For nimmo

1. Part 1. Information About Your Eligibility. (Check only one box or your Form N-400 may be delayed). You are at least 18 years old and: Check 1. Have been a Permanent Resident of the United States for at least 5 years. : B
2. Part 1. Information About Your Eligibility. (Check only one box or your Form N-400 may be delayed). You are at least 18 years old and: If 5. Other (explain), is Checked, Select Explanation from List.:
3. Part 2. Information About You (Person applying for naturalization). 1. Your Current Legal Name (do not provide a nickname). Enter Middle Name (if applicable).:
4. Part 2. Information About You (Person applying for naturalization). 1. Your Current Legal Name (do not provide a nickname). Enter Given Name (First Name).:
5. Part 2. Information About You (Person applying for naturalization). 1. Your Current Legal Name (do not provide a nickname). Enter Family Name (Last Name).:
6. Part 2. Information About You (Person applying for naturalization). 2. Your Name Exactly As It Appears on Your Permanent Resident Card (if applicable). Enter Family Name (Last Name).:
7. Part 2. Information About You (Person applying for naturalization). 2. Your Name Exactly As It Appears on Your Permanent Resident Card (if applicable). Enter Given Name (First Name).:
8. Part 2. Information About You (Person applying for naturalization). 3. Other Name or Names You Have Used Since Birth (include nicknames, aliases, and maiden name if applicable). Line 2. Enter Middle Name (if applicable).:
9. Part 2. Information About You (Person applying for naturalization). 3. Other Name or Names You Have Used Since Birth (include nicknames, aliases, and maiden name if applicable). Line 2. Enter Given Name (First Name).:
10. Part 2. Information About You (Person applying for naturalization). 3. Other Name or Names You Have Used Since Birth (include nicknames, aliases, and maiden name if applicable). Line 2. Enter Family Name (Last Name).:
11. Part 2. Information About You (Person applying for naturalization). 3. Other Name or Names You Have Used Since Birth (include nicknames, aliases, and maiden name if applicable). Line 1. Enter Middle Name (if applicable).:
12. Part 2. Information About You (Person applying for naturalization). 3. Other Name or Names You Have Used Since Birth (include nicknames, aliases, and maiden name if applicable). Line 1. Enter Given Name (First Name).:
13. Part 2. Information About You (Person applying for naturalization). 3. Other Name or Names You Have Used Since Birth (include nicknames, aliases, and maiden name if applicable). Line 1. Enter Family Name (Last Name).:
14. Part 2. Information About You (Person applying for naturalization). 2. Your Name Exactly As It Appears on Your Permanent Resident Card (if applicable). Enter Middle Name (if applicable).:
15. Page 21. Alien Registration Number (A-Number). No Entry.: 095400844
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17. Part 2. Information About You. 4. Name Change (optional). Read the Form N-400 Instructions before you decide whether or not you would like to legally change your name. Would you like to legally change your name? If ''Yes," print the new name you would like to use in the space below. Enter Middle Name (if applicable).:
18. Part 2. Information About You. 4. Name Change (optional). Read the Form N-400 Instructions before you decide whether or not you would like to legally change your name. Would you like to legally change your name? If ''Yes," print the new name you would like to use in the space below. Enter Given Name (First Name).:
19. Part 2. Information About You. 4. Name Change (optional). Read the Form N-400 Instructions before you decide whether or not you would like to legally change your name. Would you like to legally change your name? If ''Yes," print the new name you would like to use in the space below. Enter Family Name (Last Name).:
20. Part 2. Information About You. 4. Name Change (optional). Read the Form N-400 Instructions before you decide whether or not you would like to legally change your name. Would you like to legally change your name? Check Yes. If ''Yes," print the new name you would like to use in the space below. : N
21. Part 2. Information About You. 7. Enter Date You Became a Permanent Resident as 2-digit Month, 2-digit Day, and 4-digit Year.: 2011-02-07
22. Part 2. Information About You. 10. If Require another type of accommodation. (explain):, is Checked, Enter Explanation of Requested Accommodation.:
23. Part 2. Information About You. 10. Are you requesting an accommodation to the naturalization process because of a disability and/or an impairment? (See Form N-400 Instructions for accommodation examples). If "Yes," check the box or boxes below that applies: Check Require another type of accommodation. (explain)::
24. Part 2. Information About You. 10. Are you requesting an accommodation to the naturalization process because of a disability and/or an impairment? (See Form N-400 Instructions for accommodation examples). If "Yes," check the box or boxes below that applies: Check Blind or low vision.:
25. Part 2. Information About You. 10. Are you requesting an accommodation to the naturalization process because of a disability and/or an impairment? (See Form N-400 Instructions for accommodation examples). If "Yes," check the box or boxes below that applies: Check Use a wheelchair or other device that assists with mobility.:
26. Part 2. Information About You. 10. Are you requesting an accommodation to the naturalization process because of a disability and/or an impairment? (See Form N-400 Instructions for accommodation examples). If "Yes," check the box or boxes below that applies: Check Deaf or hard of hearing and need an interpreter who uses the following sign language (e. g., American Sign Language): :
27. Part 2. Information About You. 10. Are you requesting an accommodation to the naturalization process because of a disability and/or an impairment? (See Form N-400 Instructions for accommodation examples). Check Yes. If "Yes," check the box or boxes below that applies:: N
28. Part 2. Information About You. 11. 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? Check Yes. If "Yes," submit a completed Form N-6 48, Medical Certification for Disability Exceptions, when you file your Form N-400.: N
29. Part 2. Information About You. 12. 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 Permanent Resident for periods totaling at least 20 years at the time of filing your Form N-400? Check Yes.: N
30. Part 2. Information About You. 12. Exemptions from the English Language Test. B. Are you 55 years of age or older and have you lived in the United States as a Permanent Resident for periods totaling at least 15 years at the time of filing your Form N-400? Check Yes.: N
31. Part 2. Information About You. 12. Exemptions from the English Language Test. C. Are you 65 years of age or older and have you lived in the United States as a Permanent Resident for periods totaling at least 20 years at the time of filing your Form N-400? (If you meet this requirement, you will also be given a simplified version of the civics test.) Check Yes.: N
32. Part 2. Information About You. 5. Enter U. S. Social Security Number (if applicable).: 269089325
33. Part 2. Information About You. 6. Enter Date of Birth as 2-digit Month, 2-digit Day, and 4-digit Year.: 01/19/1979
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35. Part 2. Information About You. 8. Enter Country of Birth.: Nigeria
36. Part 2. Information About You. 9. Enter Country of Citizenship or Nationality.: Nigeria
37. Part 2. Information About You. 10. If Deaf or hard of hearing and need an interpreter who uses the following sign language (e. g., American Sign Language):, is Checked, Enter Requested Sign Language.:
38. Part 3. Information to Contact You. 5. Enter E-mail Address, if any. : [email protected]
39. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. A. Mailing Address (if different from the address above). Enter City.:
40. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. A. Mailing Address (if different from the address above). Select State from a List of States.:
41. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. A. Mailing Address (if different from the address above). Zip Code Plus 4. Enter 5-digit Zip Code.:
42. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. A. Mailing Address (if different from the address above). Enter Postal Code (foreign address only).:
43. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. A. Mailing Address (if different from the address above). Enter Province or Region (foreign address only).:
44. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. A. Mailing Address (if different from the address above). Enter Street Number and Name.:
45. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. A. Mailing Address (if different from the address above). Enter C/O ("In Care Of" Name, if applicable).:
46. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. A. Mailing Address (if different from the address above). If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.:
47. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. A. Mailing Address (if different from the address above). Check Apartment.:
48. Part 3. Information to Contact You. 1. Daytime Phone Number. Enter 3-digit Area Code.: 419
49. Part 3. Information to Contact You. 1. Daytime Phone Number. Enter First 3 digits of Phone Number. : 302
50. Part 3. Information to Contact You. 1. Daytime Phone Number. Enter Last 4 digits of Phone Number. : 5839
51. Part 3. Information to Contact You. 2. Work Phone Number, if any. Enter 3-digit Area Code.:
52. Part 3. Information to Contact You. 2. Work Phone Number, if any. Enter First 3 digits of Phone Number. :
53. Part 3. Information to Contact You. 2. Work Phone Number, if any. Enter Last 4 digits of Phone Number. :
54. Part 3. Information to Contact You. 3. Evening Phone Number. Enter 3-digit Area Code.: 419
55. Part 3. Information to Contact You. 3. Evening Phone Number. Enter First 3 digits of Phone Number. : 302
56. Part 3. Information to Contact You. 3. Evening Phone Number. Enter Last 4 digits of Phone Number. : 5839
57. Part 3. Information to Contact You. 4. Mobile Phone Number, if any. Enter 3-digit Area Code.: 419
58. Part 3. Information to Contact You. 4. Mobile Phone Number, if any. Enter First 3 digits of Phone Number. : 302
59. Part 3. Information to Contact You. 4. Mobile Phone Number, if any. Enter Last 4 digits of Phone Number. : 5839
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61. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. A. Mailing Address (if different from the address above). Zip Code Plus 4. Enter 4-digit Zip Code Extension.:
62. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. A. Mailing Address (if different from the address above). Enter Country (foreign address only).:
63. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. Enter Province or Region (foreign address only).:
64. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. Enter City.: Lima
65. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. Enter Street Number and Name.: 1540 Plainfield Dr
66. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. Zip Code Plus 4. Enter 5-digit Zip Code.: 45805
67. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. Select State from a List of States.: OH
68. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. Enter County.: Allen
69. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. Date of Residence. Enter From Date as 2-digit Month, 2-digit Day, and 4-digit Year.: 2012-08-01
70. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet(s) of paper. No Entry. Present.: Present
71. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.:
72. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. Check Apartment.:
73. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. Enter Postal Code (foreign address only).:
74. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. Zip Code Plus 4. Enter 4-digit Zip Code Extension.: 1070
75. Part 4. Information About Your Residence. 1. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. Enter Country (foreign address only).: USA
76. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 2. Enter Street Number and Name.: 1923 Allentown Rd
77. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 2. Date of Residence. Enter From Date as 2-digit Month, 2-digit Day, and 4-digit Year.: 2009-01-01
78. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 2. Date of Residence. Enter To Date as 2-digit Month, 2-digit Day, and 4-digit Year.: 2012-08-01
79. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 2. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.:
80. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 2. Check Apartment.:
81. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 2. Zip Code Plus 4. Enter 5-digit Zip Code.: 45805
82. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 2. Select State from a List of States.: OH
83. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 2. Enter County.: Allen
84. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 2. Enter City.: Lima
85. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 2. Zip Code Plus 4. Enter 4-digit Zip Code Extension.: 0000
86. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 3. Date of Residence. Enter To Date as 2-digit Month, 2-digit Day, and 4-digit Year.:
87. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 3. Date of Residence. Enter From Date as 2-digit Month, 2-digit Day, and 4-digit Year.:
88. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 3. Enter Postal Code (foreign address only).:
89. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 3. Enter Province or Region (foreign address only).:
90. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 3. Zip Code Plus 4. Enter 5-digit Zip Code.:
91. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 3. Select State from a List of States.:
92. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 3. Enter County.:
93. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 3. Enter City.:
94. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 3. Enter Street Number and Name.:
95. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 4. Date of Residence. Enter To Date as 2-digit Month, 2-digit Day, and 4-digit Year.:
96. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 4. Date of Residence. Enter From Date as 2-digit Month, 2-digit Day, and 4-digit Year.:
97. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 4. Enter Postal Code (foreign address only).:
98. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 4. Enter Province or Region (foreign address only).:
99. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 4. Zip Code Plus 4. Enter 5-digit Zip Code.:
100. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 4. Select State from a List of States.:
101. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 4. Enter County.:
102. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 4. Enter City.:
103. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 4. Enter Street Number and Name.:
104. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 4. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.:
105. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 4. Check Apartment.:
106. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 3. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.:
107. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 3. Check Apartment.:
108. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 3. Zip Code Plus 4. Enter 4-digit Zip Code Extension.:
109. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 4. Zip Code Plus 4. Enter 4-digit Zip Code Extension.:
110. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 3. Enter Country (foreign address only).:
111. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 4. Enter Country (foreign address only).:
112. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 2. Enter Postal Code (foreign address only).:
113. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 2. Enter Province or Region (foreign address only).:
114. Part 4. Information About Your Residence. Where have you lived during the last 5 years? Begin with where you live now and then list every location where you have lived during the last 5 years. If you need more space, use an additional sheet or sheets of paper. 2. Enter Country (foreign address only).: USA
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116. Part 5. Information About Your Parents. If your biological or legally adoptive mother or father is a U. S. citizen by birth, or naturalized before you reached your 18th birthday, you may already be a U. S. citizen. Visit the U S C I S Web site at www.u s c i s.gov for further information on this topic before you consider filing Form N-400. 1. Were your parents married before your 18th birthday? Check Yes.: Y
117. Part 5. Information About Your Parents. If your biological or legally adoptive mother or father is a U. S. citizen by birth, or naturalized before you reached your 18th birthday, you may already be a U. S. citizen. Visit the U S C I S Web site at www.u s c i s.gov for further information on this topic before you consider filing Form N-400. 2. Is your mother a U. S. citizen? Check Yes. If "Yes," complete the following information.: N
118. Part 5. Information About Your Parents. If your biological or legally adoptive mother or father is a U. S. citizen by birth, or naturalized before you reached your 18th birthday, you may already be a U. S. citizen. Visit the U S C I S Web site at www.u s c i s.gov for further information on this topic before you consider filing Form N-400. 2. Is your mother a U. S. citizen? If "Yes," complete the following information. C. Enter Mother's Date of Birth as 2-digit Month, 2-digit Day, and 4-digit Year.:
119. Part 5. Information About Your Parents. If your biological or legally adoptive mother or father is a U. S. citizen by birth, or naturalized before you reached your 18th birthday, you may already be a U. S. citizen. Visit the U S C I S Web site at www.u s c i s.gov for further information on this topic before you consider filing Form N-400. 2. Is your mother a U. S. citizen? If "Yes," complete the following information. A. Current Legal Name of U. S. Citizen Mother. Enter Mother's Middle Name, if applicable.:
120. Part 5. Information About Your Parents. If your biological or legally adoptive mother or father is a U. S. citizen by birth, or naturalized before you reached your 18th birthday, you may already be a U. S. citizen. Visit the U S C I S Web site at www.u s c i s.gov for further information on this topic before you consider filing Form N-400. 2. Is your mother a U. S. citizen? If "Yes," complete the following information. A. Current Legal Name of U. S. Citizen Mother. Enter Mother's Given Name (First Name).:
121. Part 5. Information About Your Parents. If your biological or legally adoptive mother or father is a U. S. citizen by birth, or naturalized before you reached your 18th birthday, you may already be a U. S. citizen. Visit the U S C I S Web site at www.u s c i s.gov for further information on this topic before you consider filing Form N-400. 2. Is your mother a U. S. citizen? If "Yes," complete the following information. A. Current Legal Name of U. S. Citizen Mother. Enter Mother's Family Name (Last Name).:
122. Part 5. Information About Your Parents. If your biological or legally adoptive mother or father is a U. S. citizen by birth, or naturalized before you reached your 18th birthday, you may already be a U. S. citizen. Visit the U S C I S Web site at www.u s c i s.gov for further information on this topic before you consider filing Form N-400. 2. Is your mother a U. S. citizen? If "Yes," complete the following information. B. Enter Mother's Country of Birth.:
123. Part 5. Information About Your Parents. If your biological or legally adoptive mother or father is a U. S. citizen by birth, or naturalized before you reached your 18th birthday, you may already be a U. S. citizen. Visit the U S C I S Web site at www.u s c i s.gov for further information on this topic before you consider filing Form N-400. 3. Is your father a U. S. citizen? Check Yes. If ''Yes," complete the information below. : N
124. Part 5. Information About Your Parents. If your biological or legally adoptive mother or father is a U.S. citizen by birth, or naturalized before you reached your 18th birthday, you may already be a U. S. citizen. Visit the U S C I S Web site at www.u s c i s.gov for further information on this topic before you consider filing Form N-400. 3. Is your father a U. S. citizen? If ''Yes," complete the information below. A. Current Legal Name of U. S. Citizen Father. Enter Father's Middle Name, if applicable.:
125. Part 5. Information About Your Parents. If your biological or legally adoptive mother or father is a U. S. citizen by birth, or naturalized before you reached your 18th birthday, you may already be a U. S. citizen. Visit the U S C I S Web site at www.u s c i s.gov for further information on this topic before you consider filing Form N-400. 3. Is your father a U. S. citizen? If ''Yes," complete the information below. A. Current Legal Name of U. S. Citizen Father. Enter Father's Given Name (First Name).:
126. Part 5. Information About Your Parents. If your biological or legally adoptive mother or father is a U. S. citizen by birth, or naturalized before you reached your 18th birthday, you may already be a U. S. citizen. Visit the U S C I S Web site at www.u s c i s.gov for further information on this topic before you consider filing Form N-400. 3. Is your father a U. S. citizen? If ''Yes," complete the information below. A. Current Legal Name of U. S. Citizen Father. Enter Father's Family Name (Last Name).:
127. Part 5. Information About Your Parents. If your biological or legally adoptive mother or father is a U. S. citizen by birth, or naturalized before you reached your 18th birthday, you may already be a U. S. citizen. Visit the U S C I S Web site at www.u s c i s.gov for further information on this topic before you consider filing Form N-400. 3. Is your father a U. S. citizen? If ''Yes," complete the information below. C. Enter Father's Date of Birth as 2-digit Month, 2-digit Day, and 4-digit Year.:
128. Part 6. Information for Criminal Records. NOTE: USCIS requires you to complete the categories below to conduct background checks. (See Form N-400 Instructions for more information) 2. Height. Enter Feet.: 6
129. Part 6. Information for Criminal Records. NOTE: USCIS requires you to complete the categories below to conduct background checks. (See Form N-400 Instructions for more information) 2. Height. Enter Inches.: 00
130. Part 6. Information for Criminal Records. NOTE: USCIS requires you to complete the categories below to conduct background checks. (See Form N-400 Instructions for more information) 4. Race (Select one or more). Check American Indian or Alaska Native.:
131. Part 6. Information for Criminal Records. NOTE: USCIS requires you to complete the categories below to conduct background checks. (See Form N-400 Instructions for more information)4. Race (Select one or more). Check Asian.:
132. Part 6. Information for Criminal Records. NOTE: USCIS requires you to complete the categories below to conduct background checks. (See Form N-400 Instructions for more information) 1. Gender. Check Female.: M
