Form I-600a - Application For Advance Processing Of An Orphan Petition
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3OMB No. 1615-0028
Form I-600A, Application for Advance
Department of Homeland Security
Processing of Orphan Petition
U.S. Citizenship and Immigration Services
Do not write in this block
For USCIS Use Only
It has been determined that the:
Fee Stamp
Married
Unmarried
prospective adoptive parent will furnish proper care to a beneficiary
orphan if admitted to the United States.
There:
are
are not
preadoptive requirements in the State of the child's proposed residence.
The following is a description of the preadoption requirements, if any,
of the State of the child's proposed residence:
DATE OF FAVORABLE
DETERMINATION
DD
DISTRICT
The preadoption requirements, if any:
File number of applicant, if applicable: _______________________
have been met.
have not been met.
Type or print legibly in black ink.
This application is made by the named prospective adoptive parent for advance processing of an orphan petition.
BLOCK I - Information About the Prospective Adoptive Parent
6. My telephone number is: (include area code)
1. My name is: (Last)
(First)
(Middle)
2. Other names used (including maiden name if appropriate):
7. I am a citizen of the United States through:
Birth
Parents
Naturalization
If acquired through naturalization, provide the following:
3. I reside in the U.S. at:
(C/O if appropriate)
a. Name under which you naturalized:
(Number and Street)
(Apt. No.)
b. Naturalization certificate number:
(Town or City)
(State) (Zip Code)
c. Date of naturalization (mm/dd/yyyy):
4. Address abroad (if any):
d. Place of naturalization:
(Number and Street)
(Apt. No.)
If acquired through parentage, have you obtained a
(Town or City)
(State or Province)
certificate in your own name based on that acquisition?
No
Yes
(Country)
If not, submit evidence of citizenship. See Page 2 of the
5. I was born on: (mm/dd/yyyy)
instructions.
In:
Have you or any person through whom you claimed
citizenship ever lost U.S. citizenship?
(Town or City)
(State or Province)
No
Yes (If "Yes," attach detailed
explanation)
(Country)
Received
Trans. In
Ret'd Trans. Out
Completed
Form I-600A (Rev. 01/12/11) Y
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