Form N-400, Application for Naturalization Instructions
This form contains 441 fields organized into 28 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Consent for Disclosure (12.c) - Yes/No | ||
| 12.c No - Consent for Disclosure | Checkbox |
Check this box if you do not authorize USCIS to disclose information from this application to the SSA for assigning an SSN, issuing a Social Security card, or updating your immigration status with the SSA. Fill only if '12.a Yes (Complete Item Numbers 12.b - 12.c.)' is 'Yes'.
Depends on:
12.a Yes (Complete Item Numbers 12.b - 12.c.)
|
| 12.c Yes - Consent for Disclosure | Checkbox |
Check this box if you authorize disclosure of information from this application and USCIS systems to the SSA for assigning an SSN, issuing an original or replacement Social Security card, and updating your immigration status with the SSA. Fill only if '12.a Yes (Complete Item Numbers 12.b - 12.c.)' is 'Yes'.
Depends on:
12.a Yes (Complete Item Numbers 12.b - 12.c.)
|
| Country of Birth | ||
| Country of Birth | Text |
Enter the full name of the country where you were born (use the official country name, e.g., "Canada", "India").
|
| Country of Citizenship or Nationality | ||
| Country of Citizenship or Nationality | Text |
Enter the name of the country where you hold citizenship or nationality; if you have more than one, list additional countries in the Additional Information section.
|
| Date Became Lawful Permanent Resident | ||
| Date became lawful permanent resident | Date |
Enter the date you became a lawful permanent resident.
|
| Date of Birth (mm/dd/yyyy) | ||
| Date of Birth (Item 6) | Date |
Enter the applicant's date of birth.
|
| Enter A-Number (Part 1) | ||
| Part 1 — 9‑digit A‑Number (A-) | Text |
Enter your 9‑digit Alien Registration Number (A‑Number) exactly as issued, including any leading zeros and without spaces or dashes.
|
| Form Footer / Form ID | ||
| Form Footer Identifier | Text |
Enter the form footer identifier or control number displayed in the yellow footer box (copy the exact characters or number as shown on the form).
|
| Form Page Number (Footer) | ||
| Page Number (Footer) | Text |
Enter the page number displayed in the form footer for this page (e.g., the sequential page number of the PDF).
|
| General | ||
| PDF417BarCode1 | Text | |
| Part 1. Information About Your Eligibility. Enter Your 9 Digit Alien Registration Number (A. Number) | Text | |
| Part 4. Biographic Information. 2. Race (Select all applicable boxes). Select American Indian or Alaska Native | CheckBox | |
| Part 4. Biographic Information. 2. Race (Select all applicable boxes). Select Asian | CheckBox | |
| Part 4. Biographic Information. 2. Race (Select all applicable boxes). Select Black or African American | CheckBox | |
| Part 4. Biographic Information. 2. Race (Select all applicable boxes). Select Native Hawaiian or Other Pacific Islander | CheckBox | |
| Part 4. Biographic Information. 2. Race (Select all applicable boxes). Select White | CheckBox | |
| Part 4. Biographic Information. 1. Ethnicity (Select only one box). Select Not Hispanic or Latino | CheckBox | |
| Part 4. Biographic Information. NOTE: U S C I S requires you to complete the categories below to conduct background checks. (See the Form N - 400 Instructions for more information.) 1. Ethnicity (Select only one box). Select Hispanic or Latino | CheckBox | |
| Part 4. Biographic Information. 4. Weight in Pounds. Enter second digit of three digit weight | Text | |
| Part 4. Biographic Information. 3. Height. Enter Feet | ComboBox |
5
3
2
8
6
7
4
|
| Part 4. Biographic Information. 3. Height. Enter Inches | ComboBox |
5
3
9
2
8
1
6
10
7
11
4
0
|
| Text | ||
| Part 4. Biographic Information. 4. Weight in Pounds. Enter first digit of three digit weight | Text | |
| Part 4. Biographic Information. 4. Weight in Pounds. Enter third digit of three digit weight | Text | |
| Part 4. Biographic Information. 5. Eye color (Select only one box). Select Brown | CheckBox | |
| Part 4. Biographic Information. 5. Eye color (Select only one box). Select Blue | CheckBox | |
| Part 4. Biographic Information. 5. Eye color (Select only one box). Select Green | CheckBox | |
| Part 4. Biographic Information. 5. Eye color (Select only one box). Select Hazel | CheckBox | |
| Part 4. Biographic Information. 5. Eye color (Select only one box). Select Gray | CheckBox | |
| Part 4. Biographic Information. 5. Eye color (Select only one box). Select Black | CheckBox | |
| Part 4. Biographic Information. 5. Eye color (Select only one box). Select Pink | CheckBox | |
| Part 4. Biographic Information. 5. Eye color (Select only one box). Select Maroon | CheckBox | |
| Part 4. Biographic Information. 5. Eye color (Select only one box). Select Unknown / Other | CheckBox | |
| Part 4. Biographic Information. 6. Hair color (Select only one box). Select Bald (No hair) | CheckBox | |
| Part 4. Biographic Information. 6. Hair color (Select only one box). Select Sandy | CheckBox | |
| Part 4. Biographic Information. 6. Hair color (Select only one box). Select Red | CheckBox | |
| Part 4. Biographic Information. 6. Hair color (Select only one box). Select White | CheckBox | |
| Part 4. Biographic Information. 6. Hair color (Select only one box). Select Gray | CheckBox | |
| Part 4. Biographic Information. 6. Hair color (Select only one box). Select Blond | CheckBox | |
| Part 4. Biographic Information. 6. Hair color (Select only one box). Select Brown | CheckBox | |
| Part 4. Biographic Information. 6. Hair color (Select only one box). Select Black | CheckBox | |
| Part 4. Biographic Information. 6. Hair color (Select only one box). Select Unknown / Other | CheckBox | |
| Part 3. Information About Your Residence. List every location where you have lived during the last 5 years. List your current physical address in the first row. If you need extra space, use the space provided in Part 14. Additional Information. 1. Physical Address. Line 1. Enter Physical Addresses | Text | |
| Part 3. Information About Your Residence. 1. Physical Address. Line 2. Enter Physical Addresses | Text | |
| Part 3. Information About Your Residence. 1. Physical Address. Line 3. Enter Physical Addresses | Text | |
| Part 3. Information About Your Residence. 1. Physical Addresses. Line 3. Enter City/Town, State, ZIP Code (if outside the United States, indicate Province and Country) | Text | |
| Part 3. Information About Your Residence. 1. Physical Addresses. Line 2. Enter City/Town, State, ZIP Code (if outside the United States, indicate Province and Country) | Text | |
| Part 3. Information About Your Residence. List every location where you have lived during the last 5 years. List your current physical address in the first row. If you need extra space, use the space provided in Part 14. Additional Information. 1. Physical Addresses. Line 1. Enter City/Town, State, ZIP Code (if outside the United States, indicate Province and Country) | Text | |
| Part 3. Information About Your Residence. List every location where you have lived during the last 5 years. List your current physical address in the first row. If you need extra space, use the space provided in Part 14. Additional Information. 1. Physical Addresses. Line 1. Dates of Residence. Enter From Date. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 3. Information About Your Residence. 1. Physical Addresses. Line 2. Dates of Residence. Enter From Date. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 3. Information About Your Residence. 1. Physical Addresses. Line 3. Dates of Residence. Enter From Date. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 3. Information About Your Residence. 1. Physical Addresses. Line 2. Dates of Residence. Enter To Date. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 3. Information About Your Residence. 1. Physical Addresses. Line 3. Dates of Residence. Enter To Date. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 3. Information About Your Residence. 2. Is your current physical address also your current mailing address? Select No | CheckBox | |
| Part 3. Information About Your Residence. 2. Is your current physical address also your current mailing address? Select Yes. If you answered “Yes,” skip to Part 4 | CheckBox | |
| Part 3. Information About Your Residence. List every location where you have lived during the last 5 years. List your current physical address in the first row. If you need extra space, use the space provided in Part 14. Additional Information. 1. Physical Addresses. Line 1. Enter City/Town, State, ZIP Code (if outside the United States, indicate Province and Country) | Text | |
| Part 3. Information About Your Residence. 1. Physical Addresses. Line 2. Enter City/Town, State, ZIP Code (if outside the United States, indicate Province and Country) | Text | |
| Part 3. Information About Your Residence. 1. Physical Addresses. Line 3. Enter City/Town, State, ZIP Code (if outside the United States, indicate Province and Country) | Text | |
| P4_Line3_State1 | Text | |
| P4_Line3_State2 | Text | |
| P4_Line3_State3 | Text | |
| P4_Line3_Country1 | Text | |
| P4_Line3_Country2 | Text | |
| P4_Line3_Country3 | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Enter City or Town | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Select State from List of States | ComboBox |
VA
DE
MT
OK
FL
ID
MN
NH
RI
WV
AL
MS
CA
KS
LA
MH
VT
PR
KY
MI
WI
NJ
HI
AR
MP
ND
NE
AE
DC
ME
NC
AA
IA
CO
OR
AK
NY
UT
OH
SC
AS
VI
WY
FM
IN
MA
AZ
SD
TN
WA
GU
AP
NM
IL
PA
CT
TX
MD
MO
GA
NV
PW
|
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable).Enter Zip Code Plus 4. Enter 5-digit Zip Code | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Enter Postal Code (foreign address only) | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Enter Province or Region (foreign address only) | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Enter Street Number and Name | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Enter In Care Of Name, if any | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Enter Apartment, Suite or Floor Number | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Select Floor | CheckBox | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Select Suite | CheckBox | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Select Apartment | CheckBox | |
| P4_Line1_DatesofResidence | Text | |
| P4_Line1_DatesofResidence | Text | |
| Part 3. Information About Your Residence. List every location where you have lived during the last 5 years. List your current physical address in the first row. If you need extra space, use the space provided in Part 14. Additional Information. 1. Physical Addresses. Line 1. Dates of Residence. Enter From Date. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Enter Country (foreign address only) | Text | |
| PDF417BarCode1 | Text | |
