📄 Extracted Text (8,396 words)
No. 27 564 548
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IT IS PUNISHABLE BY U S LAW TO COPY.
PRINT OR PHOTOGRAPH THIS CERTIFICATE.
WITHOUT LAWFUL AUTHORITY.
SDNY_GM_00000718
EFFA_00114802
EFTA01263124
t..S. Ikparinteen of.hunicc uSILI No ilia woo
I trimly-anon and Naturalization Service Application for Naturalization
Print dearly or type your answers using CAPITAI. letters. Failure to print clearly may delay your application. Use black or blue Ink.
Part 1. Your Naine (The Person Applying for Naturalization)
A Ymor ritrreta treat name.
Ali9f4V
r Write your INS "A"- number here:
I
FOR IN Via b. °NIA
E tea 11 Dar Code 'a te (Imp
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Goal Name (first Name) Full Middle Name Of appltiable)
i2i is la ine V Hv
rri
44
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13. Your name fruity as it appears on your Permanent Resident Card.
Family Name (Last Name)
gz7. astet
=men
P)
• to :le • •
Maxwell
Citron Name (Firer Name) Full Middk Name (Ifapplicable) (7,
et,
Ghislaine N. -n
fri
CO
C. If you have ever used other names. provide them below.
Family Name (Last Name) Given Name (First Name) Middle Name
D. htme change (optional)
Please read the Instructions before you decide whether to change your name.
.11. Would you like to legally change your name? Yes Z No
2.11"Ycs." print the new name you would like to use. Do not use initials or 3..
.
.
.
.
.
.
.
.
abbreviations when writing your new name.
Family Name (Los: Name) APPROVED
SAJ DISTRICT DIRECTOR
A
Given Name (First Mime) Full Middle Namc
AUG 29 2002
Part 2. Information About Your Eligibility (cheek Only One) 6672
I am.at least I8 years old AND
A El I have been a Lawful Permanent Resident of the United States for at least 5 years.
ty I have been a Lawful Permanent Resident of the United States for at least 3 years. AND
I have been roamed to and living with the same C.S. citizen for the last 3 years. AND
my spouse has been a U.S. citizen for the last 3 years.
C. 0 I am applying on the basis of qualifying military service.
D. ❑ Other (Please explain)
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Part .1. Information About You Mut your INS "A. number haw:
A. Social Stonily Number B. Dale of Birth allonth/DaWY ar) C. Dale You Became a Pennanent 'dent (Month/Day/Yea')
9 9
0 2 /0 5/1 — —
D. Country of Birth E Country of Nationality
France France
I firs. 'Ann ol your parents II S. citizens? (tf:vrt. A e hisuntrtions) O Yes 1:1 No
G. What is your current marital status? El angk. Never Married Defamed Onivoreed DWidowed
O MaMage Annulled or Other (Erpiain)
II Arc you requesting a waiver of the English and/or U.S. History and Govenunent
requirements based on a disability or impairment and attaching a Form N-648 with your
application?
I Arc you requesting an accommodation to the naturalization process because of o
disabilityor impairment? (See Instruction,for some eventie's ofaccompowlatione.)
If you answered "Yes", cheek the box below that applies:
❑ I am deaf or hearing impaired and need a sign language interpreter who uses the following language.
❑ I use a wheelchair.
El I am blind or sight unpaired.
❑ I will need another type of accommodation. Please explain:
Parf 4. Addresses and Telephone Numbers
A. Home Address •- Street Number and Name NOT write a P.O. Box in tint space) Apartment Nwnbe
Little St. James Island
1/ 115°
City County State ZIP Code Country
St. Thomas U . S . V .1 . 00802 USA
B. Core of Mailing Address - Street Number and (If different from home address) A Smolt Number
Chiral/line Maxwell 6100 Red Hook Quarter
City Slate ZIP Code Country
St. Thomas U.S.V.I. USA
C. Daytime Phone Number (f am') Evening Phone Number (Ifl an 7 E-mail Address Of any)
None
1.88Ne-10IMR800007201IN
EFTA_00114804
EFTA01263126
Part 5. information for Criminal Record. Search
Note: The categories below arc those required by the FBI. Sec Instructions for more information.
