Form I-600A/I-600 Sup 3 Edition 04/01/24 Page 1 of 9

Supplement 3, 

Request for Action on Approved Form I-600A/I-600 

Department of Homeland Security 

U.S. Citizenship and Immigration Services 

USCIS 

Form I-600A/I-600 

Supplement 3 

OMB No. 1615-0028 

Expires 02/28/2026

To be Completed by 

an Attorney or 

Accredited 

Representative

► START HERE - Type or print in black ink.

For 

USCIS 

Use 

Only

Extension Granted to: Action Block

Select this box if 

Form G-28 or G-28I 

is attached.

Attorney State Bar Number 

(if applicable)

Attorney or Accredited Representative 

USCIS Online Account Number (if any)

(Date)

New Non-Hague country:

(Name of Country)

Other Change:

(Type of Change)

Duplicate Approval Notice:

(Date)

If you have changed your marital status since filing your Form I-600A or Form I-600, STOP. Do NOT file this supplement. 

Please see the Instructions for Form I-600A, Application for Advance Processing of an Orphan Petition, and Form I-600, Petition to 

Classify Orphan as an Immediate Relative, for additional information.

Other Names Used 

Part 1. Information About You (Applicant/Petitioner who has a valid approved Form I-600A/I-600)

1. Family Name (Last Name) Given Name (First Name) Middle Name

2.

Family Name (Last Name) Given Name (First Name) Middle Name 

Provide all other names you have ever used, including aliases, maiden name, and nicknames. If you need extra space to complete 

this section, use the space provided in Part 7. Additional Information.

State or Province of Birth

Country of Birth

3. Date of Birth (mm/dd/yyyy)

4. City/Town/Village of Birth 

Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been married and the 

question asks, “Provide the name of your current spouse”), type or print “N/A” unless otherwise directed. If your answer to a question 

which requires a numeric response is zero or none (for example, “How many children do you have?” or “How many times have you 

departed the United States?”), type or print “None” unless otherwise directed.

See USCIS Form G-1055, Fee Schedule, available at www.uscis.gov/g-1055, for information on filing fees. 
Form I-600A/I-600 Sup 3 Edition 04/01/24 Page 2 of 9

Part 1. Information About You (continued)

6.

If you answered “No” to Item Number 6., provide the address of your U.S. residence in Item Number 7. or the address for your 

residence abroad in Item Number 8., as appropriate.

Is your current U.S. mailing address the same as your physical residence? Yes No

Street Number and Name

City or Town State ZIP Code

Apt. Ste. Flr.

Address of U.S. Residence

Number

7.

8. Address of Residence Abroad 

Street Number and Name Apt. Ste. Flr. Number

City or Town State

Province Postal Code Country

9. Which address would you like USCIS to use for mailing notices and decisions to you?

U.S. Mailing Address Address of Residence Abroad

Daytime Telephone Number

Email Address 

10. 11. Mobile Telephone Number 

12.

13. Is your spouse's name the same as listed on your previously filed Form I-600A or Form I-600? Yes No

If you answered “No,” please explain.

Information About Current Marriage

If you have a new spouse who was not listed on your prior Form I-600A or Form I-600, this is considered a change in marital status. 

You cannot use this supplement to report a change in marital status.

5.

Street Number and Name

City or Town State ZIP Code

Apt. Ste. Flr.

U.S. Mailing Address 

In Care Of Name

Number

Your Contact Information 
Form I-600A/I-600 Sup 3 Edition 04/01/24 Page 3 of 9

Part 2. Action Requested on Your Previously Approved Form I-600A or Form I-600

Provide the following information about your approved Form I-600A or Form I-600.

1. USCIS Receipt Number Date of Approval (mm/dd/yyyy) Date Approval Expires (mm/dd/yyyy)

Location of the Office Where You Filed Your Form I-600A and/or Form I-600

USCIS Online Account Number 

►

Indicate which of the following items you are requesting. If any changes have occurred, indicate such change(s) in Item Number 

3. You must submit an updated home study if there are any changes or you are requesting an extension. 

2.

A. A FIRST or SECOND extension of your Form I-600A. 

B. A THIRD or SUBSEQUENT extension of your Form I-600A.

C. A new approval notice based on significant change or change in the number of children or characteristics (such as age, 

gender, and/or special needs) of the child or children you intend to adopt after your Form I-600A or Form I-600 was 

approved.

D. A FIRST or SECOND change to a new non-Hague Adoption Convention country for which you were not previously 

approved in your suitability determination.

If you are requesting both an extension of your approval period and a change of non-Hague Adoption Convention 

country, you must also select either Item Number 2.A. or 2.B. and indicate the change in Item Number 3.

E. A THIRD or SUBSEQUENT change to a new non-Hague Adoption Convention country for which you were not 

previously approved in your suitability determination. 

