____ Yes ____ No

If yes, did the petitioner and spouse or unmarried petitioner personally see and observe the child prior to or during the adoption proceedings? ____ Yes ____ No

Date of adoption (mm/dd/yyyy) ___________________________

Place of adoption ___________________________

19. If either answer in Question 18 is "No," answer the following:

a. Do petitioner and spouse jointly or does the unmarried petitioner intend to adopt the orphan in the United States? ____ Yes ____ No

b. Have the preadoption requirements, if any, of the orphan's proposed State of residence been met? ____ Yes ____ No

c. If b is answered "No," will they be met later? ____ Yes ____ No

20. To petitioner's knowledge, does the orphan have any physical or mental affliction? ____ Yes ____ No

If "Yes," name the affliction. ___________________________

21. Who has legal custody of the child? ___________________________

22. Name of child welfare agency, if any, assisting in this case: ___________________________

23. Name of attorney abroad, if any, representing petitioner in this case. ___________________________

Address of above. ___________________________

24. Address in the United States where orphan will reside. ___________________________

25. Present address of orphan. ___________________________

25. If orphan is residing in an institution, give full name of institution. ___________________________

26. If orphan is not residing in an institution, give full name of person with whom orphan is residing. ___________________________

27. Give any additional information necessary to locate orphan, such as name of district, section, zone or locality in which orphan resides. ___________________________

28. Location of American embassy or consulate where application for visa will be made.

(City in Foreign Country) ___________________________

(Foreign Country) ___________________________

Certification of petitioner.

I certify, under penalty of perjury under the laws of the United States of America, that the foregoing is true and correct and that I will care for an orphan or orphans properly if admitted to the United States.

(Signature of Petitioner) ___________________________

Executed on (Date) ___________________________

Certification of married prospective petitioner's spouse.

I certify, under penalty of perjury under the laws of the United States of America, that the foregoing is true and correct and that my spouse and I will care for an orphan or orphans properly if admitted to the United States.

(Signature of Petitioner) ___________________________

Executed on (Date) ___________________________

Signature of person preparing form, if other than petitioner.

I declare that this document was prepared by me at the request of the petitioner and is
based entirely on information of which I have knowledge.

(Signature) ___________________________

Street Address and Room or Suite No./City/State/Zip Code ___________________________

Executed on (Date) ___________________________

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