Citizenship Application Form

The citizenship application form is used to ascertain the citizenship of a person in a particular country. Please fill in the form using uppercase in black or blue ink.

Part one

Legal Name beginning with (surname, middle, and first Name) ______________________________

Have you ever used other names? List them below in this order (surname, middle name, first name)

Do you wish to change your name?

If NO, state NO.

If YES, indicate the name you prefer to use in the following order. (Surname, middle name, first name)

INFORMATION SHOWING YOUR ELIGIBILITY

For persons above the age of 18 please check only one.

I have lived in the country for at least five years__________________

I have been a permanent resident for at least three years. This is also the case with my spouse ____________________________

Otherwise (please state) _____________________

PERSONAL INFORMATION

Your social security number_____________________

Your date of birth___________________________

State date you became a permanent resident ___________________

Your country of Nationality/Origin ______________________

State Yes or No ;

Is any of your parent is a citizen of this country

YES_____

NO_____

Current marital Status (never married, married, divorced, widowed) __________________________

Personal Home address_______________________

City, state, zip code__________________________________

Care of personal address____________________________

City, state, zip code ____________________________________

The following information is required by the Security Authorities

Are you Male or Female ____________________________

Your height __________________________

Your weight __________________________

Race _____________________________

Hair color _______________________

Eye color _____________

I am aware of the content of this application form and I comply with all the requirements in the form.

Applicant signature________________________

Date ______________________________

(Please note that if your application is approved you will be scheduled for public oath ceremony where you shall recite an oath.)

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