Form Ds 4083 PDF Details

The DS-4083 form, formally known as the Certificate of Loss of Nationality of the United States, serves as an official document issued by the U.S. Department of State's Bureau of Consular Affairs, marking a significant juncture in the lives of individuals who decide to renounce their U.S. citizenship. This procedure, entrenched in the legal framework by the Secretary of State under the auspices of historical acts from 1940 and 1952, necessitates a meticulous process, as captured in the form's content. Applicants are required to provide comprehensive personal information, document their residence status, detail the acquisition of both U.S. nationality and foreign nationality, if applicable, and succinctly describe the expatriating act undertaken. Crucially, the form asserts that the expatriating act was done voluntarily with the intent to relinquish U.S. citizenship. Accompanying the declaration are requirements for evidence and, potentially, attachments substantiating the expatriation. Moreover, the DS-4083 document outlines an appeal process, granting individuals a structured path to contest the loss of nationality ruling within a designated timeframe, through an appeal to the Department of State's Board of Appellate Review, further emphasizing the gravity and finality of the decision to renounce one's citizenship.

QuestionAnswer
Form NameForm Ds 4083
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other names1952, formulaire ds 4083, ds 4083, expatriating

Form Preview Example

U.S. Department of State

BUREAU OF CONSULAR AFFAIRS

CERTIFICATE OF LOSS OF NATIONALITY OF THE UNITED STATES

This form is prescribed by the Secretary of State pursuant to Section 501 of the Act of

October 14, 1940 (54 Stat. 1171) and Section 358 of the Act of June 27, 1952 (66 Stat. 272).

Consulate

 

of the United States of America

at

 

 

 

 

ss:

 

 

 

 

I,

 

 

 

.

 

 

 

(Name)

hereby certify that, to the best of my knowledge and belief,

DEPARTMENT USE ONLY

(Name)

was born at

 

 

,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Town or City)

 

 

 

 

(Province or County)

 

 

 

 

 

 

 

 

 

 

 

, on

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(State or Country)

 

 

 

 

 

(Date (mm-dd-yyyy))

 

 

 

 

 

That: he/she (never resided in the United States (dates*));

;

That: he/she resides at

 

 

 

 

 

 

 

 

 

 

 

 

 

;

 

 

 

 

 

 

 

 

 

 

 

 

 

That: he/she acquired the nationality of the United States by virtue of

 

 

 

;

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

;

That: he/she acquired the nationality of

 

 

by virtue of

That: he/she

(The action causing expatriation should be set forth succinctly.)

That: said expatriating act was performed voluntarily with the intent to relinquish United States citizenship;

 

That:

he/she thereby expatriated

 

self on (Date):

 

under the provisions of

Section

 

of (The Nationality Act of 1940)* (The Immigration and Nationality Act of 1952 as

 

 

 

amended)

 

 

 

 

That the evidence of such action consists of the following:

;

That attached to and made a part of this certificate are the following documents or copies thereof:

In testimony whereof, I have hereunto subscribed by name and affixed my office seal this

day of

 

,

 

 

 

.

 

 

 

[SEAL]

 

 

 

 

 

 

 

 

 

 

 

 

 

(Signature)

 

 

 

 

 

 

 

 

*Strikeout inapplicable item.

 

 

 

 

 

(Title)

 

 

 

 

 

 

 

 

 

DS-4083 (Formerly FS-348)

 

 

 

 

 

Page 1 of 2

01-2007

 

 

 

SEE PAGE 2 FOR APPEAL PROCEDURES

 

 

 

 

 

 

 

 

APPEAL PROCEDURES

Any holding of loss of United States nationality may be appealed to the Board of Appellate Review or other designated office of the Department of State within one year or thereafter. The regulations governing appeals are set forth at Title 22 of the Code of Federal Regulations, Part 7. Notice of appeal should be addressed to the Board of Appellate Review, or other designated office and may be submitted through an American Embassy or Consulate or through an authorized attorney in the United States or directly to the Director, Office of Policy Review and Inter-Agency Liaison, Overseas Citizens Services, Bureau of Consular Affairs, SA-29, 4th Floor, U.S. Department of State, Washington, D.C. 20520.

You are advised to consult an attorney in the preparation and presentation of your appeal.

The appeal must be in writing and it must state with particularity the reason why it is being made. It may be accompanied by a legal brief. Any statement of facts or circumstances not mentioned when the case was previously considered should be sworn to before an official authorized to take oaths and should be supported by the best evidence obtainable.

For additional information about appeal procedures and to obtain copies of the relevant provisions of the Code of Federal Regulations, consult the nearest American Embassy or Consulate, or write to the Board of Appellate Review, Department of State, Washington, D.C. 20520.

For Additional Information See

http://www.travel.state.gov/law/citizenship/citizenship_778.html

DS-4083

Page 2 of 2

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1. You need to complete the ds4083 properly, thus take care while filling out the segments comprising these fields:

1952 completion process outlined (portion 1)

2. The subsequent part is to fill in the following blanks: That heshe, The action causing expatriation, That said expatriating act was, That heshe thereby expatriated, self on Date, under the provisions of, Section, of The Nationality Act of The, That the evidence of such action, That attached to and made a part, In testimony whereof I have, day of, SEAL, and Signature.

1952 writing process explained (stage 2)

3. Completing SEAL, Strikeout inapplicable item, DS Formerly FS, Signature, Title, SEE PAGE FOR APPEAL PROCEDURES, and Page of is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

Step no. 3 in submitting 1952

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