| Page 2. Alien Registration Number (A. Number). No Entry | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Enter City or Town | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Select State from List of States | ComboBox |
VA
DE
MT
OK
FL
ID
MN
NH
RI
WV
AL
MS
CA
KS
LA
MH
VT
PR
KY
MI
WI
NJ
HI
AR
MP
ND
NE
AE
DC
ME
NC
AA
IA
CO
OR
AK
NY
UT
OH
SC
AS
VI
WY
FM
IN
MA
AZ
SD
TN
WA
GU
AP
NM
IL
PA
CT
TX
MD
MO
GA
NV
PW
|
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable).Enter Zip Code Plus 4. Enter 5-digit Zip Code | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Enter Postal Code (foreign address only) | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Enter Province or Region (foreign address only) | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Enter Street Number and Name | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Enter In Care Of Name, if any | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Enter Apartment, Suite or Floor Number | Text | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Select Floor | CheckBox | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Select Suite | CheckBox | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Select Apartment | CheckBox | |
| Part 3. Information About Your Residence. 3. Current Mailing Address (Safe Mailing Address, if applicable). Enter Country (foreign address only) | Text | |
| Part 7. Information About Your Marital History. 3. How many times have you been married? (See the Specific Instructions by Item Number section of the Instructions for more information about which marriages to include.) Enter Number of Marriages | Text | |
| Part 7. Information About Your Marital History. 1. What is your current marital status? Select Divorced | CheckBox | |
| Part 7. Information About Your Marital History. 1. What is your current marital status? Select Single, Never Married. If you are single and have never married, go to Part 14. Additional Information | CheckBox | |
| Part 7. Information About Your Marital History. 1. What is your current marital status? Select Widowed | CheckBox | |
| Part 7. Information About Your Marital History. 1. What is your current marital status? Select Married | CheckBox | |
| Part 7. Information About Your Marital History. 1. What is your current marital status? Select Marriage Annulled | CheckBox | |
| Part 7. Information About Your Marital History. 1. What is your current marital status? Select Separated | CheckBox | |
| Part 7. Information About Your Marital History. 2. If you are currently married, is your spouse a current member of the U. S. armed forces? Select No | CheckBox | |
| Part 7. Information About Your Marital History. 2. If you are currently married, is your spouse a current member of the U. S. armed forces? Select Yes | CheckBox | |
| Part 7. Information About Your Marital History. Your Current Marriage. If you are currently married, including if you are legally separated, provide the following information about your current spouse. 4. A. Current Spouse's Legal Name. Enter Middle Name (if applicable)) | Text | |
| Part 7. Information About Your Marital History. Your Current Marriage. If you are currently married, including if you are legally separated, provide the following information about your current spouse. 4. A. Current Spouse's Legal Name. Enter Given Name (First Name) | Text | |
| Part 7. Information About Your Marital History. Your Current Marriage. If you are currently married, including if you are legally separated, provide the following information about your current spouse. 4. A. Current Spouse's Legal Name. Enter Family Name (Last Name) | Text | |
| Part 7. Information About Your Marital History. Your Current Marriage. If you are currently married, including if you are legally separated, provide the following information about your current spouse. 4. B. Enter Current Spouse's Date of Birth. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 7. Information About Your Marital History. Your Current Marriage. If you are currently married, including if you are legally separated, provide the following information about your current spouse. 4. C. Enter Date You Entered into Marriage with Current Spouse. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 7. Information About Your Marital History. Your Current Marriage. 4. D. Is your current spouse's present physical address the same as your physical address? Select No. (If you answered “No,” provide address in Part 14. Additional Information.) | CheckBox | |
| Part 7. Information About Your Marital History. Your Current Marriage. 4.D. Is your current spouse's present physical address the same as your physical address? Select Yes | CheckBox | |
| Part 7. Information About Your Marital History. Your Current Marriage. 5. B. Enter Date Your Current Spouse Became a U. S. Citizen. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 7. Information About Your Marital History. Your Current Marriage. If your current spouse is a U. S. citizen, complete the following information. 5. A. When did your current spouse become a U. S. citizen? Select By Birth in the United States - Go to Item Number 7 | CheckBox | |
| Part 7. Information About Your Marital History. Your Current Marriage. If your current spouse is a U. S. citizen, complete the following information. 5. A. When did your current spouse become a U. S. citizen? Select Other - Complete Item Number 5. B | CheckBox | |
| PDF417BarCode1 | Text | |
| Page 5. Alien Registration Number (A. Number). No Entry | Text | |
| Part 7. Information About Your Marital History. Your Current Marriage. 6. Enter Current Spouse's Alien Registration Number (A. Number), if any | Text | |
| Part 7. Information About Your Marital History. Your Current Marriage. 7. How many times has your current spouse been married? (See the Specific Instructions by Item Number section of the Instructions for more information about which marriages to include.) Enter total number of marriages | Text | |
| Part 7. Information About Your Marital History. Your Current Marriage. 8. Enter Current Spouse's Current Employer or Company | Text | |
| Part 8. Information About Your Children. 1. Indicate your total number of children. Enter Total Number of Children | Text | |
| Part 6. Information About Your Children . Provide the following information about your children listed in Item Number 1. For the residence and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 1. Enter Son or Daughter’s Name (First Name and Family Name) | Text | |
| Part 6. Information About Your Children . Provide the following information about your children listed in Item Number 1. For the residence and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 2. Enter Son or Daughter’s Name (First Name and Family Name) | Text | |
| Part 6. Information About Your Children . Provide the following information about your children listed in Item Number 1. For the residence and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 3. Enter Son or Daughter’s Name (First Name and Family Name) | Text | |
| Part 6. Information About Your Children. 2. Provide the following information about your children listed in Item Number 1. For the residence and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 1. Enter Date of Birth. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 6. Information About Your Children. 2. Provide the following information about your children listed in Item Number 1. For the residence and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 2. Enter Date of Birth. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 6. Information About Your Children. 2. Provide the following information about your children listed in Item Number 1. For the residence and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 3. Enter Date of Birth. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 6. Information About Your Children. 2. Provide the following information about your children listed in Item Number 1. For the residence and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 1. Residence. Enter one of the following options: Resides with me, Does not reside with me, Unknown/Missing, or Deceased | Text | |
| Part 6. Information About Your Children. 2. Provide the following information about your children listed in Item Number 1. For the residence and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 2. Residence. Enter one of the following options: Resides with me, Does not reside with me, Unknown/Missing, or Deceased | Text | |
| Part 6. Information About Your Children. 2. Provide the following information about your children listed in Item Number 1. For the residence and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 3. Residence. Enter one of the following options: Resides with me, Does not reside with me, Unknown/Missing, or Deceased | Text | |
| Part 6. Information About Your Children. 2. Provide the following information about your children listed in Item Number 1. For the Relationship and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 1. Relationship. Enter one of the following options: Biological son or daughter, Stepchild, Legally Adopted son or daughter | Text | |
| Part 6. Information About Your Children. 2. Provide the following information about your children listed in Item Number 1. For the Relationship and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 2. Relationship. Enter one of the following options: Biological son or daughter, Stepchild, Legally Adopted son or daughter | Text | |
| Part 6. Information About Your Children. 2. Provide the following information about your children listed in Item Number 1. For the Relationship and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 3. Relationship. Enter one of the following options: Biological son or daughter, Stepchild, Legally Adopted son or daughter | Text | |
| Part 6. Information About Your Children. 2. Provide the following information about your children listed in Item Number 1. For the Relationship and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 1. Are you providing support for your son or daughter? Select Yes | CheckBox | |
| Part 6. Information About Your Children. 2. Provide the following information about your children listed in Item Number 1. For the Relationship and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 1. Are you providing support for your son or daughter? Select No | CheckBox | |
| Part 6. Information About Your Children. 2. Provide the following information about your children listed in Item Number 1. For the Relationship and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 3. Are you providing support for your son or daughter? Select No | CheckBox | |
| Part 6. Information About Your Children. 2. Provide the following information about your children listed in Item Number 1. For the Relationship and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 2. Are you providing support for your son or daughter? Select Yes | CheckBox | |
