Form I-600 - 2009 Petition To Classify Orphan As An Immediate Relative
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4OMB No. 1615-0028; Expires 12/31/10
Form I-600, Petition to Classify
Department of Homeland Security
Orphan as an Immediate Relative
U.S. Citizenship and Immigration Services
Fee Stamp
TO THE U.S. SECRETARY OF STATE:
The petition was filed by:
Married petitioner
Unmarried petitioner
The petition is approved for orphan:
Adopted abroad
Coming to U.S. for adoption.
Pre adoption requirements have
been met
Remarks:
File Number:
DATE OF FAVORABLE
DETERMINATION
DD
DISTRICT
Type or print legibly in black ink. Complete a separate petition for each child.
Petition is being made to classify the named orphan as an immediate relative.
BLOCK I - Information About Petitioner
6. My telephone number is: (include area code)
1. My name is: (Last)
(First)
(Middle)
2. Other names used (including maiden name if appropriate):
7. I am a citizen of the United States through:
Birth
Parents
Naturalization
If acquired through naturalization, provide the following:
3. I reside in the U.S. at:
(C/O if appropriate)
a. Name under which you naturalized:
(Apt. No.)
(Number and Street)
b. Naturalization certificate number:
(Town or City)
(State) (Zip Code)
c. Date of naturalization (mm/dd/yyyy):
4. Address abroad (if any):
d. Place of naturalization:
(Number and Street)
(Apt. No.)
If acquired through parentage, have you obtained a
(Town or City)
(State or Province)
certificate in your own name based on that acquisition?
No
Yes
(Country)
If not, submit evidence of citizenship. See Page 2 of the
5. I was born on: (mm/dd/yyyy)
instructions.
In:
Have you or any person through whom you claimed
citizenship ever lost U.S. citizenship?
(Town or City)
(State or Province)
No
Yes (If "Yes," attach detailed
explanation)
(Country)
Received
Trans. In
Ret'd Trans. Out
Completed
Form I-600 (Rev. 12/30/09) N
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