(If any of the below-mentioned acts or conditions have been performed by or apply to the applicant, the portion which
applies should be lined out, and a supplementary explanatory statement under oath (or affirmation) by the applicant
should be attached and made a part of this application.) I have not, since acquiring United States citizenship, been
should be attached and made a part of this application.) I have not, since acquiring United States citizenship, been
naturalized as a citizen of a foreign state;
taken an oath or made an affirmation or other formal declaration of allegiance to a foreign state;
entered or served in the armed forces of a foreign state; accepted or performed the duties of any office, post, or employment under the government of a foreign state or political subdivision thereof;
made a formal renunciation of nationality either in the United States, or before a diplomatic or consular officer of the United States in a
foreign state;
foreign state;
or been convicted by a court or court martial of competent jurisdiction of committing any act of treason against, or attempting by force to overthrow, or bearing arms against,
the United States, or conspiring to overthrow, put
down, or to destroy by force, the Government of the United States. the United States, or conspiring to overthrow, put
-----and------what does all this mean? --->
AUTHORITIES
Collection of the information solicited on this form is authorized by Titles 8, 22, and 26 of the United
States Code, whether or not codified, including specifically 22 U.S.C. 211a et seq.; 26 U.S.C. 6039E, Section 236 of the
Admiral James W. Nance and Meg Donovan Foreign Relations Authorization Act, Fiscal Years 2000 and 2001;
The primary purpose for soliciting the information is to establish citizenship, identity, and entitlement to
issuance of a U.S. passport.
Admiral James W. Nance and Meg Donovan Foreign Relations Authorization Act, Fiscal Years 2000 and 2001;
Executive Order 11295 (August 5, 1966); and 22 CFR parts 50 and 51.
PURPOSE
PURPOSE
The primary purpose for soliciting the information is to establish citizenship, identity, and entitlement to
issuance of a U.S. passport.
ROUTINE USES
The information solicited on this form may be made available as a routine use to other government
agencies to assist the U.S. Department of State in adjudicating passport applications and requests for related services,
and for law enforcement and administration purposes. The information may be made available to foreign government
and for law enforcement and administration purposes. The information may be made available to foreign government
agencies to fulfill passport control and immigration duties. The information may also be provided to foreign government
agencies, international organizations and, in limited cases, private persons and organizations to investigate, prosecute,
or otherwise address potential violations of law or to further the Secretary's responsibility for the protection of U.S.
citizens and non-citizen nationals abroad. The information may be made available to private U.S. citizen 'wardens'
designated by the U.S. embassies and consulates. For a more detailed listing of the routine uses to which this
information may be put, see the Prefatory Statement of Routine Uses and the listing of routine .users set forth in the
system descriptions for Overseas Citizen Services Records (State-05) and Passport Records (State-26) published in the
Federal Register.agencies, international organizations and, in limited cases, private persons and organizations to investigate, prosecute,
or otherwise address potential violations of law or to further the Secretary's responsibility for the protection of U.S.
citizens and non-citizen nationals abroad. The information may be made available to private U.S. citizen 'wardens'
designated by the U.S. embassies and consulates. For a more detailed listing of the routine uses to which this
information may be put, see the Prefatory Statement of Routine Uses and the listing of routine .users set forth in the
system descriptions for Overseas Citizen Services Records (State-05) and Passport Records (State-26) published in the
Some could lose US citizenship?
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