Indo-American Center
N-400 Initial Application
Applicant's Contact Details
Name
First Name
Middle Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
Gender
When did you last enter the US?
In what status did you last enter the US (green card, B1B2, other?)
Demographics
Country of Birth
Country or Countries of Citizenship
Ethnicity
Race
American Indian/Alaska Native
Asian
White
Black
Latino
Middle-Eastern/North African
Highest Level of Education
Number of People in Household
Annual Income
Family Details
Marital Status
Single
Married
Divorced
Widowed
If married, nationality of spouse.
For all children, list their name, age, marital status and immigration status.
STOP QUESTIONS
Are you a resident of Illinois?
Yes
No
Have you ever left the country for more than one year continuously after receiving your green card?
Yes
No
Please detail any trips outside the US for more than one year after receiving your green card?
Are either of your parents U.S Citizens?
Yes
No
Have you previously applied for or been DENIED NATURALIZATION?
Yes
No
Have you ever voted in the U.S., registered to vote or received a voter registration card?
Yes
No
Have you ever TOLD someone that you are a US citizen?
Yes
No
Please provide the details of when you were out of the country for more than a year after obtaining a green card.
Have you ever informed (in writing or orally) an employer you are a U.S Citizen?
Yes
No
Have you ever been STOPPED or ARRESTED by the police in the U.S. or any other country?
Yes
No
Have you ever spent any time (even a few hours) in JAIL or PRISON in the U.S. or any other country?
Yes
No
Have you ever been CHARGED with a CRIME in the U.S. or in any other country?
Yes
No
Have you ever been FOUND GUILTY of any OFFENSE in the U.S. or any other country?
Yes
No
Has your RECORD ever been EXPUNGED (ERASED or WIPED CLEAN)?
Yes
No
Have you ever PERSECUTED anyone for any reason or been involved in genocide or killings?
Yes
No
Have you ever used false documents or provided false information to an immigration or consulate agent?
Yes
No
Have you ever been STOPPED, DETAINED, or ARRESTED by an IMMIGRATION official?
Yes
No
Have you ever seen an IMMIGRATION JUDGE or received DOCUMENTS regarding immigration court?
Yes
No
Have you ever been deported, removed or turned back around while seeking to enter the US?
Yes
No
Did you marry a legal permanent resident or United States citizen JUST to get a green card?
Yes
No
Have you ever failed to file a U.S. TAX RETURN since you obtained legal permanent residence?
Yes
No
Have you ever failed to PAY CHILD SUPPORT if your children do not live with you?
Yes
No
Did you LEAVE OUT ANY information at the time you were interviewed to get your green card?
Yes
No
Eligibility
What date did you obtain your green card?
Have you had your green card for at least 5 years?
Yes
No
If not, are you currently married to a US Citizen?
Yes
No
If currently married to a US Citizen, have you had a green card for three years?
Yes
No
Not Applicable
Have you left the country for even one day since obtaining your green card?
Yes
No
Have you taken a trip outside the U.S. that lasted 6 months or more since you got your green card?
Yes
No
If so, please detail all trips over six months?
Since receiving your green card you ever been stopped by an immigration officer and asked questions before being let into the country?
Yes
No
If so, please detail any issues or concerns expressed by the immigration officer.
Communication Preferences (Language and Computer Competency)
Are you comfortable communicating with the legal team in English on your own or with the help of a family member or friend?
Yes
No
If applicable, please specify the family member/friend and provide contact details:
Which languages are you comfortable communicating in?
Are you comfortable scanning documents and emailing or faxing them to IAC on your own or with the help of a family member or friend?
Yes
No
If applicable, please specify the family member/friend and provide contact details:
Are you comfortable entering data directly online on their own or with the help of a family member or friend?
Yes
No
If applicable, please specify the family member/friend and provide contact details:
What is your preferred method of intake and case communication?
Email
Phone
Video Chat
In Person
English Proficiency
(Self-Assessment) How well do you speak English?
Very well
Well
Not well
Not at all
Can you read and write English?
Yes
No
Are you willing / able to go to ESL classes to improve your English skills?
Yes
No
Do you have any kind of disability that prevents you from learning and memorizing? (for N-648 exemption)
Yes
No
(Case Worker Assessment) How well does the applicant speak English?
Very well - conversation in English flows easily
Well - not perfect but will likely pass English test at N-400 interview
Not that well but can be successful with practice and classes while waiting for N-400 interview to be schedule
Not well enough to pass the English test in the next 6-9 months
Please detail any concerns or further insights about English language proficiency.
Copy of ID & Green Card
Applicant provided copies of green card and ID.
Yes
No
Other, please explain below.
Please explain:
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