Applicant Name: Your Full Name

A-Number: A-000000000

Signature:

Date: 00/00/0000

Attachment with additional information for N-400, Application for Naturalization

Page 1, Part 2, Question 3: Other Names
I have used additional names that could not fit on the form.
Family Name (Last Name)

Given Name (First Name)

Middle Name

Page 3, Part 5: Previous Addresses

I lived in additional addresses that could not fit on the form.
Street Number and Name, Apartment Number, City, State/Province, Zip Code and Country

Dates
From

To

Page 6, Part 8: Former Schools/Employers

I attended additional schools or have more employers that could not fit on the form.
Employer or
School Name

Dates (mm/dd/yyyy)
From
To

Employer or School Address

(Street, City, State, and Zip)

Your Occupation

Applicant Name: Your Full Name

A-Number: A-000000000

Signature:

Date: 00/00/0000

Page 7, Part 9, Question 3: Time Outside the U.S.

I took more trips outside the U.S. that could not fit on the form.
Date you Left
the United
States
(mm/dd/yyyy)

Date You
Returned to the
United States
(mm/dd/yyyy)

Did Trip Last Six

Months or More?
(circle yes or no)
Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Countries to Which You Traveled

Total Days
Out of the
United
States

Page 8, Part 10, Question 8: Your Spouses Previous Marriages

My current spouse has marriages that could not fit on the form.
Prior Spouses Family Name (Last Name)

Given Name (First Name)

Date of Birth (mm/dd/yyyy)

Country of Birth

Country of Citizenship/Nationality

Date of Marriage (mm/dd/yyyy)

Full Middle Name

Immigration Status

Date Marriage Ended (mm/dd/yyyy)

Page 9, Part 10, Question 9: Previous Marriages

How Marriage Ended

Applicant Name: Your Full Name

A-Number: A-000000000

Signature:

Date: 00/00/0000

I have previous marriages that could not fit on the form.

Prior Spouses Family Name (Last Name)

Given Name (First Name)

Date of Birth (mm/dd/yyyy)

Country of Birth

Country of Citizenship/Nationality

Date of Marriage (mm/dd/yyyy)

Full Middle Name

Immigration Status (when our marriage ended)

Date Marriage Ended (mm/dd/yyyy)

How Marriage Ended

Page 9, Part 11, Question 2: Sons and Daughters

I have additional sons and daughters that could not fit on the form.
Childs Legal Family Name (Last Name)

Given Name (First Name)

Date of Birth (mm/dd/yyyy)

Full Middle Name

Country of Birth

A-Number

Childs Relationship to Me

Current Address (Street Number and Name, Apartment Number, City, State/Province, Zip Code and Country)

Applicant Name: Your Full Name

A-Number: A-000000000

Signature:

Date: 00/00/0000

Page 12, Part 12, Question 9B: Group Affiliations

I have been associated with additional groups that could on fit on the form.
Name of Group

Purpose of the Group

Dates of Membership
From
To

Page 14, Part 12, Question 29: Interactions with Law Enforcement
I have additional contacts with law enforcement that could on fit on the form.

Why were you arrested, cited,

detained, or charged?

Date arrested,
cited, detained,
or charged?
(mm/dd/yyyy)

Where were you arrested,

cited, detained, or charged?
(City, State, Country)

Outcome or disposition of the arrest,

citation, detention, or charge.
(No charges filed, charges
dismissed, jail, probation, etc.)