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]

Original Certificate Details (if known):

• 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]

• 
  

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]

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)

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)

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]