Form N-600 Application for Certificate of Citizenship

Application for Certificate of Citizenship

USCIS
Form N-600

Department of Homeland Security
U.S. Citizenship and Immigration Services
Receipt

Date Stamp

For
USCIS
Use
Only

OMB No. 1615-0057
Expires 08/31/2024
Action Block

DRAFT
NOT FOR
PRODUCTION
10/20/2022

Remarks

To be completed by an
Attorney or Accredited
Representative (if any).

Select this box if
Form G-28.

Attorney State Bar Number
(if applicable)

Attorney or Accredited Representative
USCIS Online Account Number (if any)

NOTE: You are not required to obtain evidence of your U.S. citizenship. If you want evidence of your U.S. citizenship you may
submit Form N-600 to obtain a Certificate of Citizenship from USCIS, or you may apply for a U.S. passport with the Department of
State. See travel.state.gov for more information.
► START HERE - Type or print in black ink.

Enter Your 9 Digit A-Number:
► A-

Part 1. Information About Your Eligibility
1.

I am a:

child of a U.S. citizen filing for a Certificate of Citizenship for myself.

U.S. citizen parent or legal guardian filing for a Certificate of Citizenship on behalf of a child.

For Item Number 2., provide information about yourself if you are an applicant applying for the Certificate of Citizenship. Provide
information about your child if you are a U.S. citizen parent or legal guardian applying for a Certificate of Citizenship for your
minor child.
2.

What is your relationship to your U.S. citizen parent? (Read the N-600 Instructions for more information.)
The biological child of a U.S. citizen parent. (If the U.S. citizen parent is your biological father, you will generally have to
establish that you were born in wedlock or legitimated.)
The adopted child of a U.S. citizen parent.
The child of a non-genetic gestational U.S. citizen parent (person who carried and gave birth to the child) who is also your
legal parent.
The child of a U.S. citizen parent who was married to your genetic or gestational parent at the time of your birth (even if no
genetic or gestational relationship exists with the U.S. citizen parent) and both of your parents are also your legal parents.
Other (Explain fully):
NOTE: If you need extra space to complete this section, use the space provided in Part 11. Additional Information.

Part 2. Information About You (Child of a U.S. Citizen)
Provide information about yourself if you are an applicant applying for the Certificate of Citizenship. Provide information about
your child if you are a U.S. citizen parent or legal guardian applying for a Certificate of Citizenship for your minor child.
1.

Current Legal Name (do not provide a nickname)
Family Name (Last Name)

Form N-600 Edition 08/10/22

Given Name (First Name)

Middle Name

Page 1 of 16

Part 2. Information About You (Child of a U.S. Citizen) (continued)
2.

Your Name Exactly As It Appears on Your Permanent Resident Card (if different from above)
Family Name (Last Name)

3.

Given Name (First Name)

Middle Name

DRAFT
NOT FOR
PRODUCTION
10/20/2022

Other Names You Have Used Since Birth
Provide all other names you have ever used, include nicknames, maiden name, and aliases.
Family Name (Last Name)

4.

A-

Given Name (First Name)

U.S. Social Security Number (if any)

5.

Middle Name

USCIS Online Account Number (if any)
►

►
6.

Date of Birth (mm/dd/yyyy)

7.

8.

Country of Prior Citizenship or Nationality

Country of Birth

9.

Gender

Male

10.

Height Feet

11.

Current Mailing Address

Female

Inches

(USPS ZIP Code Lookup)

In Care Of Name (if any)

Street Number and Name

Apt. Ste. Flr.

City or Town

State

ZIP Code

Postal Code (foreign address only) Country (foreign address only)

Province (foreign address only)

12.

Number

Current Physical Address (if different from the address above)
Street Number and Name (Do not provide a PO Box in this space unless it is your ONLY address.) Apt. Ste. Flr. Number

City or Town

State

Province (foreign address only)

13.

ZIP Code

Postal Code (foreign address only) Country (foreign address only)

Current Marital Status
Single, Never Married

Married

Divorced

Widowed

Separated

Marriage Annulled

Other
14.

U.S. Armed Forces
Are you a member or veteran of any branch of the U.S. Armed Forces?
Yes

No

Form N-600 Edition 08/10/22

Page 2 of 16

Part 2. Information About You (Child of a U.S. Citizen) (continued)
15.