| Part 6. Information About Your Children. 2. Provide the following information about your children listed in Item Number 1. For the Relationship and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 3. Are you providing support for your son or daughter? Select No | CheckBox | |
| Part 6. Information About Your Children. 2. Provide the following information about your children listed in Item Number 1. For the Relationship and relationship columns, you must type or print one of the valid options listed. If any of your children do not reside with you, provide the address(es) where those children live in Part 14. Additional Information. If you have more than four children, use the space provided in Part 14. Additional Information. Line 3. Are you providing support for your son or daughter? Select Yes | CheckBox | |
| Part 5. Information About Your Employment and Schools You Attended. Employer Name or School Name. Line 1. Enter Name | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Employer Name or School Name. Line 2. Enter Name | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Employer Name or School Name. Line 3. Enter Name | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Line 3. Enter Employer's City (if outside the United States, indicate Province and Country) | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Line 2. Enter Employer's City (if outside the United States, indicate Province and Country) | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Line 1. Enter Employer's City (if outside the United States, indicate Province and Country) | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Employment Dates. Line 1. Enter From Date. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Employment Dates. Line 2. Enter From Date. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Employment Dates. Line 3. Enter From Date. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Employment Dates. Line 2. Enter To Date. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Employment Dates. Line 3. Enter To Date. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Line 1. Enter Occupation or Field of Study | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Line 2. Enter Occupation or Field of Study | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Line 3. Enter Occupation or Field of Study | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Line 1. Enter Employer' State (if outside the United States, indicate Province and Country) | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Line 2. Enter Employer's State (if outside the United States, indicate Province and Country) | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Line 3. Enter Employer's State (if outside the United States, indicate Province and Country) | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Line 1. Enter Employer's Zip Code (if outside the United States, indicate Province and Country) | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Line 2. Enter Employer's Zip Code (if outside the United States, indicate Province and Country) | Text | |
| Part 5. Information About Your Employment and Schools You Attended. Line 3. Enter Employer's Zip Code (if outside the United States, indicate Province and Country) | Text | |
| P7_Country3 | Text | |
| P7_Country2 | Text | |
| P7_Country1 | Text | |
| PDF417BarCode1 | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip One. Enter Date You Returned to the United States. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip Three. Enter Date You Returned to the United States. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip Five. Enter Date You Returned to the United States. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip Six. List the Countries to Which You Traveled | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip Six. Enter Date You Left the United States. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip Six. Enter Date You Returned to the United States. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip Five. Enter Date You Left the United States. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip Five. List the Countries to Which You Traveled | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip Four. List the Countries to Which You Traveled | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip Four. Enter Date You Left the United States. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip Four. Enter Date You Returned to the United States. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip Three. Enter Date You Left the United States. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip Three. List the Countries to Which You Traveled | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip Two. List the Countries to Which You Traveled | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip Two. Enter Date You Left the United States. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip Two. Enter Date You Returned to the United States. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip One. Enter Date You Left the United States. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 6. Time Outside the United States. 1. List below all the trips that you have taken outside the United States during the last 5 years. Start with your most recent trip and work backwards. Do not include day trips (where the entire trip was completed within 24 hours) in the table. If you have taken any trips outside the United States that lasted more than 6 months, see the Required Evidence - Continuous Residence section of the Instructions for evidence you should provide. If you need extra space to complete this section, use the space provided in Part 14. Additional Information. Trip One. List the Countries to Which You Traveled | Text | |
| Page 5. Alien Registration Number (A. Number). No Entry | Text | |
| Part 9. Additional Information About You. 2. Have you EVER registered to vote or voted in any Federal, state, or local election in the United States? If you lawfully voted only in a local election where aliens are eligible to vote, you may answer “No.” Select No | CheckBox | |
| Part 9. Additional Information About You. 2. Have you EVER registered to vote or voted in any Federal, state, or local election in the United States? If you lawfully voted only in a local election where aliens are eligible to vote, you may answer “No.” Select Yes | CheckBox | |
| Part 9. Additional Information About You. 1. Have you EVER claimed to be a U.S. citizen (in writing or any other way)? Select No | CheckBox | |
| Part 9. Additional Information About You. 1. Have you EVER claimed to be a U.S. citizen (in writing or any other way)? Select Yes | CheckBox | |
| Part 9. Additional Information About You. 3. Do you currently owe any overdue Federal, state, or local taxes in the United States? Select Yes | CheckBox | |
| Part 9. Additional Information About You. 3. Do you currently owe any overdue Federal, state, or local taxes in the United States? Select No | CheckBox | |
| Part 9. Additional Information About You. 4. Since you became a lawful permanent resident, have you called yourself a “non-U.S. resident” on a Federal, state, or local tax return or decided not to file a tax return because you considered yourself to be a non-U.S. resident? Select Yes | CheckBox | |
| Part 9. Additional Information About You. 4. Since you became a lawful permanent resident, have you called yourself a “non-U.S. resident” on a Federal, state, or local tax return or decided not to file a tax return because you considered yourself to be a non-U.S. resident? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER. 5. A. Been a member of, involved in, or in any way associated with any Communist or totalitarian party anywhere in the world? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER. 5. A. Been a member of, involved in, or in any way associated with any Communist or totalitarian party anywhere in the world? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER. 5. B. Been a member of, involved in, or in any way associated with any group anywhere in the world that advocates or teaches any of the following: Opposition to all organized government; World communism; The establishment in the United States of a totalitarian dictatorship; The overthrow by force or violence or other unconstitutional means of the Government of the United States or all forms of law; The unlawful assaulting or killing of any officer or officers of the Government of the United States or of any other organized government because of their official character; The unlawful damage, injury, or destruction of property; or Sabotage? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER. 5. B. Been a member of, involved in, or in any way associated with any group anywhere in the world that advocates or teaches any of the following: Opposition to all organized government; World communism; The establishment in the United States of a totalitarian dictatorship; The overthrow by force or violence or other unconstitutional means of the Government of the United States or all forms of law; The unlawful assaulting or killing of any officer or officers of the Government of the United States or of any other organized government because of their official character; The unlawful damage, injury, or destruction of property; or Sabotage? Select No | CheckBox | |
| PDF417BarCode1 | Text | |
