Naturalization Eligibility Screening
Personal Information
Full Legal Name
Date of Birth
A-Number (if any)
Residency
Date Became Permanent Resident
Number of Trips Outside U.S. in Last 5 Years
Longest Single Trip Duration (days)
Eligibility
Served in U.S. Military?
Yes
No
Married to U.S. Citizen?
Yes
No
Any Criminal History?
Yes
No
Filed Taxes Every Year?
Yes
No
Able to Read, Write, and Speak English?
Yes
No
Prepared for Civics Test?
Yes
No