133. Part 6. Information for Criminal Records. NOTE: USCIS requires you to complete the categories below to conduct background checks. (See Form N-400 Instructions for more information) 4. Race (Select one or more). Check Black or African American.: B
134. Part 6. Information for Criminal Records. NOTE: USCIS requires you to complete the categories below to conduct background checks. (See Form N-400 Instructions for more information) 4. Race (Select one or more). Check Native Hawaiian or Other Pacific Islander.:
135. Part 6. Information for Criminal Records. NOTE: USCIS requires you to complete the categories below to conduct background checks. (See Form N-400 Instructions for more information) 5. Hair Color. Check Black.: BLK
136. Part 5. Information About Your Parents. If your biological or legally adoptive mother or father is a U. S. citizen by birth, or naturalized before you reached your 18th birthday, you may already be a U. S. citizen. Visit the U S C I S Web site at www.u s c i s.gov for further information on this topic before you consider filing Form N-400. 3. Is your father a U. S. citizen? If ''Yes," complete the information below. B. Enter Father's Country of Birth.:
137. Part 6. Information for Criminal Records. NOTE: USCIS requires you to complete the categories below to conduct background checks. (See Form N-400 Instructions for more information) 4. Race (Select one or more). Check White.:
138. Part 6. Information for Criminal Records. NOTE: USCIS requires you to complete the categories below to conduct background checks. (See Form N-400 Instructions for more information) 3. Ethnicity (Select one). Check Hispanic or Latino.:
139. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 1. Enter City. : Perrysburg
140. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 1. Select State from a List of States.: OH
141. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 1. Zip Code Plus 4. Enter 5-digit Zip Code.: 43551
142. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 1. Zip Code Plus 4. Enter 4-digit Zip Code Extension.: 4602
143. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 1. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.:
144. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 1. Check Apartment.:
145. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 1. Enter Street Number and Name. : 28727 Oregon Rd
146. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 1. Enter Employer or School Name. : Walgreens Distribution Center
147. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 1. Enter Date From as 2 digit month, 2 digit day and 4 digit year.: 2008-01-20
148. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 1. Enter Date To as 2 digit month, 2 digit day and 4 digit year.: 2011-08-30
149. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 1. Select Your Occupation from List.:
150. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 2. Enter Employer or School Name. : Colorado Technical University
151. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet(s) of paper to complete. 2. Enter Province or Region (foreign address only).: Colorado Springs
152. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 2. Select State from a List of States.: CO
153. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 2. Zip Code Plus 4. Enter 5-digit Zip Code.: 80907
154. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 2. Enter Street Number and Name. : 4435 North Chestnut Street
155. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 2. Enter Date From as 2 digit month, 2 digit day and 4 digit year.: 2011-08-15
156. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 2. Enter Date To as 2 digit month, 2 digit day and 4 digit year.: 2013-06-25
157. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 2. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.:
158. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 2. Check Apartment.:
159. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 2. Zip Code Plus 4. Enter 4-digit Zip Code Extension.: 3812
160. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 1. Enter Postal Code (foreign address only).:
161. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 1. Enter Country (foreign address only).: USA
162. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 1. Enter Province or Region (foreign address only).:
163. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 2. Enter Postal Code (foreign address only).:
164. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 2. Enter Country (foreign address only).: USA
165. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 2. Enter Province or Region (foreign address only).:
166. PaperFormsBarcodep5:
167. Part 6. Information for Criminal Records Check. NOTE: USCIS requires you to complete the categories below to conduct background checks. (See Form N-400 Instructions for more information) 6. Eye color. Check Other.: BRO
168. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 2. Select Your Occupation from List.:
169. PaperFormsBarcode1p6:
170. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 3. Enter Employer or School Name. : Columbia Southern University
171. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 3. Enter Street Number and Name. : 21982 University Lane
172. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 3. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.:
173. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 3. Check Apartment.:
174. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 3. Enter Date To as 2 digit month, 2 digit day and 4 digit year.: 2014-11-17
175. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 3. Enter Date From as 2 digit month, 2 digit day and 4 digit year.: 2013-08-08
176. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 3. Zip Code Plus 4. Enter 5-digit Zip Code.: 36561
177. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 3. Select State from a List of States.: AL
178. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet(s) of paper to complete. 3. Enter City.: Orange Beach
179. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 3. Zip Code Plus 4. Enter 4-digit Zip Code Extension.: 9000
180. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 3. Enter Postal Code (foreign address only).:
181. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 3. Enter Country (foreign address only).: USA
182. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 3. Enter Province or Region (foreign address only).:
183. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 1. Enter Date You Returned to the United States as 2-digit Month, 2-digit Day, and 4-digit Year.: 2013-02-22
184. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 2. Enter Total Days Outside the United States.:
185. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 3. Enter Date You Returned to the United States as 2-digit Month, 2-digit Day, and 4-digit Year.:
186. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 4. Enter Total Days Outside the United States.:
187. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 5. Enter Date You Returned to the United States as 2-digit Month, 2-digit Day, and 4-digit Year.:
188. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 6. Enter Total Days Outside the United States.:
189. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 6. Enter Countries to Which You Traveled.:
190. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 6. Did Trip Last 6 Months or More? Check Yes.:
191. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 6. Enter Date You Left the United States as 2-digit Month, 2-digit Day, and 4-digit Year.:
192. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 6. Enter Date You Returned to the United States as 2-digit Month, 2-digit Day, and 4-digit Year.:
193. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 5. Enter Date You Left the United States as 2-digit Month, 2-digit Day, and 4-digit Year.:
194. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 5. Did Trip Last 6 Months or More? Check No.:
195. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 5. Enter Countries to Which You Traveled.:
196. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 5. Enter Total Days Outside the United States.:
197. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 4. Enter Countries to Which You Traveled.:
198. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 4. Did Trip Last 6 Months or More? Check Yes.:
199. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 4. Enter Date You Left the United States as 2-digit Month, 2-digit Day, and 4-digit Year.:
200. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 4. Enter Date You Returned to the United States as 2-digit Month, 2-digit Day, and 4-digit Year.:
201. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 3. Enter Date You Left the United States as 2-digit Month, 2-digit Day, and 4-digit Year.:
202. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 3. Did Trip Last 6 Months or More? Check No.:
203. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 3. Enter Countries to Which You Traveled.:
204. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 3. Enter Total Days Outside the United States.:
205. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 2. Enter Countries to Which You Traveled.:
206. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 2. Did Trip Last 6 Months or More? Check Yes.:
207. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 2. Enter Date You Left the United States as 2-digit Month, 2-digit Day, and 4-digit Year.:
208. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 2. Enter Date You Returned to the United States as 2-digit Month, 2-digit Day, and 4-digit Year.:
209. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 1. Enter Date You Left the United States as 2-digit Month, 2-digit Day, and 4-digit Year.: 2013-02-10
210. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 1. Did Trip Last 6 Months or More? Check No.: N
211. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 1. Enter Countries to Which You Traveled.: Nigeria
212. Part 8. Time Outside the United States. 3. List below all the trips of 24 hours or longer that you have taken outside the United States during the last 5 years. Begin with your most recent trip and work backwards. If you need more space, use an additional sheet or sheets of paper. Trip 1. Enter Total Days Outside the United States.: 12
213. Part 8. Time Outside the United States. 2. How many trips of 24 hours or longer have you taken outside the United States during the last 5 years? Enter Number of Trips. : 1
214. Part 8. Time Outside the United States. 1. How many total days (24 hours or longer) did you spend outside the United States during the last 5 years? Enter Number of Days. : 12
215. Part 7. Information About Your Employment and Schools You Attended. List where you have worked or attended school full time or part time during the last 5 years. Provide information for the complete time period. Include all military, police, and/or intelligence service. Begin by providing information about your most recent or current employment, studies, or unemployment (if applicable). Provide the locations and dates where you worked, were self-employed, were unemployed, or have studied for the last 5 years. If you worked for yourself, write "self-employed." If you were unemployed, write "unemployed." If you need more space, use an additional sheet or sheets of paper to complete. 3. Select Your Occupation from List.:
216. PaperFormsBarcodep7:
217. Part 9. Information About Your Marital History. 3. How many times have you been married (including annulled marriages and marriage or marriages to the same person)? If you are single and have never been married, indicate "0" and go to Part 10. Enter Number of Marriages.: 2
