Citizenship Intake Form

First name

Last name

Email

Phone

Current Immigrant Status

LPR (Lawful Permanent Resident)- Green Card Holder

US National

Unknown

If you are an LPR (Green Card holder), what DATE did you become an LPR?

If you are an LPR (Green Card holder), what is your A number?

Marital Status

Single

Married to a US Citizen

Married to a LPR- Green Card Holder

Married to a foreign national

What is your Eligibility Criterior?

5 year - Permanent Resident (LPR)

3 year - Married to a US Citizen

Military Service

Other

CHECK THE BOX THAT APPLIES TO YOU:

I have continuously resided in the U.S. for 3 years (if married to a US Citizen) OR 5 years.

I have been PHYSICALLY present in the U.S. for at least 18 months (if married to a US Citizen) or 30 months.

I have lived in the district/state for at least 3 months

I have Good Moral character for the past 3 years (if married to a US Citizen) OR 5 years. *

I have BASIC English and Knowledge of U.S. History and Government

I support the U.S. Constitution

I am willing to take an oath of allegiance to the U.S.

I have/will register for Civil Service (for males in U.S. between ages 18 and 26 years of age (exceptions)

Have you ever been arrested/cited/charged with any offense/convicted/received a diversion/had a case dismissed/been on probation/received a traffic ticket involving alcohol or drugs? If YES, please briefly describe (date, city, type of charge):

DOCUMENTS YOU CURRENTLY HAVE:

Copy of Legal Permanent Resident Card (front and back)

Certified Copy of Conviction, Arrest, Citation/DMV Traffic Record (if applicable)

IF MARRIED - Proof of U.S. Citizenship for spouse (birth certificate/passport);

IF MARRIED - Marriage Certificate;

IF MARRIED - Proof of termination of prior marriages (if applicable);

Support the U.S. IF MARRIED - Documents referring to you and your spouse (utility bills, phone bills, etc)

IF MARRIED - Tax returns (3 years), bank accounts, leases, mortgages, child(ren) birth certificates

PLEASE CHECK THE BOX IF APPLICABLE:

Is there anything else we should know about you that might come up during this process?

Folau Samoa

Via Alofa provides educational support and referral services.
Submission of this form does not create an attorney-client relationship.

Citizenship Intake Form

Folau Samoa

Via Alofa provides educational support and referral services. Submission of this form does not create an attorney-client relationship.

Citizenship Intake Form

Via Alofa provides educational support and referral services.
Submission of this form does not create an attorney-client relationship.