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information for 30 days, or from the last time you worked on the form.
Fee waiver: If you are requesting a fee waiver, you cannot file online. You must file a paper version of
both the Form I-912, Request for Fee Waiver and the form for the specific benefit you are requesting.
You can review the fee waiver guidance at www.uscis.gov/feewaiver.
Select the form you want to file online.
N-565 Application for Replacement Naturalization/Citizenship Document
Use this form to request a replacement of a Certificate of Naturalization, Certificate of Citizenship,
Declaration of Intention, Repatriation Certificate, or to apply for a special certificate of naturalization
to be recognized as a U.S. citizen by a foreign country.
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N-565, Application For Replacement
Naturalization/Citizenship Document
The Application for Replacement Naturalization/Citizenship Document (N-565) is used to apply to U.S.
Citizenship and Immigration Services (USCIS) for a replacement of a Certificate of Naturalization,
Certificate of Citizenship, Declaration of Intention, or Repatriation Certificate. You can also use this
application to apply for a special certificate of naturalization to have a foreign country recognize you
as a U.S. citizen.
Learn more about applying for a replacement document
Before You Start Your Application
Eligibility
Your eligibility to apply for a replacement document depends on the reason for your
request. You may apply for a replacement if: you were issued a Certificate of
Naturalization, Certificate of Citizenship, Declaration of Intention, or Repatriation
Certificate, and at least one of the following applies:
• The document was lost, stolen, destroyed, or mutilated;
• The document is incorrect due to a typographical or clerical error by USCIS;
• Your name was changed by marriage, divorce, annulment, or court order, and
you seek a document in your new name;
• You want to remove marital status, sex/gender and height from the certificate; or
• You obtained a court order or a document issued by the U.S. government or the
government of any U.S. state that changes your date of birth, and you seek a
document with the new date of birth.
You may also file this application if you are a naturalized citizen seeking a special
certificate of naturalization for the purpose of a foreign country recognizing you as a U.S.
citizen.
If the document was lost in the mail, please submit an online case service request for
non-delivery of document prior to submitting Form N-565.
Note: USCIS will not change your name without evidence such as a marriage certificate,
divorce decree, or court order. We will not change the date of birth on a certificate
without documentation such as a U.S. court order or state-issued documents.
Fee
We will automatically calculate the cost for you before you submit your application. For
specific information about fees applicable to this form, see Form G-1055.
Fee waiver: If you are requesting a fee waiver, you cannot file online. You must file a
paper version of both the Form I-912, Request for Fee Waiver and the form for the specific
benefit you are requesting. You can review the fee waiver guidance at www.uscis.gov/
feewaiver.
Refund policy: USCIS does not refund fees, regardless of any action we take on your
application, petition, or request, or how long USCIS takes to reach a decision. By
continuing this transaction, you acknowledge that you must submit fees in the exact
amount and that you are paying the fees for a government service.
Please refer to the instructions for the form(s) you are filing for additional information or
you may call the USCIS Contact Center at 800-375-5283. For TTY (deaf or hard of hearing)
800-767-1833.
Documents you may need
Before starting the Application for Replacement Naturalization/Citizenship Document
(N-565), you may want to gather the documents you will need to support your
application. These include your original document, if you still have it, and a recent color
photograph of yourself.
The other documents you need will depend on the information you provide in the
application, such as the reason you are requesting the replacement document.
We will automatically determine which documents you should provide us as you fill out
your application. At the time of filing, you must submit all evidence and supporting
documentation listed.
A er You Submit Your Declaration
Track your case online
A er you submit your form, you can track its status through your USCIS account. Sign in
to your account o en to check on your case status and read any important messages
from USCIS.
Mail in your original document
USCIS may require you to mail your original document. This is required if you are
applying for a new document for one of the reasons below.
•
•
•
•
Current document is mutilated
Current document has a typographical/clerical error caused by USCIS
Name changed
Date of birth changed
You should include your A-Number with your original document.
Mail your original document to:
USCIS Nebraska Service Center
850 S. Street
Lincoln, NE 68508
If the document was lost in the mail, please submit an online case service request for
non-delivery of document prior to submitting Form N-565.
Respond to requests for information
If we need more information from you, we will send you a Request for Evidence (RFE) or
Request for Information (RFI). You can respond to our request and upload your
documents through your USCIS account.
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Completing Your Form Online
Filing online
Submitting your application online is the same as mailing in a completed paper form.
They both gather the same information and cost the same.
Complete the Getting Started section first
You should answer all questions in the Getting Started section first so we can best
customize the rest of your online form experience.
Provide as many responses as you can
You should provide as many responses as you can. Incomplete or missing information
may slow down processing of your case a er you submit the form.
