Necessary Information for you Naturalization Application
Please bring this completed form to your citizenship appointment.
Where have you lived during the past 5 years? Begin with your most recent address and list all the
places you have lived in the past 5 years. (Even if in another country)
Address (Street #, Apt, City, State, Zip Code, Country)
From (Date)
To (Date)
Where have you worked or studied in the last 5 years?
Name of Company
or School
Address of the Company of
School
Date you
began
Date you
finished
Your Occupation
List all trips you have taken outside the U.S. since received your green card, beginning with your most
recent trip.
Date you left the
U.S.
Date you returned
to the U.S.
Countries to which you traveled
Total days
outside the U.S.
Necessary Information for you Naturalization Application
Information about Your Children (Please include adopted children, stepchildren & deceased children)
Complete Name of Son
or Daughter
Birthdate
(mm/dd/yy)
Green Card (A#)
Information about your current husband/wife:
Complete Name
Birthdate
Green Card (A#)
Immigration Status
Country of Citizenship
Divorce
Social Security #
Divorce
Marriage Date
Place became citizen (if
applicable)
Marriage Date
Date Marriage ended
Spouse Deceased
Other: __________________________
Information about your husband/wife’s prior marriages:
Complete Name
Immigration Status
Marriage Date
How marriage ended:
Current Address
Date became Citizen
(if applicable)
Information about your prior marriages:
Complete Name
Immigration Status
How marriage ended:
Country of
Birth
Spouse Deceased
Date Marriage ended
Other: __________________________