Interview Based on the USCIS N-400r for Senior Citizens or Those Who Request Accommodations/Exemptions N-400 Part 1: Eligibility 1
Explain how you are eligible to become a US Citizen.
I am over 18 years old and 1. I have been a Legal Permanent Resident (USLPR) for 5 years. 2. I have been a Legal Permanent Resident for 3 years; and a. I have been married to the same US Citizen for 3 years; and b. I have been living with the same spouse for 3 years; and c. This spouse has been a US Citizen for 3 years. 3. I am married to a US citizen who works for the US government and is stationed abroad. (INA 319b) 4. I am applying for US Citizenship based on Qualifying Military Service. 5. Other.
N-400 Part 2 Your Name (similar to old N-400 Part 1) 2
What is your current legal name?
My current legal name is ___________ ____________ ____________ First Name
3 4
Spell your family name. Is the name on your Green Card the same as your current legal name?
Middle Name
Last Name
My last name is spelled _ _ _ _ _ _ _ _ _ _ _ _ a) Yes. b) No. The name on my Green Card is not the same as my current legal name because: 1. The name on my Green Card is my maiden name. I got married. 2. I went to court and legally changed my name. 3. Other: .
N-400 Part 2: Information about Your Origin (similar to old N-400 Part 3) 5
What is your Social Security Number?
My Social Security Number is 987-65-4321
6
What is your date of birth?
My date of birth is
7
What date did you become a legal
I became a legal permanent resident
permanent resident?
on
8
What is your country of birth?
My country of birth is
.
9
What is your country of nationality?
My country of nationality is
.
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uscitizenpod.com 2007, 2015
Interview Based on the USCIS N-400r for Senior Citizens or Those Who Request Accommodations/Exemptions N-400 Part 2: Accommodations (similar to old N-400 Part 3) 10
Are you requesting an accommodation to the Naturalization process
a) Yes; b) No.
because of a disability or impairment? a) Are you deaf/hard-of-hearing and require an ASL interpreter?
a) Yes; b) No.
b) Do you use a wheelchair or mobility-aid?
a) Yes; b) No.
c) Are you blind or do you have low-vision?
a) Yes; b) No.
d) Do you have another disability? (Explain:
).
a) Yes; b) No.
N-400 Part 2: Medical Exemption (submit N-648 Medical Certification for Disability) 11
Do you have a) A physical disability? (Explain:
).
b) A developmental disability? (Explain:
).
c) A mental disability? (Explain: _________________________).
a) Yes; b) No. a) Yes; b) No. a) Yes; b) No.
that prevents you from a) Demonstrating your knowledge of the English language
a) Yes; b) No.
b) Civics Requirements for Naturalization
a) Yes; b) No.
N-400 Part 2: Age Exemptions from the English Test (new on the N-400) 12
Are you age 50 or older and have you lived in US as a USLPR for at least 20 years?
13
Are you age 55 or older and have you lived in US as an USLPR for at least 15 years?
14
a) Yes; b) No.
a) Yes; b) No.
Are you age 65 or older and have you lived in US as an USLPR for at least 20 years?
a) Yes; b) No.
N-400 Part 3: Contact Information 15
What is your Daytime Phone Number?
a) My Daytime Phone Number is ( __ __ __ ) – __ __ __ – __ __ __ __. b) I don’t have a Daytime Phone Number. My cell number is (_ _ _) - _ _ _-_ _ _ _
16
What is your Email Address?
a) My Email Address is ________________________________. b) I don’t have an Email Address.
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Interview Based on the USCIS N-400r for Senior Citizens or Those Who Request Accommodations/Exemptions N-400 Part 4: Current Home Address 17
What is your Current Home Address?
My current home address is ____________________________________ Street Number Street Name
Apt.
____________ ____________ ____ _______ City
18
State/Province
Country
Zip Code
How long have you lived
I have lived at my Current Home Address
at your Current Home Address?
from ___________________ to the present.
N-400 Part 4: Previous Home Address 19
What is your Previous Home Address?
My Previous Address was ____________________________________ Street Number Street Name
Apt.
____________ ____________ ____ _______ City
20
State/Province
Country
Zip Code
How long did you live
I lived at my Previous Home Address
at your Previous Home Address?
from _____________ to ______________.
N-400 Part 5: Your Parents’ Marriage 21
Were your parents American citizens before your 18th birthday?
a) Yes. b) No.
