OMB No. 1615-0059; Expires 09/30/2012
N-644, Application for
Department of Homeland Security
Posthumous Citizenship
U.S. Citizenship and Immigration Services
For USCIS Only
Fee Stamp
Part 1. Information About the Applicant (To be completed by the applicant only)
1. Name (Last/First/Middle)
8. Your Relationship to Decedent at Time of His/Her Death
(Check one)
Next-of-Kin
2. Address (Street Name and Number)
Spouse
a.
Parent
b.
(Town/City, State/Country, Zip/Postal Code)
Son/Daughter
c.
d.
Brother/Sister
3. If Abroad, City/Country of Nearest U.S. Embassy or Consulate
Representative
Executor or Administrator of Decedent's Estate
e.
4. Date of Birth
5. A-Number, if applicable
Guardian, Conservator, or Committee of Decedent's
f.
Next-of-Kin
g.
VA Recognized Service Organization (Name below)
(Name of Service Organization)
6. Total Number of Authorization Affidavits Attached
(See instructions)
7. Telephone Number (Include Area/Country Code)
9. E-mail Address
(
)
B. Information About the Decedent
1. Name Used During Active Service (Last/First/Middle)
7. Immigration Status at Time of Death (Permanent Resident,
Student, Visitor, etc.)
2. Other Names Used
8. A-Number or Other USCIS File Number
3. Date of Birth (mm/dd/yyyy) 4. Place of Birth (City/State/Country)
5. Date of Death (mm/dd/yyyy) 6. Place of Death (City/State/Country)
9. U.S. Social Security Number (If any)
Form N-644 (09/15/11) Y