A-

Information About Your Admission into the United States and Immigration Status
A. I arrived in the following manner:

DRAFT
NOT FOR
PRODUCTION
10/20/2022

Port-of-Entry

Date of Entry (mm/dd/yyyy)

Exact Name Used at Time of Entry
Family Name (Last Name)

Given Name (First Name)

Middle Name

B. I used the following travel document to be admitted to the United States
Passport

Travel Document

Passport Number

Travel Document Number

Country of Issuance for Passport or Travel Document

Date Passport or Travel Document Issued
(mm/dd/yyyy)

C. Have you ever been a lawful permanent resident (LPR)?
Yes (Answer Item D. and Item Number 16.)

No (Go to Item Number 17.)

D. I obtained LPR status through adjustment of status in the United States or admission as a LPR (if applicable).
Date I became a LPR
(mm/dd/yyyy)

16.

U.S. Citizenship and Immigration Services (USCIS) Office That Granted my LPR Status
or Location Where I Was Admitted

Have you ever abandoned or lost your LPR status?
Yes

No

If you answered "Yes" to Item Number 16., provide an explanation below. If you need extra space to complete this section,
use the space provided in Part 11. Additional Information.

17.

Have you previously applied for a Certificate of Citizenship?
Yes

No

If you answered "Yes" to Item Number 17., provide an explanation below. If you need extra space to complete your
explanation, use the space provided in Part 11. Additional Information.

18.

Have you previously applied for a U.S. Passport?
Yes

No

If you answered "Yes" to Item Number 18., provide an explanation below. If you need extra space to complete your
explanation, use the space provided in Part 11. Additional Information.

19.

Do you regularly reside in the legal and physical custody of your U.S. citizen parent(s), or, if over 18 years of age, did you
regularly reside in the legal and physical custody of your U.S. citizen parent(s) before turning 18 years of age?
Yes

No

Form N-600 Edition 08/10/22

Page 3 of 16

Part 2. Information About You (Child of a U.S. Citizen) (continued)
20.

A-

Were you adopted?
Yes

No

DRAFT
NOT FOR
PRODUCTION
10/20/2022

If you answered “Yes” to Item Number 20., complete Item Numbers 20.A. - 20.E. If you answered “No,” go to Item
Number 23.
A. Place of Adoption
City or Town

State

Country

B. Date of Adoption
(mm/dd/yyyy)

C. Date Legal Custody Began
(mm/dd/yyyy)

D. Date Physical Custody Began
(mm/dd/yyyy)

E. Was this adoption considered a full, final, and complete adoption?
Yes

No

If you answered “Yes” to Item Number 20.E. proceed to Item Number 21. If you answered “No” to Item Number 20.E.,
complete Item Number 22.
21.

Did your state of residence recognize your foreign adoption decree as full and final under that state's adoption laws?
Yes (Go to Part 3.)

22.

No (Answer Item Numbers 22.A. - 22.D., then go to Part 3.)

Information About Re-Adoption
A. Place of Re-Adoption
City or Town

B. Date of Final Adoption
(mm/dd/yyyy)

State

Country

C. Date Legal Custody Began
(mm/dd/yyyy)

D. Date Physical Custody Began
(mm/dd/yyyy)

If you are not adopted, answer Item Numbers 23. and 24.
23.

Were your parents married to each other when you were born?
Yes

24.

No

Did your parents marry after you were born?
Yes

No

Answer Item Number 25. only if you are claiming U.S. citizenship at the time of birth and you were born before October 10, 1952.
Go to Part 3. if this does not apply to you. If you need extra space to complete this section, use the space provided in Part 11.
Additional Information.
25.

Have you been absent from the United States since you first arrived?
Yes (Answer Item Numbers 25.A. - 25.F.)

No (Go to Part 3.)

Complete the following information only if you are claiming U.S. citizenship at the time of birth if you were born before
October 10, 1952. If you need extra space to complete this section, use the space provided in Part 11. Additional Information.
A. Date You Left the United States
(mm/dd/yyyy)

Form N-600 Edition 08/10/22

B. Date You Returned to the
United States (mm/dd/yyyy)

Page 4 of 16

Part 2. Information About You (Child of a U.S. Citizen) (continued)

A-

C. Place of Entry Upon Return to the United States
City or Town

State

DRAFT
NOT FOR
PRODUCTION
10/20/2022

D. Date You Left the United States
(mm/dd/yyyy)

E. Date You Returned to the
United States (mm/dd/yyyy)

F. Place of Entry Upon Return to the United States
City or Town

State

Part 3. Information About Your U.S. Citizen Parent

NOTE: Provide information about your U.S. citizen parent. Provide information about yourself if you are a U.S. citizen parent
applying for a Certificate of Citizenship on behalf of your minor child.
1.