We will automatically save your responses
We will automatically save your information when you select next to go to a new page or
navigate to another section of the form. We will save your information for 30 days from
today, or from the last time you worked on the form.
How to continue filling out your form
A er you start your form, you can sign into your account to continue your form.
DHS Privacy Notice
AUTHORITIES: The information requested on this application, and the associated evidence,
is collected under INA section 322 and 101(c).
PURPOSE: The primary purpose for providing the requested information is to determine if
you have established eligibility for naturalization and issuance of a Certificate of Citizenship
for a child who regularly resides outside the United States. DHS will use the information you
provide to grant or deny the immigration benefit you are seeking.
DISCLOSURE: The information provided is voluntary. However, failure to provide the
requested information, including your Social Security number (if applicable), and any
requested evidence, may delay a final decision or result in denial of the beneficiaryʼs benefit
request.
ROUTINE USES: DHS may share the information you provide on this application and any
additional requested evidence with other Federal, state, local, and foreign government
agencies and authorized organizations. DHS follows approved routine uses, as described in
the associated published system of records notices [DHS/USCIS/ICE/CBP-001 - Alien File,
Index, and National File Tracking, DHS/USCIS-007 Benefits Information System, and DHS/
USCIS-018 Immigration Biometric and Background Check] and the published privacy impact
assessments [DHS/USCIS/PIA-056 USCIS Electronic Immigration System and DHS/USCIS/
PIA-071 myUSCIS Account Experience] which you can find at www.dhs.gov/privacy. DHS may
also share the information, as appropriate, for law enforcement purposes or in the interest of
national security.
Paperwork Reduction Act
An agency may not conduct or sponsor an information collection, and a person is not
required to respond to a collection of information, unless it displays a currently valid Office of
Management and Budget (OMB) control number. The public reporting burden for this
collection of information is estimated at 1 hour and 8 minutes per response, including time
for reviewing instructions, gathering the required documentation and information,
completing the application, preparing statements, attaching necessary documentation, and
submitting the application. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for reducing this burden, to:
U.S. Citizenship and Immigration Services
Office of Policy and Strategy, Regulatory Coordination Division
5900 Capital Gateway Drive, Mail Stop #2140
Camp Springs, MD 20588-0009
Do not mail your completed form N-600K to this address.
OMB No. 1615-0087
Expires: 11/30/2025
Security reminder
If you do not work on your form for more than 30 days, we will delete your data
in order to prevent storing personal information indefinitely.
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N-565, Application for
Replacement
Naturalization/
Citizenship Document…
Getting Started
Resources
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Which document are you applying for?
New Certificate of Citizenship
New Certificate of Naturalization
New Certificate of Repatriation
New Declaration of Intention
Special Certificate of Naturalization to obtain recognition
of my U.S. citizenship by a foreign country
Type of application
Preparer and interpreter
information
About You
Your Request
Evidence
Additional Information
Review and Submit
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N-565, Application for
Replacement
Naturalization/
Citizenship Document…
Getting Started
Resources
Sign Out
Which document are you applying for?
New Certificate of Citizenship
New Certificate of Naturalization
New Certificate of Repatriation
New Declaration of Intention
Special Certificate of Naturalization to obtain recognition
of my U.S. citizenship by a foreign country
Type of application
Preparer and interpreter
information
About You
Your Request
Evidence
Additional Information
Review and Submit
Why are you requesting a new document?
Select all that apply
My certificate or declaration was lost, stolen, or destroyed
My certificate or declaration is mutilated
My certificate or declaration is incorrect due to a t
ypographical or clerical error by USCIS
My name has legally changed
My date of birth has legally changed through a court
order or U.S. Government-issued document, and I am
applying for a replacement Certificate of Citizenship
I am seeking to change the gender listed on my document
My reason for applying for a new document is not listed
above.
You must mail your original document to USCIS
You must mail your original document to USCIS because of the
reason you are requesting a new document. Review of your
application may be delayed if you do not submit your original
document.
You should include your A-Number with your original
document.
Mail your original document to:
USCIS Nebraska Service Center
P.O. Box 82521
Lincoln, NE 68501
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N-565, Application for
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Naturalization/
Citizenship Document…
Getting Started
Resources
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Is someone assisting you with completing this
application?
Yes
No
Type of application
Preparer and interpreter
information
About You
Your Request
Evidence
Additional Information
Review and Submit
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N-565, Application for
Replacement
Naturalization/
Citizenship Document…
Getting Started
Resources
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Is someone assisting you with completing this
application?
Yes
No
Type of application
Preparer and interpreter
information
About You
Your Request
Evidence
Additional Information
Review and Submit
Is a preparer assisting you with completing this
application?
