N-600K, Application for Citizenship and Issuance of Certificate Under Section 322 (United States)
This form is for a child who resides outside the United States 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-600K looks like.
Department of Homeland Security
U.S Citizenship and Immigration Services
N-600K, Application for Citizenship and Issuance of Certificate Under Section 322
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If your child has an "A" Number, write it here: A ____________________
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For USCIS Use Only
Bar Code ____________________________
Date Stamp ____________________________
Remarks ____________________________
Action
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START HERE - Please type or print in black ink.
Part 1. Information About Your Child.
(Provide information about the child on whose behalf this application for citizenship and a Certificate of Citizenship is being filed.)
A. Current legal name.
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 Citizenship/Nationality ____________________________
H. Gender ____ Male ____ Female
I. Height ____________________________
Part 2. Information About the Child's Eligibility.
(Check only one)
This application is being filed on my behalf based on the fact that:
A. I am a BIOLOGICAL child (under 18 years) of a United States citizen parent who is applying for citizenship on my behalf.
B. I am an ADOPTED child (under 18 years) of a United States citizen parent who is applying for citizenship on my behalf.
C. I am a child (under 18 years) of a United States citizen parent who died during the five years preceding the filing of this application. A United States citizen grandparent or a United States citizen legal guardian is applying for citizenship on my behalf.
Part 3. Additional Information About the Child.
(Provide information about the child on whose behalf this application for citizenship and a Certificate of Citizenship is being filed.)
A. Home Address - Street Number and Name (Do not write a P.O. Box in this space.) ____________________________
Apartment Number ____________________________
City ____________________________
County ____________________________
State or Province ____________________________
Country ____________________________
Zip or 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
I arrived in the following manner:
Port of Entry (City/State) ____________________________
Date (mm/dd/yyyy) ____________________________
Exact Name Used at Time of Entry: ____________________________
F. Do you know of any prior application for a certificate of citizenship or U.S. passport for this child? ____ No ____ Yes
G. Was the child adopted? ____ No ____ Yes (Please complete the following information):
Date of Adoption (mm/dd/yyyy) ____________________________
Date Legal Custody Began (mm/dd/yyyy) ____________________________
Date Physical Custody Began (mm/dd/yyyy) ____________________________
H. Were the child's parents married to each when the child was born (or adopted)? ____ No ____ Yes
Part 4. Information About the Child's U.S. Citizen Father or Mother (or Adoptive Father or Mother).
(If you are a United States citizen father or mother applying for citizenship and a Certificate of Citizenship on behalf of your eligible child, provide information about yourself below). If you are a U.S. citizen grandparent or legal guardian, provide information about the child's U.S. citizen parent in the sections noted.
A. Current legal name of U.S. citizen father or 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. Home Address - Street Number and Name ____________________________
Apartment Number ____________________________
City ____________________________
State/Province ____________________________
Country ____________________________
Zip/Postal Code ____________________________
E. U.S. citizen by:
____ Birth in the United States
____ 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) ____________________________
____ Through birth abroad to U.S. citizen parent(s)
____ Acquired after birth through naturalization of alien parent(s)
F. as the U.S. citizen father or mother ever lost U.S. citizenship or taken any action that would cause loss of United States citizenship?
____ No ____ Yes (Please Provide Full Explanation.)
G. Dates of Residence and/or Physical Presence in the United States
Provide the dates your U.S. citizen father or 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) ____________________________
H. Marital History
1. How many times has your U.S. citizen father or mother been married (including annulled marriages)? __________
2. Information about U.S. citizen father or 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 the U.S. citizen Father or Mother's current spouse listed in Question 2 above also the parent of the child (biological or adoptive) for whom this application is being submitted? ____ No ____ Yes
Part 5. Information About U.S. Citizen Grandfather or Grandmother.
(Complete this section only if you are a U.S. citizen parent (or adoptive parent) grandparent or legal guardian applying for a Certificate of Citizenship for your biological or adopted child and the citizen parent has not been physically present in the United States for five years, two years of which were after the age of 14. The information provided here should describe, the U.S. citizen grandfather or U.S. grandmother of the minor child.)
A. Current legal name of U.S. citizen grandfather or grandmother.
Family Name (Last Name) ____________________________
Given Name (First Name) ____________________________
Full Middle Name (If applicable) ____________________________
B. Date of Birth (mm/dd/yyyy) ____________________________
C. Country of Birth ____________________________
E. Home Address - Street Number and Name ____________________________
Apartment Number ____________________________
City ____________________________
State/Province ____________________________
Country ____________________________
Zip/Postal Code ____________________________
E. U.S. citizen by:
____ Birth in the United States
____ 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) ____________________________
____ Through birth abroad to U.S. citizen parent(s)
____ Acquired after birth through naturalization of alien parent(s)
F. Has your father or mother (your child's grandfather or grandmother) ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship?
____ No ____ Yes (Provide full explanation.) ____________________________
G. Dates of Residence and/or Physical Presence in the United States
Provide the dates your U.S. citizen father or mother (your child's grandfather or grandmother) 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) ____________________________
Part 6. Legal Guardian.
(Complete this part only for applications filed by a legal guardian in lieu of a deceased
U.S. citizen parent.)
A. Current legal name of U.S. citizen Legal Guardian.
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. Home Address - Street Number and Name ____________________________
Apartment Number ____________________________
City ____________________________
State/Province ____________________________
Country ____________________________
Zip/Postal Code ____________________________
E. U.S. citizen by:
____ Birth in the United States
____ 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) ____________________________
____ Through birth abroad to U.S. citizen parent(s)
____ Acquired after birth through naturalization of alien parent(s)
F. Date of Legal Guardianship ____________________________
G. Name of Authority that Granted Legal Guardianship ____________________________
H. Address of Authority that Granted Legal Guardianship ____________________________
Part 7. Your 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 ____________________________
Print Name ____________________________
Date (mm/dd/yyyy) ____________________________
Part 8. Signature of person preparing this form, if other than above.
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 Printed Name ____________________________
Preparer's Signature ____________________________
Name of Business/Organization (If applicable) ____________________________
Preparer's Daytime Phone Number ____________________________
Date (mm/dd/yyyy) ____________________________
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 parent/grandparent/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/grandparent/legal guardian ____________________________
Date (mm/dd/yyyy) ____________________________
Subscribed and sworn or affirmed before me upon examination of the applicant and U.S. citizen parent/grandparent/legal guardian
on _______________________
at _______________________
Signature of Interviewing Officer ____________________________
Title ____________________________
Part 10. Officer Report and Recommendation.
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 is eligible to be naturalized
on ____________________________ (month/day/year),
through section 322 of the INA _____;
section 322 of the INA (grandparent residence) _____;
section 322 of the INA (grandparent or legal guardian application) _____.
And I recommend that this application be ________________ (granted or denied) and that a Certificate of Citizenship be issued
District Adjudications Officer's Name and Title ____________________________.
District Adjudications Officer's Signature _____________________________
I do ____ concur in recommendation of the application.
Date (mm/dd/yyyy) ____________________________
District Director or Officer-in-Charge Signature ____________________________