Form N-600k - Application For Citizenship And Issuance Of Certificate Under Section 322
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13Application for Citizenship and Issuance
of Certificate Under Section 322
USCIS
Form N-600K
Department of Homeland Security
OMB No. 1615-0087
U.S. Citizenship and Immigration Services
Expires 12/31/2018
Date Stamp
Receipt
Action Block
For
USCIS
Use
Only
Remarks
To be completed
Select this box if
Attorney State Bar Number
Attorney or Accredited Representative
by an Attorney
Form G-28 is
(if applicable)
USCIS Online Account Number (if any)
or Accredited
attached.
Representative (if any).
►
START HERE - Type or print in black ink.
Child's A-Number:
Part 1. Information About the Child's Eligibility
►
A-
1.
The application is being filed for a child. The child is under 18 years of age and
(Select only one box):
The BIOLOGICAL child of a qualifying U.S. citizen (USC) parent filing this application.
The ADOPTED child of a qualifying USC parent filing this application.
The grandchild of a qualifying USC grandparent or the child ward of a USC legal guardian filing this application within
five years of the death of the USC parent.
Part 2. Information About the Child (for whom this application is being filed)
1.
Current Legal Name (do not provide a nickname)
Family Name (Last Name)
Given Name (First Name)
Middle Name
2.
Your Name Exactly As It Appears on the Permanent Resident Card (if applicable)
Family Name (Last Name)
Given Name (First Name)
Middle Name
Other Names Used (if applicable)
3.
Provide all other names you have ever used, including nicknames, maiden name, and aliases.
Family Name (Last Name)
Given Name (First Name)
Middle Name
4.
U.S. Social Security Number (if applicable)
5.
USCIS Online Account Number (if any)
►
►
6.
Date of Birth (mm/dd/yyyy)
7.
Country of Birth
Form N-600K 02/13/17 N
Page 1 of 13
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