APPLICANT'S INFORMATION

* Applicant's Full Name ( First, Middle, Last)
0/50
* Applicant's Current Residential Address:
0/50
* Applicant's Phone Number:
0/50
* Applicant's Email Address:
0/50
* Is Applicant a U.S. Citizen?
0/50

Please email a copy of your U.S. Passport and Driver's License to my Email @ [email protected]

ANCESTOR'S INFORMATION

QUALIFYING ANCESTOR (last relative born in Italy, who emigrated to the U.S.)

* Full Name of Ancestor:
0/50
Degree of kinship: (father, mother, grandfather, great-grandmother, etc.)
0/50
* Date & Place of Birth
0/50
Date & Place of Marriage:
0/50
Spouse's Full Name
0/50
Citizenship at Birth:
0/50
Spouse's Country of Birth & Citizenship
0/50
Other citizenship acquired? (Yes/No - If Y, please provide)
0/50
Date of Naturalization: (important)
0/50
List all Countries & U.S. States ( as well as cities and counties, if available) where your Italian ancestor resided during his/her life:
0/50
Date and place of Death (if applicable):
0/50

SON/DAUGHTER OF ITALIAN ANCESTOR:

FULL NAME & Degree of Kinship:
0/50
Date & Place of Birth:
0/50
Citizenship at Birth:
0/250
Other citizenship acquired? (Yes/No - If Y, please provide)
0/50
Date of Naturalization (other than Italian):
0/50
*IF MARRIED* - (1) Date & Place of Marriage. (2) Spouse's FULL NAME (3) Spouse's Country of Birth & Citizenship:
0/250
List all Countries & U.S. States ( as well as cities and counties, if available) where the son/daughter of the Italian ancestor resided during his/her life:
0/250
Date and place of Death of Son/Daughter (if applicable):
0/50

GRANDCHILD OF ITALIAN ANCESTOR:

FULL NAME & Degree of Kinship:
0/50
Date & Place of Birth:
0/50
Citizenship at Birth:
0/50
Other citizenship acquired? (Yes/No - If Y, please provide)
0/50
Date of Naturalization (other than Italian):
0/50
List all Countries & U.S. States ( as well as cities and counties, if available) where the grandchild of the Italian ancestor resided during his/her life:
0/250
*IF MARRIED* - (1) Date & Place of Marriage. (2) Spouse's FULL NAME (3) Spouse's Country of Birth & Citizenship:
0/250
Date and place of Death of Grandchild (if applicable):
0/50

SON/DAUGHTER OF GRANDCHILD OF ITALIAN ANCESTOR:

FULL NAME & Degree of Kinship:
0/50
Date & Place of Birth:
0/50
Citizenship at Birth:
0/50
Other citizenship acquired? (Yes/No - If Y, please provide)
0/50
Date of Naturalization (other than Italian):
0/50
List all Countries & U.S. States ( as well as cities and counties, if available) where this particular Italian ancestor resided during his/her life:
0/250
*IF MARRIED* - (1) Date & Place of Marriage. (2) Spouse's FULL NAME (3) Spouse's Country of Birth & Citizenship:
0/250
Date and place of Death of this ancestor (if applicable):
0/50
italian_flag_colors.jpg