218. Part 9. Information About Your Marital History. 1. What is your current marital status? Check Separated.: 2
219. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. A. Legal Name of Current Spouse. Enter Middle Name, if applicable.:
220. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. A. Legal Name of Current Spouse. Enter Given Name (First Name).:
221. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. A. Legal Name of Current Spouse. Enter Family Name (Last Name).:
222. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. B. Previous Legal Name of Current Spouse. Enter Middle Name, if applicable.:
223. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. B. Previous Legal Name of Current Spouse. Enter Given Name (First Name).:
224. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. B. Previous Legal Name of Current Spouse. Enter Family Name (Last Name). :
225. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. C. Other Names Used by Current Spouse (include nicknames, aliases, and maiden name, if applicable). Enter Family Name (Last Name). :
226. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. C. Other Names Used by Current Spouse (include nicknames, aliases, and maiden name, if applicable). Enter Given Name (First Name).:
227. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. C. Other Names Used by Current Spouse (include nicknames, aliases, and maiden name, if applicable). Enter Middle Name, if applicable.:
228. Part 9. Information About Your Marital History. 2. If you are married, is your spouse a current member of the U. S. Armed Forces? Check Yes.: N
229. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. F. Current Spouse's Present Home Address. Enter Street Number and Name.: 1540 Plainfield Dr
230. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. F. Current Spouse's Present Home Address. Enter Province or Region (foreign address only).:
231. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. F. Current Spouse's Present Home Address. Enter Postal Code (foreign address only).:
232. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. F. Current Spouse's Present Home Address. Zip Code Plus 4. Enter 5-digit Zip Code.: 45805
233. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. F. Current Spouse's Present Home Address. Select State from a List of States.: OH
234. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. F. Current Spouse's Present Home Address. Enter City.: Lima
235. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. F. Current Spouse's Present Home Address. Enter County.: Allen
236. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. G. Enter Current Spouse's Present Employer. :
237. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. F. Current Spouse's Present Home Address. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.:
238. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. F. Current Spouse's Present Home Address. Check Apartment.:
239. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. F. Current Spouse's Present Home Address. Zip Code Plus 4. Enter 4-digit Zip Code Extension.: 1070
240. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. F. Current Spouse's Present Home Address. Enter Country (foreign address only).: USA
241. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. D. Enter Current Spouse's Date of Birth as 2-digit Month, 2-digit Day, and 4-digit Year.: 1974-07-26
242. Part 9. Information About Your Marital History. 4. If you are married now, provide the following information about your current spouse. E. Date You Entered into Marriage with Current Spouse. Enter Date as 2-digit Month, 2-digit Day, and 4-digit Year.: 2009-01-01
243. Part 9. Information About Your Marital History. 5. Is your current spouse a U. S. citizen? Check Yes. If ''Yes," answer Item Number 6. : Y
244. PaperFormsBarcodep8:
245. Part 9. Information About Your Marital History. 6. If your current spouse is a U. S. citizen, complete the following information. B. Date your current spouse became a U. S. citizen. Enter Date as 2-digit Month, 2-digit Day, and 4-digit Year.:
246. Part 9. Information About Your Marital History. 7. If your current spouse is not a U. S. citizen, complete the following information. C. Current Spouse's Immigration Status. Check Permanent Resident.:
247. Part 9. Information About Your Marital History. 7. If your current spouse is not a U. S. citizen, complete the following information. C. Current Spouse's Immigration Status. If Other (explain), is Checked, Enter Other Status.:
248. Part 9. Information About Your Marital History. 6. If your current spouse is a U. S. citizen, complete the following information. A. When did your current spouse become a U. S. citizen? Check Other. Complete the following information.: B
249. Part 9. Information About Your Marital History. 7. If your current spouse is not a U. S. citizen, complete the following information. B. Enter Current Spouse's Alien Registration Number (A-Number), if applicable.:
250. Part 9. Information About Your Marital History. 7. If your current spouse is not a U. S. citizen, complete the following information. A. Enter Current Spouse's Country of Citizenship or Nationality.:
251. Part 9. Information About Your Marital History. 8. If your current spouse has been married before, provide the following information about your current spouse's prior spouse. If your current spouse has had more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. B. Prior Spouse's Immigration Status. If Other (explain), is Checked, Enter Other Status.:
252. Part 9. Information About Your Marital History. 8. If your current spouse has been married before, provide the following information about your current spouse's prior spouse. If your current spouse has had more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. B. Prior Spouse's Immigration Status. Check Other (explain).:
253. Part 9. Information About Your Marital History. 8. If your current spouse has been married before, provide the following information about your current spouse's prior spouse. If your current spouse has had more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. A. Enter Middle Name, if applicable.:
254. Part 9. Information About Your Marital History. 8. If your current spouse has been married before, provide the following information about your current spouse's prior spouse. If your current spouse has had more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. A. Enter Given Name (First Name).:
255. Part 9. Information About Your Marital History. 8. If your current spouse has been married before, provide the following information about your current spouse's prior spouse. If your current spouse has had more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. A. Enter Prior Spouse's Family Name (Last Name).:
256. Part 9. Information About Your Marital History. 8. If your current spouse has been married before, provide the following information about your current spouse's prior spouse. If your current spouse has had more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. C. Enter Prior Spouse's Date of Birth as 2-digit Month, 2-digit Day, and 4-digit Year.:
257. Part 9. Information About Your Marital History. 8. If your current spouse has been married before, provide the following information about your current spouse's prior spouse. If your current spouse has had more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. F. Enter Date of Marriage with Prior Spouse as 2-digit Month, 2-digit Day, and 4-digit Year.:
258. Part 9. Information About Your Marital History. 8. If your current spouse has been married before, provide the following information about your current spouse's prior spouse. If your current spouse has had more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. G. Enter Date Marriage Ended with Prior Spouse as 2-digit Month, 2-digit Day, and 4-digit Year.:
259. Part 9. Information About Your Marital History. 8. If your current spouse has been married before, provide the following information about your current spouse's prior spouse. If your current spouse has had more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. H. How Marriage Ended with Prior Spouse. Check Other (explain).:
260. Part 9. Information About Your Marital History. 8. If your current spouse has been married before, provide the following information about your current spouse's prior spouse. If your current spouse has had more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. H. How Marriage Ended with Prior Spouse. If Other (explain), is Checked, Enter Explanation.:
261. Part 9. Information About Your Marital History. 8. If your current spouse has been married before, provide the following information about your current spouse's prior spouse. If your current spouse has had more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. D. Enter Prior Spouse's Country of Birth.:
262. Part 9. Information About Your Marital History. 8. If your current spouse has been married before, provide the following information about your current spouse's prior spouse. If your current spouse has had more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. D. Enter Prior Spouse's Country of Citizenship or Nationality.:
263. Part 9. Information About Your Marital History. 8. How many times has your current spouse been married (including annulled marriages and marriage or marriages to the same person)? Enter Number of Marriages. : 1
264. PaperFormsBarcodep9:
265. Part 9. Information About Your Marital History. 9. If you were married before, provide the following information about your prior spouse. If you have more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. H. How Marriage Ended with Your Prior Spouse. If Other (explain), is Checked, Enter Explanation.:
266. Part 9. Information About Your Marital History. 9. If you were married before, provide the following information about your prior spouse. If you have more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. H. How Marriage Ended with Your Prior Spouse. Check Annulled.: D
267. Part 9. Information About Your Marital History. 9. If you were married before, provide the following information about your prior spouse. If you have more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. G. Enter Date Marriage Ended with Your Prior Spouse as 2-digit Month, 2-digit Day, and 4-digit Year.: 2008-10-01
268. Part 9. Information About Your Marital History. 9. If you were married before, provide the following information about your prior spouse. If you have more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. F. Enter Date of Marriage with Your Prior Spouse as 2-digit Month, 2-digit Day, and 4-digit Year.: 2006-09-28
269. Part 9. Information About Your Marital History. 9. If you were married before, provide the following information about your prior spouse. If you have more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. C. Enter Your Prior Spouse's Date of Birth as 2-digit Month, 2-digit Day, and 4-digit Year.: 1980-09-06
270. Part 9. Information About Your Marital History. 9. If you were married before, provide the following information about your prior spouse. If you have more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. A. Enter Middle Name, if applicable.:
271. Part 9. Information About Your Marital History. 9. If you were married before, provide the following information about your prior spouse. If you have more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. A. Enter Given Name (First Name).:
272. Part 9. Information About Your Marital History. 9. If you were married before, provide the following information about your prior spouse. If you have more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. A. Enter Your Prior Spouse's Family Name (Last Name).:
