Form Rea 3030 – Fill Out and Use This PDF

An alien lawfully admitted for permanent residence under the Immigration and Naturalization Act (INA).

An alien who is granted asylum under Section 208 of the INA.

A refugee admitted to the United States under Section 207 of the INA.

An alien paroled into the United States for at least one year under Section 212(d)(5) of the INA.

An alien who is granted conditional entry under Section 203(a)(7) of the INA as in effect prior to April 1, 1980.

An alien paroled into the United States for less than one year under Section 212(d)(5) of the INA.

SECTION C:

An alien whose deportation is being withheld under Section 243(h) of the INA (as in effect immediately prior to September 30, 1996) or Section 241(b)(3) of such Act (as amended by Section 305(a) of Division C of Public Law 104- 208).

An alien who is a Cuban or Haitian entrant (as defined in Section 501(e) of the Refugee Education Assistance Act of 1980).

An alien not in categories 1 through 8 who has been admitted to the United States for a limited period of time (a non- immigrant). Non-immigrants are persons who have temporary status for a specific purpose.

Citizen	Y N				FOR OREA USE ONLY
Alien	Y N	Documentation Submitted			By:

Comments:

Date:

LIST A

ACCEPTABLE DOCUMENTATION TO ESTABLISH

U.S. CITIZENSHIP

A person who is a citizen of the United States as evidenced by submitting one of the following:

•A birth certificate showing birth in one of the following: * One of the 50 States;

*The District of Columbia;

*Puerto Rico (on or after January 13, 1941);

*Guam;

*The U.S. Virgin Islands (on or after January 17, 1917);

*American Samoa; or

*Swain’s Island or the Northern Mariana Islands.

•A United States passport (except limited passports, which are issued for periods of less than five years);

•A Report of birth abroad of a U.S. citizen (FS-240) or Certificate of birth (FS-545 or DS-1350);

•A Certificate of Naturalization (N-550 or N-570);

•A Certificate of Citizenship (N-560 or N-561);

•An United States Citizen Identification Card (I-197 or I-179);

•A Northern Mariana Identification Card (issued by the INS to a collectively naturalized citizen of the U.S. who was born in the Northern Mariana Islands before November 3, 1986);

•A Statement provided by a U.S. Consular Officer certifying that the individual is a U.S. citizen; or

•An American Indian Card with a classification code “KIC” and a statement on the back.

REA 3030 (Revised 01/03/11) Page 2 of 2

LIST B

ACCEPTABLE DOCUMENTATION TO ESTABLISH

ALIEN STATUS

An alien lawfully admitted for permanent residence under the INA must submit supporting documentation to establish legal presence under one of the following categories:

•An alien lawfully admitted for permanent residence under the INA.

Evidence Includes:

* INS Form I-551 (Alien Registration Receipt Card commmonly known as a “green card”); or

*Unexpired Temporary I-551 stamp in foreign passport or on INS Form I-94.

•An alien who is granted asylum under Section 208 of the INA. Evidence Includes:

*INS Form I-94 annotated with stamp showing grant of asylum under Section 208 of the INA;

*INS Form I-688B (Employment Authorization Card) annotated “274a.12(a)(5)”;

*INS Form I-766 (Employment Authorization Document) annotated “A5”;

*Grant Letter from the Asylum Office of INS; or

*Order of an immigration judge granting asylum.

•A refugee admitted to the United States under Section 207 of the INA. Evidence Includes:

*INS Form I-94 annotated with stamp showing admission under Section 207 of the INA;

*INS Form I-688B (Employment Authorization Card) annotated “274a.12(a)(3)”;

*INS Form I-766 (Employment Authorization Document) annotated “A3”; or

*INS Form I-571 (Refugee Travel Document).

•An alien paroled into the United States for at least one year under Section 212(d)(5) of the INA. Evidence includes:

*INS Form I-94 with stamp showing admission for at least one year under Section 212(d)(5) of the INA. (Applicant cannot aggregate periods of admission for less than one year to meet the one-year requirement.)