A preparer is anyone who completes or helps you complete all or part of
your application using information and answers that you provide.
Yes
No
Is an interpreter assisting you with completing
this application?
Yes
No
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N-565, Application for
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Naturalization/
Citizenship Document…
Getting Started
Resources
Sign Out
What is your preparerʼs full name?
Given name (first name)
Family name (last name)
Type of
Type
ofapplication
application
Preparer and interpreter
information
Preparer information
About You
Preparer and interpreter
information
Your
Request
What is your preparerʼs business or organization
name?
Evidence
About You
Additional Information
Your Request
Review and Submit
Evidence
Additional Information
Review and Submit
My preparer is not part of a business or organization
What is your preparerʼs mailing address?
Country
Address line 1
Street number and name
Address line 2
Apartment, suite, unit, or floor
City or town
State/Province
ZIP code/Postal code
Provide a 5 or 9-digit
ZIP code.
What is your preparerʼs contact information?
Daytime telephone number
Provide a 10-digit phone number
Mobile telephone number
My preparer does not have a mobile telephone number.
Provide a 10-digit phone number
Email address
My preparer does not have an email address.
Example: user@domain.com
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N-565, Application for
Replacement
Naturalization/
Citizenship Document…
Getting Started
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Sign Out
What is your interpreterʼs full name?
Given name (first name)
Family name (last name)
Type of application
Preparer and interpreter
information
What is your interpreterʼs business or
organization name?
Preparer information
Interpreter information
My preparer is not part of a business or organization
About You
Your Request
Evidence
Additional Information
Review and Submit
What is your interpreterʼs mailing address?
Country
Address line 1
Street number and name
Address line 2
Apartment, suite, unit, or floor
City or town
State/Province
ZIP code/Postal code
Provide a 5 or 9-digit
ZIP code.
What is your interpreterʼs contact information?
Daytime telephone number
Provide a 10-digit phone number
Mobile telephone number
My interpreter does not have a mobile telephone number.
Provide a 10-digit phone number
Email address
My interpreter does not have an email address.
Example: user@domain.com
What language is your interpreter using to
interpret this application for you?
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N-565, Application for
Replacement
Naturalization/
Citizenship Document…
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What is your current legal name?
Your current legal name is the name on your birth certificate, unless it
changed a er birth by a legal action such as marriage or court order. Do not
provide any nicknames here.
Getting Started
About You
Given name (first name)
Middle name
Your name
Family name (last name)
Your contact information
Other information
Your Request
Evidence
Additional Information
Review and Submit
Have you used any other names since birth?
Other names used may include nicknames, aliases, and maiden names.
Yes
No
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Naturalization/
Citizenship Document…
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How may we contact you?
Daytime telephone number
About You
Provide a 10-digit phone number
Your name
Mobile telephone number
My preparer does not have a mobile telephone number.
Your contact information
Other information
Evidence
Additional Information
Review and Submit
Provide a 10-digit phone number
Your Request
Email address
My preparer does not have an email address.
Example: user@domain.com
What is your current mailing address?
We will use your current mailing address to contact you throughout the
application process. We may not be able to contact you if you do not
provide a complete and valid address.
In care of name (if any)
Country
Address line 1
Street number and name
Address line 2
Apartment, suite, unit, or floor
City or town
State/Province
ZIP code/Postal code
Provide a 5 or 9-digit
ZIP code.
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N-565, Application for
Replacement
Naturalization/
Citizenship Document…
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What is your A-Number?
I do not have or know my A-Number.
Getting Started
About You
Your name
Provide a 7, 8, or 9-digit number. If your A-Number is fewer than 9 digits,
the system will automatically add zero(s) a er the “A” and before the first
digit so there is a total of 9 digits, for example: A-001234567.
Your contact information
Other information
Your Request
Evidence
Additional Information
Review and Submit
Since becoming a U.S. citizen, have you lost or
renounced your citizenship in any manner?
Yes
No
Has your marital status changed since your last
document was issued?
Yes
No
What is your current marital status?
Single, Never Married
Married
Divorced
Widowed
Separated
Marriage Annulled
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Naturalization/
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What is the certificate or declaration number on
your current document?
Getting Started
About You
Your Request
Which U.S. Citizenship and Immigration Services
(USCIS) Office or court issued your certificate or
declaration?
Current document
Your document was lost, stolen, or
destroyed
You have an error correction
Your name was changed
Your date of birth was changed
Your gender changed
Special Certificate of
Naturalization
Evidence
Additional Information
Review and Submit
When was this certificate or declaration issued?
MM/DD/YYYY
In which name was your current certificate or
declaration issued?