Current Legal Name of a U.S. Citizen Parent
Family Name (Last Name)

2.

Date of Birth (mm/dd/yyyy)

4.

Country of Birth

5.

Current Physical Address

Given Name (First Name)

3.

Middle Name

This Parent is My:
Mother
Father

Street Number and Name (Type or print “Deceased” and the date of death if applicable.)

City or Town

State

ZIP Code

Postal Code (foreign address only) Country (foreign address only)

Province (foreign address only)

6.

Apt. Ste. Flr. Number

My parent is a U.S. citizen by
Birth in the United States

Acquisition after birth through naturalization of parent(s)

Certificate of Citizenship Number (if any)

Alien Registration (A-Number) (if any)
► A-

Birth abroad to U.S. citizen parent(s)
Certificate of Citizenship Number (if any)

Alien Registration (A-Number) (if any)
► A-

Naturalization
Place of Naturalization (Name of Court or USCIS Office Location)

Form N-600 Edition 08/10/22

Page 5 of 16

Part 3. Information About Your U.S. Citizen Parent (continued)
City or Town

A-

State

DRAFT
NOT FOR
PRODUCTION
10/20/2022

Certificate of Naturalization Number

A-Number

Date of Naturalization (mm/dd/yyyy)

► A-

7.

Has your parent ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship?
Yes

No

If you answered “Yes” to Item Number 7., provide an explanation in Part 11. Additional Information.
8.

Marital History

A. How many times has your U.S. citizen parent been married (including annulled marriages and marriages to the same
person)?
►

B. What is your U.S. citizen parent's current marital status?
Single, Never Married

Married

Divorced

Widowed

Separated

Marriage Annulled

Other

If you selected "Other," provide an explanation. If you need extra space to complete this section, use the space provided in
Part 11. Additional Information.
9.

If your U.S. citizen parent is married, is their current spouse also your other parent?
Yes (Go to Part 4.)

10.

No (Answer Item Numbers 10.A. - 10.H.)

Information About U.S. Citizen Parent's Current Spouse
A. Family Name (Last Name)

Given Name (First Name)

Middle Name

B. Date of Birth (mm/dd/yyyy)
C. Country of Birth

D. Country of Citizenship or Nationality

E. Spouse's Current Physical Address
Street Number and Name

Apt. Ste. Flr. Number

City or Town

Province
(foreign address only)

State

Postal Code
(foreign address only)

ZIP Code

Country
(foreign address only)

F. Date of Marriage (mm/dd/yyyy)

G. Place of Marriage
City or Town

Form N-600 Edition 08/10/22

State

Country

Page 6 of 16

Part 3. Information About Your U.S. Citizen Parent (continued)

A-

H. Spouse's Immigration Status
U.S. Citizen

Lawful Permanent Resident

DRAFT
NOT FOR
PRODUCTION
10/20/2022

Other (Explain):

If you selected "Other," provide an explanation. If you need extra space to complete this section, use the space provided in
Part 11. Additional Information.

Part 4. Information About Your Other Parent
1.

Current Legal Name of Other Parent
Family Name (Last Name)

2.

Date of Birth (mm/dd/yyyy)

4.

Country of Birth

6.

Current Physical Address

Given Name (First Name)

3.

Middle Name

This Parent is My:
Mother
Father
5.

Country of Citizenship or Nationality

Street Number and Name (Type or print “Deceased” and the date of death if applicable.)

City or Town

State

Province (foreign address only)

7.

ZIP Code

Postal Code (foreign address only) Country (foreign address only)

Is your other parent a U.S. citizen?
Yes (Go to Item Number 8.)

8.

Apt. Ste. Flr. Number

No (Go to Item Number 9.)

My other parent is a U.S. citizen by
Birth in the United States

Acquisition after birth through naturalization of parent(s)

Certificate of Citizenship Number (if any) Alien Registration (A-Number) (if any)
► ABirth abroad to U.S. citizen parent(s)
Certificate of Citizenship Number (if any) Alien Registration (A-Number) (if any)
► ANaturalization
Place of Naturalization (Name of Court or USCIS Office Location)

City or Town

Certificate of Naturalization Number

State

Alien Registration (A-Number)

Date of Naturalization (mm/dd/yyyy)

► A-

Form N-600 Edition 08/10/22

Page 7 of 16

Part 4. Information About Your Other Parent (continued)
9.

