CitizenPath - Immigration Made Simple



Additional InformationForm N-400, Application for NaturalizationFamily Name:SampleA-Number: A-000000000Given Name: SampleMiddle Name: SamplePage 2, Part 2, Item 3: Other Names UsedOther Name 3Family Name: SampleGiven Name: SampleMiddle Name: SamplePage 4, Part 5: Information About Your ResidencePhysical Address 5Street Number and Name: SampleApt/Ste/Flr: SampleCity or Town: SampleState: SampleZIP Code: 00000Province:SamplePostal Code:00000Country:SampleDate From: 00/00/0000Date To: 00/00/0000Page 6, Part 8: Information About Your Employment and SchoolsEmployer 4Employer or School Name: SampleStreet Number and Name: SampleApt/Ste/Flr: SampleCity or Town: SampleState: SampleZIP Code: 00000Province:SamplePostal Code:00000Country:SampleOccupation:SampleDate From: 00/00/0000Date To: 00/00/0000Page 7, Part 9, Item 3: Time Outside the United States[Note: When the applicant has any trips with an N-470 or service on a U.S. vessel, ALL trips will be listed on this additional information page starting with Trip 1. "See Additional Information Addendum" shall be inserted in the first Country text box of P9.3]Statement Regarding Approved N-470Custom long textStatement Regarding Service on a U.S. VesselCustom long textTrip 1/7Date of Departure: SampleDate of Return: SampleTrip of 6 Months or More: SampleCountries Traveled To: SampleTotal Days: SampleCovered by approved N-470: Yes/No (display only when Yes)Service on U.S. Vessel:Yes/No (display only when Yes)Page 7, Part 10, Item 4C: Other Names Used by Current SpouseOther Name 2Family Name: SampleGiven Name: SampleMiddle Name: SamplePage 7, Part 10, Item 8: Marital History/Current Spouse’s Prior MarriagesPrior Spouse 2Family Name: SampleGiven Name: SampleMiddle Name: SampleImmigration Status: SampleDate of Birth: 00/00/0000Country of Birth: SampleCountry of Citizenship: SampleDate of Marriage: 00/00/0000Date Marriage Ended: 00/00/0000Marriage Ended By: SamplePage 9, Part 10, Item 9: Marital History/Applicant’s Prior MarriagesPrior Spouse 2Family Name: SampleGiven Name: SampleMiddle Name: SampleImmigration Status: SampleDate of Birth: 00/00/0000Country of Birth: SampleCountry of Citizenship: SampleDate of Marriage: 00/00/0000Date Marriage Ended: 00/00/0000Marriage Ended By: SamplePage 11, Part 11, Item 2E: Information About Your ChildrenChild 5Family Name: SampleGiven Name: SampleMiddle Name: SampleA-Number: SampleDate of Birth: 00/00/0000Country of Birth: SampleCurrent Address:Child is living with me (line displays only if used)Street Number and Name: SampleApt/Ste/Flr: SampleCity or Town: SampleCounty: SampleState:SampleZIP Code + 4: SampleProvince or Region: SamplePostal Code: SampleCountry: SampleChild’s Relationship: SamplePage 12, Part 12, Item 9B: Groups and OrganizationsGroup 1Name of the Group: SamplePurpose of the Group: SampleExplanation:Sample long textDate From: 00/00/0000Date To: 00/00/0000Page 14, Part 12, Item 29: Citations, Arrests and ChargesIncident 6Reason: SampleDate of Incident: 00/00/0000Location: SampleOutcome/Disposition: Sample ................
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