Simple Interview based on the Revised N-400 PARTS 1-11 PERSONAL INFORMATION 1

How are you eligible to become a US Citizen?

a) I have been a Legal Permanent Resident for 5 years. b) I have been a Legal Permanent Resident for 3 years and married to a US citizen for 3 years c) I have Qualifying Military Service

2

What is your legal name?

My legal name is _____________________________

3

Are you requesting an accommodation a) No. because of a disability?

b) Yes, my disability is ________________________

4

What is your phone number?

My phone number is __________________________

5

What is your home address?

My home address is ____________________________

6

address? Was your mother or father a

a) No.

US citizen before you were 18 yrs old? b) Yes. My (mother / father) was a US citizen. 7

Are you Hispanic or Latino?

a) No. b) Yes, I am Hispanic or Latino.

8

Do you work or go to school?

a) Yes, I work at ______________________________ b) Yes, I go to school at c) I am retired.

e) I am disabled.

d) I take care of my family. f) I am unemployed. 9

10

11

Have you taken any trips outside of the US?

a) No, I have not left the US.

Are you married?

a) I am single.

c) I am widowed.

b) I am married.

d) I am divorced.

Do you have any children?

b) Yes, I left __________and returned

_________

I have _________________________(child / children)

PART 12 ADDITIONAL INFORMATION (similar to the old N-400 Part 11) 1

Have you ever claimed to be a U.S. citizen?

a) Yes. b) No.

3

Have you ever voted in any U.S. elections?

a) Yes. b) No.

7

Do you pay your taxes every year?

a) Yes. b) No.

9

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.

This work by Jennifer Gagliardi is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Simple Interview based on the Revised N-400 14

PART 12: War Crimes 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.

16

Have you ever worked in a place like a prison or labor camp?

a) Yes. b) No.

17

Have you ever been a member of a gang?

a) Yes. b) No.

18

Have you ever sold or given weapons to another person?

a) Yes. b) No.

19

Have you ever received military or weapons training?

a) Yes. b) No.

20

Have you ever forced a child (under 15) to become a soldier?

a) Yes. b) No.

21

Have you ever forced a child (under 15) to help soldiers?

a) Yes. b) No.

23

PART 12: Crimes and Military Service Have you ever been arrested?

a) Yes. b) No.

30a

Have you ever been a habitual drunkard?

a) Yes. b) No.

30c

Have you ever sold or smuggled illegal drugs?

a) Yes. b) No.

30e

Have you ever married someone to get a Green Card?

a) Yes. b) No.

30i

Have you ever lied to the US government get public benefits (ex: welfare)?

a) Yes. b) No.

33

Have you ever been deported?

a) Yes. b) No.

37

Have you ever served in the US armed forces?

a) Yes. b) No.

45

PART 12: Attachment to the Constitution Do you support the Constitution and the form of government of the US?

a) Yes. b) No.

46

Do you understand the full Oath of Allegiance to the United States?

a) Yes. b) No.

47

Are you willing to take the full Oath Of Allegiance to the US government?

a) Yes. b) No.

48

If the law requires it, are you willing to bear arms in the US Army?

a) Yes. b) No.

49

Are you willing to perform non-combatant services in the US Army?

a) Yes. b) No.

50

Are you willing to help the government during a national emergency?

a) Yes. b) No.

13

PART 13 TO 18: SIGNATURES Sign your name. (Certify that everything is TRUE).

SEND IN YOUR

14

Name of your interpreter who helped translate your N-400 application.

N-400!

15

Name of the person who helped you fill out your N-400 application.

16

Sign your name at the interview.

17 Renounce your title of nobility. 18

DO NOT SIGN THESE SECTIONS UNTIL YOU GO TO THE USCIS

Sign the Oath of Allegiance at your Oath Ceremony INTERVIEW. This work by Jennifer Gagliardi is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

A Simple Interview Based on the N-400r - Libsyn

a) No. b) Yes. My (mother / father) was a US citizen. 7. Are you Hispanic or Latino? a) No. b) Yes, I am Hispanic or Latino. 8. Do you work or go to school? a) Yes ...

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