Instructions For N-565, Application For Replacement Naturalization/citizenship Document (Page 3 of 3) in pdf

Instructions For N-565, Application For Replacement Naturalization/citizenship Document Page 3

In addition, you will face severe penalties provided by law,

and may be subject to criminal prosecution.

Privacy Act Notice.

We ask for the information on this form, and associated

evidence, to determine if you have established eligibility for

the immigration benefit for which you are filing. Our legal

right to ask for this information can be found in the

Immigration and Nationality Act, as amended. We may

provide this information to other government agencies. Failure

to provide this information, and any requested evidence, may

delay a final decision or result in denial of your Form N-565.

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

OMB control number. The public reporting burden for this

collection of information is estimated at 55 minutes per

response, including the time for reviewing instructions,

completing and submitting the form. 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,

Regulatory Management Division, 111 Massachusetts

Avenue, N.W., 3rd Floor, Suite 3008, Washington, DC 20529.

OMB No. 1615-0091. Do not mail your application to this

address.

Form N-565 Instructions (Rev. 07/30/07)Y Page 3

Instructions For N-565, Application For Replacement Naturalization/citizenship Document Page 3