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pdfN-445, Notice of Naturalization Oath Ceremony
Department of Homeland Security
U.S. Citizenship and Immigration Services
A-Number
USCIS
Form N-445
OMB No. 1615-0054
Expires 06/30/2019
Date
Sworn Statement
► A-
For
Other
USCIS
Use
Only FCO:
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07/06/2016
United States Citizenship and Immigration Services (USCIS) thanks you for your interest in becoming a United States citizen. You
must now appear at a Naturalization Oath Ceremony to complete the naturalization process.
You are scheduled to appear for a Naturalization Oath Ceremony on:
Date and Time:
Location:
Please bring the following with you:
• This notice with the reverse side completed. Please refer to instructions on the reverse side.
• Your Permanent Resident Card (“green card”).
• All Reentry Permits or Refugee Travel Documents you may have, valid or expired.
• Any other documents USCIS issued to you.
The naturalization ceremony is a solemn and meaningful event. USCIS asks that you dress in proper attire to respect the dignity of
this event.
If you cannot come to this ceremony, return this notice immediately with a written explanation on why you cannot attend. You will
then receive an appointment for a ceremony at a later date.
If you require an accommodation, such as a sign language interpreter, please contact the USCIS National Customer Service Center at
1-800-375-5283, at least 10 days prior to your scheduled ceremony.
Please answer the questionnaire on the reverse side of this notice on the day of your scheduled ceremony. Print clearly in black ink.
Please read the instructions before answering the questions, which concern events that may have occurred since your interview.
If you answer "YES" to any of the questions, bring documents to support your answers. For example, if you married or divorced after
your interview, bring your marriage certificate or divorce decree. If you were arrested after your interview, bring your arrest records
and court dispositions. If you were serving in the military and have been discharged, bring your DD214 or other discharge papers.
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INSTRUCTIONS: You MUST bring this completed questionnaire with you to the Naturalization Oath Ceremony, along with
the documents listed on the front side of this notice. You are required to give these items to an employee of USCIS at the oath
ceremony.
Answer the following questions on the day of your Naturalization Oath Ceremony. Please note that these questions do not refer to any
events that happened before your naturalization interview. These questions refer to the time period after your interview at the USCIS
office. For example, if you were married at the time of your interview and there has been no change in your marital status since your
interview, select "NO" to Item Number 1 below. If you traveled outside the United States after your interview, select "YES" to
Item Number 2 below.
After you have answered each question, print the date and the location (city and state) where you completed the questionnaire. Also,
sign the questionnaire and print your current address.
1.
Since your interview, have you married, or been widowed, separated or divorced?
Yes
2.
Since your interview, have you traveled outside the United States?
Yes
No
3.
Since your interview, have you knowingly committed any crime or offense, for which you have not
been arrested?
Yes
No
4.
Since your interview, have you been arrested, cited, charged, indicted, convicted, fined, or
imprisoned for breaking or violating any law or ordinance, including traffic violations?
Yes
No
5.
Since your interview, have you joined, become associated, or connected with any organization in any
way, including the Communist Party, a totalitarian organization, or terrorist group?
Yes
No
6.
Since your interview, have you deserted from, claimed exemption from, or been separated or
discharged from military service?
Yes
No
7.
Since your interview, has there been any change in your willingness to bear arms on behalf of the
United States; to perform non-combatant service in the armed forces of the United States; or to
perform work of national importance under civilian direction if the law requires it?
Yes
No
8.
Since your interview, have you practiced polygamy, received income from illegal gambling, been
involved in prostitution, helped anyone enter the United States illegally, trafficked controlled
substances, given false testimony to obtain immigration benefits, or been a habitual drunkard?
Yes
No
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I certify that each answer shown above was made by me or at my direction, and that each answer is true and correct as of the date of
my Naturalization Oath Ceremony.
Signed at
on
City and State
Signature
Date
Full Address and ZIP Code
Street Number and Name
Apt. Ste. Flr. Number
City or Town
State
Form N-445 06/21/16 N
ZIP Code
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USCIS Privacy Act Statement
AUTHORITIES: The information requested on this form, and the associated evidence, is collected pursuant to Sections 101(f),
313, 316, 332, 334, 335 and 336 of the Immigration and Nationality Act (8 U.S.C. sections 1101 (f), 1424, 1427, 1443, 1445, 1446
and 1447).
PURPOSE: The primary purpose for providing the requested information on this form is to determine if you have maintained good
moral character and other continued eligibility for naturalization from the date of your last interview until the naturalization ceremony.
DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and any
requested evidence, may delay the date of your naturalization ceremony or result in denial of your request for naturalization.
ROUTINE USES: The information you provide on this form may be shared with other federal, state, local, and foreign government
agencies and authorized organizations in accordance with approved routine uses, as described in the associated published system of
records notices [DHS/USCIS-001 - Alien File, Index, and National File Tracking System of Records] which can be found at
www.dhs.gov/privacy. The information may also be made available, as appropriate for law enforcement purposes or in the interest
of national security.
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Reproduction
07/06/2016
Paperwork Reduction Act
The public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including
suggestions for reducing this burden to: U.S. Citizenship and Immigration Services, Regulatory Coordination Division, Office of
Policy and Strategy, 20 Massachusetts Avenue, NW, Washington, DC 20529-2140; OMB No 1615-0054. Do not mail your
completed Form N-445 to this address.
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File Type | application/pdf |
Author | USCIS |
File Modified | 2016-07-06 |
File Created | 2016-06-22 |