•An alien whose deportation is being withheld under Section 243(h) of the INA (as in effect immediately prior to September 30, 1966) or Section 241(b)(3) of such Act (as amended by Section 305(a) of Division C of Public Law104-208). Evidence Includes:

*INS Form I-668B (Employment Authorization Card) annotated “274a.12(a)(10)”.

*INS Form I-766 (Employment Authorization Document) annotated “A10”; or

*Order from an immigration judge showing deportation withheld under Section 243(h) of the INA as in effect prior to April 1, 1997, or removal withheld under Section 241(b)(3) of the INA.

LIST A

A. PRIMARY EVIDENCE

A person who is a citizen or national of the United States should submit one of the following:

•A birth certificate showing birth in one of the 50 States, the District of Columbia, Puerto Rico (on or after January 13, 1941), Guam, the U.S. Virgin Islands (on or after January 17, 1917), American Samoa, Swain’s Island or the Northern Mariana Islands, unless the person was born to foreign diplomats residing in the U.S.;

•United States passport (except limited passports, which are issued for periods of less than five years);

•Report of birth abroad of a U.S. citizen (FS-240) (issued by the Department of State to U.S. citizens);

•Certificate of birth (FS-545) (issued by a foreign service post) or Certification of Report of Birth (DS-1350) (issued by the Department of State), copies of which are available from the Department of State;

•Certificate of Naturalization (N-550 or N-570) (issued by the INS through a Federal or State court, or through administrative naturalization after December 1990 to individuals who are individually naturalized);

•Certificate of Citizenship (N-560 or N-561) (issued by the INS to individuals who derive U.S. citizenship through a parent);

•United States Citizen Identification Card (I-197) (issued by the INS until April 7, 1983, to U.S. citizens living near the Canadian or Mexican border who needed it for frequent border crossings) (formerly Form I-179, last issued in February 1974);

•Northern Mariana Identification Card (issued by the INS to a collectively naturalized citizen of the U.S. who was born in the Northern Mariana Islands before November 3, 1986);

•Statement provided by a U.S. Consular Officer certifying that the individual is a U.S. citizen (this is given to an individual born outside the U.S. who derives citizenship through a parent but does not have an FS-240, FS-545 or DS-1350); or

•American Indian Card with a classification code “KIC” and a statement on the back (identifying U.S. citizen members of the Texas Band of Kickapoos living near the U.S./Mexican border).

B. SECONDARY EVIDENCE

If the applicant cannot present one of the documents listed in A above, the following may be relied upon to establish U.S. citizenship or nationality:

•Religious record recorded in one of the 50 States, the District of Columbia, Puerto Rico (on or after January 13, 1941), Guam, the U.S. Virgin Islands (on or after January 17, 1917), American Samoa, Swain’s Island or the Northern Mariana Islands (unless the person was born to foreign diplomats residing in such a jurisdiction) within three months after birth showing that the birth occurred in such jurisdiction and the date of birth or the individual’s age at the time the record was made;

•Evidence of civil service employment by the U.S. government before June 1, 1976;

•Early school records (preferably from the first school) showing the date of admission to the school, the child’s date and place of birth, and the name(s) and place(s) of birth of the parent(s);

•Census record showing name, U.S. citizenship or a U.S. place of birth, and date of birth or age of applicant;

•Adoption Finalization Papers showing the child’s name and place of birth in one of the 50 States, the District of Columbia, Puerto Rico (on or after January 13, 1941), Guam, the U.S. Virgin Islands (on or after January 17, 1917), American Samoa, Swain’s Island or the Northern Mariana Islands (unless the person was born to foreign diplomats residing in such a jurisdiction) or, where an adoption is not finalized and the State or other jurisdiction listed above in which the child was born will not release a birth certificate prior to final adoption, a statement from a state-approved adoption agency showing the child’s name and place of birth in one of such jurisdictions; or

•Any other document that establishes a U.S. place of birth or in some way indicates U.S. citizenship (e.g., a contemporaneous hospital record of birth in that hospital in one of the 50 States, the District of Columbia, Puerto Rico (on or after January 13, 1941), Guam, the U.S. Virgin Islands (on or after January 17, 1917), American Samoa, Swain’s Island or the Northern Mariana Islands (unless the person was born to foreign diplomats residing in such a jurisdiction)).

