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Get N -565, Application For Replacement Naturalization ... - ILW .COM

- Please type or print in black ink. Part 1. Information about you. Family Name For USCIS Use Only Receipt Returned Middle Name Given Name Address - In care of: Street Number and Name Apt # City or town Resubmitted State or Province Zip or Postal Code Country Date of Birth (mm/dd/yyyy) Country of Birth Certificate Number A# Telephone # (with area/country codes) E-Mail Address (if any) Reloc Sent Reloc Rec'd Part 2. Type of application. 1. I hereby apply for: (check one) a. b. c.

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