A. Gender B. Height C. Weight
,
DAUB Efernale 5 Feet 8 Inches 126 .00:10,,43
D. Race
El White Asp or Pacific Islander DBlack Amencan Indian or Alaskan Native I IUnknown
E. Hair color
Blade Motown
Kr/
Li Blonde n Gray U White URed Li Sandy LiBald (No flair)
F. Eye color
n Brown Blue ri Green
n Hazel El Gray n Black ❑ Pink El Maroon Other
Part ti. Information About Your Residence aid Employment
A. Where lave you lived during the last 5 years? Begin with where you live now and then list every place you lived for the last 5 years.
If you need more space, use a separate sheet of paper.
Dates (Month/Year)
Street Number and Name. Apartment Number, City, State, Zip Code and Country
From To
Current Home Address - Barrie
Sam as Part 4A 0 7 /2 0 0 1 Present
0 1 2 0 0 1 0 6 2 0 0 1
/
0 2 /1 9 9 6 0 1 2 0 0 1
/
I /
/ /
B. What have you worked (or, if you were a student, what schools did you attend) during the last 5 years? Include military service.
Begin with your careen or latest employer and then list every place you have worked or studied for tbc last S years. If you need more
space. use a separate sheet of paper.
Dates (Month/Year) Your
Employer or Employer or School Address
School Name , (Street City and State) From To Occupation
/ 'Present
1...S.J ,. , LLC / 6100 Red Ilk, St. Thom. , Ur D... LR63 il L i manager
NEB, LLC , y i 457 Madison Ave. , NY, NY o 1 2 0 0 2. ji ttelLL Manager
/
J. Epstein a C./. 457 Madison Ave., NY, NY 0 1 /1 9 9 3 1 2 I 2 0 0 0 Manager
v
I /
_ _ /_ - I
Farm N-400 (Rev. 05/3I/011N Page
SDNY_GM_00000721
EFTA 00114805
EFTA01263127
Part 7. Time Outside tie Halted States
(ladmithig Alia to Canada, Maks, oaths Caribbean islands)
A. How many total days did you spend outside of the United States doing the past 5 years? 253 days
B. How many trips of 24 hours or mom have you taken outside of the United States during the past 5 years? 39 trips
C. List below all the trips of 24 hours or more that you have taken outside of the United States since becoming a Lawful jt
Permanent Resident. Begin with your most recent trip. [(you need more space, use a separate sheet of paper. Sec Iror inAtst‘rnerit
Date You Left the Date You Returned to Did Trip Last Total Days
United States the United States 6 Months or Out of the
(ManthMay/Yeer) (Month/Day/year) Mote? Countries to Which You Traveled United States