273. Part 9. Information About Your Marital History. 9. If you were married before, provide the following information about your prior spouse. If you have more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. B. Your Prior Spouse's Immigration Status When Your Marriage Ended. If Other (explain), is Checked, Enter Explanation.:
274. Part 9. Information About Your Marital History. 9. If you were married before, provide the following information about your prior spouse. If you have more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. B. Your Prior Spouse's Immigration Status When Your Marriage Ended. Check Other (explain).: USC
275. Part 9. Information About Your Marital History. 9. If you were married before, provide the following information about your prior spouse. If you have more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. D. Enter Your Prior Spouse's Country of Birth. : United States of America
276. Part 9. Information About Your Marital History. 9. If you were married before, provide the following information about your prior spouse. If you have more than one previous marriage, use an additional sheet or sheets of paper to provide the information requested in Items A. through H. below for each marriage. E. Enter Your Prior Spouse's Country of Citizenship or Nationality.: United States of America
277. Part 10. Information About Your Children. 1. Indicate your total number of children. (All children should be indicated, including: A. Children who are alive, missing, deceased; B. Children born in the United States or in other countries; C. Children under 18 years of age or older; D. Children who are currently married or unmarried; E. Children living with you or elsewhere; F. Current stepchildren; G. Legally adopted children; and H. Children born when you were not married.) Enter Total Number of Children.: 2
278. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 1. Child's Current Legal Name. Enter Middle Name if applicable.:
279. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 1. Child's Current Legal Name. Enter Given Name (First Name).:
280. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 1. Child's Current Legal Name. Enter Family Name (Last Name).:
281. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 2. Enter Child's Alien Registration Number (A-Number), if applicable. :
282. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 3. Enter Child's Date of Birth as 2-digit Month, 2-digit Day, and 4-digit Year.: 2011-03-08
283. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 4. Enter Child's Country of Birth. : United States of America
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285. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 1. Child's Current Legal Name. Enter Middle Name if applicable.:
286. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 1. Child's Current Legal Name. Enter Given Name (First Name).:
287. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 1. Child's Current Legal Name. Enter Family Name (Last Name).:
288. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 2. Enter Child's Alien Registration Number (A-Number), if applicable. :
289. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 3. Enter Child's Date of Birth as 2-digit Month, 2-digit Day, and 4-digit Year.: 2001-06-25
290. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 4. Enter Child's Country of Birth. : United States of America
291. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 5. Child's Current Address. Enter Street Number and Name.: 1540 Plainfield Dr
292. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 5. Child's Current Address. Enter Province or Region (foreign address only).:
293. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 5. Child's Current Address. Enter Postal Code (foreign address only).:
294. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 5. Child's Current Address. Zip Code Plus 4. Enter 5-digit Zip Code.:
295. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 5. Child's Current Address. Select State from a List of States.: OH
296. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 5. Child's Current Address. Enter City.: Lima
297. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 5. Child's Current Address. Enter County.: Allen
298. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 5. Child's Current Address. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.:
299. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 5. Child's Current Address. Check Apartment.:
300. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 5. Child's Current Address. Zip Code Plus 4. Enter 4-digit Zip Code Extension.: 1070
301. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 6. What is your child's relationship to you? (e. g., biological child, stepchild, legally adopted child). Enter Relationship.:
302. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. A. 5. Child's Current Address. Enter Country (foreign address only).: USA
303. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 5. Child's Current Address. Enter Street Number and Name.: 1540 Plainfield Dr
304. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 5. Child's Current Address. Enter Province or Region (foreign address only).:
305. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 5. Child's Current Address. Enter Postal Code (foreign address only).:
306. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 5. Child's Current Address. Zip Code Plus 4. Enter 5-digit Zip Code.: 45805
307. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 5. Child's Current Address. Select State from a List of States.: OH
308. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 5. Child's Current Address. Enter City.: Lima
309. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 5. Child's Current Address. Enter County.: Allen
310. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 5. Child's Current Address. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.:
311. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 5. Child's Current Address. Check Apartment.:
312. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 6. What is your child's relationship to you? (e. g., biological child, stepchild, legally adopted child). Enter Relationship.:
313. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 5. Child's Current Address. Zip Code Plus 4. Enter 4-digit Zip Code Extension.: 1070
314. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. B. 5. Child's Current Address. Enter Country (foreign address only).: USA
315. PaperFormsBarcodep11:
316. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 2. Enter Child's Alien Registration Number (A-Number), if applicable. :
317. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 3. Enter Child's Date of Birth as 2-digit Month, 2-digit Day, and 4-digit Year.:
318. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 5. Child's Current Address. Enter Street Number and Name.:
319. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 5. Child's Current Address. Enter Province or Region (foreign address only).:
320. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 5. Child's Current Address. Enter Postal Code (foreign address only).:
321. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 5. Child's Current Address. Zip Code Plus 4. Enter 5-digit Zip Code.:
322. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 5. Child's Current Address. Select State from a List of States.:
323. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 5. Child's Current Address. Enter City.:
324. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 5. Child's Current Address. Enter County.:
325. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 5. Child's Current Address. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.:
326. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 5. Child's Current Address. Check Apartment.:
327. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 5. Child's Current Address. Zip Code Plus 4. Enter 4-digit Zip Code Extension.:
328. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 6. What is your child's relationship to you? (e. g., biological child, stepchild, legally adopted child). Enter Relationship.:
329. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 4. Enter Child's Country of Birth. :
330. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 5. Child's Current Address. Enter Country (foreign address only).:
331. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 1. Child's Current Legal Name. Enter Middle Name if applicable.:
332. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 1. Child's Current Legal Name. Enter Given Name (First Name).:
333. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 1. Child's Current Legal Name. Enter Family Name (Last Name).:
334. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 2. Enter Child's Alien Registration Number (A-Number), if applicable. :
335. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 5. Child's Current Address. Enter Street Number and Name.:
336. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 5. Child's Current Address. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.:
337. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 5. Child's Current Address. Check Apartment.:
338. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 5. Child's Current Address. Enter Province or Region (foreign address only).:
339. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 5. Child's Current Address. Enter Postal Code (foreign address only).:
340. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 5. Child's Current Address. Zip Code Plus 4. Enter 5-digit Zip Code.:
341. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 5. Child's Current Address. Select State from a List of States.:
342. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 5. Child's Current Address. Enter City.:
343. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 5. Child's Current Address. Enter County.:
344. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 3. Enter Child's Date of Birth as 2-digit Month, 2-digit Day, and 4-digit Year.:
345. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 6. What is your child's relationship to you? (e. g., biological child, stepchild, legally adopted child). Enter Relationship.:
346. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 5. Child's Current Address. Zip Code Plus 4. Enter 4-digit Zip Code Extension.:
347. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 4. Enter Child's Country of Birth. :
348. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. D. 5. Child's Current Address. Enter Country (foreign address only).:
349. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 1. Child's Current Legal Name. Enter Middle Name if applicable.:
350. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 1. Child's Current Legal Name. Enter Given Name (First Name).:
351. Part 10. Information About Your Children. 2. Provide the following information about all your children (sons and daughters) listed in Item Number 1., regardless of age. Use an additional sheet or sheets of paper to list any additional children. C. 1. Child's Current Legal Name. Enter Family Name (Last Name).:
352. PaperFormsBarcodep12:
353. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 2. Have you ever registered to vote in any Federal, State, or local election in the United States? Check Yes.: N
354. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 1. Have you ever claimed to be a U. S. citizen (in writing or any other way)? Check Yes.: N
355. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 3. Have you ever voted in any Federal, State, or local election in the United States? Check Yes.: N
356. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 4. Do you now have, or did you ever have, a hereditary title or an order of nobility in any foreign country? Check No.: N
357. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 5. Have you ever been declared legally incompetent, or been confined to a mental institution? Check Yes.: N
358. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 6. Do you owe any overdue Federal, State, or local taxes? Check No.: N
359. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 7. A. Have you ever not filed a Federal, State, or local tax return since you became a Permanent Resident? Check No.: N
360. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 7. B. If "Yes," did you consider yourself to be a "non-U. S. resident"? Check No.: N
361. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 8. Have you called yourself a "non-U. S. resident" on a Federal, State, or local tax return since you became a Permanent Resident? Check Yes.: N
362. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. A. Have you ever been a member of, involved in, or in any way associated with, any organization, association, fund, foundation, party, club, society, or similar group in the United States or in any other location in the world? Check Yes.: N
363. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 1. Enter Name of Group.:
364. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 2. Enter Name of Group.:
365. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 3. Enter Name of Group.:
366. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 4. Enter Name of Group.:
367. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 4. Enter Purpose of the Group.:
368. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 3. Enter Purpose of the Group.:
369. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 2. Enter Purpose of the Group.:
370. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 1. Enter Purpose of the Group.:
371. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 1. Dates of Membership. Enter From Date as 2-digit Month, 2-digit Day, and 4-digit Year.:
372. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 2. Dates of Membership. Enter From Date as 2-digit Month, 2-digit Day, and 4-digit Year.:
373. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 3. Dates of Membership. Enter From Date as 2-digit Month, 2-digit Day, and 4-digit Year.:
374. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 4. Dates of Membership. Enter From Date as 2-digit Month, 2-digit Day, and 4-digit Year.:
375. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 10. Have you ever been a member of, or in any way associated (either directly or indirectly) with: A. The Communist Party? Check No.: N
376. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 10. Have you ever been a member of, or in any way associated (either directly or indirectly) with: B. Any other totalitarian party? Check Yes.: N
377. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 10. Have you ever been a member of, or in any way associated (either directly or indirectly) with: C. A terrorist organization? Check Yes.: N
378. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 1. Dates of Membership. Enter To Date as 2-digit Month, 2-digit Day, and 4-digit Year.:
379. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 2. Dates of Membership. Enter To Date as 2-digit Month, 2-digit Day, and 4-digit Year.:
380. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 3. Dates of Membership. Enter To Date as 2-digit Month, 2-digit Day, and 4-digit Year.:
381. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 9. B. If "Yes," provide the information below. If you need more space, attach the names of the other group or groups on an additional sheet or sheets of paper and provide any evidence to support your answer. Group 4. Dates of Membership. Enter To Date as 2-digit Month, 2-digit Day, and 4-digit Year.:
382. PaperFormsBarcodep13:
383. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 11. Have you ever advocated (either directly or indirectly) the overthrow of any government by force or violence? Check No.: N
384. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 13. Between March 23, 1933 and May 8, 1945, did you work for or associate in any way (either directly or indirectly) with: A. The Nazi government of Germany? Check No.: N
385. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 13. Between March 23, 1933 and May 8, 1945, did you work for or associate in any way (either directly or indirectly) with: B. Any government in any area (1) occupied by, (2) allied with, or (3) established with the help of the Nazi government of Germany? Check Yes.: N
386. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 13. Between March 23, 1933 and May 8, 1945, did you work for or associate in any way (either directly or indirectly) with: C. Any German, Nazi, or S. S. military unit, paramilitary unit, self-defense unit, vigilante unit, citizen unit, police unit, government agency or office, extermination camp, concentration camp, prisoner of war camp, prison, labor camp, or transit camp? Check No.: N
387. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 14. Were you ever involved in any way with any of the following: A. Genocide? Check Yes.: N
388. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 14. Were you ever involved in any way with any of the following: B. Torture? Check Yes.: N
389. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 14. Were you ever involved in any way with any of the following: C. Killing, or trying to kill, someone? Check Yes.: N
390. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 14. Were you ever involved in any way with any of the following: D. Badly hurting, or trying to hurt, a person on purpose? Check Yes.: N
391. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 14. Were you ever involved in any way with any of the following: E. Badly hurting, or trying to hurt, a person on purpose? Check Yes.: N
392. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 14. Were you ever involved in any way with any of the following: F. Not letting someone practice his or her religion? Check Yes.:
393. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 15. Were you ever a member of, or did you ever serve in, help, or otherwise participate in, any of the following groups: A. Military unit? Check Yes.: N
394. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 15. Were you ever a member of, or did you ever serve in, help, or otherwise participate in, any of the following groups: B. Paramilitary unit? (a group of people who act like a military group but are not part of the official military) Check No.: N
395. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 15. Were you ever a member of, or did you ever serve in, help, or otherwise participate in, any of the following groups: C. Police unit? Check Yes.: N
396. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 15. Were you ever a member of, or did you ever serve in, help, or otherwise participate in, any of the following groups: D. Self-defense unit? Check Yes.: N
397. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 15. Were you ever a member of, or did you ever serve in, help, or otherwise participate in, any of the following groups: E. Vigilante unit? (a group of people who act like the police, but are not part of the official police). Check Yes.: N
398. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 15. Were you ever a member of, or did you ever serve in, help, or otherwise participate in, any of the following groups: F. Rebel group? Check Yes.: N
399. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 15. Were you ever a member of, or did you ever serve in, help, or otherwise participate in, any of the following groups: G. Guerrilla group? (a group of people who use weapons against or otherwise physically attack the military, police, government, or other people) Check Yes.: N
400. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 15. Were you ever a member of, or did you ever serve in, help, or otherwise participate in, any of the following groups: H. Militia? (an army of people, not part of the official military). Check Yes.: N
401. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 15. Were you ever a member of, or did you ever serve in, help, or otherwise participate in, any of the following groups: I. Insurgent organization? (a group that uses weapons and fights against a government). Check Yes.: N
402. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 12. Have you ever persecuted (either directly or indirectly) any person because of race, religion, national origin, membership in a particular social group, or political opinion? Check Yes.: N
403. PaperFormsBarcodep14:
404. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 16. Were you ever a worker, volunteer, or soldier, or did you otherwise ever serve in any of the following: A. Prison or jail? Check Yes.: N
405. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 16. Were you ever a worker, volunteer, or soldier, or did you otherwise ever serve in any of the following: B. Prison camp? Check Yes.: N
406. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 16. Were you ever a worker, volunteer, or soldier, or did you otherwise ever serve in any of the following: C. Detention facility? (a place where people are forced to stay). Check Yes.: N
407. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 16. Were you ever a worker, volunteer, or soldier, or did you otherwise ever serve in any of the following: D. Labor camp? (a place where people are forced to work). Check Yes.: N
408. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 16. Were you ever a worker, volunteer, or soldier, or did you otherwise ever serve in any of the following: E. Any other place where people were forced to stay? Check No.: N
409. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 17. Were you ever a part of any group, or did you ever help any group, unit, or organization that used a weapon against any person, or threatened to do so? A. If "Yes," when you were part of this group, or when you helped this group, did you ever use a weapon against another person? Check Yes.: N
410. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 17. Were you ever a part of any group, or did you ever help any group, unit, or organization that used a weapon against any person, or threatened to do so? B. If "Yes," when you were part of this group, or when you helped this group, did you ever tell another person that you would use a weapon against that person? Check No.: N
411. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 17. Were you ever a part of any group, or did you ever help any group, unit, or organization that used a weapon against any person, or threatened to do so? Check Yes.: N
412. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 18. Did you ever sell, give, or provide weapons to any person, or help another person sell, give, or provide weapons to any person? Check Yes.: N
413. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 18. Did you ever sell, give, or provide weapons to any person, or help another person sell, give, or provide weapons to any person? A. If "Yes," did you know that this person was going to use the weapons against another person? Check No.: N
414. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 18. Did you ever sell, give, or provide weapons to any person, or help another person sell, give, or provide weapons to any person? B. If "Yes," did you know that this person was going to sell or give the weapons to someone who was going to use them against another person? Check No.: N
415. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 19. Did you ever receive any type of military, paramilitary (a group of people who act like a military group but are not part of the official military), or weapons training? Check Yes.: N
416. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 20. Did you ever recruit (ask), enlist (sign up), conscript (require), or use any person under age 15 to serve in or help an armed force or group? Check Yes.: N
417. Part 11. Additional Information. Answer Item Numbers 1. through 21. If you answer "Yes" to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 21. Did you ever use any person under age 15 to do anything that helped or supported people in combat? Check Yes.: N
418. Part 11. Additional Information. If any of Item Numbers 22. through 28. apply to you, you must answer "Yes" even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if anyone, including a judge, law enforcement officer, or attorney, told you that it no longer constitutes a record or told you that you do not have to disclose the information. 22. Have you ever committed, assisted in committing, or attempted to commit, a crime or offense for which you were not arrested? Check Yes.: N
419. Part 11. Additional Information. If any of Item Numbers 22. through 28. apply to you, you must answer "Yes" even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if anyone, including a judge, law enforcement officer, or attorney, told you that it no longer constitutes a record or told you that you do not have to disclose the information. 23. Have you ever been arrested, cited, or detained by any law enforcement officer (including any and all immigration officials or the U. S. Armed Forces) for any reason? Check Yes.: N
420. Part 11. Additional Information. If any of Item Numbers 22. through 28. apply to you, you must answer "Yes" even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if anyone, including a judge, law enforcement officer, or attorney, told you that it no longer constitutes a record or told you that you do not have to disclose the information. 24. Have you ever been charged with committing, attempting to commit, or assisting in committing a crime or offense? Check Yes.: N
421. Part 11. Additional Information. If any of Item Numbers 22. through 28. apply to you, you must answer "Yes" even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if anyone, including a judge, law enforcement officer, or attorney, told you that it no longer constitutes a record or told you that you do not have to disclose the information. 25. Have you ever been convicted of a crime or offense? Check Yes.: N
422. Part 11. Additional Information. If any of Item Numbers 22. through 28. apply to you, you must answer "Yes" even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if anyone, including a judge, law enforcement officer, or attorney, told you that it no longer constitutes a record or told you that you do not have to disclose the information. 26. Have you ever been placed in an alternative sentencing or a rehabilitative program (e. g., diversion, deferred prosecution, withheld adjudication, deferred adjudication)? Check Yes.: N
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424. Part 11. Additional Information. If any of Item Numbers 22. through 28. apply to you, you must answer "Yes" even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if anyone, including a judge, law enforcement officer, or attorney, told you that it no longer constitutes a record or told you that you do not have to disclose the information. 27. A. Have you ever received a suspended sentence, been placed on probation, or been paroled? Check Yes.: N
425. Part 11. Additional Information. If any of Item Numbers 22. through 28. apply to you, you must answer "Yes" even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if anyone, including a judge, law enforcement officer, or attorney, told you that it no longer constitutes a record or told you that you do not have to disclose the information. 27. B. If "Yes," have you completed the probation or parole? Check Yes.: N
426. Part 11. Additional Information. If any of Item Numbers 22. through 28. apply to you, you must answer "Yes" even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if anyone, including a judge, law enforcement officer, or attorney, told you that it no longer constitutes a record or told you that you do not have to disclose the information. 28. A. Have you ever been in jail or prison? Check Yes.: N
427. Part 11. Additional Information. If any of Item Numbers 22. through 28. apply to you, you must answer "Yes" even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if anyone, including a judge, law enforcement officer, or attorney, told you that it no longer constitutes a record or told you that you do not have to disclose the information. 28. B. If "Yes," how long were you in jail or prison? Enter Number of Years.:
428. Part 11. Additional Information. If any of Item Numbers 22. through 28. apply to you, you must answer "Yes" even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if anyone, including a judge, law enforcement officer, or attorney, told you that it no longer constitutes a record or told you that you do not have to disclose the information. 28. B. If "Yes," how long were you in jail or prison? Enter Number of Months.:
429. Part 11. Additional Information. If any of Item Numbers 22. through 28. apply to you, you must answer "Yes" even if your records have been sealed, expunged, or otherwise cleared. You must disclose this information even if anyone, including a judge, law enforcement officer, or attorney, told you that it no longer constitutes a record or told you that you do not have to disclose the information. 28. B. If "Yes," how long were you in jail or prison? Enter Number of Days.:
430. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 1. Why were you arrested, cited, detained, or charged? Enter Reason.:
431. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 2. Why were you arrested, cited, detained, or charged? Enter Reason.:
432. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 3. Why were you arrested, cited, detained, or charged? Enter Reason.:
433. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 4. Why were you arrested, cited, detained, or charged? Enter Reason.:
434. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 5. Why were you arrested, cited, detained, or charged? Enter Reason.:
435. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 1. Enter Date arrested, cited, detained, or charged as 2-digit Month, 2-digit Day, and 4-digit Year.:
436. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 2. Enter Date arrested, cited, detained, or charged as 2-digit Month, 2-digit Day, and 4-digit Year.:
437. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 3. Enter Date arrested, cited, detained, or charged as 2-digit Month, 2-digit Day, and 4-digit Year.:
438. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 4. Enter Date arrested, cited, detained, or charged as 2-digit Month, 2-digit Day, and 4-digit Year.:
439. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 5. Enter Date arrested, cited, detained, or charged as 2-digit Month, 2-digit Day, and 4-digit Year.:
440. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 1. Where were you arrested, cited, detained, or charged? Enter City, State, Country. :
441. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 5. Where were you arrested, cited, detained, or charged? Enter City, State, Country. :
442. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 4. Where were you arrested, cited, detained, or charged? Enter City, State, Country. :
443. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 3. Where were you arrested, cited, detained, or charged? Enter City, State, Country. :
444. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 2. Where were you arrested, cited, detained, or charged? Enter City, State, Country. :
445. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 5. Enter Outcome or disposition of the arrest, citation, detention or charge (no charges filed, charges dismissed, jail, probation, etcetera).:
446. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 4. Enter Outcome or disposition of the arrest, citation, detention or charge (no charges filed, charges dismissed, jail, probation, etcetera).:
447. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 3. Enter Outcome or disposition of the arrest, citation, detention or charge (no charges filed, charges dismissed, jail, probation, etcetera).:
448. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 2. Enter Outcome or disposition of the arrest, citation, detention or charge (no charges filed, charges dismissed, jail, probation, etcetera).:
449. Part 11. Additional Information. 29. If you answered "Yes" to Item Numbers 23. through 28., complete the following table. If you need more space, use an additional sheet or sheets of paper and provide any evidence to support your answer. If you answered "No" to all Item Numbers 23. through 28., go to Item Number 30. Row 1. Enter Outcome or disposition of the arrest, citation, detention or charge (no charges filed, charges dismissed, jail, probation, etcetera).:
450. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 30. Have you ever: A. Been a habitual drunkard? Check Yes.: N
451. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 30. Have you ever: B. Been a prostitute, or procured anyone for prostitution? Check Yes.: N
452. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 30. Have you ever: C. Sold or smuggled controlled substances, illegal drugs, or narcotics? Check Yes.: N
453. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 30. Have you ever: D. Been married to more than one person at the same time? Check Yes.: N
454. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 30. Have you ever: F. Helped anyone to enter, or try to enter, the United States illegally? Check Yes.: N
455. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 30. Have you ever: G. Gambled illegally or received income from illegal gambling? Check Yes.: N
456. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 30. Have you ever: H. Failed to support your dependents or to pay alimony? Check Yes.: N
457. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 30. Have you ever: E. Married someone in order to obtain an immigration benefit? Check Yes.: N
458. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 30. Have you ever: I. Made any misrepresentation to obtain any public benefit in the United States? Check Yes.: N
459. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 31. Have you ever given any U. S. Government official or officials any information or documentation that was false, fraudulent, or misleading? Check No.: N
460. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 32. Have you ever lied to any U. S. Government official to gain entry or admission into the United States or to gain immigration benefits while in the United States? Check No.: N
461. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 33. Have you ever been removed, excluded, or deported from the United States? Check Yes.: N
462. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 34. Have you ever been ordered removed, excluded, or deported from the United States? Check Yes.: N
463. PaperFormsBarcodep16:
464. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 37. Have you ever served in the U. S. Armed Forces? Check Yes.: N
465. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 36. Are removal, exclusion, rescission, or deportation proceedings (including administratively closed proceedings) currently pending against you? Check Yes.: N
466. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 35. Have you ever been placed in removal, exclusion, rescission, or deportation proceedings? Check Yes.: N
467. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 39. If you are currently a member of the U. S. Armed Forces, are you scheduled to deploy overseas, including to a vessel, within the next 3 months? (Refer to the Address Change section within the Form N-400 Instructions on how to notify U S C I S if you learn of your deployment plans after you file your Form N-400.) Check Yes.: N
468. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 38. Are you currently a member of the U. S. Armed Forces? Check Yes.: N
469. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 40. If you are currently a member of the U. S. Armed Forces, are you currently stationed overseas? Check Yes.: N
470. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 41. Have you ever been court-martialed, administratively separated, or disciplined, or have you received an other than honorable discharge, while in the U. S. Armed Forces? Check No.: N
471. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 42. Have you ever been discharged from training or service in the U. S. Armed Forces because you were an alien? Check No.: N
472. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 43. Have you ever left the United States to avoid being drafted in the U. S. Armed Forces? Check Yes.: N
473. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 44. Have you ever applied for any kind of exemption from military service in the U. S. Armed Forces? Check Yes.: N
474. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 45. Have you ever deserted from the U. S. Armed Forces? Check Yes.: N
475. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 46. A. Are you a male who lived in the United States at any time between your 18th and 26th birthdays? (This does not include living in the United States as a lawful nonimmigrant.) Check Yes.: N
476. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 46. B. If "Yes," when did you register for the Selective Service? Provide the information below. Enter Selective Service Number.:
477. Part 11. Additional Information. Answer Item Numbers 30. through 46. If you answer "Yes" to any of these questions, except Item Numbers 37. and 38., include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 46. B. If "Yes," when did you register for the Selective Service? Provide the information below. Enter Date Registered as 2-digit Month, 2-digit Day, and 4-digit Year.:
478. Part 11. Additional Information. Answer Item Numbers 47. through 53. If you answer ''No'' to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 47. Do you support the Constitution and form of government of the United States? Check Yes.: Y
479. Part 11. Additional Information. Answer Item Numbers 47. through 53. If you answer ''No'' to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 48. Do you understand the full Oath of Allegiance to the United States? Check No.: Y
480. PaperFormsBarcodep17:
481. Part 11. Additional Information. Answer Item Numbers 47. through 53. If you answer ''No'' to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 50. If the law requires it, are you willing to bear arms on behalf of the United States? Check No.: Y
482. Part 11. Additional Information. Answer Item Numbers 47. through 53. If you answer ''No'' to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 51. If the law requires it, are you willing to perform noncombatant services in the U. S. Armed Forces? Check Yes.: Y
483. Part 11. Additional Information. Answer Item Numbers 47. through 53. If you answer ''No'' to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 49. Are you willing to take the full Oath of Allegiance to the United States? Check Yes.: Y
484. Part 11. Additional Information. Answer Item Numbers 47. through 53. If you answer ''No'' to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 52. If the law requires it, are you willing to perform work of national importance under civilian direction? Check No.: Y
485. Part 12. Your Signature (U S C I S will reject your Form N-400 if it is not signed). Enter Date of Signature as 2-digit Month, 2-digit Day, and 4-digit Year.:
486. Part 12. Your Signature (U S C I S will reject your Form N-400 if it is not signed). Your Statement. I certify, under penalty of perjury under the laws of the United States of America, that this application, and the evidence submitted with it, are all true and correct. I authorize the release of any information U S C I S needs to determine my eligibility for naturalization. Your Signature. No Entry. Print and Sign completed form.:
487. Part 11. Additional Information. Answer Item Numbers 47. through 53. If you answer ''No'' to any of these questions, include a written explanation on an additional sheet or sheets of paper and provide any evidence to support your answer. 53. At your naturalization ceremony, are you willing to give up any inherited titles or orders of nobility that you have in a foreign country? Check Yes.: Y
488. PaperFormsBarcodep18:
489. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Address. Enter City.:
490. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Address. Select State from a List of States.:
491. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Address. Zip Code Plus 4. Enter 5-digit Zip Code.:
492. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Address. Enter Postal Code (foreign address only).:
493. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Address. Enter Province or Region (foreign address only).:
494. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Address. Enter Street Number and Name.:
495. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Enter Preparer's Firm or Organization Name, if applicable. :
496. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Address. Enter County.:
497. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Enter Preparer's E-mail Address.:
498. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Fax Number. Enter 3-digit Area Code.:
499. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Fax Number. Enter First 3 digits of Phone Number.:
500. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Fax Number. Enter Last 4 digits of Phone Number.:
501. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Daytime Phone Number. Enter 3-digit Area Code.:
502. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Daytime Phone Number. Enter First 3 digits of Phone Number.:
503. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Daytime Phone Number. Enter Last 4 digits of Phone Number.:
504. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Address. If Apartment, Suite or Floor is Checked, Enter Apartment, Suite or Floor Number.:
505. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Address. Check Apartment.:
506. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Address. Zip Code Plus 4. Enter 4-digit Zip Code Extension.:
507. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Address. Enter Country (foreign address only).:
508. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Enter Date of Signature as 2-digit Month, 2-digit Day, and 4-digit Year.:
509. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Signature. No Entry. Print and Sign completed form.:
510. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Printed Name. Enter Middle Name, if applicable.:
511. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Printed Name. Enter Given Name (First Name).:
512. Part 13. Signature and Contact Information of the Person Who Prepared This Form, If Other Than the Applicant. Preparer's Printed Name. Enter Family Name (Last Name).:
513. Part 14. Statement of Applicants Who Used an Interpreter. Enter Date of Signature as 2-digit Month, 2-digit Day, and 4-digit Year.:
514. Part 14. Statement of Applicants Who Used an Interpreter. I understand each and every question and instruction on this form, as translated to me by my interpreter, and have provided true and correct responses in the language indicated above. Your Signature. No Entry. Print and Sign completed form.:
515. Part 14. Statement of Applicants Who Used an Interpreter. Applicant's Statement. Each and every question and instruction on this form, as well as my answer to each question, has been read to me by the interpreter named below in a language in which I am fluent. Enter Language Used. :
516. Part 15. Signature at Interview. Applicant's Signature. No Entry. Print and Sign completed form.:
517. Part 15. Signature at Interview. U S C I S Officer's Signature. No Entry. Print and Sign completed form.:
518. Part 15. Signature at Interview. Enter Date of Signature as 2-digit Month, 2-digit Day, and 4-digit Year.:
519. Part 15. Signature at Interview. I swear (affirm) and certify under penalty of perjury under the laws of the United States of America that I know that the contents of this Form N-400, Application for Naturalization, subscribed by me, including corrections number 1 through: [Enter Total Number of Corrections] are true and correct.:
520. Part 15. Signature at Interview. The evidence submitted by me on numbered pages 1 through: [Enter Total Number of Pages] is true and correct.:
521. PaperFormsBarcodep20:
522. Part 15. Signature at Interview. Subscribed to and sworn to (affirmed) before me. Enter U S C I S Officer's Printed Name or Stamp. No Entry. Print and Sign completed form.:
523. Part 14. Statement of Applicants Who Used an Interpreter. Interpreter's Telephone Number. Enter 3-digit Area Code.:
524. Part 14. Statement of Applicants Who Used an Interpreter. Interpreter's Telephone Number. Enter First 3 digits of Phone Number.:
525. Part 14. Statement of Applicants Who Used an Interpreter. Interpreter's Telephone Number. Enter Last 4 digits of Phone Number.:
526. Part 14. Statement of Applicants Who Used an Interpreter. Interpreter's Printed Name. Enter Middle Name. if applicable.:
527. Part 14. Statement of Applicants Who Used an Interpreter. Interpreter's Printed Name. Enter Given Name (First Name).:
528. Part 14. Statement of Applicants Who Used an Interpreter. Interpreter's Printed Name. Enter Family Name (Last Name).:
529. Part 14. Statement of Applicants Who Used an Interpreter. Enter Date of Signature as 2-digit Month, 2-digit Day, and 4-digit Year.:
530. Part 14. Statement of Applicants Who Used an Interpreter. Interpreter's Signature. No Entry. Print and Sign completed form.:
531. Part 14. Statement of Applicants Who Used an Interpreter. Your Interpreter's Statement. I certify that I am fluent in English and: Enter Language Used. :
532. Part 16. Renunciation of Foreign Titles. Applicant's Signature. No Entry. Print and Sign completed form.:
533. Part 17. Oath of Allegiance. Applicant's Printed Name. Enter Middle Name, if applicable.:
534. Part 17. Oath of Allegiance. Applicant's Printed Name. Enter Given Name (first name).:
535. Part 17. Oath of Allegiance. Applicant's Printed Name. Enter Family Name (Last Name).:
536. Part 16. Renunciation of Foreign Titles. If you answered "Yes" to Part 11., Item Numbers 4. and 53., then you must affirm the following before a U S C I S officer: I further renounce the title of: [Enter Title or Titles] which I have heretofore held; or:
537. Part 16. Renunciation of Foreign Titles. If you answered "Yes" to Part 11., Item Numbers 4. and 53., then you must affirm the following before a U S C I S officer: I further renounce the order of nobility of: [List order of nobility] to which I have heretofore belonged.:
538. Part 16. Renunciation of Foreign Titles. Enter Applicant's Printed Name.:
539. Part 16. Renunciation of Foreign Titles. U S C I S Officer's Signature. No Entry. Print and Sign completed form.:
540. Part 16. Renunciation of Foreign Titles. Enter U S C I S Officer's Printed Name.:

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