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Get DS-5507 2013

At this affidavit is for the purpose of establishing my relationship to the aforementioned child/children and his/her/their claim to U.S. citizenship. Signature of affiant Present Street Address State City Zip Code Country Telephone Number SUBSCRIBED AND SWORN TO (AFFIRMED) before me this at day of , , , [SEAL] Signature and Title of Administering Officer DS-5507 Page 4 of 5 PRIVACY ACT STATEMENT AUTHORITY: The State Department is authorized to collect this information pursuant .

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