Form DS-5507, Affidavit of Physical Presence Completed Form Examples and Samples
Explore detailed examples of DS-5507 forms used to document physical presence and continuous residence in the U.S. for supporting children's citizenship applications. Our samples provide step-by-step guidance, showcasing completed forms with accurate entries and necessary documentation.
DS-5507 Example – Proof of Physical Presence for U.S. Citizenship
How this form was filled:
John Smith uses Form DS-5507 to document his periods of physical presence in the U.S. to support a citizenship application for his child born abroad. Detailed entries of his travel dates, supported by official records, are listed to provide evidence of compliance.
Information used to fill out the document:
- Affiant's Name: John Smith
- Child's Name: Emma Smith
- Child's Date of Birth: 09/15/2023
- Periods of Physical Presence: 06/01/2010 to 12/30/2014, 01/10/2016 to 11/20/2019
- Travel Documents: Passport, Visa Stamps
- Signature: John Smith
- Date: 10/05/2025
What this filled form sample shows:
- Detailed documentation of physical presence in the U.S.
- Inclusion of travel documents such as passport and visa stamps
- Accurate dates of presence supporting citizenship claims
- Clear and certified signature provided by the affiant
Form specifications and details:
| Use Case: | Proving physical presence for child's U.S. citizenship application |
| Relevant Documents: | Travel history, passport, and visa scans |
DS-5507 Example – Documenting Continuous Residence for Citizenship
How this form was filled:
Maria Gonzalez fills out Form DS-5507 to affirm her continuous residence in the U.S., supporting her application for her child's citizenship. The form includes verifiable residence periods and essential documentation to establish compliance with the requirements.
Information used to fill out the document:
- Affiant's Name: Maria Gonzalez
- Child's Name: Luis Gonzalez
- Child's Date of Birth: 03/12/2024
- Periods of Residence: 02/15/2011 to 07/29/2017, 08/03/2018 to 06/11/2023
- Supporting Documents: Utility Bills, Lease Agreements
- Signature: Maria Gonzalez
- Date: 11/02/2025
What this filled form sample shows:
- Providing proof of continuous residence in the United States.
- Including supporting documents such as utility bills and leases.
- Verification of consistent residency periods to establish eligibility.
- Submission of a certified signature by the affiant.
Form specifications and details:
| Use Case: | Proving continuous residence for child's citizenship application |
| Relevant Documents: | Residential records, utility bills, and lease agreements |