1 1 / 1 j/ 2 0 0 1 1 1 /21/2 0 0 1 Oy el Vo. No France, Italy. United Kingdom a
olip _Di o o 1 1 o /01./2 o o 3. a vcg v. µ, France, Italy, United Kingdom 10
OL/1 9/2 0 0 1 0 8 /01/2 0 0 1 ❑yea V mo United Kingdom, France 12
0 6/2 2/2 0 0 1 0 6/2 9J2 0 0 1 ❑y en LENo
1, France 7
o sa2j2 0 0 1 0 s ail /2 0 0 1❑yet iNa Canada 3
0 3 alp 0 0 1 0 3 /1 i2 0 0 1 Myna/N o France, United Kingdom 6
1 2/0i/2 0 0 0 1 2 /0 9/2 0 0 0 Ely" V No France. United Kingdom 5
10/21/20 0 0 1 0/2 9./2 0 0 0 y et be NO United Kingdom 4
0 8 /3 .2.../2 0 0 0 0 9 /0 4 /2 0 0 0 ❑y e, V me United Kingdom 4
0 7 Li 5/2 0 0 0 0 7a 7/2 0 0 0 ❑Vei l, No Prance, United Kingdom 12
Part S. laformatios About Your Marital History
A. How many times have you been married (including annulled marriages)? 0 I Iyou have NEVER been manned, go to Pan 9.
V
B. If you arc now married, give the following information about your spouse:
I. Spouse's Family Name (Last Name) Given Name (First Name) Full Middle Name (/lappheable)
1
2. Date of Birth (Month/Day/Year) 3. Date of Mamap (Month/Day/Year) 4. Spouse's Social Security Number
/
5. Nome Address - Street Number and Name Apartment Number
City State ZIP Code
SDNY GM 00000722
runs N.4007Rev—OX3 I/01)N tap 4
EFTA_00 I 14806
EFTA01263128
Part R. Information About Your Marital Filson, taairitare.0
C. Is your spouse a U.S. citizen? likes O No
D. If your spouse is a U.S. citizen. give the following information:
I. When did your spouse become a U.S. citizen? O At Birth O Other
If "Other." QAT the following information.
l)alv 'our spouse became a U.S. citizen 3. Place your spouse became a U S. citizen (Pfeove..re blyirital(MA)
I I
City and State
I-. II your spouse is NO1 a U.S. citizen. give the lollowing Information :
I. Spouses Country of Citizenship 2. Spouses INS 'A". Number (4 applicable)
3. Spouses Immigration Sums
El Lawful Permanent Resident El Other
F. If you were married before, provide the following information about 3, or spouse. If you have more than one previous
marriage. use a separate sheet of paper to provide the information req in questions I.5 below.
I . Prim Spouses Family Name (LW Nunw) Give/nN e (First Name) Full Middle Name Illunplicstbk1
2. Prior Spouses Immigration Status 3/Date of Marriage (Monde/Day/Year) 4. Date Marriage Ended (Month/Day/Year)
❑ U.S. Citizen
❑ Lawful Permanent Resident 5. How Moulage Ended
❑ Other ❑ Divorce ❑ Spouse Died ❑ Other
G. How many times has your inure spo e been married (including annulled marriages)?
If your spouse has EVER been cd before, gin the following information about your spouse's prior marriage.
If your spouse has more than m vious marriage. use a separate sheet of paper to provide the information requested in questions
I • 5 below.
I. Poor Spouses Family N (Last Name) Given Name (first Name) Full Middle Name NIapplicable)
2. Prim Spouses Iminij 1ion Status 3. Date of Marriage (Momh/Day/Year) 4. Date Marriage Ended (Month/Day/Year)
0 U.S. Citizen I
O Lawful Permanent Resident 5. How Marriage Ended
tEl Other ODivorce 0 Spouse Died CI Other
Form N.400 I Re.. OS/3 MN IN Page
SDNY_GM_00000723
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Part 11 In formation Altntit 3.01ir Children Write your INS"A"- moldier hem
L
A. How many sons and daughters have you had? For more information on which sons and daughters
you should include and how to complete this section. see the Instructions.
[o I
R. Provide the following infomtation about all of your sons and daughters. If you need more space. use a separate sheet of paper.
flat Ntiow of Date nrnitth INC "3". number
r
i runt°. at Huth
.on in Dauphin I4lenth 11ovolectri III Auld ha% inul (Song. C in. 4a/t• & Cumin(
i
I 1 A
I / A
__ / /
/ /
/ /
I I a
/ I A_
—
1
/ 1 _ A
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Part M. Additional Questktu
PiCaSC ZUISINCI questions I through 14. If you answer "Yes" to any of these questions, include a written explanation with this form Your
wnllen explanation should I I explain why your answer was -Yes; and (2) provide any additional infomiation that helps to explain your
answer.
A. General Questions
I. Ilave you EVER claimed to be a U.S. citizen (in writing or any other way)? Ekes
2. Have you EVER registered to vote in any Federal. state, or local election in the United States? Dyes
3. Have you EVER voted in any Federal. state. or local election in the United States? CI Yes
4. Since becoming a Lawful Permanent Resident. have you EVER failed to tile a required Federal.
state, or local tax return? Elva
5. Do you owe any Federal. state. or local taxes that arc overdue? Elves
6. Do you have any title ofnobility in any foreign country?
oyes
7. Have you ever been declared legally incompetent or been confined to a mental institution
within the last 5 years? Ova
Fomi IMItlyItculdata'age 6
EFTA_00114808
EFTA01263130
Part 10. Additional Questions (ennzinucet La
B. Affiliations
8. a. Have you EVER been a member of or associated with any organization. association, fund.
