Instructions For Form N-565, Application For Replacement Naturalization Page 3
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3Requests for more information or interview. We may
PURPOSE: The primary purpose for providing the requested
request more information or evidence or we may request that
information on this form is to determine if you have
you appear at a USCIS office for an interview. We may also
established eligibility for the immigration benefit for which
request that you submit the originals of any document. We
you are filing. The information you provide will be used to
will return these originals when they are no longer required.
grant or deny the benefit sought.
Decision. If you establish eligibility for the document, your
DISCLOSURE: The information you provide is voluntary.
application will be approved and the document issued. Where
However, failure to provide the requested information, and
appropriate, a special certificate of naturalization will be
any requested evidence, may delay a final decision or result in
forwarded to the U.S. Department of State for delivery to a
denial of your form.
foreign government official. If your application is denied, you
ROUTINE USES: The information you provide on this form
will be notified in writing of the reasons for the denial.
may be shared with other Federal, State, local, and foreign
government agencies and authorized organizations following
USCIS Forms and Information
approved routine uses described in the associated published
system of records notices [DHS-USCIS-007 - Benefits
Information System and DHS-USCIS-001 - Alien File (A-
To ensure you are using the latest version of this form, visit
File) and Central Index System (CIS), which can be found at
the USCIS Web site at where you can obtain
The information may also be made
the latest USCIS forms and immigration-related information.
available, as appropriate, for law enforcement purposes or in
If you do not have internet access, you may order USCIS
the interest of national security.
forms by calling our toll-free number at 1-800-870-3676. You
may also obtain forms and information by telephoning our
USCIS National Customer Service Center at 1-800-375-5283.
Paperwork Reduction Act
For TDD (hearing impaired) call: 1-800-767-1833.
An agency may not conduct or sponsor an information
As an alternative to waiting in line for assistance at your local
collection and a person is not required to respond to a
USCIS office, you can now schedule an appointment through
collection of information unless it displays a currently valid
the USCIS Internet-based system, InfoPass. To access the
OMB control number. The public reporting burden for this
system, visit the USCIS Web site. Use the InfoPass
collection of information is estimated at 55 minutes per
appointment scheduler and follow the screen prompts to set up
response, including the time for reviewing instructions,
your appointment. InfoPass generates an electronic
completing and submitting the form. Send comments
appointment notice that appears on the screen.
regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing
Penalties
this burden, to: U.S. Citizenship and Immigration Services,
Regulatory Coordination Division, Office of Policy &
Strategy, 20 Massachusetts Avenue, NW, Washington, DC
If you knowingly and willfully falsify or conceal a material
20529-2140. OMB No. 1615-0091. Do not mail your
fact or submit a false document with this request, we will deny
completed Form N-565 to this address.
the benefit you are filing for, and may deny any other
immigration benefit.
In addition, you will face severe penalties provided by law,
and may be subject to criminal prosecution.
USCIS Privacy Act Statement
AUTHORITIES: The information requested on this form,
and the associated evidence, is collected under the
Immigration and Nationality Act, section 101, et seq.
Form N-565 Instructions (Rev. 02/28/13) Y Page 3
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