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Item Number 14. Employment Position and Length of Employment. Provide an explanation of your employment

position requiring you to be absent from the United States. Also state the intended length of time you will be employed

when absent from the United States. If you are a religious worker filing Form N-470 after your return to the United States

from outside the United States, provide the entire length of time of your employment outside the United States in said

capacity.

Item Number 15. Income Tax. Select the box to indicate if you have, or have not, ever filed an income tax return as a

nonresident or otherwise claimed or received benefits as a nonresident alien under U.S. Federal, state, or local income tax

laws since you became a lawful permanent resident.

Part 3. Information About Family Members Who Reside With You

Item Number 1. Residence With You Inside the United States. Select the box to indicate whether you have lawful

permanent resident family members who reside with you inside the United States.

Item Number 2. Residence With You Outside the United States. Select the box to indicate whether those lawful

permanent resident family members will reside with you outside the United States.

If you select “Yes,” provide information for your spouse and all of your children who will reside with you outside the

United States.

Part 4. Applicant’s Statement, Contact Information, Certification, and Signature

Item Numbers 1. - 6. Select the appropriate box to indicate whether you read this application yourself or whether you

had an interpreter assist you. If someone assisted you in completing the application, select the box indicating that you

used a preparer. Further, you must sign and date your application and provide your daytime telephone number, mobile

telephone number (if any), and email address (if any). Every application MUST contain the signature of the applicant (or

parent or legal guardian, if applicable). A stamped or typewritten name in place of a signature is not acceptable.

Part 5. Interpreter’s Contact Information, Certification, and Signature

Item Numbers 1. - 7. If you used anyone as an interpreter to read the Instructions and questions on this application to

you in a language in which you are fluent, the interpreter must fill out this section, provide his or her name, the name and

address of his or her business or organization (if any), his or her daytime telephone number, his or her mobile telephone

number (if any), and his or her email address (if any). The interpreter must sign and date the application.

Part 6. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than

the Applicant

Item Numbers 1. - 8. This section must contain the signature of the person who completed your application, if other than

you, the applicant. If the same individual acted as your interpreter and your preparer, that person should complete both

Part 5. and Part 6. If the person who completed this application is associated with a business or organization, that person

should complete the business or organization name and address information. Anyone who helped you complete this

application MUST sign and date the application. A stamped or typewritten name in place of a signature is not acceptable.

If the person who helped you prepare your application is an attorney or accredited representative whose representation

extends beyond preparation of this of this application, he or she may be obliged to also submit a completed Form G-28,

Notice of Entry of Appearance as Attorney or Accredited Representative, along with your application.

Part 7. Additional Information

Item Numbers 1. - 6. If you need extra space to provide any additional information within this application, use the space

provided in Part 7. Additional Information. If you need more space than what is provided in Part 7., you may make

copies of Part 7. to complete and file with your application, or attach a separate sheet of paper. Type or print your name

and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which

your answer refers; and sign and date each sheet.

Form N-470 Instructions 12/23/16 N

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Instructions For Form N-470 - Application To Preserve Residence For Naturalization Purposes Page 5