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Petition To Classify Orphan As An Immediate Relative I-600 - Official Federal Forms
| Petition To Classify Orphan As An Immediate Relative Form. This is a national form and can be used in US Citizenship And Immigration Services . |
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OMB No. 1615-0028; Expires 03/31/15 Department of Homeland Security U.S. Citizenship and Immigration Services Form I-600, Petition to Classify Orphan as an Immediate Relative Fee Stamp The petition was filed by: Married petitioner The petition is approved for orphan: Adopted abroad Unmarried petitioner Coming to U.S. for adoption. Pre adoption requirements have been met File Number: DATE OF FAVORABLE DETERMINATION DD DISTRICT Remarks: Type or print legibly in black ink. Complete a separate petition for each child. Petition is being made to classify the named orphan as an immediate relative. BLOCK I - Information About Petitioner 1. My name is: (Last) (First) (Middle) 6. My telephone number is: (include area code) 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: a. Name under which you naturalized: 3. I reside in the U.S. at: (Number and Street) (Town or City) 4. Address abroad (if any): (Number and Street) (Town or City) (Country) (C/O if appropriate) (Apt. No.) b. Naturalization certificate number: (State) (Zip Code) c. Date of naturalization (mm/dd/yyyy): d. Place of naturalization: (Apt. No.) (State or Province) If acquired through parentage, have you obtained a certificate in your own name based on that acquisition? No Yes 5. I was born on: (mm/dd/yyyy) In: (Town or City) (Country) Received Trans. In Ret'd Trans. Out Completed If not, submit evidence of citizenship. See Page 2 of the instructions. Have you or any person through whom you claimed citizenship ever lost U.S. citizenship? No Yes (If "Yes," attach detailed explanation) (State or Province) Form I-600 (Rev. 03/05/13) N American LegalNet, Inc. www.FormsWorkFlow.com BLOCK I - Information About the Prospective Adoptive Parent (Continued) 8. My marital status is: a. Married Widowed Divorced Single b. I have been married time(s) 9. If you are now married, provide the following information: Date of present marriage (mm/dd/yyyy): Name of present spouse: (Last) (First) (Middle) Place of birth of present spouse: (Maiden, if any) Place of present marriage: Date of birth of present spouse (mm/dd/yyyy): My spouse has been married My spouse resides: With me time(s) Apart from me (provide address below) (Number and Street) BLOCK II - Information About Orphan Beneficiary 10. Name at birth: (Last) 11. Name at present: (Last) (First) (First) (Apt. No.) (City) (State) (Country) (Middle) (Middle) 12. Any other names by which orphan is or was known: 13. Gender: 15. Place of birth: (City) Male Female 14. Date of birth (mm/dd/yyyy): (State or Province) He or she has no parents (Country) He or she has only one parent who is the sole or surviving parent 16. The beneficiary is an orphan because (check one): 17. If the orphan has only one parent, answer the following: a. State what has become of the other parent: b. Is the remaining parent capable of providing for the orphan's support? c. Has the remaining parent in writing irrevocably released the orphan for emigration and adoption? No No Yes Yes Form I-600 (Rev. 03/05/13) N Page 2 American LegalNet, Inc. www.FormsWorkFlow.com BLOCK II - Information About Orphan Beneficiary (Continued) No No Yes Yes 18. Has the orphan been adopted abroad by the petitioner and spouse jointly or the unmarried petitioner? If "Yes," did the petitioner and spouse or unmarried petitioner personally see and observe the child prior to or during the adoption proceedings? Date of adoption (mm/dd/yyyy) Place of adoption 19. If either answer in Question 18 is "No," answer the following: a. Does the petitioner and spouse jointly or does the unmarried petitioner intend to adopt the orphan in the United States? b. Have the preadoption requirements, if any, of the orphan's proposed State of residence been met? c. If b is answered "No," will they be met later? 20. To petitioner's knowledge, does the orphan have any physical or mental affliction? If "Yes," name the affliction. No No No No Yes Yes Yes Yes 21. Who has legal custody of the child? 22. Name of child welfare agency, if any, assisting in this case: 23. Name of attorney abroad, if any, representing petitioner in this case: Address of above attorney abroad: 24. Address in the United States where orphan will reside: 25. Present address of orphan: 26. If orphan is residing in an institution, give full name of institution: 27. If orphan is not residing in an institution, give full name of person with whom residing: 28. Give any additional information necessary to locate orphan, such as name of district, section, zone, or locality in which orphan resides: Form I-600 (Rev. 03/05/13) N Page 3 American LegalNet, Inc. www.FormsWorkFlow.com BLOCK II - Information About Orphan Beneficiary (Continued) 29. Location of U.S. Embassy or consulate where application for visa will be made: (City in Foreign Country) (Foreign Country) BLOCK III - Accommodations for Individuals With Disabilities and Impairments (Read the information in the instructions before completing this section.) 30. I am requesting an accommodation: A. Because of my disability(ies) and/or impairment(s). B. For my spouse because of his or her disability(ies) and/or impairment(s). C. For my household member because of his or her disability(ies) and/or impairment(s). No No No Yes Yes Yes If you answered "Yes," check any applicable box. Provide information on the disability(ies) and/or impairment(s) for each person: Deaf or hard of hearing and request the following accommodation(s) (if requesting a sign-language interpreter, indicate which language (e.g., American Sign Language)): Blind or sight-impaired and request the following accommodation(s): Other type of disability(ies) and/or impairment(s) (describe the nature of the disability(ies) and/or impairment(s) and accommodation(s) being requested): Certification of Petitioner I certify, under penalty of perjury under the laws of the United States of America, that the foregoing is true and correct, and that I will care for an orphan or orphans properly if admitted to the United States. Certification of Petitioner's Spouse I certify, under penalty of perjury under the laws of the United States of America, that the foregoing is true and correct, and that my spouse and I will care for an orphan or orphans properly if admitted to the United States. (Signature of Petitioner's Spouse) Executed on (Date) (Signature of Petitione
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