Application for Replacement Naturalization/ Citizenship Document
[N-565, Application for Replacement Naturalization/Citizenship Document]
IMPORTANT: Information on this site may be outdated. For up-to-date instructions and filing fees check always with the USCIS site:
http://www.uscis.gov/forms
Purpose of Form :
This form is used to apply for a replacement Declaration of Intention, Naturalization Certificate, Certificate of Citizenship, or Repatriation Certificate, or to apply for a special certificate of naturalization as a U.S. citizen to be recognized by a foreign country.
Number of Pages :
4
Edition Date :
01/25/07. Prior versions acceptable.
Where to File :
File with either the Nebraska or Texas Service Center, depending on the state where you live. See the form’s instructions for specifics.
Filing Fee :
$220.00
Special Instructions :
(NA)
Department of Homeland Security
U.S. Citizenship and Immigration Services
OMB No. 1615-0091; Expires 01/31/07
N-565, Application for Replacement Naturalization/Citizenship Document
Purpose of This Form.
This form is used to apply to U.S. Citizenship and Immigration Services (USCIS) for a replacement:
- Declaration of Intention, or
- Naturalization Certificate, or
- Certificate of Citizenship, or
- Repatriation Certificate, or to
- Apply for a special certificate of naturalization as a U.S. citizen to be recognized by a foreign country.
Who May File?
You may apply for a replacement:
- If you have been issued a Naturalization Certificate, Certificate of Citizenship, Declaration of Intention or Repatriation Certificate which has been lost, mutilated, or destroyed, or;
- If your name has been changed by marriage or by court order after the document was issued and you seek a document in the new name.
- If you are a naturalized citizen desiring to obtain recognition as a citizen of the United States by a foreign country, you may apply for a special certificate for that purpose.
General Filing Instructions.
Please answer all questions by typing or clearly printing in black ink. Indicate that an item is not applicable with “N/A.” If an answer is “none,” so state. If you need extra space to answer any item, attach a sheet of paper with your name and your A#, if any, and indicate the number of the item.
Every application must be properly signed and filed with the correct fee. If you are under 14 years of age, your parent or guardian may sign the application in your behalf.
Initial Evidence Requirements.
You must file your application with the following evidence:
- You must submit two standard passport-style photographs in color of yourself taken within 30 days of this application. These photos must be glossy, unretouched and unmounted, and have a white background. The dimension of your full frontal facial position should be about 1 inch from your chin to the top of your hair. Using pencil or felt pen, lightly print your name and A# if any, on the back of each photo. This requirement may be waived by USCIS if you can establish that you are confined because of age or physical infirmity.
- If you are applying for replacement of a mutilated document, you must attach the mutilated document.
- If you are applying for a new document because your name has been changed, you must submit the original USCIS (or former INS) document and a copy of the marriage certificate or court order showing the name change.
- If you are applying for a special certificate of naturalization, you must attach a copy of your naturalization certificate.
Copies.
If these instructions state that a copy of a document may be filed with this application, and you choose to send us the original, we may keep that original for our records.
Where to File.
If you reside in AL, AR, CT, DE, DC, FL, GA, KY, LA,
MS, ME, MD, MA, NH, NJ, NM, NY, NC, SC, OK, PA, PR, RI, TN, TX, VA, VI, VT, WV
submit your N-565 to the Texas Service Center at:
DHS/USCIS
Texas Service Center
PO Box 851182
Mesquite, TX 75185-1182
If you reside in AK, AZ, CA, CO, GU, HI, ID, IL, IN, IA, KS, MI, MN, MO, MT, NE, NV, ND, OH, OR, SD, UT, WA, WI, WY
submit your N-565 to the Nebraska Service Center at:
DHS/USCIS
Nebraska Service Center
PO Box 87565
Lincoln, NE 68501-7565
What Is the Fee?
The fee for this application is $220.00, except there is no fee if you check block 2 (d) of Part 2 of the form.
The fee must be submitted in the exact amount. It cannot be refunded. Do not mail cash.
