Form N-600k - Application For Citizenship And Issuance Of Certificate Page 2
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7Part 3. Additional information about the child. (Provide information about the child on whose behalf this
application for citizenship and a Certificate of Citizenship is being filed.) - Continued.
B. Mailing Address - Street Number and Name (If Different From Home Address)
Apartment Number
City
County
State or Province
Country
Zip Code
C. Daytime Phone Number (If any)
Evening Phone Number (If any)
E-Mail Address (If any)
D. Marital Status
Single, Never Married
Married
Divorced
Widowed
Marriage Annulled or Other (Explain)
E.
Information about entry into the United States and current immigration status.
(Do not complete this section. The Adjudicator will complete it with you during the interview.)
I arrived in the following manner:
Port of Entry (City/State)
Date of Entry (mm/dd/yyyy)
Current Immigration Status
Exact Name Used at Time of Entry:
F.
Do you know of any prior application for a certificate of citizenship or U.S. passport for this child?
No
Yes
G. Was the child adopted?
No
Yes (Please complete the following information.)
Date of Adoption (mm/dd/yyyy)
Date Legal Custody Began (mm/dd/yyyy)
Date Physical Custody Began (mm/dd/yyyy)
H. Were the child's parents married to each other when the child was born (or adopted)?
No
Yes
Part 4. Information about the child's U.S. citizen father or mother (or adoptive father or mother). (If you
are a United States citizen father or mother applying for citizenship and a Certificate of Citizenship on behalf
of your eligible child, provide information about yourself below). If you are a U.S. citizen grandparent or
legal guardian, provide information about the child's U.S. citizen parent in the sections noted.
A.
Current legal name of U.S. citizen father or mother.
Family Name (Last Name)
Given Name (First Name)
Full Middle Name (If applicable)
B.
Date of Birth (mm/dd/yyyy)
C. Country of Birth
D.
Home Address - Street Number and Name
Apartment Number
City
County
State or Province
Country
Zip Code
Form N-600K (02/05/12) Y Page 2
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