Given name (first name)
Middle name (if applicable)
Family name (last name)
What is your date of birth on your certificate or
declaration?
MM/DD/YYYY
What is your country of former citizenship or
nationality?
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Naturalization/
Citizenship Document…
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When, where, and how was your document lost,
stolen, or destroyed?
Getting Started
About You
Your Request
Current document
Back
Your document was lost, stolen,
or destroyed
Next
You have an error correction
Your name was changed
Your date of birth was changed
Your gender changed
Special Certificate of
Naturalization
Evidence
Additional Information
Review and Submit
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Naturalization/
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What was the typographical or clerical error in
your document that needs to be corrected?
Select all that apply
Getting Started
About You
Your Request
Name
Date of birth
Gender
Other
Current document
Your document was lost, stolen, or
destroyed
Provide an explanation of what is incorrect on
your current certificate or declaration
You have an error correction
Your name was changed
Your date of birth was changed
Your gender changed
Special Certificate of
Naturalization
Evidence
Additional Information
Review and Submit
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Naturalization/
Citizenship Document…
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Why has your name changed?
Getting Started
About You
Your Request
Current document
Marriage
Divorce
Annulment
Court order
On what date did your name change?
Your document was lost, stolen, or
destroyed
MM/DD/YYYY
You have an error correction
Your name was changed
Your date of birth was changed
Your gender changed
What is your new legal name?
Special Certificate of
Naturalization
Evidence
Additional Information
Review and Submit
Given name (first name)
Middle name (if applicable)
Family name (last name)
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How was your date of birth changed?
Select all that apply
Getting Started
About You
Your Request
Current document
Your document was lost, stolen, or
destroyed
Court order
U.S. Government-issued document
What is the date on the court order?
MM/DD/YYYY
You have an error correction
Your name was changed
Your date of birth was changed
What is the date on the government-issued
document?
Your gender changed
Special Certificate of
Naturalization
Evidence
Additional Information
Review and Submit
MM/DD/YYYY
What is your new date of birth?
Provide the new date of birth as shown in the court order or U.S.
Government-issued document.
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How did you officially change your gender?
Select all that apply
Getting Started
About You
Your Request
Court order
Licensed health care professionalʼs certification of
gender
Government-issued document reflecting the gender
change
Current document
Your document was lost, stolen, or
destroyed
What is your current gender designation?
You have an error correction
Male
Female
Your name was changed
Your date of birth was changed
Your gender changed
Special Certificate of
Naturalization
Evidence
Additional Information
Review and Submit
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What is the name of the foreign country?
Getting Started
About You
Your Request
What is the name of the foreign official who is
requesting this certificate?
Current document
Your document was lost, stolen, or
destroyed
You have an error correction
Given name (first name)
Your name was changed
Middle name
Your date of birth was changed
Your gender changed
Family name (last name)
Special Certificate of
Naturalization
Evidence
Additional Information
Review and Submit
What is the foreign officialʼs title?
What is the foreign officialʼs government agency?
What is the foreign officialʼs address?
Country
Address line 1
Street number and name
Address line 2
Apartment, suite, unit, or floor
City or town
State/Province
ZIP code/Postal code
Provide a 5 or 9-digit
ZIP code.
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2” x 2” photo of you
Getting Started
About You
Your Request
Evidence
If you reside in the United States, USCIS may request that you attend an
appointment at an ASC to have your photograph taken. If you reside
outside the United States, you must submit two identical color passportstyle photographs of yourself taken recently.
Upload a recent color photograph of yourself that measures 2 inches by 2
inches, with your face measuring 1 inch to 1 3/8 inch from your chin to the
top of your head. Your eyes should be between 1 1/8 inch and 1 3/8 inch
from the bottom of the photo.
2” x 2” photo of you
U.S. government-issued photo
identification
Make sure your whole face is visible, you are facing the camera directly, and
the background is white or off-white. Your head must be bare, unless
contrary to your religious beliefs.
Evidence of change in marital
status
If you need help understanding the photo requirements or want to resize,
rotate, or crop your photo, you can use to the Department of Stateʼs photo
composition tools.
Loss of citizenship
Evidence of incorrect document
Evidence of your lost, stolen, or
destroyed document
Evidence of your mutilated
document
Original document from USCIS
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Evidence of clerical or
typographical error
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Evidence of your name change by
marriage
Evidence of your name change by
court order
Evidence of your date of birth
change
Court order showing legally
changed gender
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Government-issued document
reflecting the requested gender
designation
Translations
If your documents are in a foreign language, upload an English
translation along with the original.
