Form N-644 - Application For Posthumous Citizenship - Uscis Page 2
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4B. Information About the Decedent (Continued)
10. Father's Full Name
Living
B.
Living
Deceased
Date of Birth
Deceased
Name (Last/First/Middle)
(mm/dd/yyyy)
11. Mother's Maiden Name
Living
Deceased
C.
Living
Deceased
Date of Birth
12. Marital Status at Time of Death
Name (Last/First/Middle)
(mm/dd/yyyy)
a. Married
c. Widowed
b. Divorced
d. Single
D.
Living
Deceased
13. Military Service Serial Number
(If different from Social Security Number)
Date of Birth
Name (Last/First/Middle)
(mm/dd/yyyy)
14. Date Entered Active Duty Service (mm/dd/yyyy)
E.
Living
Deceased
Date of Birth
Name (Last/First/Middle)
15. Place Entered Active Duty Service (City/State/Country)
(mm/dd/yyyy)
16. Date Released From Active Duty Service (mm/dd/yyyy)
24. Total Number of Brothers and Sisters (If none, write "None")
17. Branch of Service
18. Type of Discharge
25. Complete the Following for Each Brother and Sister
A.
Living
Deceased
Date of Birth
Name (Last/First/Middle)
20. Retired From Military?
19. Military Rank at Time of
(mm/dd/yyyy)
Discharge
Yes
No
B.
Living
Deceased
21. VA Claim Number (If any)
Date of Birth
Name (Last/First/Middle)
(mm/dd/yyyy)
22. Total Number of Children (If none, write "None")
C.
Living
Deceased
Date of Birth
Name (Last/First/Middle)
(mm/dd/yyyy)
23. Complete the Following for Each Child
A.
Living
Deceased
Date of Birth
Name (Last/First/Middle)
D.
Living
Deceased
(mm/dd/yyyy)
Date of Birth
Name (Last/First/Middle)
(mm/dd/yyyy)
Form N-644 08/05/15 N Page 2
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