Application for NaturalizationFile Online

• Legal Form Number: N-400
• Section: Citizenship and Immigration Services (United States of America)
• Issuer: Citizenship and Immigration Services (United States of America)

Form N-400 Edition 09/17/19 E Page 1 of 20

For

USCIS

Use

Only

Other (Explain):

E.

Are applying on the basis of qualifying military service.

D.

C.

Have been a lawful permanent resident of the United States for at least 3 years. In addition, you have been married to

and living with the same U.S. citizen spouse for the last 3 years, and your spouse has been a U.S. citizen for the last

3 years at the time you filed your Form N-400.

B.

Have been a lawful permanent resident of the United States for at least 5 years.

A.

You are at least 18 years of age and:

Part 1. Information About Your Eligibility (Select only one box or your

Form N-400 may be delayed)

Enter Your 9 Digit A-Number:

Date Stamp

Remarks

Your Current Legal Name (do not provide a nickname)

Family Name (Last Name) Given Name (First Name) Middle Name (if applicable)

1.

Part 2. Information About You (Person applying for naturalization)

Family Name (Last Name) Given Name (First Name)

Your Name Exactly As It Appears on Your Permanent Resident Card (if applicable)2.

Are a lawful permanent resident of the United States and you are the spouse of a U.S. citizen and your U.S. citizen

spouse is regularly engaged in specified employment abroad. (See the Immigration and Nationality Act (INA) section

319(b).) If your residential address is outside the United States and you are filing under Section 319(b), select the

USCIS Field Office from the list below where you would like to have your naturalization interview:

Middle Name (if applicable)

START HERE - Type or print in black ink. Type or print "N/A" if an item is not applicable or the answer is none, unless

otherwise indicated. Failure to answer all of the questions may delay U.S. Citizenship and Immigration Services (USCIS) processing

your Form N-400. NOTE: You must complete Parts 1. - 15.

►A-

Action BlockReceipt

Application for Naturalization

Department of Homeland Security

U.S. Citizenship and Immigration Services

USCIS

Form N-400

OMB No. 1615-0052

Expires 11/30/2025

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1.

If your biological or legal adoptive mother or father is a U.S. citizen by birth, or was naturalized before you reached your 18th

birthday, you may already be a U.S. citizen. Before you consider filing this application, please visit the USCIS Website at

www.uscis.gov for more information on this topic and to review the instructions for Form N-600, Application for Certificate of

Citizenship, and Form N-600K, Application for Citizenship and Issuance of Certificate Under Section 322.

NOTE: Are either of your parents a United States citizen? If you answer “Yes,” then complete Part 6. Information About Your

Parents as part of this application. If you answer “No,” then skip Part 6. and go to Part 7. Biographic Information.

Form N-400 Edition 09/17/19 E Page 2 of 20

Part 2. Information About You (Person applying for naturalization) (continued)

Middle Name (if applicable)Given Name (First Name)Family Name (Last Name)

If you answered ''Yes," type or print the new name you would like to use in the spaces provided below.

NoYes

Would you like to legally change your name?

Read the Form N-400 Instructions before you decide whether or not you would like to legally change your name.

Name Change (Optional)4.

Date You Became a Lawful

Permanent Resident (mm/dd/yyyy)

9.8.

U.S. Social Security Number (if applicable)5.

Country of Citizenship or Nationality

11.

Country of Birth

10.

Date of Birth

(mm/dd/yyyy)

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6. USCIS Online Account Number (if any)

Gender

Male Female

7.

Do you have a physical or developmental disability or mental impairment that prevents you from

demonstrating your knowledge and understanding of the English language and/or civics requirements

for naturalization?

No

Yes

12.

If you answered "Yes," submit a completed Form N-648, Medical Certification for Disability Exceptions, when you file your

Form N-400.

13. Exemptions from the English Language Test

A. Are you 50 years of age or older and have you lived in the United States as a lawful permanent

resident for periods totaling at least 20 years at the time you file your Form N-400? NoYes

B. Are you 55 years of age or older and have you lived in the United States as a lawful permanent

resident for periods totaling at least 15 years at the time you file your Form N-400? NoYes

C. Are you 65 years of age or older and have you lived in the United States as a lawful permanent

resident for periods totaling at least 20 years at the time you file your Form N-400? (If you meet

this requirement, you will also be given a simplified version of the civics test.)

NoYes

A-

Part 3. Accommodations for Individuals With Disabilities and/or Impairments

I am deaf or hard of hearing and request the following accommodation. (If you are requesting a sign-language

interpreter, indicate for which language (for example, American Sign Language).)

If you answered "Yes," select any applicable box.

NoYesAre you requesting an accommodation because of your disabilities and/or impairments? 1.

I am blind or have low vision and request the following accommodation:

A.

B.

NOTE: Read the information in the Form N-400 Instructions before completing this part.

Middle Name (if applicable)Given Name (First Name)Family Name (Last Name)

Other Names You Have Used Since Birth (include nicknames, aliases, and maiden name, if applicable)3.

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