Letter from licensed health care
professional
Your naturalization certificate
Additional Information
Review and Submit
U.S. Government-Issued Photo Identification
Upload an image or copy of your U.S. Government-issued photo
identification.
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Translations
If your documents are in a foreign language, upload an English
translation along with the original.
Evidence Of Change In Marital Status
If your marital status has changed since your original document was issued,
you must upload an image or copy of the document establishing your
change in marital status. Such documents may include your marriage
certificate, divorce decree, annulment decree, or spouseʼs death certificate.
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Translations
If your documents are in a foreign language, upload an English
translation along with the original.
Loss Of Citizenship
Upload an image or copy of a document explaining how and why you lost
or renounced your United States citizenship.
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Translations
If your documents are in a foreign language, upload an English
translation along with the original.
Evidence Of Incorrect Document
Upload images or copies of any documents supporting your explanation of
the error and request for a replacement document.
You also must mail your incorrect original document to USCIS to complete
your application. You should include your A-Number with your original
document.
Mail your original document to:
USCIS Nebraska Service Center
P.O. Box 82521
Lincoln, NE 68501
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Translations
If your documents are in a foreign language, upload an English
translation along with the original.
Evidence Of Your Lost, Stolen, Or Destroyed
Document
Upload an image or copy of your original document if you have one.
You can also upload a copy of a police report and/or a sworn statement
explaining what happened to the document and any attempts to retrieve
the document.
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Translations
If your documents are in a foreign language, upload an English
translation along with the original.
Evidence Of Your Mutilated Document
Upload an image or copy of your original mutilated document.
You also must mail your original mutilated document to USCIS to complete
your application. You should include your A-Number with your original
document.
Mail your original document to:
USCIS Nebraska Service Center
P.O. Box 82521
Lincoln, NE 68501
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Translations
If your documents are in a foreign language, upload an English
translation along with the original.
Original Document From USCIS
Upload an image or copy of your original document.
You also must mail your original document to USCIS to complete your
application. You should include your A-Number with your original
document.
Mail your original document to:
USCIS Nebraska Service Center
P.O. Box 82521
Lincoln, NE 68501
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Translations
If your documents are in a foreign language, upload an English
translation along with the original.
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Naturalization/
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Evidence Of Clerical Or Typographical Error
Getting Started
About You
Your Request
Evidence
Upload images or copies of documents supporting your explanation of the
error and request for a new document.
You also must mail your incorrect original document to USCIS to complete
your application. You should include your A-Number with your original
document.
Mail your original document to:
2” x 2” photo of you
USCIS Nebraska Service Center
P.O. Box 82521
Lincoln, NE 68501
U.S. government-issued photo
identification
Evidence of change in marital
status
Loss of citizenship
Evidence of incorrect document
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Evidence of your lost, stolen, or
destroyed document
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Evidence of your mutilated
document
Original document from USCIS
Evidence of clerical or
typographical error
Evidence of your name change by
marriage
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Evidence of your name change by
court order
Translations
Evidence of your date of birth
change
If your documents are in a foreign language, upload an English
translation along with the original.
Court order showing legally
changed gender
Government-issued document
reflecting the requested gender
designation
Evidence Of Your Name Change By Marriage
Letter from licensed health care
professional
Upload an image or copy of the original certified marriage certificate,
divorce certificate or annulment decree that shows your legally changed
name.
Your naturalization certificate
Additional Information
Review and Submit
You also must mail your original or certified document to USCIS to
complete your application. You should include your A-Number with your
original document.
Mail your original document to:
USCIS Nebraska Service Center
P.O. Box 82521
Lincoln, NE 68501
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Translations
If your documents are in a foreign language, upload an English
translation along with the original.
Evidence Of Your Name Change By Court Order
Upload an image or copy of the original or certified court order that shows
your legally changed name.
You also must mail your original or certified document to USCIS to
complete your application. You should include your A-Number with your
original document.
Mail your original document to:
USCIS Nebraska Service Center
P.O. Box 82521
Lincoln, NE 68501
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Translations
If your documents are in a foreign language, upload an English
translation along with the original.
Evidence Of Your Date Of Birth Change
Upload an image or copy of the original or certified U.S. Government-issued
document, court order, or a vital record document establishing the date of
birth change.
A U.S. Government document may include:
Birth certificates
Certificate recognizing foreign birth
Certificate of birth abroad
Other similar vital records issued by the U.S. state where you resided
when the document was issued
You also must mail your original document to USCIS to complete your
application. You should include your A-Number with your original
document.
Mail your original document to:
USCIS Nebraska Service Center
P.O. Box 82521
Lincoln, NE 68501
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Translations
If your documents are in a foreign language, upload an English
translation along with the original.
