Information Pertaining to Naturalization Application

Information Pertaining to Naturalization Application

Please complete the tables of information below and complete the attached pages 13-18 of the N-400 Application Form. Please respond to every box:

If unknown – write “unknown”
If not applicable – write “N/A”
If none – write “none”

Personal Information

Current Legal Name
(First, Middle, Last/Maiden Name)
Other Names you have used since Birth
(First, Middle, Last/Maiden Name)
U.S. Social Security Number
Phone Number
(Daytime, Work and Mobile)
Email Address
U.S. Address
(Residency and Mailing Address if different)
Would you like to legally change your name?

Information Regarding your Parents

Full Name
(First, Middle, Last/Maiden Name) / Date of Birth / Country of Birth / Is your parent a U.S. Citizen?
Father
Mother

Were your parents married before your 18th Birthday? ______

Information for Criminal Records Check

Gender / Ethnicity
(Hispanic or Latino or not Hispanic or Latino) / Race
(White, Asian, Black or African American, American Indian or Alaska Native or Native Hawaiian or Other Pacific Islander) / Hair Color / Eye Color / Height
Personal Information

Marriage History [ Please Provide Information for All Previous Spouses]

[Full Name – include Maiden name] / Date of Birth / Date of Marriage / Date of Divorce / Current Employer / Immigration Status

Your Spouse:

======

Your Former Spouse:

======

Your Spouse's Former Spouse:

/ ======
======/ ======
======/ N/A
======
======/ ======
N/A
======N/A / □ USC at birth
□ Naturalized on [Date]:
□ Citizen of [Country] :
□ Legal Permanent Resident
□ Other ______
Alien Registration Number:
–------
□ USC at birth
□ Naturalized on [Date]:
□ Citizen of :
□ Legal Permanent Resident
□ Other ______
Alien Registration Number:
======
□ USC at birth
□ Naturalized on [Date]:
□ Citizen of [Country]:
□ Legal Permanent Resident
□ Other ______
Alien Registration Number:

Information Regarding your Children

All children should be indicated, including: children who are alive, missing, deceased, children born in the U.S. or other countries, children under 18 or older, children currently married or unmarried, living with you or elsewhere, current stepchildren, legally adopted children, and children born out of wedlock.

Full Name
(First, Middle, Last/Maiden Name) / Date of Birth / Child's relationship to you? (Biological child, stepchild, legally adopted child) / Country of Birth / Current Address / Alien Registration Number, if applicable
Child #1
Child #2
Child #3
Child #4

Information about Residence History

Please provide all addresses that you have held in the last five (5) years starting with your current address Please make sure there are no gaps.

Street Name and Number / City / State or Province / Country / Dates of Residency (mm/dd/yyyy – mm/dd/yyyy)

Please list all employment for the last five (5) years. If none, so state. (If you were in school or unemployed in the last 5 years please list those as well).

Employer/School Name & Street Address / Job Title / City / State or Province / Country / Dates of Employment (mm/dd/yyyy – mm/dd/yyyy)

Please list Time spent outside of the United States for the last 5 years.

Date you Left the United States / Date you Returned to the United States / Did the Trip Last 6 Months or More? / Countries to Which you Traveled / Total Days Outside the United States