N-565 Replacement Naturalization Document Cover Letter Template

N-565 Application for Replacement Naturalization/Citizenship Document Cover Letter Template

[Your Full Name]

[A-Number (if any)]

[Street Address]

[City, State, ZIP Code]

Phone: [Phone Number]

Email: [Email Address]

[Date]

U.S. Citizenship and Immigration Services

[USCIS Lockbox or Service Center Name for N-565]

[Street Address]

[City, State, ZIP Code]

1. Subject and Applicant Information

Re: Form N-565, Application for Replacement Naturalization/Citizenship Document

Applicant: [Your Full Name], DOB: [MM/DD/YYYY], A-Number: [A-Number or “None”]

I, [Your Full Name], am submitting this cover letter in support of my Form N-565, Application for Replacement Naturalization/Citizenship Document.

2. Citizenship Document Background

Type of Original Document (select one):

• Certificate of Naturalization

• Certificate of Citizenship

• Repatriation Certificate

• Declaration of Intention

• Other Citizenship Document: [Description]

Certificate of Naturalization

Certificate of Citizenship

Repatriation Certificate

Declaration of Intention

Other Citizenship Document: [Description]

Original Certificate Details (if known):

• Certificate Number: [Certificate Number]

• Date of Issuance: [MM/DD/YYYY]

• Place of Issuance (City/State): [City, State]

Certificate Number: [Certificate Number]

Date of Issuance: [MM/DD/YYYY]

Place of Issuance (City/State): [City, State]

3. Reason for Filing Form N-565

I am requesting a replacement or corrected document for the following reason(s):

[Select and complete as applicable:]

• Lost Certificate

  • Approximate Date of Loss: [MM/DD/YYYY]

  • Place or Circumstances of Loss: [City, State / Description]

• Stolen Certificate

  • Approximate Date of Theft: [MM/DD/YYYY]

  • Place or Circumstances of Theft: [City, State / Description]

• Destroyed or Severely Damaged Certificate

  • Description of Damage or Destruction: [Description]

• Never Received Original Certificate

  • Approximate Date of Approval of Naturalization/Citizenship: [MM/DD/YYYY]

• Legal Name Change After Naturalization/Citizenship

  • New Legal Name: [New Full Name]

  • Effective Date of Name Change: [MM/DD/YYYY]

• Correction of USCIS Error on Certificate

  • Incorrect Information on Certificate: [Description]

  • Correct Information: [Description]

• Correction of Biographic Information (Not USCIS Error)

  • Information to Be Corrected: [Description]

  • Correct Information and Legal Basis: [Description]

Lost Certificate

• Approximate Date of Loss: [MM/DD/YYYY]

• Place or Circumstances of Loss: [City, State / Description]

Approximate Date of Loss: [MM/DD/YYYY]

Place or Circumstances of Loss: [City, State / Description]

Stolen Certificate

• Approximate Date of Theft: [MM/DD/YYYY]

• Place or Circumstances of Theft: [City, State / Description]

Approximate Date of Theft: [MM/DD/YYYY]

Place or Circumstances of Theft: [City, State / Description]

Destroyed or Severely Damaged Certificate

• Description of Damage or Destruction: [Description]

Never Received Original Certificate

• Approximate Date of Approval of Naturalization/Citizenship: [MM/DD/YYYY]

Legal Name Change After Naturalization/Citizenship

• New Legal Name: [New Full Name]

• Effective Date of Name Change: [MM/DD/YYYY]

New Legal Name: [New Full Name]

Effective Date of Name Change: [MM/DD/YYYY]

Correction of USCIS Error on Certificate

• Incorrect Information on Certificate: [Description]

• Correct Information: [Description]

Incorrect Information on Certificate: [Description]

Correct Information: [Description]

Correction of Biographic Information (Not USCIS Error)

• Information to Be Corrected: [Description]

• Correct Information and Legal Basis: [Description]

Information to Be Corrected: [Description]

Correct Information and Legal Basis: [Description]

4. Explanation of Circumstances

Explanation:

[Circumstances of loss, theft, damage, non-delivery, name change, or correction request.]

5. Forms and Supporting Documents Enclosed

The following items are enclosed with my Form N-565 filing:

Forms:

• Form N-565, Application for Replacement Naturalization/Citizenship Document (completed and signed)

• Form G-1145, E-Notification of Application/Petition Acceptance [if used]

Form N-565, Application for Replacement Naturalization/Citizenship Document (completed and signed)

Form G-1145, E-Notification of Application/Petition Acceptance [if used]

Identity and Citizenship Documents:

• Copy of original certificate (front and back), if available

• Copy of biographical page of U.S. passport, if available

• Copy of government-issued photo identification (such as driver’s license or state ID)

Copy of original certificate (front and back), if available

Copy of biographical page of U.S. passport, if available

Copy of government-issued photo identification (such as driver’s license or state ID)

Reason-Specific Documents:

• Police report or incident number relating to loss or theft of certificate, if available

• Evidence of legal name change (marriage certificate, divorce decree, court order)

• Civil records supporting correction of date of birth, name, or other biographic data (birth certificate, passport, or other documents)

• Evidence that original certificate was never received, if available (USPS tracking, notices, or correspondence)

Police report or incident number relating to loss or theft of certificate, if available

Evidence of legal name change (marriage certificate, divorce decree, court order)

Civil records supporting correction of date of birth, name, or other biographic data (birth certificate, passport, or other documents)

Evidence that original certificate was never received, if available (USPS tracking, notices, or correspondence)

Additional Supporting Documents (if any):

• [Description of any other relevant supporting documents]

6. Contact Information and Request

If additional information or documentation is needed, I can be contacted at:

Phone: [Phone Number]

Email: [Email Address]

I respectfully request that USCIS approve my Form N-565 and issue a replacement or corrected naturalization/citizenship document based on the information and evidence submitted.

7. Closing and Signature

Thank you for your time and consideration.

Sincerely,

[Your Signature, if printed]

[Your Full Name]

Date: [MM/DD/YYYY]