| Part 9. Additional Information About You. Have you EVER been a member of, involved in, or in any way associated with, or have you EVER provided money, a thing of value, services or labor, or any other assistance or support to a group that: 6. A. Used a weapon or explosive with intent to harm another person or cause damage to property? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER been a member of, involved in, or in any way associated with, or have you EVER provided money, a thing of value, services or labor, or any other assistance or support to a group that: 6. A. Used a weapon or explosive with intent to harm another person or cause damage to property? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER been a member of, involved in, or in any way associated with, or have you EVER provided money, a thing of value, services or labor, or any other assistance or support to a group that: 6. B. Engaged (participated) in kidnapping, assassination, or hijacking or sabotage of an airplane, ship, vehicle, or other mode of transportation? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER been a member of, involved in, or in any way associated with, or have you EVER provided money, a thing of value, services or labor, or any other assistance or support to a group that: 6. B. Engaged (participated) in kidnapping, assassination, or hijacking or sabotage of an airplane, ship, vehicle, or other mode of transportation? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER been a member of, involved in, or in any way associated with, or have you EVER provided money, a thing of value, services or labor, or any other assistance or support to a group that: 6. C. Threatened, attempted (tried), conspired (planned with others), prepared, planned, advocated for, or incited (encouraged) others to commit any of the acts listed in Item Numbers 6.a. or 6.b.? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER been a member of, involved in, or in any way associated with, or have you EVER provided money, a thing of value, services or labor, or any other assistance or support to a group that: 6. C. Threatened, attempted (tried), conspired (planned with others), prepared, planned, advocated for, or incited (encouraged) others to commit any of the acts listed in Item Numbers 6.a. or 6.b.? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 7. A. Torture? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 7. A. Torture? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 7. B. Genocide? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 7. B. Genocide? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 7. C. Killing or trying to kill any person? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 7. C. Killing or trying to kill any person? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 7. D. Intentionally and severely injuring or trying to injure any person? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 7. D. Intentionally and severely injuring or trying to injure any person? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 7. E. Any kind of sexual contact or activity with any person who did not consent (did not agree) or was unable to consent (could not agree), or was being forced or threatened by you or by someone else? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 7. E. Any kind of sexual contact or activity with any person who did not consent (did not agree) or was unable to consent (could not agree), or was being forced or threatened by you or by someone else? Select Yes | CheckBox | |
| Part 9. Additional Information About. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. Not letting someone practice his or her religion? Select No | CheckBox | |
| Part 9. Additional Information About. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following. Not letting someone practice his or her religion? Select Yes | CheckBox | |
| Page 5. Alien Registration Number (A. Number). No Entry | Text | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 8. A. Have you EVER served in, been a member of, assisted (helped), or participated in any armed group (a group that carries weapons), for example: a military unit, paramilitary unit (a group of people who act like a military group but are not part of the official military), police unit, self-defense unit, vigilante unit, rebel group, or guerrilla group? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 8. A. Have you EVER served in, been a member of, assisted (helped), or participated in any armed group (a group that carries weapons), for example: a military unit, paramilitary unit (a group of people who act like a military group but are not part of the official military), police unit, self-defense unit, vigilante unit, rebel group, or guerrilla group? Select Yes. If you answered “Yes” to Item Number 8., include the name of the country, the name of the military unit or armed group, your rank or position, and your dates of involvement in your explanation in Part 14. Additional Information | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 9. Have you EVER worked, volunteered, or otherwise served in a place where people were detained (forced to stay), for example, a prison, jail, prison camp (a camp where prisoners of war or political prisoners are kept), detention facility, or labor camp, or have you EVER directed or participated in any other activity that involved detaining people? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 9. Have you EVER worked, volunteered, or otherwise served in a place where people were detained (forced to stay), for example, a prison, jail, prison camp (a camp where prisoners of war or political prisoners are kept), detention facility, or labor camp, or have you EVER directed or participated in any other activity that involved detaining people? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 10. B. If you answered “Yes” to Item Number 10.a., when you were part of this group, or when you helped this group, did you ever use a weapon against another person? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 10. C. If you answered “Yes” to Item Number 10.a., when you were part of this group, or when you helped this group, did you ever threaten another person that you would use a weapon against that person? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 10. C. If you answered “Yes” to Item Number 10.a., when you were part of this group, or when you helped this group, did you ever threaten another person that you would use a weapon against that person? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 10. B. If you answered “Yes” to Item Number 10.a., when you were part of this group, or when you helped this group, did you ever use a weapon against another person? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 10. A. Were you EVER a part of any group, or did you EVER help any group, unit, or organization that used a weapon against any person, or threatened to do so? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 10. A. Were you EVER a part of any group, or did you EVER help any group, unit, or organization that used a weapon against any person, or threatened to do so? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 7. G. Causing harm or suffering to any person because of his or her race, religion, national origin, membership in a particular social group, or political opinion? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 7. G. Causing harm or suffering to any person because of his or her race, religion, national origin, membership in a particular social group, or political opinion? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 8. B. Have you EVER served in, been a member of, assisted (helped), or participated in any armed group (a group that carries weapons), for example: a military unit, paramilitary unit (a group of people who act like a military group but are not part of the official military), police unit, self-defense unit, vigilante unit, rebel group, or guerrilla group? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 8. B. Have you EVER served in, been a member of, assisted (helped), or participated in any armed group (a group that carries weapons), for example: a military unit, paramilitary unit (a group of people who act like a military group but are not part of the official military), police unit, self-defense unit, vigilante unit, rebel group, or guerrilla group? Select Yes. If you answered “Yes” to Item Number 8., include the name of the country, the name of the military unit or armed group, your rank or position, and your dates of involvement in your explanation in Part 14. Additional Information | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 11. Have you EVER sold, provided, or transported weapons, or assisted any person in selling, providing, or transporting weapons, which you knew or believed would be used against another person? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 11. Have you EVER sold, provided, or transported weapons, or assisted any person in selling, providing, or transporting weapons, which you knew or believed would be used against another person? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 12. Have you EVER received any weapons training, paramilitary training, or other military-type training? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 12. Have you EVER received any weapons training, paramilitary training, or other military-type training? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 13. Have you EVER recruited (asked), enlisted (signed up), conscripted (required to join), or used any person under 15 years of age to serve in or help an armed group, or attempted or worked with others to do so? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 13. Have you EVER recruited (asked), enlisted (signed up), conscripted (required to join), or used any person under 15 years of age to serve in or help an armed group, or attempted or worked with others to do so? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 14. Have you EVER used any person under 15 years of age to take part in hostilities or attempted or worked with others to do so? This could include participating in combat or providing services related to combat (such as serving as a messenger or transporting supplies). Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 14. Have you EVER used any person under 15 years of age to take part in hostilities or attempted or worked with others to do so? This could include participating in combat or providing services related to combat (such as serving as a messenger or transporting supplies). Select Yes | CheckBox | |
| PDF417BarCode1 | Text | |
| Page 9. Alien Registration Number (A. Number). No Entry | Text | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 15. A. Have you EVER committed, agreed to commit, asked someone else to commit, helped commit, or tried to commit a crime or offense for which you were NOT arrested? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 15. A. Have you EVER committed, agreed to commit, asked someone else to commit, helped commit, or tried to commit a crime or offense for which you were NOT arrested? Select Yes | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 15. B. Have you EVER been arrested, cited, detained or confined by any law enforcement officer, military official (in the U.S. or elsewhere), or immigration official for any reason, or been charged with a crime or offense, or notified that you were being investigated for a crime? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following: 15. B. Have you EVER been arrested, cited, detained or confined by any law enforcement officer, military official (in the U.S. or elsewhere), or immigration official for any reason, or been charged with a crime or offense, or notified that you were being investigated for a crime? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. What was the crime or offense? Line 1. Enter Crime or Offense | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. What was the crime or offense? Line 2. Enter Crime or Offense | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. What was the crime or offense? Line 3. Enter Crime or Offense | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. What was the crime or offense? Line 4. Enter Crime or Offense | Text | |
