. City and Date of Marriage Spouse s Full Name (use maiden name for women) Spouse s City, Province and Date of Birth

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Form 1 APPLICATION FOR ITALIAN CITIZENSHIP JURE SANGUINIS (Please fill out in every part and bring to appointment) (this form is available for download on the website of the Italian Embassy in Washington, D.C. if you are applying at another Consulate, you may want to download the specific form from the local Consulate website) THE UNDERSIGNED Last/First/Middle name City, State and Country of birth: Date of birth (DD/MM/YYYY) Current residential address: Telephone (Home) (Business) (Cell) E-mail: Married (YES/NO): Divorced. (YES/NO). City and Date of Marriage Spouse s Full Name (use maiden name for women) Spouse s City, Province and Date of Birth CHILDREN UNDER 18 YEARS OF AGE Full Name City of Birth Date of Birth (DD/MM/YYY) 1) 2) 3) REQUESTS that his/her right to Italian citizenship be recognized and, therefore, declares to be a descendant of: (Please fill in the full name of all ancestors in the direct bloodline and of their spouses, and their corresponding relation to you. Use the check-list to make sure you collect all necessary supporting documents). DIRECT BLOODLINE ANCESTOR Generation 0 (he/she who was born in and emigrated from Italy) NATURALIZATION Certificate no: City: Date of Naturalization: BIRTH MARRIAGE NATURALIZATION (or No-Record Found) DOCUMENTATION Generation 1 SPOUSE *Note: Spouse s documents are not mandatory by applicable Italian Law, but you can submit them in simple copy (or the Consular Officer may request them) if they help address any discrepancies in the bloodline ancestor s documents. Generation 1 Spouse *See Note above

Generation 2 Generation 3 Generation 2 Spouse *See Note above Generation 3 Spouse *See Note above Notes: -All Italian issued vital records must be in original. -All foreign (non-italian) issued vital records must be in long form, in original, with Apostille, and exact Italian translation. -Naturalization records issued by USCIS do not require apostille, nor translation. -Italian translations must mirror the format of the original document (i.e.: if original is in table format, the same table must be reproduced on the translation), and must include all headers, footers and side notes. -Italian translations of U.S.-issued vital records will be legalized by this Consular Officer when you submit your application. Translations of foreign-issued vital records must be legalized in the country where they were issued, by and/or in accordance with the requirements of the local Italian Embassy/Consulate. -Make sure the vital records have consistent names and dates. Any discrepancies (spelling, aliases, clerical errors, wrong dates etc) must be rectified before submitting the application. -Italian Law acknowledges as valid a person s name as written in his/her birth certificate only. Any name changes must be supported by a court decree or they won t be acknowledged. -Attachments must be prepared in the order indicated below Attachments: FORM 2, applicant (filled out in every part, to be signed by the applicant on the day of the interview) FORM 3, living Italian ascendant (filled out in every part, signed by the living ascendant, notarized) FORM 4, deceased Italian ascendant (filled out in every part, to be signed by the applicant on the day of the interview) PASSPORT COPY DRIVER S LICENSE COPY WITH CURRENT RESIDENTIAL ADDRESS (serving as proof of residence; in alternative, please submit the copy of a current utility bill in your name) Italian ancestor generation 0 supporting documents Documents of all other Italian ancestor generations 1, 2, 3 etc (as applicable), in chronological order, for each ancestor Documents of the Applicant (birth, marriage(s), divorce(s) as applicable, minor children s birth certificates if applicable)

Dichiara, sotto la propria responsabilità, che quanto sopra scritto risponde a verità e di essere a conoscenza delle conseguenze penali previste nel caso di mendaci e false dichiarazioni (art. 76 del D.P.R. 28 dicembre 2000, n. 445) - I Declare, under penalty of perjury, that the above stated facts are true and that I am aware of the criminal penalties against those who make Date: Signature: Print Name: For Office Use Only: Date Filed: Notes:

