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) ___________________________