Czech Citizenship Certificate "Dotazník" MINOR 1-15

Before you begin:

If you are applying on behalf of your child, the Applicant is the parent with Czech citizenship submitting the request. If both parents are Czech citizens, either may act as the applicant.

In this case, the information of the Czech parent appears in both the Applicant section and the Mother or Father section, depending on their relationship to the child.

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

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.

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.
Child's information
Child's Name
Enter first name, middle name, and last name.
CzechWay Citizenship Solutions
Child's date of birth

DayMonthYear
Enter date in European format
Child'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.)
Child's place of birth
Child's address
Czech address if available; otherwise enter your current foreign address
Child's foreign (non-Czech) citizenship
Does the child have any other citizenship than Czech?
How many non-Czech citizenships does the child have?
This form is limited to two foreign citizenships. Any additional non-Czech citizenships can be added during your appointment at the Czech consulate.
Child's foreign citizenship
Other than Czech (e.g., USA, SK, GB), if applicable. This form supports up to two foreign citizenships. If the child has more than two, please add any additional ones manually.
Date of acquisition of the child's foreign citizenship

DayMonthYear
Enter date in European format
Method of acquisition of the child's foreign citizenship

Other
narozenim
naturalizaci
Second foreign citizenship of the child

Only if you listed more than one foreign citizenship other than Czech
The method of acquisition of the 2nd foreign child's citizenship

Other
narozenim 2
naturalizaci 2
Date of acquisition of the 2nd foreign child's citizenship

DayMonthYear
Enter date in European format
svobodny/svobodna
Child's last Czech address (if applicable)
Even if the Czech permanent residence has been terminated
Child's previous Czech address (before the last one, if applicable)
Childs second-to-last permanent residence in the Czech Republic
Purpose of requesting the citizenship certificate

Other
rodny
cesky pas
Expiration date of child's last Czech passport (if applicable)

DayMonthYear
Enter date in European format, skip if unknown
Information of the Parent Submitting the Form

The Applicant is the parent with Czech citizenship submitting the application. If both parents are Czech citizens, either may act as the applicant.
Applicant's email
Email address to receive your completed form
Applicant's full name
Enter first name, middle name, and last name
I am child's
Date applicant's birth

DayMonthYear
Enter date in European format
Place of applicant's birth
City and state/country
Applicant's Czech birth number
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.)
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.
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 applicant's foreign citizenship

DayMonthYear
Enter Date in European format
Method of acquisition of the applicant's foreign citizenship

Other
naturalizaci
narozenim
manzelstvim
Second non-Czech citizenship of the applicant
Date of acquisition of your other (2nd) foreign citizenship

DayMonthYear
Enter date in European format
The method of acquisition your other (2nd) foreign citizenship

Other
naturalizaci 2
narozenim 2
manzelstvim 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
May refer to a previous marriage if relevant.
Details of Both Parents
Father
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
Ener date in European format
Father's place of birth
City and state/country
Father’s citizenship at time of child’s birth
E.g. USA, CZ...
Child's father's last Czech address (if applicable)
Even if his Czech residency has been terminated
Mother
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
Ener date in European format
Mother's place of birth
City and state/country
Mother’s citizenship at time of childs birth
E.g. USA, CZ...
Child's mother's last Czech address (if applicable)
Even if his Czech residency has been terminated
Date of application submission

DayMonthYear
Enter 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
Pas CR
ID CR
RP CR
PAS zahr
ID zahr
RP zahr
Applicant's identification document number
Identification document was issued on

DayMonthYear
Enter date in European formate
Identification document expires on

DayMonthYear
Enter date in European formate
Note: Fields No. 36, 58, and 80 of the final PDF must be signed by hand by the applicant.

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Citizenship Certificate - Minor 1-15

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Child's information

Child's foreign (non-Czech) citizenship

Second foreign citizenship of the child

Information of the Parent Submitting the Form

Second non-Czech citizenship of the applicant

Details of Both Parents

Father

Mother

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