DECLARATION OF APPLICANT Form 2 I, THE UNDERSIGNED (Last/First/Middle Name) BORN IN (City and State/Province): DATE OF BIRTH (DD/MM/YYYY): CURRENT ADDRESS: Telephone (Home) (Business) (Cell) IN REFERENCE TO HIS/HER REQUEST FOR RECOGNITION OF ITALIAN CITIZENSHIP JURE SANGUINIS, DECLARE THAT I HAVE NEVER RENOUNCED ITALIAN CITIZENSHIP BEFORE ANY ITALIAN AUTHORITY, THAT STARTING FROM THE AGE OF EIGHTEEN (18), I HAVE RESIDED IN: CITY, STATE/PROVINCE APPROXIMATE TIME PERIOD (YEARS) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Dichiara, sotto la propria responsabilità, che quanto sopra scritto risponde a verità e di essere a conoscenza delle conseguenze penali previste nel caso di mendaci e false dichiarazioni (art. 76 del D.P.R. 28 dicembre 2000, n. 445) - I Declare, under penalty of perjury, that the above stated facts are true and that I am aware of the criminal penalties against those who make DATE (DD/MM/YYYY): SIGNATURE: (SIGNATURE MUST BE NOTARIZED. OTHERWISE THIS DECLARATION MUST BE SIGNED BEFORE A CONSULAR OFFICER)

DECLARATION OF LIVING ITALIAN ASCENDANT (one for each living ascendant) Form 3 I, THE UNDERSIGNED (Last/First/Middle Name) BORN IN (City and State/Province): DATE OF BIRTH (DD/MM/YYYY): CURRENT ADDRESS: Telephone (Home) (Business) (Cell) (PLEASE CHECK THE APPROPRIATE BOX) FATHER MOTHER GRANDFATHER GRANDMOTHER GREAT GRANDFATHER GREAT GRANDMOTHER OF THE APPLICANT (Applicant's last/first/middle name) IN REFERENCE TO THE APPLICANT'S REQUEST FOR RECOGNITION OF ITALIAN CITIZENSHIP JURE SANGUINIS DECLARE THAT I NEVER RENOUNCED ITALIAN CITIZENSHIP BEFORE ANY ITALIAN AUTHORITY, THAT STARTING FROM THE AGE OF EIGHTEEN (18), I HAVE RESIDED IN: CITY, STATE/PROVINCE APPROXIMATE TIME PERIOD (YEARS) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Dichiara, sotto la propria responsabilità, che quanto sopra scritto risponde a verità e di essere a conoscenza delle conseguenze penali previste nel caso di mendaci e false dichiarazioni (art. 76 del D.P.R. 28 dicembre 2000, n. 445) - I Declare, under penalty of perjury, that the above stated facts are true and that I am aware of the criminal penalties against those who make DATE (DD/MM/YYYY): SIGNATURE: (SIGNATURE MUST BE NOTARIZED. OTHERWISE THIS DECLARATION MUST BE SIGNED BEFORE A CONSULAR OFFICER)

DECLARATION OF DECEASED ITALIAN ASCENDANT (If any of your Italian ancestor(s) is(are) deceased, please fill out the following declaration for each of them) Form 4 I, THE UNDERSIGNED (Last/First/Middle Name) BORN IN (City and State/Province): DATE OF BIRTH (DD/MM/YYYY): CURRENT ADDRESS: Telephone (Home) (Business) (Cell) IN REFERENCE TO THE APPLICANT'S REQUEST FOR RECOGNITION OF ITALIAN CITIZENSHIP JURE SANGUINIS DECLARE THAT (Name of deceased ancestor): BORN IN (City and State/Province): DATE OF BIRTH (DD/MM/YYYY): AND RELATED TO THE APPLICANT AS (PLEASE CHECK THE APPROPRIATE BOX) FATHER MOTHER GRANDFATHER GRANDMOTHER GREAT GRANDFATHER GREAT GRANDMOTHER NEVER RENOUNCED ITALIAN CITIZENSHIP BEFORE ANY ITALIAN AUTHORITY, and THAT HE/SHE, STARTING FROM THE AGE OF EIGHTEEN (18), RESIDED IN: CITY, STATE/PROVINCE APPROXIMATE TIME PERIOD (YEARS) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Dichiara, sotto la propria responsabilità, che quanto sopra scritto risponde a verità e di essere a conoscenza delle conseguenze penali previste nel caso di mendaci e false dichiarazioni (art. 76 del D.P.R. 28 dicembre 2000, n. 445) - I Declare, under penalty of perjury, that the above stated facts are true and that I am aware of the criminal penalties against those who make DATE (DD/MM/YYYY): SIGNATURE: (SIGNATURE MUST BE NOTARIZED. OTHERWISE THIS DECLARATION MUST BE SIGNED BEFORE A CONSULAR OFFICER)