| Part 9. Additional Information About You. 29. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. What was the crime or offense? Line 5. Enter Crime or Offense | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. Date of the Crime or Offense. Line 1. Enter Date as Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 9. Additional Information About You. 29. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. Date of the Crime or Offense. Line 2. Enter Date as Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. Date of the Crime or Offense. Line 3. Enter Date as Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 9. Additional Information About You. 29. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. Date of the Crime or Offense. Line 4. Enter Date as Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. Date of the Crime or Offense. Line 5. Enter Date as Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. What was the result or disposition of the arrest, citation, or charge? Line 5. Enter No Charges Filed, Convicted, Charges Dismissed, Detention, Jail, Probation, Etc | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. What was the result or disposition of the arrest, citation, or charge? Line 4. Enter No Charges Filed, Convicted, Charges Dismissed, Detention, Jail, Probation, Etc | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. What was the result or disposition of the arrest, citation, or charge? Line 3. Enter No Charges Filed, Convicted, Charges Dismissed, Detention, Jail, Probation, Etc | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. What was the result or disposition of the arrest, citation, or charge? Line 2. Enter No Charges Filed, Convicted, Charges Dismissed, Detention, Jail, Probation, Etc | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. What was the result or disposition of the arrest, citation, or charge? Line 1. Enter No Charges Filed, Convicted, Charges Dismissed, Detention, Jail, Probation, Etc | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. Place of Crime or Offense (City or Town, State, Country) Line 5. Enter City or Town, State, Country where offense occurred | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. Place of Crime or Offense (City or Town, State, Country) Line 4. Enter City or Town, State, Country where offense occurred | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. Place of Crime or Offense (City or Town, State, Country) Line 3. Enter City or Town, State, Country where offense occurred | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. Place of Crime or Offense (City or Town, State, Country) Line 2. Enter City or Town, State, Country where offense occurred | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. Place of Crime or Offense (City or Town, State, Country) Line 1. Enter City or Town, State, Country where offense occurred | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. What was your sentence? Line 5. Enter For Example, 90 Days In Jail, 90 Days On Probation | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. What was your sentence? Line 4. Enter For Example, 90 Days In Jail, 90 Days On Probation | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. What was your sentence? Line 3. Enter For Example, 90 Days In Jail, 90 Days On Probation | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. What was your sentence? Line 2. Enter For Example, 90 Days In Jail, 90 Days On Probation | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. What was your sentence? Line 1. Enter For Example, 90 Days In Jail, 90 Days On Probation | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. Date of your conviction or guilty plea (if applicable)? Line 5. Enter Date as Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. Date of your conviction or guilty plea (if applicable)? Line 4. Enter Date as Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. Date of your conviction or guilty plea (if applicable)? Line 3. Enter Date as Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. Date of your conviction or guilty plea (if applicable)? Line 2. Enter Date as Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any part of Item Number 15. below, complete the table below with each crime or offense even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if someone, including a judge, law enforcement officer, or attorney, told you that it is no longer on your record, or told you that you do not have to disclose the information. If you need extra space, use the space provided in Part 14. Additional Information. Submit evidence to support your answers with your Form N-400. Date of your conviction or guilty plea (if applicable)? Line 1. Enter Date as Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following:16. If you received a suspended sentence, were placed on probation, or were paroled, have you completed your suspended sentence, probation, or parole? Select No | CheckBox | |
| Part 9. Additional Information About You. Have you EVER ordered, incited, called for, committed, assisted, helped with, or otherwise participated in any of the following:16. If you received a suspended sentence, were placed on probation, or were paroled, have you completed your suspended sentence, probation, or parole? Select Yes | CheckBox | |
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| Page 12. Alien Registration Number (A. Number). No Entry | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. A. Engaged in prostitution, attempted to procure or import prostitutes or persons for the purpose of prostitution, or received any proceeds or money from prostitution? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. A. I Engaged in prostitution, attempted to procure or import prostitutes or persons for the purpose of prostitution, or received any proceeds or money from prostitution? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. B. Manufactured, cultivated, produced, distributed, dispensed, sold, or smuggled (trafficked) any controlled substances, illegal drugs, narcotics, or drug paraphernalia in violation of any law or regulation of a U.S. state, the United States, or a foreign country? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. B. Manufactured, cultivated, produced, distributed, dispensed, sold, or smuggled (trafficked) any controlled substances, illegal drugs, narcotics, or drug paraphernalia in violation of any law or regulation of a U.S. state, the United States, or a foreign country? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. C. Been married to more than one person at the same time? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. C. Been married to more than one person at the same time? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. D. Married someone in order to obtain an immigration benefit? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. D. Married someone in order to obtain an immigration benefit? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. E. Helped anyone to enter, or try to enter, the United States illegally? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. E. Helped anyone to enter, or try to enter, the United States illegally? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. H. Made any misrepresentation to obtain any public benefit in the United States? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. H. Made any misrepresentation to obtain any public benefit in the United States? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. G. Failed to support your dependents (pay child support) or to pay alimony (court-ordered financial support after divorce or separation)? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. G. Failed to support your dependents (pay child support) or to pay alimony (court-ordered financial support after divorce or separation)? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. F. Gambled illegally or received income from illegal gambling? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 17. F. Gambled illegally or received income from illegal gambling? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 21. Have you EVER been removed or deported from the United States? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 21. Have you EVER been removed or deported from the United States? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 20. Have you EVER been placed in removal, rescission, or deportation proceedings? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 20. Have you EVER been placed in removal, rescission, or deportation proceedings? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 22. A. Are you a male who lived in the United States, except as a lawful nonimmigrant, at any time between your 18th and 26th birthdays? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 22. A. Are you a male who lived in the United States, except as a lawful nonimmigrant, at any time between your 18th and 26th birthdays? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 22. C. If you answered “Yes” to Item Number 22.b., provide information about your registration. Enter Date Registered. Enter date as Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 22. B. If you answered “Yes” to Item Number 22.b., provide information about your registration. Enter Selective Service Number | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 22. B. If you answered “Yes,” to Item Number 22.a., did you register for the Selective Service? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 22. B. If you answered “Yes,” to Item Number 22.a., did you register for the Selective Service? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 19. Have you EVER lied to any U.S. Government officials to gain entry or admission into the United States or to gain immigration benefits while in the United States? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 19. Have you EVER lied to any U.S. Government officials to gain entry or admission into the United States or to gain immigration benefits while in the United States? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 18. Have you EVER given any U.S. Government officials any information or documentation that was false, fraudulent, or misleading? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to any of the questions in Item Numbers 17.a. - 19., provide an explanation in the space provided in Part 14. Additional Information. Submit evidence to support your answers. Have you EVER: 18. Have you EVER given any U.S. Government officials any information or documentation that was false, fraudulent, or misleading? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 23. Have you EVER left the United States to avoid being drafted in the U.S. armed forces? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 23. Have you EVER left the United States to avoid being drafted in the U.S. armed forces? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 24. Have you EVER applied for any kind of exemption from military service in the U.S. armed forces? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 24. Have you EVER applied for any kind of exemption from military service in the U.S. armed forces? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 25. Have you EVER served in the U.S. armed forces? Select No. If you answered “No” to Item Number 25., go to Item Number 30.a | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 25. Have you EVER served in the U.S. armed forces? Select Yes | CheckBox | |