N-400 Part 7: Work 22
Do you work? (How do you support yourself?) (How do you make a living?)
a) b) c) d) e) f) g)
Yes, I work. I am a student. I am disabled. I am retired. I stay at home and take care of my family. I was laid off and I am looking for a job. My family supports me.
23
Where do you work?
I work at _____________________________
24
How long have you worked at your job?
I have worked at my current job from __ __ / __ __ / __ __ __ _ to the present.
25
What is your job?
n-400r-seniors
I am a _______________________________
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Interview Based on the USCIS N-400r for Senior Citizens or Those Who Request Accommodations/Exemptions Part 8: Travel 26
Have you taken any trips outside the US during the last 5 years?
a) Yes, I have. b) No, I haven’t. (Skip to Part 9)
27
How many total days did you spend outside the US during the last 5 years?
a) I was outside the US for ________days.
28
How many trips have you taken outside of the US during the last 5 years?
I have taken _____ trips outside of the US during the past five years
29
Tell me about your last trip.
I left the US on
When did you leave?
__ __ / __ __ / __ __ __ __.
When did you return?
I returned to the US on
30
b) I have not traveled outside the US.
__ __ / __ __ / __ __ __ __. 31
Where did you go?
I went to ___________________________.
Part 9: Marital History 32
What is your current marital status?
a) b) c) d) e) f)
33
How many times have you been married?
I have been married ______________ times.
34
What is your spouse’s name?
My husband’s / wife’s name is
I am single (never married). I am married. I am legally separated from my spouse. I am divorced. I am widowed. My marriage was annulled.
____________________________________ Last Name
First Name
Middle Name
35
What is your spouse’s date of birth?
His / Her birth date is __ __ / __ __ / __ __ __ __.
36
What is the date of your marriage?
We got married on __ __ / __ __ / __ __ __ __.
37
What is your spouse’s home address?
a) He / She lives with me. b) My spouse’s address is ____________________________________
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Interview Based on the USCIS N-400r for Senior Citizens or Those Who Request Accommodations/Exemptions 38
Is your spouse a US citizen? a) My spouse was born a US citizen. b) My spouse became a US citizen on ____/____/______ c) My spouse is a Permanent Resident. He / She is a citizen of _________________________. d) My spouse is neither a US citizen nor a Permanent Resident. He / She is a citizen of _________________.
34
If you were married before, what was the name of your Prior Spouse?
My ex-spouse’s name was ____________________________________ Last Name
35
Was your prior spouse a US citizen?
First Name
Middle Name
a) My ex-spouse was born a US citizen. b) He / She was a Permanent Resident. c) Other_____________________________
Part 10: Children 36
How many children do you have?
a) I don’t have any children. b) I have __ living, __ missing, __ dead children.
37
What is your ___ child’s name?
My child’s name is ________________________
38
Is he / she a U.S. citizen?
a) Yes, he / she is a US citizen. b) The A-Number is A-__ __ __ __ __ __ __ __ __ c) Other __________________________________.
39
What is your child’s date of birth?
His / Her birth date is __ __ / __ __ / __ __ __ __.
40
What is your child’s country of birth?
His / Her country of birth is _____________________.
41
What is your child’s home address?
My child’s address is ______________________
42
What is your child’s relationship to you?
a) Biological child b) Stepchild
Child 1st
US Citizen Yes / No
2nd
Yes / No
rd
Yes / No
4th
Yes / No
3
Name
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Date of Birth
c) Legally Adopted Child d) Other _____________
Country of Birth
Address (ex: “With me” or “NYC”)
uscitizenpod.com 2007, 2015
Interview Based on the USCIS N-400r for Senior Citizens or Those Who Request Accommodations/Exemptions
1
PART 11 ADDITIONAL INFORMATION (similar to the old N-400 10AB) Have you ever claimed to be a US citizen?
a) Yes. b) No.
3
Have you ever voted in any US elections?
a) Yes. b) No.
5
Have you been declared legally incompetent?
a) Yes. b) No.
7a
Have you ever failed to file your taxes?
9
a) No. b) My income is too low to file taxes. c) My family supports me. Do you belong to any groups or organizations? a) Yes. b) No.
10a
Have you ever been a member of the Communist party?
a) Yes. b) No.
10c
Have you ever been a terrorist?
a) Yes. b) No.
13
**NEW** PART 11 Violence (greatly expanded old N-400 Part 10C; questions 14-21 are new!) Have you ever persecuted any person based on race, religion, etc.? a) Yes. b) No.
