Czech Citizenship Certificate "Dotazník" ADULT APPLICANT

Before you begin:

Signatures must be provided during your consular appointment. If applying by mail, they must be notarized. For more information, please refer to the website of the consulate with jurisdiction over your state.

The completed form may still contain a few blank fields. These are either not applicable to your case or intended for consular use.

Each Czech consulate in the U.S. covers specific states. If you’re unsure which consulate serves your area, you can check the list of consulate jurisdictions here.
Applicant's information
Applicant's email
Email address to receive your completed form
CzechWay Citizenship Solutions
Full Applicant's Name
Enter first name, middle name, and last name.
Applicant's date of birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearEnter date in European format
Applicant's Czech birth number (if applicable)
Czech birth number is a unique number issued by Czech authorities. It is not the SSN. Leave blank if unknown. (You’ll find it on a Czech birth certificate, ID, or passport.)
Applicant's place of birth
City and state/country
Applicant's address
Czech address if available; otherwise enter your current foreign address
Applicant's foreign (non-Czech) citizenship
Do you have any other citizenship than Czech?
How many foreign (non-Czech) citizenships do you have?
This form is limited to two foreign citizenships. Any additional non-Czech citizenships can be added during your appointment at the Czech consulate.
Name all your foreign citizenships:
Other than Czech (e.g., USA, SK, GB), if applicable. This form supports up to two foreign citizenships. If you have more than two, please add any additional ones manually.
Date of acquisition of the first foreign citizenship

DayMonthYear
2 digit day, 2 digit month, 4 digit yearEnter date in European format
The method of acquisition of the first foreign citizenship

Other
narozenim 1
narozenim 1.2
naturalizaci 1
naturalizaci 1.2
snatkem 1
snatkem 1.2
Applicant's second foreign (non-Czech) citizenship
Date of acquisition of your other (2nd) foreign citizenship

DayMonthYear
2 digit day, 2 digit month, 4 digit yearEnter date in European format
The method of acquisition of your other (2nd) foreign citizenship

Other
narozenim 2
narozenim 2.2
naturalizaci 2
naturalizaci 2.2
snatkem 2
snatkem 2.2
What was your spouse’s citizenship at the time you acquired any current foreign citizenship? (if you were married at the time)
This may refer to a different spouse than your current one, if applicable.
Date of marriage (linked to the acquisition of foreign citizenship)

DayMonthYear
2 digit day, 2 digit month, 4 digit yearMay refer to a previous marriage if relevant.
Applicant's marital status at the time of submission
Calculation
Applicant's last Czech address (if applicable)
Even if your Czech permanent residence has been terminated
Applicant's previous Czech address (before the last one, optional)
Your second-to-last address in the Czech Republic
Purpose of requesting the citizenship certificate

Other
rodny
oddaci
rodny a oddaci
cesky pas
Expiration date of your last Czech passport (if applicable)

DayMonthYear
2 digit day, 2 digit month, 4 digit yearEnter date in European format, skip if unknown
Date of departure from the Czech Republic (optional if known)
If you’re unsure, approximate the year. You may leave this blank if it doesn’t apply.
Are you currently married?
Spouse's full name
Enter first name, middle name, and last name.
Spouse's date of birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearEnter date in European format
Spouse's place of birth
City and state/country
Citizenship of your spouse at the time of marriage
You can list more citizenships in this field. E.g. USA, CZ, GER...
Date of marriage

DayMonthYear
2 digit day, 2 digit month, 4 digit yearEnter date in European format
Place of marriage
City and State/Country
Spouse's last Czech address (if applicable)
Even if their Czech permanent residence has been terminated
I declare that between January 1, 1969 and December 31, 1992, I acquired the citizenship of the Slovak Socialist Republic or the Slovak Republic by choice or by being granted it.
Applicant's parents' information
Father of the applicant
Father's full name
Enter first name, middle name, and last name.
Father's last name at birth
If different from above
Father's date of birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearEner date in European format
Father's place of birth
City and state/country
Father’s citizenship at time of applicant’s birth
E.g. USA, CZ...
Applicant's father's last Czech address (if applicable)
Even if his Czech residency has been terminated
Mother of the applicant
Mother's full name
Enter first name, middle name, and last name.
Mother's maiden name
If different from above
Mother's date of birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearEner date in European format
Mother's place of birth
City and state/country
Mother’s citizenship at time of applicant’s birth
E.g. USA, CZ...
Applicant's mother's last Czech address (if applicable)
Even if his Czech residency has been terminated
Date of application submission

DayMonthYear
2 digit day, 2 digit month, 4 digit yearEnter date in European format
Which Czech consulate in the U.S. will you be applying at?
Each consulate has different jurisdiction, see link above.
For applications outside the U.S., select your city of submission.
Find the Czech consulate or Embassy worldwide. If you do not see your city, skip this field.
Applicant's identification document
Applicant's identification document number
Identification document was issued on

DayMonthYear
2 digit day, 2 digit month, 4 digit yearEnter date in European formate
Identification document expires on

DayMonthYear
2 digit day, 2 digit month, 4 digit yearEnter date in European formate
Note: Fields No. 36 and 80 of the final PDF must be signed by hand by the applicant.

My Products

Czech Citizenship Form §42 (adult)

Completed PDF form for submission at the Consulate

$50.00

Enter coupon

Subtotal

Tax

Total

Payment Methods

Credit Card

Apple Pay

Google Pay

Should be Empty:

Applicant's information

Applicant's foreign (non-Czech) citizenship

Applicant's second foreign (non-Czech) citizenship

Applicant's parents' information

Father of the applicant

Mother of the applicant

My Products*

Payment Methods

My Products