Court Order Showing Legally Changed Gender
Upload an image or certified copy of the court order granting your change
of sex or gender.
You also must mail your original document to USCIS to complete your
application. You should include your A-Number with your original
document.
Mail your original document to:
USCIS Nebraska Service Center
P.O. Box 82521
Lincoln, NE 68501
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Translations
If your documents are in a foreign language, upload an English
translation along with the original.
Government-Issued Document Reflecting The
Requested Gender Designation
Upload an image or certified copy of the government-issued document that
shows your legally changed gender.
An acceptable government-issued document may include:
Amended birth certificate
Passport recognizing the gender change
Driverʼs license recognizing the gender change
You also must mail your original document to USCIS to complete your
application. You should include your A-Number with your original
document.
Mail your original document to:
USCIS Nebraska Service Center
P.O. Box 82521
Lincoln, NE 68501
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Translations
If your documents are in a foreign language, upload an English
translation along with the original.
Letter From Licensed Health Care Professional
Upload an image or copy of a letter from a licensed health care professional
certifying the requested gender designation is consistent with your gender
identity. Licensed health care professionals include licensed counselors,
nurse practitioners, physicians (Medical Doctors or Doctors of Osteopathy),
physician assistants, psychologists, social workers, and therapists. The
health care certification must include the following information:
A court order granting change of sex or gender
The health care professionalʼs license number and issuing state,
country, or other jurisdiction of the professional license
Language stating the health care professional has treated or evaluated
you in relation to your gender identity
The health care professionalʼs assessment of your gender identity
You also must mail your original document to USCIS to complete your
application. You should include your A-Number with your original
document.
Mail your original document to:
USCIS Nebraska Service Center
P.O. Box 82521
Lincoln, NE 68501
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Translations
If your documents are in a foreign language, upload an English
translation along with the original.
Your Naturalization Certificate
Upload an image or copy of your naturalization certificate.
Drag files here or choose a file
Accepted file formats: JPG, JPEG, PDF, TIF, or TIFF
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
No encrypted or password-protected files
Maximum size: 12MB per file
Upload no more than five documents at a time
Attaching your files
Use a scanner or take pictures of each document. Make sure each
image you attach is clear and that all text is readable.
Translations
If your documents are in a foreign language, upload an English
translation along with the original.
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Naturalization/
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Additional Information
If you need to provide any additional information for any of your answers to
the questions in this form, enter it into the space below. You should include
the questions that you are referencing.
Getting Started
About You
Your Request
Evidence
Additional Information
If you do not need to provide any additional information, you may leave
this section blank.
Add a response
Additional Information
Review and Submit
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Naturalization/
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Check your application before you submit
Please review your application for completeness before you submit it.
Getting Started
About You
Your Request
Evidence
Additional Information
Review and Submit
We encourage you to provide as many responses as you can throughout the
application. Missing or incomplete information may slow down the review
process a er you submit your application.
You can return to this page to review your application as many times as you
want before you submit it.
Your fee
Your form filing fee is: $[xxx]
Refund policy: USCIS does not refund fees, regardless of any action we
Review your application
take on your application, petition or request, or how long USCIS takes to
reach a decision. By continuing this transaction, you acknowledge that you
must submit fees in the exact amount and that you are paying the fees for a
government service.
Your application summary
Preparer statement
Preparer signature
Alerts and warning
Interpreter certification
Interpreter signature
A green alert means you have completed all required fields and responses.
Your statement
Your signature
We found no alerts or warnings in your declaration.
Pay and submit
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N-565, Application for
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Naturalization/
Citizenship Document…
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Review the N-565 form information
Here is a summary of all the information you provided in your application.
Getting Started
About You
Your Request
Evidence
Additional Information
Review and Submit
Make sure you have provided responses for everything that applies to you
before you submit your application. You can edit your responses by going
to each application section using the site navigation.
We also prepared a dra case snapshot with your responses, which you can
download below.
View dra snapshot
Print
Getting Started
Preparer or interpreter information
Review your application
Your application summary
Is someone assisting you with completing
this application?
Preparer statement
Preparer signature
Interpreter certification
Interpreter signature
Your statement
Your signature
Yes
Is a preparer assisting you with
completing this application?
Yes
Is an interpreter assisting you
with completing this application?
Yes
Preparer or interpreter information
Pay and submit
Is someone assisting you with completing
this application?
Yes
Is a preparer assisting you with
completing this application?
Yes
Is an interpreter assisting you
with completing this application?
Yes
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Naturalization/
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Preparerʼs statement
Your preparer must read the statements below and select the statement
that applies to him or her.
