Form N-600k - Application For Citizenship And Issuance Of Certificate Under Section 322 Page 3
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13A-
Part 2. Information About the Child (for whom this application is being filed)
(continued)
16.
Was the child adopted?
Yes
No
A. Date of Adoption
B. Date Legal Custody Began
C. Date Physical Custody Began
(mm/dd/yyyy)
(mm/dd/yyyy)
(mm/dd/yyyy)
17.
Were the child's parents married to each other when the child was born (or adopted)?
Yes
No
Part 3. Information About the Child's U.S. Citizen Biological or Adoptive Parent
NOTE: Provide information about the U.S. citizen father or mother applying on behalf of the eligible child. Provide information
about the child's U.S. citizen parent in the sections noted if the U.S. citizen grandparent or legal guardian is filing this form.
1.
Current Legal Name of U.S. Citizen Parent
Family Name (Last Name)
Given Name (First Name)
Middle Name
2.
Date of Birth (mm/dd/yyyy)
3.
Country of Birth
4.
U.S. Social Security Number (if applicable)
►
5.
Physical Address
Street Number and Name (Do not provide a PO Box in this space unless it is your ONLY address.) Apt. Ste. Flr. Number
City or Town
State
ZIP Code
-
Province
Postal Code
Country
6.
Daytime Telephone Number
7.
Work Telephone Number (if any)
8.
Evening Telephone Number
9.
Mobile Telephone Number (if any)
10.
Email Address (if any)
Form N-600K 02/13/17 N
Page 3 of 13
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