All checks and money orders must be drawn on a bank or other institutions located in the United States and must be payable in United States currency. The checks or money orders should be made payable to the Department of Homeland Security, except that:
- If you reside in Guam, make your check or money order payable to the “Treasurer, Guam.”
- If you reside in the U.S. Virgin Islands, make your check or money order payable to the “Commissioner of Finance of the Virgin Islands.”
Checks are accepted subject to collection. An uncollected check will render the application and any document issued invalid. A charge of $30.00 will be imposed if a check in payment of a fee is not honored by the bank on which it is drawn.
How to Check If the Fee Is Correct.
The fee on this form is current as of the edition date appearing in the lower right corner of this page. However, because USCIS fees change periodically, you can verify if the fee is correct by following one of the steps below:
- Visit our website at www.uscis.gov and scroll down to “Forms and E-Filing ” to check the appropriate fee, or
- Review the Fee Schedule included in your form package, if you called us to request the form, or
- Telephone our National Customer Service Center at 1-800-375-5283 and ask for the fee information.
Processing Information.
Rejection. Any application that is not signed or not accompanied by the correct fee will be rejected with a notice that the application is deficient. You may correct the deficiency and resubmit the application. However, an application is not considered properly filed until accepted by USCIS.
Initial processing. Once the application has been accepted, it will be checked for completeness, including submission of the required initial evidence. If you do not completely fill out the form, or file it without required initial evidence, you will not establish a basis for eligibility and we may deny your application.
Requests for more information or interview. We may request more information or evidence or we may request that you appear at a USCIS office for an interview. We may also request that you submit the originals of any copy. We will return these originals when they are no longer required.
Decision. If you establish eligibility for the document, your application will be approved and the document issued. Where appropriate, a special certificate of naturalization will be forwarded to the U.S. Department of State for delivery to a foreign government official. If your application is denied, you will be notified in writing of the reasons for the denial.
USCIS Forms and Information.
To order USCIS forms, call our toll-free forms line at 1-800-870-3676. You can also get USCIS forms and information on immigration laws, regulations or procedures by telephoning our National Customer Service Center at 1-800-375-5283 or visiting our USCIS internet website at www.uscis.gov.
Use InfoPass for Appointments.
As an alternative to waiting in line for assistance at your local USCIS office, you can now schedule an appointment through our internet-based system, InfoPass. To access the system, visit our website at www.uscis.gov. Use the InfoPass appointment scheduler and follow the screen prompts to set up your appointment. InfoPass generates an electronic appointment notice that appears on the screen. Print the notice and take it with you to your appointment. The notice gives the time and date of your appointment, along with the address of the USCIS office.
Penalties.
If you knowingly and willfully falsify or conceal a material fact or submit a false document with this request, we will deny the benefit you are filing for, and may deny any other immigration benefit. In addition, you will face severe penalties provided by law, and may be subject to criminal prosecution.
Privacy Act Notice.
We ask for the information on this form, and associated evidence, to determine if you have established eligibility for the immigration benefit you are seeking. Our legal right to ask for this information is in 8 USC 1439, 1440, 1443, 1445, 1446, and 1452. We may provide this information to other government agencies. Failure to provide this information, and any requested evidence, may delay a final decision or result in denial of your request.
Paperwork Reduction Act Notice.
A person is not required to respond to a collection of information unless it displays a currently valid OMB control number.
We try to create forms and instructions that are accurate, can be easily understood and which impose the least possible burden on you to provide us with information. Often this is difficult because some immigration laws are very complex.
Accordingly, the reporting burden for this collection of information is computed as follows: (1) learning about the law and form, 10 minutes; (2) completing the form, 10 minutes; and (3) assembling and filing the application, 35 minutes, for an estimated average of 55 minutes per response.
If you have comments regarding the accuracy of this estimate, or suggestions for making this form simpler, you can write to U.S. Citizenship and Immigration Services, Regulatory Management Division, 111 Massachusetts Avenue, N.W., Suite 3008, Washington, DC 20529; OMB No. 1615-0091. Do not mail your completed application to this address.