Getting Started
About You
Your Request
Evidence
Additional Information
Review and Submit
If your preparer is an attorney or accredited representative whose
representation extends beyond preparation of this application, he or she
may be obliged to submit a completed Notice of Entry of Appearance as
Attorney or Accredited Representative (G-28) with your application.
I am not an attorney or accredited representative but
have prepared this application on behalf of the applicant
and with the applicantʼs consent.
I am an attorney or accredited representative and my
representation of the applicant in this case does not
extend beyond the preparation of this application.
I am an attorney or accredited representative and my
representation of the applicant in this case extends
beyond the preparation of this application.
Review your application
Your application summary
Preparer statement
Preparer signature
Interpreter certification
Interpreter signature
Your statement
Preparerʼs certification and signature
Your signature
Your preparer must read and agree to the certification below.
Pay and submit
By my signature, I certify, under penalty of perjury, that I
prepared this application at the request of the applicant.
The applicant 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 Applicantʼs Certification, and
that all of this information is complete, true, and correct. I
completed this application based only on information that
the applicant provided to me or authorized me to obtain
or use.
As the applicantʼs preparer, you must sign on paper and
provide your signature page to the applicant. Follow these
steps:
1. Download the Preparer Signature page
2. Print the Preparer Signature page
3. Read and sign the Preparer Signature page
4. Give the signed Preparer Signature page to
the applicant
The applicant will need to scan and upload your
completed signature page on the next screen.
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Naturalization/
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Preparerʼs signature upload
Scan and upload your preparerʼs completed signature page below.
Getting Started
About You
Your Request
Evidence
Additional Information
Review and Submit
File requirements
Clear and readable
Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
No encrypted or password-protected files
If your documents are in a foreign language, upload a full English
translation and the translatorʼs certification with each original
document.
Upload no more than five documents at a time
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
Maximum size: 12MB per file
Review your application
Your application summary
Preparer statement
Choose or drop files here to upload
Preparer signature
Interpreter certification
Interpreter signature
Your statement
Your signature
Back
Pay and submit
Next
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Naturalization/
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Interpreterʼs certification and signature
Your interpreter must read and agree to the certification below.
Getting Started
About You
Your Request
Evidence
Additional Information
Review and Submit
I certify, under penalty of perjury that: I am fluent in
English and the language provided in the Getting Started
section of this application, and I have read to this
applicant every question and instruction on this
application and his or her answer to every question. The
applicant informed me that he or she understands every
instruction, question, and answer on the application,
including the Applicantʼs Certification, and has verified the
accuracy of every answer.
Review your application
Your application summary
Preparer statement
As the applicantʼs interpreter, you must sign on paper and
provide your signature page to the applicant. Follow these
steps:
Preparer signature
Interpreter certification
Interpreter signature
Your statement
Your signature
1. Download the Interpreter Signature page
2. Print the Interpreter Signature page
3. Read and sign the Interpreter Signature page
4. Give the signed Interpreter Signature page to
the applicant
Pay and submit
The applicant will need to scan and upload your
completed signature page on the next screen.
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N-565, Application for
Replacement
Naturalization/
Citizenship Document…
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Interpreterʼs signature upload
Scan and upload your interpreterʼs completed signature page below.
Getting Started
About You
Your Request
Evidence
Additional Information
Review and Submit
File requirements
Clear and readable
Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
No encrypted or password-protected files
If your documents are in a foreign language, upload a full English
translation and the translatorʼs certification with each original
document.
Upload no more than five documents at a time
Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
Maximum size: 12MB per file
Review your application
Your application summary
Preparer statement
Choose or drop files here to upload
Preparer signature
Interpreter certification
Interpreter signature
Your statement
Your signature
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An official website of the United States government Hereʼs how you know
My Account
N-565, Application for
Replacement
Naturalization/
Citizenship Document…
Resources
Sign Out
Applicantʼs statement
You must read and agree to the statement below.
Getting Started
About You
Your Request
Evidence
Additional Information
Review and Submit
I can read and understand English, and have read and understand
every question and instruction on this application, as well as my
answer to every question.
Back
Next
Review your application
Your application summary
Preparer statement
Preparer signature
Interpreter certification
Interpreter signature
Your statement
Your signature
Pay and submit
Return to top
Topics
Contact Us
Citizenship
Schedule An Appointment
Find A Doctor
Find A Class
Contact USCIS
USCIS.gov
An official website of the U.S. Department of Homeland Security
About USCIS
Freedom of Information Act
Office of the Inspector General
Accessibility
No FEAR Act Data
The White House
Budget and Performance
Privacy and Legal Disclaimers
USA.gov
DHS Components
Site Map
An official website of the United States government Hereʼs how you know
My Account
N-565, Application for
Replacement
Naturalization/
Citizenship Document…
Resources
Sign Out
Applicantʼs statement regarding the preparer
You must read and agree to the statement below.
