Form N-400 - Application For Naturalization
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10OMB No. 1615-0052
N-400 Application
Department of Homeland Security
U.S Citizenship and Immigration Services
for Naturalization
Print clearly or type your answers using CAPITAL letters. Failure to print clearly may delay your application. Use black ink.
Write your USCIS A-Number here:
Part 1. Your Name (P
erson applying for naturalization)
A
A. Your current legal name.
Family Name (Last Name)
For USCIS Use Only
Bar Code
Date Stamp
Given Name (First Name)
Full Middle Name (If applicable)
B. Your name exactly as it appears on your Permanent Resident Card.
Family Name (Last Name)
Remarks
Given Name (First Name)
Full Middle Name (If applicable)
C. If you have ever used other names, provide them below.
Family Name (Last Name)
Given Name (First Name)
Middle Name
D. Name change (optional)
Read the Instructions before you decide whether to change your name.
1. Would you like to legally change your name?
Yes
No
2. If ''Yes," print the new name you would like to use. Do not use initials or
abbreviations when writing your new name.
Action Block
Family Name (Last Name)
Given Name (First Name)
Full Middle Name
Part 2. Information About Your Eligibility
(Check only one)
I am at least 18 years old AND
I have been a lawful permanent resident of the United States for at least five years.
A.
I have been a lawful permanent resident of the United States for at least three years, and I
B.
have been married to and living with the same U.S. citizen for the last three years, and my
spouse has been a U.S. citizen for the last three years.
I am applying on the basis of qualifying military service.
C.
Other (Explain)
D.
Form N-400 (Rev. 06/17/11) Y
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