Uscis Form N-400 - Application For Naturalisation Page 4

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Part 5. Information About Your Residence (continued)
A-
C.
Physical Address 2
Street Number and Name
Apt.
Ste.
Flr.
Number
City or Town
County
State
ZIP Code + 4
-
Province or Region
Postal Code
Country
(foreign address only)
(foreign address only)
(foreign address only)
From (mm/dd/yyyy)
To (mm/dd/yyyy)
Dates of
Residence
D.
Physical Address 3
Street Number and Name
Apt.
Ste.
Flr.
Number
City or Town
County
State
ZIP Code + 4
-
Province or Region
Postal Code
Country
(foreign address only)
(foreign address only)
(foreign address only)
From (mm/dd/yyyy)
To (mm/dd/yyyy)
Dates of
Residence
E.
Physical Address 4
Street Number and Name
Apt.
Ste.
Flr.
Number
City or Town
County
State
ZIP Code + 4
-
Province or Region
Postal Code
Country
(foreign address only)
(foreign address only)
(foreign address only)
From (mm/dd/yyyy)
To (mm/dd/yyyy)
Dates of
Residence
Part 6. Information About Your Parents
If neither one of your parents is a United States citizen, then skip this part and go to Part 7.
1.
Were your parents married before your 18th birthday?
Yes
No
Information About Your Mother
2.
Is your mother a U.S. citizen?
Yes
No
If you answered "Yes," complete the following information. If you answered "No," go to Item Number 3.
Form N-400 09/29/16 Y
Page 4 of 20

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