Getting Started
About You
Your Request
Evidence
Additional Information
Review and Submit
At my request, the preparer named in the Getting Started section of this
application prepared this application for me based only upon
information I provided or authorized.
Applicantʼs statement regarding the interpreter
You must read and agree to the statement below.
Review your application
Your application summary
Preparer statement
The interpreter named in the Getting Started section of this application
to me every question and instruction on this application and my
answer to every question in the language I specified in the Getting
Started section, a language in which I am fluent, and I understood
everything.
Preparer signature
Interpreter certification
Interpreter signature
Your statement
Back
Your signature
Next
Pay and submit
Return to top
Topics
Contact Us
Citizenship
Schedule An Appointment
Find A Doctor
Find A Class
Contact USCIS
USCIS.gov
An official website of the U.S. Department of Homeland Security
About USCIS
Freedom of Information Act
Office of the Inspector General
Accessibility
No FEAR Act Data
The White House
Budget and Performance
Privacy and Legal Disclaimers
USA.gov
DHS Components
Site Map
An official website of the United States government Hereʼs how you know
My Account
N-565, Application for
Replacement
Naturalization/
Citizenship Document…
Resources
Sign Out
Applicantʼs declaration, certification and
signature
Getting Started
About You
Your Request
Evidence
Additional Information
Review and Submit
You must read and agree to the certification below. If you knowingly and
willfully falsify or conceal a material fact or submit a false document with
your application, we can deny your application and may deny any other
immigration benefit. You may also face criminal prosecution and penalties
provided by law.
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.
Review your application
Your application summary
Preparer statement
Preparer signature
Interpreter certification
I further 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.
Interpreter signature
Your statement
Your signature
Pay and submit
I understand that USCIS may require me to appear for an
appointment to take my biometrics (fingerprints,
photograph, and/or signature) and, at that time, I will be
required to sign an oath reaffirming that:
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 all of the
information in my application, and any document
submitted with it were provided or authorized by me, that
I reviewed and understand all of the information
contained in, and submitted with, my application, and
that all of this information is complete, true, and correct.
I have read and agree to the applicantʼs statement
You must provide your digital signature below by typing
your full legal name. We may deny your application if you
do not completely fill out this application or fail to submit
required documents. We will record the date of your
signature with your application.
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Topics
Contact Us
Citizenship
Schedule An Appointment
Find A Doctor
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Contact USCIS
USCIS.gov
An official website of the U.S. Department of Homeland Security
About USCIS
Freedom of Information Act
Office of the Inspector General
Accessibility
No FEAR Act Data
The White House
Budget and Performance
Privacy and Legal Disclaimers
USA.gov
DHS Components
Site Map
An official website of the United States government Hereʼs how you know
My Account
N-565, Application for
Replacement
Naturalization/
Citizenship Document…
Resources
Sign Out
Pay for and submit your application
The final step to submit your Application to Replace Permanent Resident
Card is to pay the required fee.
Getting Started
About You
Your Request
Evidence
Additional Information
Review and Submit
Your application fee is: $[xxx]
Refund policy: By continuing this transaction, you agree that you are
paying for a government service and that the filing fee, biometric services
fee and all related financial transactions are final and not refundable,
regardless of any action USCIS takes on an application, petition or request,
or how long USCIS takes to reach a decision. You must submit all fees in the
exact amounts.
Review your application
Your application summary
We will send you to Pay.gov — our safe and secure
payment website — to pay your fees and submit your form
online.
Preparer statement
Preparer signature
Interpreter certification
Here are the steps in the payment and submission
process:
1. Provide your billing information on Pay.gov
Interpreter signature
Your statement
Your signature
2. Provide your credit card or U.S. bank account
information
Pay and submit
3. Submit your payment
When you have paid your fee, your form will be submitted.
Pay.gov will redirect you to a uscis.gov confirmation
screen, which will include your receipt number. Please
keep a copy of your receipt number for your records. You
can track the status of your application through your
USCIS online account.
Pay and submit
Back
Next
Return to top
Topics
Contact Us
Citizenship
Schedule An Appointment
Find A Doctor
Find A Class
Contact USCIS
USCIS.gov
An official website of the U.S. Department of Homeland Security
About USCIS
Freedom of Information Act
Office of the Inspector General
Accessibility
No FEAR Act Data
The White House
Budget and Performance
Privacy and Legal Disclaimers
USA.gov
DHS Components
Site Map
| File Type | application/pdf |
| File Modified | 2024-01-26 |
| File Created | 2024-01-26 |