A-

Has your other parent ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship?
Yes

No

DRAFT
NOT FOR
PRODUCTION
10/20/2022

If you answered “Yes” to Item Number 9., provide an explanation in Part 11. Additional Information.
10.

Marital History

A. How many times has your other parent been married (including annulled marriages and marriages to the same person)?
►

B. What is your other parent's current marital status?
Single, Never Married

Married

Divorced

Widowed

Separated

Marriage Annulled

Other

If you selected “Other,” provide an explanation. If you need extra space to complete this section, use the space provided in
Part 11. Additional Information.
11.

If your parent identified in Part 4. is married, is their current spouse your parent identified in Part 3.?
Yes (Go to Part 5.)

12.

No (Answer Item Numbers 12.A. - 12.H.)

Information About Other Parent's Current Spouse
A. Family Name (Last Name)

Given Name (First Name)

Middle Name

B. Date of Birth (mm/dd/yyyy)
C. Country of Birth

D. Country of Citizenship or Nationality

E. Spouse's Current Physical Address
Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

Province
(foreign address only)

Postal Code
(foreign address only)

ZIP Code

Country
(foreign address only)

F. Date of Marriage (mm/dd/yyyy)
G. Place of Marriage
City or Town

State

Country

H. Spouse's Immigration Status
U.S. Citizen

Lawful Permanent Resident

Other
If you selected “Other,” provide an explanation. If you need extra space to complete this section, use the space provided in
Part 11. Additional Information.

Form N-600 Edition 08/10/22

Page 8 of 16

Part 5. Information About a Legal Guardian Applying on Behalf of a Child

A-

Complete this section if you are a legal guardian applying on behalf of a minor child.
1.

Current Legal Name of Legal Guardian

DRAFT
NOT FOR
PRODUCTION
10/20/2022

Family Name (Last Name)

2.

Date of Birth (mm/dd/yyyy)

3.

Current Physical Address

Given Name (First Name)

Middle Name

Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

ZIP Code

Postal Code (foreign address only) Country (foreign address only)

Province (foreign address only)

Part 6. Physical Presence in the United States From U.S. Citizen Parent's Birth Until Child's Birth
NOTE: Only applicants born outside the United States claiming to have been born U.S. citizens are required to provide all the dates
when their U.S. citizen parent was physically present in the United States. Include all dates from the U.S. citizen parent's birth
until the child's birth.
1.

Indicate to which U.S. citizen parent this information relates
U.S. Citizen Parent Identified in Part 3.
U.S. Citizen Parent Identified in Part 4.

2.

Physical Presence in the United States
A. From (mm/dd/yyyy)

To (mm/dd/yyyy)

B. From (mm/dd/yyyy)

To (mm/dd/yyyy)

C. From (mm/dd/yyyy)

To (mm/dd/yyyy)

D. From (mm/dd/yyyy)

To (mm/dd/yyyy)

E. From (mm/dd/yyyy)

To (mm/dd/yyyy)

F. From (mm/dd/yyyy)

To (mm/dd/yyyy)

G. From (mm/dd/yyyy)

To (mm/dd/yyyy)

H. From (mm/dd/yyyy)

To (mm/dd/yyyy)

Part 7. Information About Military Service of U. S. Citizen Parents
NOTE: Complete this only if you are an applicant claiming U.S. citizenship at time of birth abroad.
1.

Has your U.S. citizen parent served in the U.S. Armed Forces?
Yes

No

If both of your parents are U.S. citizens and have both served in the U.S. Armed Forces, provide information about the other
parent's service in Part 11. Additional Information.
2.

If you answered “Yes” to Item Number 1., provide the name of your parent who served in the U.S. Armed Forces.

Form N-600 Edition 08/10/22

Page 9 of 16

Part 7. Information About Military Service of U. S. Citizen Parents
(continued)
3.

Dates of Service (mm/dd/yyyy) (If time of service fulfills any of the required physical presence, submit evidence of the service.)
A. From (mm/dd/yyyy)

4.

A-

To (mm/dd/yyyy)

B. From (mm/dd/yyyy)

To (mm/dd/yyyy)

DRAFT
NOT FOR
PRODUCTION
10/20/2022

Type of Military Service
Honorable

Other than Honorable

Dishonorable

Other (Explain):

Part 8. Applicant's, Parent's, or Legal Guardian's Statement, Contact Information, Certification, and
Signature
NOTE: Read the Penalties section of the Form N-600 Instructions before completing this section.

Applicant's, Parent's, or Legal Guardian's Statement

NOTE: Select the box for either Item A. or B. in Item Number 1. If applicable, select the box for Item Number 2.
1.