❑ Yes No
foundation. party, club. society. or similar group in the United Slates or to any other place?
h. If you answered -Yes: list the name of each group below. If you need more space. wrack the names of the oilier groups) on a
:rnoalat4. .disei of Papa.
Name of Gmop Name of Group
I 6
2. 7
1 8
4. 9
S. 10.
9. Have you EVER been a member of or in any way associated (either directly or indirectly) with:
u. The Conunwtisl Party? ❑Ya
11. Any oilier totalitarian party? Dyes
c. A tcnonst organization? DYes
10. (lave you EVER advocated (either directly nr indirect6) the overthrow of any government
by force or violence? Elves
I I. lime you EVER persecuted (either directly or indirectly) any person because of race.
religion. national origin. membership in a particular social group, or political opinion? Eyes
I?. Between March 23. 1933. and May 8. 1945. did you work for or associate in any way (either
directly or indirectly) with:
a. The Nari govenuneni of Germany? D Ycs Nit7
b. Any government in any area ( I) occupied by. (2) allied with, or (3) established with the
help of the Nazi government of Germany? Oyes EN°,
c. Any Gentian. Nazi. or S.S. military wilt. paramilitary unit, self•defense unit, vigilante unit.
citizen unit, police ;mil. government agency or office. extermination camp, concentration
camp. prisoner of war camp, prison. labor camp. or transit camp?
C. Continuous Residence
Since becoming a Lawful Permanent Resident of the United States:
13. Have you EVER called yourself a "nonresident on a Federal, state, or local tax return? ElYea
14. Hove you EVER failed to file a Federal. state. or local tax return because you considered
yourself to be a "nonresident*? ❑Yes ZA0/
FO7711 N.400 IRev. 05/11/01IN Pap 7
SDNY_GM_00000725
EFTA_00114809
EFTA01263131
l'arr lit 'AMUoo al Oittoions (Conamted) 11rile sour INS 'A-- number herr
D. Good Moral Character
For the purposes of this application. you must answer "Yes" to the following questions. if applicable. even if your records were
scaled or otherwise cleared or if anyone. including a judge. law enforcement officer. or attorney. told you that you no longer have a
record.
13. Hasa you EVER coniniared a crime or intense fit which you were NO 1 arrested'
tn. ( la', c you LVER bum micatcd. %owl. ur demurral by any law clifun.ciman officer
tint:hiding INS and military officers) for any reason? Eve.
17. Have you EVER helm charged with cominitieng any crime or offense? ❑Yes
tx. Have you E\'ER been convicted ol' a crime or offense? 0 ym
19. Have you EVER been placed in an alternative sentencing or a rehabilitative program
( for example: diversion. deferred prosecution. withheld adjudication. deferred adjudication)? Elva
20. Have you EVER received a suspended sentence. been placed on probation. or been paroled? Eyes
21. Have you EVER been in jail or prison? ❑ yes
If you answered -Yes" to any of questions I S through 21. complete the following table. If you need more space. use a separate sheet
of paper to give the same information.
Why were ymi arrested. cited. Date arrested. cited. Where were you arrested. Outcome or disposition of Ike
detained. or charged? detained. or charged cited. detained or charged? arrest. citation. detention or charge
thfi ithiDavarar) (City. State. Count)) (No ( larger flint charge..
&snset!. keit prob.:ma. ere.)
\nswer questions?? through 33. If you answer "Yes" to any o these questions. attach ( your written explanation why your answer
was "Yes." and (2) any additional information or documentation that helps explain your answer.