14
Have you ever badly hurt or killed a person on purpose?
a) Yes. b) No.
15
Have you ever participated in a rebel group, militia, or army?
a) Yes. b) No.
19
Have you ever received military or weapons training?
a) Yes. b) No.
22
PART 11 Good Moral Character and Military Service (similar to the old N-400 Part 10DEF) Have you ever been arrested or committed a crime? a) Yes. b) No.
30a
Have you ever been a habitual drunkard?
a) Yes. b) No.
30c
Have you ever gambled illegally?
a) Yes. b) No.
30e
Have you ever lied to the US government to get public benefits (welfare, SNAP)?
a) Yes. b) No.
33
Have you ever been deported?
a) Yes. b) No.
PART 11 Attachment to the Constitution (very similar to the old N-400 Part 10H) 47
Do you support the Constitution and the form of government of the US?
a) Yes. b) No.
48
Do you understand the full Oath of Allegiance to the United States?
a) Yes. b) No.
49
Are you willing to take the full Oath Of Allegiance to the US government?
a) Yes. b) No.
50
If the law requires it, are you willing to bear arms in the US Army?
a) Yes. b) No.
What is “to bear arms”? 51
Are you willing to perform non-combatant services for the US Army? What is “non-combatant”?
52
I will use a weapon to protect the US if the government requires it. a) Yes. b) No.
I will help the U.S. Army without using a weapon.
Are you willing to help the government during a national emergency?
a) Yes. b) No.
Do you promise that everything you said is true?
a) Yes. b) No.
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Interview Based on the USCIS N-400r for Senior Citizens or Those Who Request Accommodations/Exemptions
* If you are 65 years old or older and have been a legal permanent resident of the United States for 20 or more years, you may study just the questions that have been marked with an asterisk. Civics Questions for the 65/20 Exemption 1
What is one right or freedom from the
▪ speech
First Amendment?* (06)
▪ religion ▪ assembly ▪ press ▪ petition the government
2
3
What is the economic system in the
▪ capitalist economy
United States?* (11)
▪ market economy
Name one branch or part of the
▪ Congress
government.* (13)
▪ legislative ▪ President ▪ executive ▪ the courts ▪ judicial
4
What are the two parts of the U.S.
▪ the Senate and House (of Representatives)
Congress?* (17) 5
Who is one of your state’s U.S.
▪ Answers will vary.
Senators now?* (20) 6
In what month do we vote for
▪ November
President?* (27) What is the name of the President of
▪ Barack Obama
the United States now?* (28)
▪ Obama
8
What is the capital of your state?* (44)
▪ Answers will vary.
9
What are the two major political
▪ Democratic and Republican
7
parties in the United States?* (45) 10
What is one responsibility that is only
▪ serve on a jury
for United States citizens?* (49)
▪ vote in a federal election
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uscitizenpod.com 2007, 2015
Interview Based on the USCIS N-400r for Senior Citizens or Those Who Request Accommodations/Exemptions 11
How old do citizens have to be to vote
▪ eighteen (18) and older
for President?* (54) 12
When is the last day you can send in
▪ April 15
federal income tax forms?* (56) 13
Who was the first President?* (70)
▪ (George) Washington
14
What was one important thing that
▪ freed the slaves (Emancipation Proclamation)
Abraham Lincoln did?* (75)
▪ saved (or preserved) the Union ▪ led the United States during the Civil War
15
Name one war fought by the United
▪ World War I
States in the 1900s.* (78)
▪ World War II ▪ Korean War ▪ Vietnam War ▪ (Persian) Gulf War
16
17
What did Martin Luther King, Jr. do?*
▪ fought for civil rights
(85)
▪ worked for equality for all Americans
What is the capital of the United
▪ Washington, D.C.
States?* (94) 18
Where is the Statue of Liberty?* (95)
▪ New York (Harbor) ▪ Liberty Island [Also acceptable are New Jersey, near New York City, and on the Hudson (River).]
19
Why does the flag have 50 stars?* (97)
▪ because there is one star for each state ▪ because each star represents a state ▪ because there are 50 states
20
When do we celebrate Independence
▪ July 4
Day?* (99)
Applicants are also required to read one sentence and write a dictated sentence. For a list of the Reading and Writing Vocabulary words, go to http://goo.gl/tud3Gw. There are large print versions of the Reading and writing Vocabulary List. There is no official list of Reading and Writing Sentences. Good luck! I know that you will be a great American citizen!
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uscitizenpod.com 2007, 2015