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| Page 13. Alien Registration Number (A. Number). No Entry | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 26. A. Are you currently a member of the U.S. armed forces? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 26. A. Are you currently a member of the U.S. armed forces? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 26. B. If you answered “Yes” to Item Number 26.a., are you scheduled to deploy outside the United States, including to a vessel, within the next 3 months? (Call the Military Help Line at 877-247-4645 if you transfer to a new duty station after you file your Form N-400, including if you are deployed outside the United States or to a vessel.) Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 26. B. If you answered “Yes” to Item Number 26.a., are you scheduled to deploy outside the United States, including to a vessel, within the next 3 months? (Call the Military Help Line at 877-247-4645 if you transfer to a new duty station after you file your Form N-400, including if you are deployed outside the United States or to a vessel.) Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 26. C. If you answered “Yes,” to Item Number 26.a., are you currently stationed outside the United States? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 26. C. If you answered “Yes,” to Item Number 26.a., are you currently stationed outside the United States? Select Yes | CheckBox | |
| Part 12. Additional Information About You (Person Applying for Naturalization). Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a typed or printed explanation on additional sheets of paper and provide any evidence to support your answers. 38. C. If you answered "Yes," are you currently stationed overseas? Select No | CheckBox | |
| Part 12. Additional Information About You (Person Applying for Naturalization). Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a typed or printed explanation on additional sheets of paper and provide any evidence to support your answers. 38. C. If you answered "Yes," are you currently stationed overseas? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 27. Have you EVER been court-martialed or have you received a discharge characterized as other than honorable, bad conduct, or dishonorable, while in the U.S. armed forces? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 27. Have you EVER been court-martialed or have you received a discharge characterized as other than honorable, bad conduct, or dishonorable, while in the U.S. armed forces? SelecNo | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 28. Have you EVER been discharged from training or service in the U.S. armed forces because you were an alien? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 28. Have you EVER been discharged from training or service in the U.S. armed forces because you were an alien? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 29. Have you EVER deserted from the U.S. armed forces? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 29. Have you EVER deserted from the U.S. armed forces? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 30. A. Do you now have, or did you EVER have, a hereditary title or an order of nobility in any foreign country? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 30. A. Do you now have, or did you EVER have, a hereditary title or an order of nobility in any foreign country? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 30. B. If you answered “Yes,” to Item Number 30.a., are you willing to give up any inherited titles or orders of nobility that you have in a foreign country at your naturalization ceremony? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 30. B. If you answered “Yes,” to Item Number 30.a., are you willing to give up any inherited titles or orders of nobility that you have in a foreign country at your naturalization ceremony? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 31. Do you support the Constitution and form of Government of the United States? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 32. Do you understand the full Oath of Allegiance to the United States (see Part 15. Oath of Allegiance)? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 32. Do you understand the full Oath of Allegiance to the United States (see Part 15. Oath of Allegiance)? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 31. Do you support the Constitution and form of Government of the United States? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 35. If the law requires it, are you willing to bear arms on behalf of the United States? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 36. If the law requires it, are you willing to perform noncombatant services in the U.S. armed forces? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 36. If the law requires it, are you willing to perform noncombatant services in the U.S. armed forces? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 35. If the law requires it, are you willing to bear arms on behalf of the United States? Select No | CheckBox | |
| Part 12. Additional Information About You (Person Applying for Naturalization). Answer Item Numbers 45. through 50. If you answer ''No'' to any of these questions, include a typed or printed explanation on additional sheets of paper and provide any evidence to support your answers. 47. Are you willing to take the full Oath of Allegiance to the United States? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 34. Are you willing to take the full Oath of Allegiance to the United States? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 37. If the law requires it, are you willing to perform work of national importance under civilian direction? Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 37. If the law requires it, are you willing to perform work of national importance under civilian direction? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 33. Are you unable to take the Oath of Allegiance because of a physical or developmental disability or mental impairment? If you answer “Yes,” skip Item Numbers 34. - 37. and see the Legal Guardian, Surrogate, or Designated Representative section in the Instructions. Select Yes | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 33. Are you unable to take the Oath of Allegiance because of a physical or developmental disability or mental impairment? If you answer “Yes,” skip Item Numbers 34. - 37. and see the Legal Guardian, Surrogate, or Designated Representative section in the Instructions. Select No | CheckBox | |
| Part 10. Applicant's Contact Information, Certification, and Signature. Applicant's Contact Information. 1. Enter Applicant's Daytime Telephone Number | Text | |
| PDF417BarCode1 | Text | |
| Page 14. Alien Registration Number (A. Number). No Entry | Text | |
| Part 10. Applicant's Contact Information, Certification, and Signature. Applicant's Certification and Signature. 4. Enter Applicant's Signature (or signature of a legal guardian, surrogate, or designated representative, if applicable). This form can not be signed electronically. The name of the applicant can not be typewritten into this space. If the applicant is a minor child, the parent must sign the Son or Daughter’s Name in this space. This form will be rejected without a signature in this space | Text | |
| Part 10. Applicant's Contact Information, Certification, and Signature. Applicant's Certification and Signature. 4. Enter Date of Signature. Enter date as Enter as 2-digit Month, 2-digit Day, and 4-digit | Text | |
| Part 10. Applicant's Contact Information, Certification, and Signature. Applicant's Contact Information. 3. Enter Applicant's Email Address (if any) | Text | |
| Part 10. Applicant's Contact Information, Certification, and Signature. Applicant's Contact Information. 1. Enter Applicant's Daytime Telephone Number | Text | |
| Part 10. Applicant's Contact Information, Certification, and Signature. Applicant's Contact Information. 2. Enter Applicant's Mobile Telephone Number (if any) | Text | |
| Part 8. Information About Your Children. 1. Indicate your total number of children. Enter Total Number of Children | Text | |
| Part 8. Information About Your Children. 1. Indicate your total number of children. Enter Total Number of Children | Text | |
| Part 8. Information About Your Children. 1. Indicate your total number of children. Enter Total Number of Children | Text | |
| Part 7. Information About Your Marital History. Your Current Marriage. 4. D. Is your current spouse's present physical address the same as your physical address? Select No. (If you answered “No,” provide address in Part 14. Additional Information.) | CheckBox | |
| Part 7. Information About Your Marital History. Your Current Marriage. 4.D. Is your current spouse's present physical address the same as your physical address? Select Yes | CheckBox | |
| Part 8. Information About Your Children. 1. Indicate your total number of children. Enter Total Number of Children | Text | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 31. Do you support the Constitution and form of Government of the United States? Select No | CheckBox | |
| Part 9. Additional Information About You. If you answer “Yes” to Item Numbers 20. - 21. below, provide an explanation in the space provided in Part 14. Additional Information and provide any evidence to support your answers. 31. Do you support the Constitution and form of Government of the United States? Select No | CheckBox | |
| PDF417BarCode1 | Text | |
| Page 15. Alien Registration Number (A. Number). No Entry | Text | |
| Part 11. Additional Information.. Interpreter's Contact Information, Certification, and Signature. Provide the following information about the interpreter. 2. Enter Interpreter's Business or Organization Name, if any | Text | |
| Part 11. Additional Information.. Interpreter's Contact Information, Certification, and Signature. Provide the following information about the interpreter. Interpreter's Full Name. 1. Enter Interpreter's Given Name (First Name) | Text | |