22. Have you EVER:
a. been a habitual drunkard? ElYes k‘
b. been a prostitute, or procured anyone for prostitution? Eyes Nov'
c. sold or smuggled controlled substances, illegal drugs or narcotics? Oyes ENV
d. been married 10 more than one person at the same nine? EN4/
e. helped anyone enter or try to enter the United Slates illegally? ENV
gambled illegally or received income from illegal gambling? ElYcs EINfr
g. failed to suppon your dependents or to pay alimony?
a es si
23. Have you EVER given false or misleading information to any U.S. govemmem official
while applying for any immigration benefit or to prevent deportation, exclusion. or removal? Dyes E
24. I lave you EVER lied to any U.S. government o0icial to gain entry or admission into the
United Stales? Oyes C:1NI/
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EFTA 00114810
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Vail In, tilditi tttt 31 Qurstiont (Can fount?
E. Removal. Exclusion, and Deportation Proceedings
25. Arc removal. exclusion. rescission or deportation proceedings pending against you?
:6. Have you EVER been removed. excluded. or deported from the United Stales?
' 7 I frive -Fly EVER Sinn, °Mitred in he retrovrii erri.ydrel or drpnyled rrdir the r'90 'd
2". 1hr.,. you EVER applied for .1111, kind of relief from I anoval. exclusion. ur deportation? OYci
INZ.E A—S
Nlititeri Service n tt-PciarAclot-
Av -
29. Iliac you EVER served in the U.S. Armed Forces? .1.,j0 tint : [Sits
30. Iliac you EVER lei the United States to avoid being droned into the U.S. Armed Forces? ❑ Ycs
31. Rave you EVER applied for any kind of exemption front military service in the U.S. Armed Forces? Elves
32. Have you EVER deserted from the U.S. Armed Forces? IJ Yes
C. Selective Service Registration
33. Arc you a male who lived in the United States at any time between your ISM and 26th birthdays
in any statist except as a lawful nonimmigrant? EYes 1:1No
It you answered "NO". go on to question 34.
If you answered "YES". provide the information below.
If you answered "YES". but you did NOT register with the Selective Service System and are still under 26 years of age. you
must register before you apply for naturalization, so that you can complete the information below:
Date Registered (Month/Day/Year) Selective Service Number
II you answered "YES", but you did NOT register with the Selective Service and you are now 26 years old or older. attach a
statement explaining why you did not register.
H. Oath Requirements /See Parr 140r the rev ql the nods)
Answer questions 34 through 39. If you answer -Non to any of these questions, attach ( I your written explanation why the answer was
"No' and (Rally additional information or documentation that helps to explain your answer.
34. Do you support the Constitution and fonii of govenunent of the United States?
35. Do you understand the full Oath of Allegiance to the United States?
36. Arc you willing to take the full Oath of Allegiance to the United States?
37. If the law requires it. are you willing to bear antes on behalf of the United Stales?
3R. If the law requires it. arc you willing to perfomi noncombatant services in the U.S. Armed Forces?
39.11the law requires it. are you willing to perform work of national importance under civilian
direction?
noon N.4%131414‘Glut IO1300098F 9
EETA_00114811
EFTA01263133
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a
[ Pail It. Vile Signature write 'n' I ' a' • maser hat' — 1
I ccrniy. ander penalty of penny under the taws of du United States of AMCI1C1. that this appbc mon. and the evidence submitted with it
arc all true and correct l authorize the release of any information which INS needs to deteramne my eligibility tor naturalization.
Date tahonia/Dor/Year)
/Z.
Past t2. Shinano. of Parson Vino Prepared This Appltaalon far tout (If oppliortal0
'Khali) of sici hay that I pswated Jus appliLaihni al the Saglatall of tie abort pawn.. The Jinn ers prig RICCI at: based
of watch 1how periunal lotowledgc andor went prat/Wed to nix by die above owned pet ion ut ...passe 14.• tlw ..rise I
PIC' • iiiiii • criatattred on was town.
no.-parer s Pinned Name Prepares Cipatiirt
One Mirmik/Devffeer) Prcpam's Firm or Organisation Name (//appficabler Preparct's Daytime Phone Number
Palmists Address - Street Number and Name City Sate ZIP Code
Do Not Complete Parts 13 and 14 Until an INS Offices Instructs You To Du So
I Part I.3. Signature at luttritt ,
I .wear (affirm' and certify under pc-awry of parfuly under the laws of the United States of AMC,ica that I know that the contents or this
application for ItanIlliliati0n subscribed by me. stchataag corrections numbered I through and the evidence submitted by me
numbered pages I through — arc mit and correct to the best of my knowledge and belief.