C. Collective Naturalization

If the applicant cannot present one of the documents listed in A or B above, the following will establish U.S. citizenship for collectively naturalized individuals:

Puerto Rico:

•Evidence of birth in Puerto Rico on or after April 11, 1899, and the applicant’s statement that he or she was residing in the U.S., a U.S. possession or Puerto Rico on

January 13, 1941; or

•Evidence that the applicant was a Puerto Rican citizen and the applicant’s statement that he or she was residing in Puerto Rico on March 1, 1917, and that he or she did not take an oath of allegiance to Spain.

U.S. Virgin Islands:

•Evidence of birth in the U.S. Virgin Islands, and the applicant’s statement of residence in the U.S., a U.S. possession or the U.S. Virgin Islands on February 25, 1927;

•The applicant’s statement indicating residence in the U.S. Virgin Islands as a Danish citizen on January 17, 1917, and residence in the U.S., a U.S. possession or the U.S. Virgin Islands on February 25, 1927, and that he or she did not make a declaration to maintain Danish citizenship; or

•Evidence of birth in the U.S. Virgin Islands and the applicant’s statement indicating residence in the U.S., a U.S. possession or territory or the Canal Zone on June 28, 1932.

Northern Mariana Islands (NMI) (formerly part of the Trust Territory of the Pacific Islands (TTPI)):

•Evidence of birth in the NMI, TTPI citizenship and residence in the NMI, the U.S., or a U.S. territory or possession on November 3, 1986, (NMI local time) and the applicant’s statement that he or she did not owe allegiance to a foreign state on November 4, 1986 (NMI local time);

•Evidence of TTPI citizenship, continuous residence in the NMI since before November 3, 1981, (NMI local time), voter registration prior to January 1, 1975, and the applicant’s statement that he or she did not owe allegiance to a foreign state on November 4, 1986 (NMI local time); or

•Evidence of continuous domicile in the NMI since before January 1, 1974, and the applicant’s statement that he or she did not owe allegiance to a foreign state on

November 4, 1986 (NMI local time).

D. Derivative Citizenship

If the applicant cannot present one of the documents listed in A or B above, make a determination of derivative U.S. citizenship in the following situations:

Applicant born abroad to two U.S. citizen parents:

•Evidence of the U.S. citizenship of the parents and the relationship of the applicant to the parents, and evidence that at least one parent resided in the U.S. or an outlying possession prior to the applicant’s birth.

Applicant born abroad to a U.S. citizen parent and a U.S. non- citizen national parent:

•Evidence that one parent is a U.S. citizen and that the other is a U.S. non-citizen national, evidence of the relationship of the applicant to the U.S. citizen parent, and evidence that the U.S. citizen parent resided in the U.S., a U.S. possession, American Samoa or Swain’s Island for a period of at least one year prior to the applicant’s birth.

Applicant born out of wedlock abroad to a U.S. citizen mother:

•Evidence of the U.S. citizenship of the mother, evidence of the relationship to the applicant and, for births on or before December 24, 1952, evidence that the mother resided in the U.S. prior to the applicant’s birth or, for births after December 24, 1952, evidence that the mother had resided, prior to the child’s birth, in the U.S. or a U.S. possession for a period of one year.

Applicant born in the Canal Zone or the Republic of Panama:

•A birth certificate showing birth in the Canal Zone on or after February 26, 1904, and before October 1, 1979, and evidence that one parent was a U.S. citizen at the time of the applicant’s birth; or

•A birth certificate showing birth in the Republic of Panama on or after February 26, 1904, and before October 1, 1979, and evidence that at least one parent was a U.S. citizen and employed by the U.S. government or the Panama Railroad Company or its successor in title.

