Request For Action On Form I-600a
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1
2Request for Action on Form I-600A
Revised 09/24/10
Applicant Names______________________________________________ Form I-600A Approval
Date:________________
SIM Number__________________________________________________No-Fee Extension Approval Date:
_____________
Failure to submit this notice along with your request may result in processing delays.
Please mark all blocks that apply below:
I am requesting my one-time no-charge extension of Form I-600A. I have attached the following:
A letter requesting the extension
A copy of all previous Form I-600A approval notices (171H)
A copy of my current valid Form I-600A approval notice (171H)
An amended/updated home study with original signatures that is no more than six months old
A photocopy of my original home study
I am requesting my one-time, no-charge be re-fingerprinted. This is my first request for re-
fingerprinting. I have attached the following:
A letter listing the names and dates of birth of all adult members of my household
A copy of my current valid Form I-600A approval notice
A copy of my latest home study
I am requesting that an amended I-600A approval notice be issued due to the fact that certain
circumstances have changed. I have attached the following:
A letter explaining the nature of these changes
An amended/updated home study with original signatures that is no more than six months old
A photocopy of my original home study
A copy of my current valid Form I-600A approval notice
Circumstances have changed due to the addition of an adult (over 18 years) member of the household
since my original approval. Please contact the National Benefits Center by:
Calling the Adoptions National number: 877-424-8374 or
Emailing at: NBC.Adoptions@dhs.gov
I am requesting that my Form I-600A approval notice be transferred to a different overseas site than
originally indicated on my Form I600A.
This is my first request for a change of overseas site.
My original Form I-600A did not list a specific country and I now need to have an overseas
site notified of my approval.
I have attached the following:
A letter indicating from which country I intend to adopt and which overseas site I
would like notified.
An amended/updated home study (Required only if your original home study
specifically recommended your adoption for a child from a different country.)
A photocopy of my original home study
A copy of my current valid Form I-600A approval notice.
I am requesting to be re-fingerprinted. This is my second or subsequent request to be re-fingerprinted.
Please contact the National Benefits Center by:
Calling the Adoptions National number: 877-424-8374 or
Emailing at: NBC.Adoptions@dhs.gov
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