Sonsc..ribcd to mud sworn 1O laffinncd) before rot
DOROTHEA BERTRAND -DS 139It
Officals Printed Name or Stamp Dare (Adonthenvaeor)
‘it‘szitk
Con c S -nature or Applimt Okettes
;U s /A so. itf O...//kO-
gcni—awas--._
11 -- // r__
Pan 14.. Oath of Altivisap
tryout applx anon i• approved you will be scheduled for a public oath ceremony at which time you will be required to take the following
oath or Mice:tame uranediatcly pilot to becoming a natunfind citizen. By signing below, you acknowledge your willingness and ability
to take this oath:
I hereby dectaic. cm oath. that 1 absolutely and timely retail:act and abjure all allegiance and fidelity to any foreign pnnce. potentate.
SIC or sovereignty- of whom or which which I have kerciofoic been a subject or citiern.
inn I will support and attend the Constitution and Lsats of the United States of America a3ainst all entail... foreign and domestic.
ilun I will bear true faith and allegiance to the same.
that l will bear dried on behalf of the United Slates when motored by the law;
ion I will perform noncombatant Serviec nn the Armed Forces of the United States wham requucd b) the law:
that I will perform wort of national unpottance under civilian direction when required by the 14‘.. and
dun I take des obligation freely. without any mental rnervatioll or purpose ofevasion, so help nit God.
Pruned Natal. of Applicant Co c_Stgruinut o p Imam
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N
U.S. Department of Justice 0M8 No. 1115-0053
Immigration and Naturalization Service Application to Register Permanent Residence or Adjust Status
START HERE - Please Type or Print FOR NS USEONLY
Part 1. Information about you. Returned Reeeia
Famity Gwen Middle
Name Name India
Maxwell Chia Laing
Address CtO
_RECEIVED L-!121
The Villard t Resubmitted INFORMATION
Street Number
and Name 0CT 12 1995
Cary Immitfreion and
Naliseizaton Service
New York New York, N.Y.
State bp Cade Rdoc Sent --- .
New York 113O2.2- / 87) <:- 1 ,..... ,
Date of But Camay 3C:ilia%
of Birth
(rmithIciaa France
A i (if any)
Security 9
None Robe Reed
Deb of LaW Arrival '4114.a
(month/clay/year) 9/19/95 • -can
Mime— *Ad
- e.„„-"
70051451304 fotwaszatm.• 4.••:1
•
Current INS
Slake
H-18 QI.
Visa
Part 2. Application Type. (check one)
0
Expires on
(nonei/daytyear)
.1/4/95 cipinAp
f.ev. Yoir. t:•\ •
red
c
I am applying for adjustment to permanent resident status because:
a. ❑ an invngranl petition ening me an immediately available mungont visa number has Section of Law
been approved (attach a copy of the approval notiCe), or a relative, special O Sec 209(b). NA
O Sec. 13. ACI 01 9/1157
immigrant juvenile. or special immigrant military visa pennon tied with this applicator SOC. 215. NA
will give me an mm/Matey available visa number if approval. ■ Sec 219, min
El Sec I Act of 'IRA%
b O My spouse or parent applied for adµstment of status a was granted lawful O Sec 2 Act of 1 ii2r66
permanent residence o an immigrant visa category which allows derivative status O Other
for spouses and children. Country Chattiest:tie
c. O I entered as a K-1 fonce(e) of a V.S. citizen whom I married within 90 days of
entry, or I am me K-2 child of such a hanco(o) (attach a copy of the liance
ℹ️ Document Details
SHA-256
2d232c81c27a159b181a9700f3be36b7639ca27a60286f2657f646cfd4795178
Bates Number
EFTA01263124
Dataset
DataSet-10
Document Type
document
Pages
21
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