E.Adoption of Foreign-Born Child by U.S. Citizen

•If the birth certificate shows a foreign place of birth and the applicant cannot be determined to be a naturalized citizen under any of the above criteria, obtain other evidence of U.S. citizenship.

F.U.S. Citizenship By Marriage

Submit evidence of U.S. citizenship of the spouse, and evidence showing the marriage occurred prior to September 22, 1922.

A.Documentation Evidencing an Approved Petition or Application

•INS Form I-551 (“Resident Alien Card” or “Alien Registration Receipt Card”, commonly known as a “greencard”) with one of the following INS class of admission (“COA”) codes printed on the front of a white card or the back of a pink card: AR1, AR6, C20 through C29, CF1, CF2, CR1, CR2, CR6, CR7, CX1 through CX3, CX6 through CX8, F20 through F29, FX1 through FX3, FX6 through FX8, IF1, IF2, IR1 through IR4, IR6 through IR9, IW1, IW2, IW6, IW7, MR6, MR7, P21 through P23, or P26 through P28.

•INS Form I-551 with one of the following COA codes stamped on the lower left side of the back of a pink card: IB1 through IB3, IB6 through IB8, B11, B12, B16, B17, B20 through B29, B31 through B33, B36 through B38, BX1 through BX3, or BX6 through BX8.

•Form I-551 with COA code Z13.

•Unexpired Temporary I-551 stamp in foreign passport or on INS Form I-94 with one of the COA codes specified in the preceding paragraphs.

•INS Form I-797 indicating approval of an INS I-130 petition or approval of an I-360 petition

•A final order of an Immigration Judge or the Board of Immigration Appeals granting suspension of deportation under Section 244(a)(3) of the INA as in effect prior to April 1, 1997, or cancellation of removal under Section 240A(b)(2) of the INA.

B.Documentation Demonstrating that the Applicant has Established a Prima Facie Case

•INS Form I-797 indicating that the applicant has established a prima facie case; or

•An immigration court or Board of Immigration Appeals order indicating that the applicant has established a prima facie case for suspension of deportation under INA Section 244(a)(3) as in effect prior to April 1, 1997, or cancellation of removal under Section 240A(b)(2) of the INA.

C.Documentation Indicating that the Applicant has Filed a Petition or that a Petition has been Filed on the Applicant’s Behalf, as Applicable, but with no Evidence of Approval of the Petition or Establishment of a Prima Facie Case

The benefit provider shall determine from the documentation when the petition was filed and take the actions set forth below:

•Applicants with petitions filed before June 7, 1997, should have an INS Form I-797 indicating filing of the I-360 petition by “self-petitioning spouse [or child] of abusive U.S.C. or a Lawful Permanent Resident (LPR),” a file-stamped copy of the petition, or another document demonstrating filing (including a cash register or computer-generated receipt indicating filing of Form I-360).

•Applicants with petitions filed after June 7, 1997, should have an INS Form I-797 indicating filing of the I-360 petition.

D.Documentation Indicating that the Applicant has Filed a Petition or that a Petition was Filed on His or Her Behalf, as Applicable

The following must indicate that the applicant is the widow/ widower of a U.S. citizen, the husband or wife of a U.S. citizen or LPR, the unmarried child under age 21 of a U.S. citizen or LPR, or the unmarried child age 21 or older of an LPR:

•For aliens on whose behalf a petition has been filed: INS Form I-797 indicating filing of an INS I-130 petition, a file- stamped copy of the petition, or another document demonstrating filing (including a cash register or computer- generated receipt indicating filing of Form I-130).

•For self-petitioning widows or widowers: a file-stamped copy of the INS I-360 petition, or another document demonstrating filing (including a cash register or computer-generated receipt indicating filing of Form I-360).

E.Documentation Indicating that the INS has Initiated Deportation or Removal Proceedings in which Relief may be Available

•An “Order to Show Cause”;

•a “Notice to Appear”; or

•a “Notice of Hearing in Deportation Proceedings”.