Form Ds 4080 PDF Details

Renouncing one's U.S. citizenship is a significant decision that comes with profound effects and legal implications. It's a process legitimized through the U.S. Department of State, and the DS-4080 form is at the heart of this procedure. This documented Oath/Affirmation of Renunciation of Nationality of the United States is to be completed at a U.S. Embassy or Consulate in the country where the individual resides. The form requires detailed personal information, including the applicant's full name, places of birth and residence, and how U.S. nationality was acquired—whether through birth in the United States, abroad to U.S. parent(s), or through naturalization, including the specifics of the naturalization process. It is explicitly stated that by filling out this form, the individual desires to make a formal renunciation of U.S. nationality, relinquishing all rights and privileges, as well as duties and allegiances associated with U.S. citizenship. This decision, underscored by an intentional, voluntary oath free of duress or undue influence, is binding and comes into effect only upon approval by the U.S. Department of State. The DS-4080 form thus serves as a vital legal document, marking the cessation of U.S. nationality from the date the oath or affirmation was taken, contingent upon governmental consent.

QuestionAnswer
Form NameForm Ds 4080
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesrenunciation application, ds 4080, renunciation oath tennessee, renunciation states form

Form Preview Example

U. S. Department of State

BUREAU OF CONSULAR AFFAIRS

OATH/AFFIRMATION OF RENUNCIATION OF

NATIONALITY OF UNITED STATES

 

 

 

 

 

 

 

 

 

 

 

at

 

 

(Embassy/Consulate)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ss:

 

 

(Country)

 

 

 

 

 

 

 

I,

,

a national of the United States,

 

 

Name (Print Full Name)

 

 

 

 

 

 

 

solemnly swear/affirm that I was born at

 

 

 

 

,

 

 

 

 

 

 

 

 

(City or Town)

 

 

,

 

 

 

 

 

, on

 

 

 

(Province or County)

(State or Country)

 

 

 

Date (mm-dd-yyyy)

That I formerly resided in the United States at:

(Street Address)

(City, State and ZIP Code)

That I am a national of the United States by virtue of:

Birth in United States or Abroad to U.S. Parent(s)

Naturalization

Date of Naturalization

Date (mm-dd-yyyy)

(If naturalized, give the name and place of the court in the United States before which naturalization was granted.)

(Name of Court)

(Street Address)

(City, State and ZIP Code)

I desire and hereby make a formal renunciation of my U.S. nationality, as provided by section 349(a)(5) of the Immigration and Nationality Act of 1952, as amended, and pursuant thereto, I hereby absolutely and entirely renounce my United States nationality together with all rights and privileges and all duties and allegiance and fidelity thereunto pertaining. I make this renunciation intentionally, voluntarily, and of my own free will, free of any duress or undue influence.

,

 

 

 

 

 

 

 

(Signature)

Subscribed and sworn/affirmed to before me this

 

 

day of

 

 

,

 

 

at the

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Embassy/Consulate)

 

 

 

 

 

 

(Place)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Signature of Officer)

SEAL

(Typed Name of Officer)

(Title of Officer)

Note: A renunciation of United States nationality/citizenship is effective only upon approval by the U.S. Department of State but, when approved, the loss of nationality/citizenship occurs as of the date the above Oath/Affirmation was taken.

DS-4080

Page 1 of 1

01-2013

 

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