Petition to Classify Convention Adoptee as an Immediate Relative

• Legal Form Number: I-800
• Section: Citizenship and Immigration Services (United States of America)
• Issuer: Citizenship and Immigration Services (United States of America)

Form I-800, Petition to Classify Convention

Adoptee as an Immediate Relative

Department of Homeland Security

U.S. Citizenship and Immigration Services

Form I-800 03/10/17 N

2. Is the daytime phone number the same as the one provided on

Form I-800A?

START HERE - Type or Print (Use black ink)

Other Names Used (including maiden name if appropriate)

1. Provide the following information about yourself:

NOTICE

You may not submit Form I-800 if there have been certain changes in your circumstances

since your last home study was completed and your Form I-800A, Application for

Determination of Suitability to Adopt a Child from a Convention Country, was last

approved or extended. If there has been a change, STOP. See instructions for Form I-800

for more information on the type of changes requiring the filing of a new Form I-800A or

Form I-800A, Supplement 3.

NOTE: If you need more space to complete an answer, use a separate sheet of paper.

Write your name, your USCIS Account Number, and the child's current legal name at the

top of each sheet of paper and indicate the part and number of the item to which the

answer refers.

Part 1. Information About You (Person filing this petition)

Family Name (Last Name)

USCIS Account #

Home Address - Street Number and Name

U.S. Social Security # (if any)

City State or Province

Zip/Postal Code Country

Apt. #

Mailing Address (if different from home address)

City State or Province

Zip/Postal Code Country

E-Mail Address

(if any)

Apt. #

C/O (in care of)

Place of Birth (City/Town, State/Province, Country)

Given Name (First Name) Middle Name

Date of Birth (mm/dd/yyyy)

Contact Information:

Daytime Phone #

(with area/country code)

3. Is the e-mail address (if any) the same as the one provided on

Form I-800A?

Yes No

Yes No

Returned

Date

Date

Date

Date

Date

Date

Date

Date

Resubmitted

Reloc Sent

Reloc Rec'd

Receipt

For Official Use Only

ATTY State License #

To Be Completed By

Attorney or Representative, if any.

Check if G-28 is attached.

1. The petition is provisionally approved

for a Convention Adoptee who will be:

Adopted

abroad.

2. The child will seek:

IV.

Adjustment of Status under Sec. 245.

Provisional Action Block:

Final Action Block:

Officer Signature Date

Coming to the U.S. for

adoption. Preadoption

requirements met.

Child's legal name after adoption:

NIV, so as to apply for

naturalization under Sec. 322

after lawful admission.

3. The petitioner is:

Married Unmarried