2.

Applicant's, Parent's, or Legal Guardian's Statement Regarding the Interpreter
A.

I can read and understand English, and I have read and understand every question and instruction on this application
and my answer to every question.

B.

The interpreter named in Part 9. read to me every question and instruction on this application and my answer to
every question, in
, a language in which I am fluent and I
understood everything.

Applicant's, Parent's, or Legal Guardian's Statement Regarding the Preparer
At my request, the preparer named in Part 10.,

,

prepared this application for me based only upon information I provided or authorized.

Applicant's, Parent's or Legal Guardian's Contact Information
3.

Daytime Telephone Number

5.

Email Address (if any)

4.

Mobile Telephone Number (if any)

Applicant's, Parent's, or Legal Guardian's Certification
Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS may
require that I submit original documents to USCIS at a later date. Furthermore, I authorize the release of any information from any
and all of my records that USCIS may need to determine my eligibility for the immigration benefit that I seek.
I furthermore authorize release of information contained in this application, in supporting documents, and in my USCIS records, to
other entities and persons where necessary for the administration and enforcement of U.S. immigration law.

Form N-600 Edition 08/10/22

Page 10 of 16

Part 8. Applicant's, Parent's, or Legal Guardian's Statement, Contact
Information, Certification, and Signature (continued)

A-

I understand that USCIS may require me (the applicant/child) to appear for an appointment to take my biometrics and, that if I am
required to appear, I will be required to sign an oath reaffirming that:

DRAFT
NOT FOR
PRODUCTION
10/20/2022

1) I reviewed and provided or authorized all of the information in my application;

2) I understood all of the information contained in, and submitted with, my application; and
3) All of this information was complete, true, and correct at the time of filing.

I certify, under penalty of perjury, that I provided or authorized all of the information in my application, I understand all of the
information contained in, and submitted with, my application, and that all of this information is complete, true, and correct.

Applicant's, Parent's, or Legal Guardian's Signature
6.

Signature (sign in ink)

Date of Signature (mm/dd/yyyy)

NOTE TO ALL APPLICANTS: If you do not completely fill out this application or fail to submit required documents listed in the
Instructions, USCIS may deny your application.

Part 9. Interpreter's Contact Information, Certification, and Signature
Provide the following information about the interpreter.

Interpreter's Full Name
1.

Interpreter's Family Name (Last Name)

Interpreter's Given Name (First Name)

2.

Interpreter's Business or Organization Name (if any)

Interpreter's Mailing Address
3.

Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

Province

Postal Code

ZIP Code

Country

Interpreter's Contact Information
4.

Interpreter's Daytime Telephone Number

6.

Interpreter's Email Address (if any)

Form N-600 Edition 08/10/22

5.

Interpreter's Mobile Telephone Number (if any)

Page 11 of 16

A-

Part 9. Interpreter's Contact Information, Certification, and Signature
(continued)
Interpreter's Certification

DRAFT
NOT FOR
PRODUCTION
10/20/2022

I certify, under penalty of perjury, that:

, which is the same language specified in Part 8.,

I am fluent in English and

Item B. in Item Number 1., and I have read to this applicant (or their parent or legal guardian) in the identified language every
question and instruction on this application and his or her answer to every question. The applicant (or their parent or legal guardian)
informed me that he or she understands every instruction, question, and answer on the application, including the Applicant's
Certification, and has verified the accuracy of every answer.

Interpreter's Signature
7.

Interpreter's Signature

Date of Signature (mm/dd/yyyy)

Part 10. Contact Information, Declaration, and Signature of the Person Preparing this Application, if
Other Than the Applicant, Parent, or Legal Guardian
Provide the following information about the preparer.

Preparer's Full Name
1.

Preparer's Family Name (Last Name)

Preparer's Given Name (First Name)

2.

Preparer's Business or Organization Name (if any)

Preparer's Mailing Address
3.

Street Number and Name

Apt. Ste. Flr. Number

City or Town

State

Province

Postal Code

ZIP Code

Country

Preparer's Contact Information
4.

Preparer's Daytime Telephone Number

6.

Preparer's Email Address (if any)

Form N-600 Edition 08/10/22

5.

Preparer's Mobile Telephone Number (if any)

Page 12 of 16

Part 10. Contact Information, Declaration, and Signature of the Person
Preparing this Application, if Other Than the Applicant, Parent, or Legal
Guardian (continued)

A-

DRAFT
NOT FOR
PRODUCTION
10/20/2022

Preparer's Statement
7.