| Part 11. Additional Information.. Interpreter's Contact Information, Certification, and Signature. Provide the following information about the interpreter. Interpreter's Full Name. 1. Enter Interpreter's Family Name (Last Name) | Text | |
| Part 11. Additional Information.. Interpreter's Contact Information, Certification, and Signature. Interpreter's Contact Information. 5. Enter Interpreter's Email Address, if any | Text | |
| Part 11. Additional Information.. Interpreter's Contact Information, Certification, and Signature. Interpreter's Contact Information. 3. Enter Interpreter's Daytime Telephone Number | Text | |
| Part 11. Additional Information.. Interpreter's Contact Information, Certification, and Signature. Interpreter's Contact Information. 4. Enter Interpreter's Mobile Telephone Number, if any | Text | |
| Part 14. Additional Information.. Interpreter's Contact Information, Certification, and Signature. Interpreter's Certification and Signature. I certify, under penalty of perjury, that I am fluent in English and I have interpreted every question on the application and Instructions and interpreted the applicant's answers to the questions in that language, and the applicant informed me that he or she understood every instruction, question, and answer on the application. Enter Language in which you are fluent | Text | |
| Part 14. Additional Information.. Interpreter's Contact Information, Certification, and Signature. Interpreter's Certification and Signature. 6. Enter Date of Signature. Enter date as Enter as 2-digit Month, 2-digit Day, and 4-digit | Text | |
| Part 14. Additional Information.. Interpreter's Contact Information, Certification, and Signature. Interpreter's Certification and Signature. 6. Enter Interpreter's Signature. This form can not be signed electronically. The name of the applicant can not be typewritten into this space. If the applicant is a minor child, the parent must sign the Son or Daughter’s Name in this space. This form will be rejected without a signature in this space | Text | |
| Part 12. Contact Information, Declaration, and Signature of the Person Preparing This Application, if Other Than the Applicant. Provide the following information about the preparer. Preparer's Full Name. 1. Enter Preparer's Given Name (First Name) | Text | |
| Part 12. Contact Information, Declaration, and Signature of the Person Preparing This Application, if Other Than the Applicant. Provide the following information about the preparer. Preparer's Full Name. 1. Enter Preparer's Family Name (Last Name) | Text | |
| Part 12. Contact Information, Declaration, and Signature of the Person Preparing This Application, if Other Than the Applicant. Provide the following information about the preparer. 2. Enter Preparer's Business or Organization Name, if any | Text | |
| Part 12. Contact Information, Declaration, and Signature of the Person Preparing This Application, if Other Than the Applicant. Preparer's Contact Information. 5. Enter Preparer's Email Address, if any | Text | |
| Part 12. Contact Information, Declaration, and Signature of the Person Preparing This Application, if Other Than the Applicant. Preparer's Contact Information. 3. Enter Preparer's Daytime Telephone Number | Text | |
| Part 12. Contact Information, Declaration, and Signature of the Person Preparing This Application, if Other Than the Applicant. Preparer's Contact Information. 4. Enter Preparer's Mobile Telephone Number, if any | Text | |
| Part 12. Contact Information, Declaration, and Signature of the Person Preparing This Application, if Other Than the Applicant. Preparer's Signature. 6. Enter Date of Signature. Enter as 2 digit month, 2 digit day and 4 digit year | Text | |
| Part 12. Applicant's Statement, Certification, and Signature. Applicant's Signature. 6. Applicant's Signature. This form can not be signed electronically. The name of the applicant can not be typewritten into this space. If the applicant is a minor child, the parent must sign the Son or Daughter’s Name in this space. This form will be rejected without a signature in this space | Text | |
| PDF417BarCode1 | Text | |
| Alien Registration Number (A. Number). This is a read only field. This field is pre-populated from Page 1 | Text | |
| Part 14. Additional Information. 5. Enter Additional Information | Text | |
| Part 14. Additional Information. 6. Enter Page Number | Text | |
| Part 14. Additional Information. 6. Enter Part Number | Text | |
| Part 14. Additional Information. 6. Enter Item Number | Text | |
| Part 14. Additional Information. 6. Enter Additional Information | Text | |
| Part 14. Additional Information. 5.Enter Item Number | Text | |
| Part 14. Additional Information. 5. Enter Part Number | Text | |
| Part 14. Additional Information. 5. Enter Page Number | Text | |
| Part 14. Additional Information. 3. Enter Page Number | Text | |
| Part 14. Additional Information. 3. Enter Part Number | Text | |
| Part 14. Additional Information. 3.Enter Item Number | Text | |
| Part 14. Additional Information. 3. Enter Additional Information | Text | |
| Part 14. Additional Information. No Entry. 1. Family Name (Last Name). This is a read only field. This field pre-populated from page 1 | Text | |
| Part 14. Additional Information.., No Entry. 1. Given Name (First Name). This is a read only field. This field pre-populated from page 1 | Text | |
| Part 14. Additional Information.., No Entry. 1. Middle Name. This is a read only field. This field pre-populated from page 1 | Text | |
| Part 14. Additional Information. 4. Enter Page Number | Text | |
| Part 14. Additional Information. 4. Enter Part Number | Text | |
| Part 14. Additional Information. 4. Enter Item Number | Text | |
| Part 14. Additional Information. 4. Enter Additional Information | Text | |
| PDF417BarCode1 | Text | |
| Page 20. Alien Registration Number (A. Number). No Entry | Text | |
| Part 15. Signature at Interview. Applicant's Signature. No Entry. Print and Sign completed form | Text | |
| Part 15. Signature at Interview. U S C I S Officer's Signature. No Entry. Print and Sign completed form | Text | |
| Part 15. Signature at Interview. Enter Date of Signature. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Part 15. Signature at Interview. Subscribed to and sworn to (affirmed) before me. Enter U S C I S Officer's Printed Name or Stamp. No Entry. Print and Sign completed form | Text | |
| Part 16. Oath of Allegiance. Applicant's Signature. No Entry. Print and Sign completed form | Text | |
| Part 16. Oath of Allegiance. Enter Date of Signature. Enter as 2-digit Month, 2-digit Day, and 4-digit Year | Text | |
| Name Change - Yes/No | ||
| 3. Would you like to legally change your name? — No (skip to Item Number 4.) | Checkbox |
Check this box if you do not want to legally change your name (you should skip to Item Number 4).
|
| 3. Would you like to legally change your name? — Yes | Checkbox |
Check this box if you want to legally change your name and will provide the new family, given, and middle names in the fields below.
|
| New Legal Name - Family/Given/Middle | ||
| Middle Name (if applicable) | Text |
Enter your new legal middle name exactly as you want it to appear; leave blank if you do not have or are not changing a middle name. Fill only if '3. Would you like to legally change your name? — Yes' is 'Yes'.
Depends on:
3. Would you like to legally change your name? — Yes
|
| Given Name (First Name) | Text |
Enter your new legal given (first) name exactly as you want it to appear on official records. Fill only if '3. Would you like to legally change your name? — Yes' is 'Yes'.
Depends on:
3. Would you like to legally change your name? — Yes
|
| Family Name (Last Name) | Text |
Enter your new legal family (last) name exactly as you want it to appear on official records. Fill only if '3. Would you like to legally change your name? — Yes' is 'Yes'.
Depends on:
3. Would you like to legally change your name? — Yes
|
| Parent U.S. Citizen Before 18 | ||
| Parent U.S. Citizen Before 18 - No | Checkbox |
Check this box if your mother or father (including adoptive mother or father) was not a U.S. citizen before your 18th birthday.
|
| Parent U.S. Citizen Before 18 - Yes | Checkbox |
Check this box if your mother or father (including adoptive mother or father) was a U.S. citizen before your 18th birthday.
|
| Part 2 - Current Legal Name | ||
| Part 2 – Current Legal Name: Middle Name | Text |
Enter your current middle name as it appears on legal documents, or leave blank if you have no middle name.
|
| Part 2 – Current Legal Name: Given Name (First Name) | Text |
Enter your current given (first) name exactly as it appears on your legal documents; do not use a nickname.
|
| Part 2 – Current Legal Name: Family Name (Last Name) | Text |
Enter your current family name (last name or surname) exactly as it appears on your legal documents; do not provide a nickname.
|
| Part 2 - Other Names You Have Used - First Entry | ||
| Part 2 - First Entry: Middle Name (if applicable) | Text |
Enter the middle name you have used for this other name entry; leave blank if you have not used a middle name for this name.
|
| Part 2 - First Entry: Given Name (First Name) | Text |
Enter the first (given) name you have used for this other name entry exactly as it appears or appeared when you used this name.
|
| Part 2 - First Entry: Family Name (Last Name) | Text |
Enter the family or last name you have used for this other name entry exactly as it appears or appeared when you used this name.
|
| Part 2 - Other Names You Have Used - Second Entry | ||
| Second Other Middle Name | Text |
Enter the middle name you have used for the second alternate name entry, or leave blank if none.
|
| Second Other Given Name (First Name) | Text |
Enter the first name (given name) you have used other than your current legal first name for the second alternate name entry.
|
| Second Other Family Name (Last Name) | Text |
Enter the last name (family name) you have used other than your current legal last name for the second alternate name entry.
|
| Part 2 Header - Section/Page Number | ||
| Part 2 Section/Page Number | Text |
Enter the section or page number shown in the Part 2 header of the form (the small number that identifies this page or section).
|
| Physical/Developmental Disability (Exception) - Yes/No | ||
| Do you have a physical or developmental disability or mental impairment? - No | Checkbox |
Check this box if you do NOT have a physical or developmental disability or mental impairment that prevents you from demonstrating knowledge and understanding of the English language or civics requirements for naturalization.
|
| Do you have a physical or developmental disability or mental impairment? - Yes | Checkbox |
Check this box if you have a physical or developmental disability or mental impairment that prevents you from demonstrating knowledge and understanding of the English language or civics requirements for naturalization.
