Application for Citizenship and Issuance of Certificate Under Section 322 Department of Homeland Security U.S. Citizenship and Immigration Services Date Stamp Receipt USCIS Form N-600K OMB No. 1615-0087 Expires 12/31/2018 Action Block For USCIS Use Only Remarks To be completed by an Attorney or Accredited Representative (if any). Select this box if Form G-28 is attached. Attorney State Bar Number (if applicable) Attorney or Accredited Representative USCIS Online Account Number (if any) START HERE - Type or print in black ink. Part 1. Information About the Child's Eligibility 1. The application is being filed for a child. The child is under 18 years of age and (Select only one box): Child's A-Number: A- The BIOLOGICAL child of a qualifying U.S. citizen (USC) parent filing this application. The ADOPTED child of a qualifying USC parent filing this application. The grandchild of a qualifying USC grandparent or the child ward of a USC legal guardian filing this application within five years of the death of the USC parent. Part 2. Information About the Child (for whom this application is being filed) 1. Current Legal Name (do not provide a nickname) Family Name (Last Name) Given Name (First Name) Middle Name 2. Your Name Exactly As It Appears on the Permanent Resident Card (if applicable) Family Name (Last Name) Given Name (First Name) Middle Name 3. Other Names Used (if applicable) Provide all other names you have ever used, including nicknames, maiden name, and aliases. Family Name (Last Name) Given Name (First Name) Middle Name 4. U.S. Social Security Number (if applicable) 5. USCIS Online Account Number (if any) 6. Date of Birth (mm/dd/yyyy) 7. Country of Birth Form N-600K 02/13/17 N Page 1 of 13 American LegalNet, Inc. www.FormsWorkFlow.com Part 2. Information About the Child (for whom this application is being filed) (continued) 8. Prior Country of Citizenship or Nationality 9. Gender Male 11. Mailing Address In Care Of Name (if any) Female 10. A- Height Feet Inches Street Number and Name Apt. Ste. Flr. Number City or Town State ZIP Code - Province Postal Code Country 12. Physical Address (Do not provide a PO Box in this space unless it is the ONLY address.) Street Number and Name Apt. Ste. Flr. Number City or Town State ZIP Code - Province Postal Code Country 13. Marital Status Single, Never Married Other (Explain): Married Divorced Widowed Separated Marriage Annulled 14. Information About the Admission Into the United States and Current Immigration Status NOTE: Do NOT complete this section. The USCIS officer will complete it during the interview. A. Arrived in the following manner: Port-of-Entry City or Town State Date of Entry (mm/dd/yyyy) Exact Name Used at Time of Entry Family Name (Last Name) Given Name (First Name) Middle Name B. Current Immigration Status 15. Was there any prior application for citizenship or for a U.S. passport? Yes No Form N-600K 02/13/17 N Page 2 of 13 American LegalNet, Inc. www.FormsWorkFlow.com Part 2. Information About the Child (for whom this application is being filed) (continued) 16. Was the child adopted? A. Date of Adoption (mm/dd/yyyy) B. Date Legal Custody Began (mm/dd/yyyy) A- Yes C. Date Physical Custody Began (mm/dd/yyyy) No 17. Were the child's parents married to each other when the child was born (or adopted)? Yes No Part 3. Information About the Child's U.S. Citizen Biological or Adoptive Parent NOTE: Provide information about the U.S. citizen father or mother applying on behalf of the eligible child. Provide information about the child's U.S. citizen parent in the sections noted if the U.S. citizen grandparent or legal guardian is filing this form. 1. Current Legal Name of U.S. Citizen Parent Family Name (Last Name) Given Name (First Name) Middle Name 2. Date of Birth (mm/dd/yyyy) 3. Country of Birth 4. U.S. Social Security Number (if applicable) 5. Physical Address Street Number and Name (Do not provide a PO Box in this space unless it is your ONLY address.) Apt. Ste. Flr. Number City or Town State ZIP Code - Province Postal Code Country 6. Daytime Telephone Number 7. Work Telephone Number (if any) 8. Evening Telephone Number 9. Mobile Telephone Number (if any) 10. Email Address (if any) Form N-600K 02/13/17 N Page 3 of 13 American LegalNet, Inc. www.FormsWorkFlow.com Part 3. Information About the Child's U.S. Citizen Biological or Adoptive Parent (continued) 11. The parent is a U.S. citizen by: Birth in the United States Birth abroad to U.S. citizen parents Certificate of Citizenship Number A- Acquisition after birth through naturalization of alien parents Alien Registration Number (A-Number) (if known) ANaturalization Place of Naturalization Name of Court or USCIS Office Location City or Town State Certificate of Naturalization Number A-Number (if known) Date of Naturalization (mm/dd/yyyy) A12. Has the U.S. citizen father or mother ever lost U.S. citizenship or taken any action that would cause loss of U.S. citizenship? Yes No If the answer is "Yes" to Item Number 12., provide a full explanation in the space provided in Part 11. Additional Information. 13. Marital History A. How many times has the U.S. citizen father or mother been married (including annulled marriages and marriages to the same person)? B. What is the U.S. citizen father or mother's current marital status? Single, Never Married Other (Explain): C. Information About the U.S. Citizen Father's or Mother's Current Spouse Family Name (Last Name) Given Name (First Name) Middle Name Married Divorced Widowed Separated Marriage Annulled Date of Birth (mm/dd/yyyy) Country of Birth Country of Citizenship or Nationality Spouse's Physical Address Street Number and Name (Do not provide a PO Box in this space unless it is your spouse's ONLY address.) Apt. Ste. Flr. Number City or Town State ZIP Code - Province Postal Code Country Form N-600K 02/13/17 N Page 4 of 13 American LegalNet, Inc. www.FormsWorkFlow.com Part 3. Information About the Child's U.S. Citizen Biological or Adoptive Parent (continued) Date of Marriage (mm/dd/yyyy) A- Place of Marriage City or Town State Country Spouse's Immigration Status U.S. Citizen Lawful Permanent Resident Other (Explain): Yes No D. Is the U.S. citizen father's or mother's current spouse also the child's biological (or adoptive) parent? 14. Member of U.S. Armed Forces A. Is the sponsoring U.S. citizen parent a member of the U.S. Armed Forces? B. If the answer is "Yes," then are there official orders authorizing the child to accompany an