A.

I am not an attorney or accredited representative but have prepared this application on behalf of the applicant and with
the applicant's consent (or the consent of their parent or legal guardian).

B.

I am an attorney or accredited representative and my representation of the applicant in this case
extends
does not extend beyond the preparation of this application.

NOTE: If you are an attorney or accredited representative, you may need to submit a completed Form G-28, Notice of
Entry of Appearance as Attorney or Accredited Representative, with this application. Members of the Armed Forces
applying outside the United States for a Certificate of Citizenship under INA section 320 may file Form G-28I, Notice
of Entry of Appearance as Attorney In Matters Outside the Geographical Confines of the United States with this
application, if applicable.

Preparer's Certification

By my signature, I certify, under penalty of perjury, that I prepared this application at the request of the applicant (or their parent or
legal guardian). The applicant (or their parent or legal guardian) then reviewed this completed application and informed me that he or
she understands all of the information contained in, and submitted with, his or her application, including the Applicant's
Certification, and that all of this information is complete, true, and correct. I completed this application based only on information
that the applicant (or their parent or legal guardian) provided to me or authorized me to obtain or use.

Preparer's Signature
8.

Preparer's Signature

Form N-600 Edition 08/10/22

Date of Signature (mm/dd/yyyy)

Page 13 of 16

Part 11. Additional Information

A-

If you need extra space to provide any additional information within this application, use the space below. If you need more space
than what is provided, you may make copies of this page to complete and file with this application or attach a separate sheet of paper.
Type or print your name and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item
Number to which your answer refers; and sign and date each sheet.

DRAFT
NOT FOR
PRODUCTION
10/20/2022

1.

Family Name (Last Name)

2.

A-Number (if any) ► A-

3.

A. Page Number

D.

4.

A. Page Number

D.

5.

A. Page Number

Given Name (First Name)

B. Part Number

C. Item Number

B. Part Number

C. Item Number

B. Part Number

C. Item Number

B. Part Number

C. Item Number

Middle Name

D.

6.

A. Page Number

D.

Form N-600 Edition 08/10/22

Page 14 of 16

NOTE: Do not complete Parts 12. and 13. unless the USCIS officer instructs you to do so at the interview.
Part 12. Affidavit (Do NOT complete this part unless instructed to do so
AT THE INTERVIEW)

A-

DRAFT
NOT FOR
PRODUCTION
10/20/2022

I, the (applicant, parent, or legal guardian)

do swear or affirm, under

penalty of perjury under the laws of the United States, that I know and understand the contents of this application signed by me, and
the attached supplementary pages number
to
inclusive, that the same are true and correct to the best of my knowledge,
and that corrections number
to
were made by me or at my request.
Applicant's, Parent's, or Legal Guardian's Signature

Date of Signature (mm/dd/yyyy)

Subscribed and sworn or affirmed before me upon examination of the applicant, parent, or legal guardian on
at

Date (mm/dd/yyyy)

.

(Location)

USCIS Officer's Printed Name

USCIS Officer's Title

USCIS Officer's Signature

Date of Signature (mm/dd/yyyy)

Part 13. Officer Report on Application for Certificate of Citizenship (for USCIS use ONLY)

On the basis of the documents, records, the testimony of persons examined, and the identification upon personal appearance of the
underage beneficiary (if applicable), I find that all the facts and conclusions set forth under oath in this application are:
1.

True and correct

2.

The applicant derived or acquired U.S. citizenship on Date (mm/dd/yyyy)

3.

The applicant derived or acquired U.S. citizenship through (Select the box next to the appropriate section of law, or if the
section of law is not reflected, type or print the applicable section of law in the space next to “Other.”)

4.

A.

INA Section 301

B.

INA Section 309

C.

INA Section 320

D.

Former INA Section 321

E.

Other
The applicant has not been expatriated since that time

Form N-600 Edition 08/10/22

Page 15 of 16

Part 13. Officer Report on Application for Certificate of Citizenship
(for USCIS use ONLY) (continued)
This Form N-600 is:

Approved

A-

Denied

DRAFT
NOT FOR
PRODUCTION
10/20/2022

Issue Certificate of Citizenship in the name of
Family Name (Last Name)

USCIS Officer's Printed Name

USCIS Officer's Signature

Form N-600 Edition 08/10/22

Given Name (First Name)

Middle Name

USCIS Officer's Title

Date of Signature (mm/dd/yyyy)

Page 16 of 16