|
| Reason A - General Provision | ||
| A. General Provision | Checkbox |
Check this box if you are filing under Reason A (General Provision) because you meet the general eligibility requirements listed in the form instructions.
|
| Reason B - Spouse of U.S. Citizen | ||
| B. Spouse of U.S. Citizen | Checkbox |
Check this box if your basis for filing Form N-400 is that you are the spouse of a U.S. citizen and you meet the eligibility requirements based on marriage to a U.S. citizen.
|
| Reason C - VAWA | ||
| C. VAWA (Violence Against Women Act) | Checkbox |
Check this box if you are filing Form N-400 under Reason C because you are eligible as the spouse, former spouse, or child of a U.S. citizen under the Violence Against Women Act (VAWA).
|
| Reason D - Spouse of U.S. Citizen in Qualified Employment Outside the United States | ||
| D. Spouse of U.S. Citizen in Qualified Employment Outside the United States | Checkbox |
Check this box if you are filing under Reason D because you are the spouse of a U.S. citizen who is working for a qualified employer outside the United States and your residential address is outside the United States (see INA section 319(b)).
|
| D. Preferred USCIS Field Office | Combobox |
If you are filing under Reason D (spouse of a U.S. citizen in qualified employment outside the United States), enter the name or location of the USCIS field office where you would like to have your naturalization interview. Fill only if 'D. Spouse of U.S. Citizen in Qualified Employment Outside the United States' is 'Yes'.
Nevada - USCIS Reno Field Office
Virginia - USCIS Norfolk Field Office
Florida - USCIS Tampa Field Office
Florida - USCIS Hialeah Field Office
Georgia - USCIS Atlanta Field Office
Texas - USCIS Houston Field Office
California - USCIS San Bernardino Field Office
California - USCIS Sacramento Field Office
Florida - USCIS Orlando Field Office
Texas - USCIS El Paso Field Office
South Carolina - USCIS Charleston Field Office
New Jersey - USCIS Newark Field Office
Utah - USCIS Salt Lake City Field Office
Washington - USCIS Spokane Field Office
Tennessee - USCIS Nashville Field Office
Florida - USCIS Kendall Field Office
Wisconsin - USCIS Milwaukee Field Office
Vermont - USCIS Northeast Regional Office
Pennsylvania - USCIS Pittsburgh Field Office
Arkansas - USCIS Fort Smith Field Office
Florida - USCIS Southeast Region Office
Virginia - USCIS Potomac Service Center
Iowa - USCIS Des Moines Field Office
Missouri - USCIS Kansas City Field Office
Virgin Islands - USCIS Charlotte Amalie VI Field Office
Alaska - USCIS Anchorage Field Office
Washington - USCIS Seattle Field Office
Missouri - USCIS St Louis Field Office
California - USCIS San Jose Field Office
Pennsylvania - USCIS Philadelphia Field Office
Michigan - USCIS Detroit Field Office
Colorado - USCIS Denver Field Office
Missouri - USCIS National Benefits Center
Arizona - USCIS Phoenix Field Office
Florida - USCIS Miami Field Office
Hawaii - USCIS Honolulu Field Office
Guam - USCIS Guam Field Office
Illinois - USCIS Chicago Field Office
New York - USCIS Albany Field Office
Texas - USCIS Harlingen Field Office
New York - USCIS Queens Field Office
California - USCIS Imperial Field Office
Idaho - USCIS Boise Field Office
California - USCIS San Fernando Valley Field Office
Minnesota - USCIS St Paul Field Office
Louisiana - USCIS New Orleans Field Office
Maine - USCIS Portland Field Office
Massachusetts - USCIS Boston Field Office
Tennessee - USCIS Memphis Field Office
New York - USCIS Brooklyn Field Office
Florida - USCIS West Palm Beach Field Office
Nebraska - USCIS Omaha Field Office
New York - USCIS Buffalo Field Office
New Jersey - USCIS Mount Laurel Field Office
Texas - USCIS Central Region Office
Texas - USCIS Texas Service Center
Virginia - USCIS Washington Field Office
California - USCIS Los Angeles Field Office
New York - USCIS New York City District Office
North Carolina - USCIS Raleigh Field Office
Kentucky - USCIS Louisville Field Office
Vermont - USCIS Vermont Service Center
New Hampshire - USCIS Manchester Field Office
Rhode Island - USCIS Providence Field Office
Nevada - USCIS Las Vegas Field Office
Massachusetts - USCIS Lawrence Field Office
Ohio - USCIS Columbus Field Office
California - USCIS Santa Ana Field Office
Indiana - USCIS Indianapolis Field Office
California - USCIS San Francisco Field Office
Connecticut - USCIS Hartford Office
Florida - USCIS Fort Myers Field Office
Ohio - USCIS Cleveland Field Office
Montana - USCIS Helena Field Office
Oregon - USCIS Portland Field Office
Alabama - USCIS Montgomery Field Office
California - USCIS Los Angeles County Field Offi
Florida - USCIS Jacksonville Field Office
Maryland - USCIS Baltimore Field Office
Washington - USCIS Yakima Field Office
Texas - USCIS Dallas Field Office
Kansas - USCIS National Benefits Center
Kansas - USCIS Wichita Field Office
Florida - USCIS Oakland Park Field Office
New Mexico - USCIS Albuquerque Field Office
California - USCIS San Diego Field Office
Vermont - USCIS St Albans Field Office
South Carolina - USCIS Greer Field Office
North Carolina - USCIS Charlotte Field Office
New York - USCIS Long Island Field Office
California - USCIS Western Region Office
Ohio - USCIS Cincinnati Field Office
California - USCIS Fresno Field Office
New York - USCJS Syracuse Field Office
Arizona - USCIS Tuscon Field Office
Texas - USCIS San Antonio Field Office
Depends on:
D. Spouse of U.S. Citizen in Qualified Employment Outside the United States
|
| Reason E - Military Service During Period of Hostilities | ||
| E. Military Service During Period of Hostilities | Checkbox |
Check this box if you are claiming eligibility under Reason E because you served in the U.S. Armed Forces during a period of hostilities and are using that military service as the basis for your naturalization application.
|
| Reason F - At Least One Year of Honorable Military Service | ||
| F. At Least One Year of Honorable Military Service at Any Time | Checkbox |
Check this box if you have served at least one year of honorable military service at any time and are claiming eligibility for naturalization based on that service.
|
| Reason G - Other Reason for Filing Not Listed Above (specify) | ||
| Reason G - Other Reason for Filing (specify) | Text |
Enter a short, specific explanation of the other reason you are filing (the eligibility basis not listed above); provide enough detail to identify the provision, including any relevant dates or circumstances. Fill only if 'G. Other Reason for Filing Not Listed Above (specify)' is 'Yes'.
Depends on:
G. Other Reason for Filing Not Listed Above (specify)
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| G. Other Reason for Filing Not Listed Above (specify) | Checkbox |
Check this box when none of the other listed reasons (A–F) apply to your eligibility and you will specify the other reason in the space provided.
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| Sex | ||
| Male | Checkbox |
Check this box if you are male.
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| Female | Checkbox |
Check this box if you are female.
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| Social Security Number (12.b) | ||
| Social Security Number (12.b) | Text |
Enter your Social Security number (SSN) if you have one — provide the full nine-digit SSN (do not include spaces or dashes). Fill only if '12.a Yes (Complete Item Numbers 12.b - 12.c.)' is 'Yes'.
Depends on:
12.a Yes (Complete Item Numbers 12.b - 12.c.)
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| Social Security Update - Choice (12.a) | ||
| 12.a No (Go to Part 3.) | Checkbox |
Check this box if you do not want the Social Security Administration to issue or update a Social Security card and you will skip to Part 3.
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| 12.a Yes (Complete Item Numbers 12.b - 12.c.) | Checkbox |
Check this box if you want the Social Security Administration to issue you an original or replacement Social Security card and to update your immigration status with the SSA if and when you are naturalized.
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| USCIS Online Account Number | ||
| USCIS Online Account Number (Item 4) | Text |
Enter your USCIS Online Account Number if you have one; leave this field blank if you do not have an account number.
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