Form N-400 - Application For Naturalization Page 3
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10Write your USCIS A-Number here:
Part 5. Information for Criminal Records Search
A
NOTE: The categories below are those required by the FBI. See instructions for more information.
A. Gender
B. Height
C. Weight
Feet
Inches
Pounds
Female
Male
D. Are you Hispanic or Latino?
No
Yes
E. Race (Select one or more)
White
Asian
Black or African
American Indian or Alaskan Native
Native Hawaiian or
American
Other Pacific Islander
F. Hair color
Black
Brown
Blonde
Gray
White
Red
Sandy
Bald (No Hair)
G. Eye color
Pink
Other
Brown
Blue
Green
Hazel
Gray
Black
Maroon
Part 6. Information About Your Residence and Employment
A.
Where have you lived during the last five years? Begin with where you live now and then list every place you lived for the last five
years. If you need more space, use a separate sheet of paper.
Dates (mm/dd/yyyy)
Street Number and Name, Apartment Number, City, State, Zip Code, and Country
From
To
Current Home Address - Same as Part 4.A
Present
B. Where have you worked (or, if you were a student, what schools did you attend) during the last five years? Include military service.
Begin with your current or latest employer and then list every place you have worked or studied for the last five years. If you need
more space, use a separate sheet of paper.
Dates (mm/dd/yyyy)
Employer or
Employer or School Address
Your
School Name
(Street, City, and State)
Occupation
From
To
Form N-400 (Rev. 06/17/11) Y Page 3
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