Form N-336 - Request For A Hearing On A Decision In Naturalization Proceedings Under Section 336 - U.s. Citizenship And Immigration Services

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Request for a Hearing on a Decision in Naturalization
Proceedings Under Section 336
USCIS
Form N-336
Department of Homeland Security
OMB No. 1615-0050
U.S. Citizenship and Immigration Services
Expires 05/31/2019
For USCIS Use Only
Barcode
Date Stamp
Remarks
Re-Affirm N-400 Denial
Re-Determine N-400 Denial
Attorney State Bar Number
Select this box if
Attorney or Accredited Representative
To be completed by an
Form G-28 is
(if applicable)
USCIS Online Account Number (if any)
attorney or accredited
attached.
representative (if any).
START HERE - Type or print in black ink.
NOTE: Type or print "N/A" if an item is not applicable. Type or print "None" if the answer is none. Failure to answer all of the
questions may delay your Form N-336.
Enter Your 9 Digit A-Number:
Part 1. Information About You, the Naturalization Applicant
A-
1.
Current Legal Name (do not provide a nickname)
Family Name (Last Name)
Given Name (First Name)
Middle Name
2.
Other Names Used (if any)
List all other names you have ever used, including aliases, maiden name, and nicknames. If you need extra space to complete this
section, use the space provided in Part 9. Additional Information.
Family Name (Last Name)
Given Name (First Name)
Middle Name
3.
Date of Birth (mm/dd/yyyy)
4.
USCIS Online Account Number (if any)
5.
Physical Address (do not provide a PO Box in this space unless it is your only address)
Street Number and Name
Apt.
Ste.
Flr. Number
State
City or Town
County
ZIP Code + 4
-
Province or Region
Postal Code
Country
(foreign address only)
(foreign address only)
(foreign address only)
Form N-336 12/23/16 N
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