If you are requesting both an extension of your approval period and a second or subsequent change of non-Hague 

Adoption Convention country, you must select either Item A. or B. in Item Number 2. and indicate the change in Item 

Number 3.

F. A duplicate approval notice. 

14. Is your spouse's address and contact information the same as listed on your previously filed Form I-600A or Form I-600? 

Yes No

If you answered “No,” please explain.

Part 1. Information About You (continued)

If you are requesting an extension of your approval period and a new approval notice based on a significant change after 

your suitability determination was approved, you must select either Item Number 2.A. or 2.B.

Select this option if you are not requesting an extension and there have been no significant changes since your suitability 

determination, and you are not changing to a new non-Hague Adoption Convention country. 
Form I-600A/I-600 Sup 3 Edition 04/01/24 Page 4 of 9

Part 2. Action Requested on Your Previously Approved Form I-600A or Form I-600 (continued)

Provide information on any significant changes that have occurred since your suitability determination was approved or extended. 

Your home study preparer must fully explain and evaluate all significant changes in your required home study update. Select all 

boxes that apply.

3.

There have been no significant changes.

Change to a different non-Hague Adoption Convention country.

Name of new non-Hague Adoption Convention country

Change of residence, including a change in the child's proposed residence.

Significant decrease in financial resources, such as loss of employment, garnishment of wages, etc.

Change in history of arrest or criminal history for any household member regardless of age.

Change in history of child abuse or neglect, as an offender, for any household member regardless of age.

Change in history of substance abuse, as an offender, for any household member regardless of age.

Change in history of family violence, as an offender, for any household member regardless of age.

Change in history of sexual abuse, as an offender, for any household member regardless of age.

Change in the number and/or identity of children in your household. If you need extra space to complete this section, 

use the space provided in Part 7. Additional Information.

Name (First/Middle/Last) Date of Birth 

(mm/dd/yyyy)

Country of Birth A-Number Relationship to 

You 

Change in the number and/or identity of adult members of your household. If you select this box, you must also submit 

a Form I-600A/ I-600, Supplement 1, Listing of Adult Member of the Household for each new adult member of your 

household.

Change in the number of children or the characteristics (such as age, gender, and/or special needs) of the child or 

children you intend to adopt. 

Other significant change in your household. (If you select this box, please explain the significant change(s) below. If you 

need extra space to complete this section, use the space provided in Part 7. Additional Information.

A development of a serious health condition for any household member regardless of age, including but not limited 

to: heart attacks, cancer, strokes, conditions requiring extensive therapy, dementia, severe injuries, etc. 
Form I-600A/I-600 Sup 3 Edition 04/01/24 Page 5 of 9

Part 3. Applicant's/Petitioner's Statement, Certification, Duty of Disclosure, and Signature

NOTE: Read the Penalties section of the Form I-600A and Form I-600 Instructions before completing this section.

A. I can read and understand English, and I have read and understand every question and instruction on this supplement and 

my answer to every question.

 Applicant's/Petitioner's Statement

1. Applicant's/Petitioner's Statement Regarding the Interpreter (select the box for either Item A. or B.)

B.

question in

The interpreter named in Part 5. read to me every question and instruction on this supplement and my answer to every 

, a language in which I am fluent, and I 

understood everything.

At my request, the preparer named in Part 6.,

prepared this supplement for me based only upon information I provided or authorized.

, 

2. Applicant's/Petitioner's Statement Regarding the Preparer (if applicable)

Applicant's/Petitioner's Certification

Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS may 

require that I submit original documents to USCIS at a later date. Furthermore, I authorize the release of any information from any 

and all of my records that USCIS may need to determine my suitability and eligibility to adopt and whether the child I am petitioning 

for is an orphan and eligible to be classified as my immediate relative.

I furthermore authorize the release of information contained in this supplement, in supporting documents, and in my USCIS records, 

to other entities and persons where necessary for the administration and enforcement of U.S. immigration law.

I certify, under penalty of perjury under the laws of the United States, that I provided or authorized all of the information in my 

supplement, I understand all of the information contained in and submitted with my supplement, and that all of this information is 

complete, true, and correct.

3. Applicant's/Petitioner's Signature Date of Signature (mm/dd/yyyy) 

Applicant's/Petitioner's Signature

Applicant's/Petitioner's Duty of Disclosure

I understand the ongoing duty to disclose information concerning my suitability and eligibility to adopt, as described in the Form 

I-600A and/or Form I-600 instructions, and I agree to notify my home study preparer and USCIS of any new information that I am 

required to disclose.

Part 4. Your Spouse's Statement, Certification, Duty of Disclosure, and Signature 

Your Spouse's Statement

1. Your Spouse's Statement Regarding the Interpreter (select the box for either Item A. or B.)

A. I can read and understand English, and have read and understand every question and instruction on this supplement and 

my answer to every question.

B.

question in

The interpreter named in Part 5. read to me every question and instruction on this application and my answer to every 

, a language in which I am fluent, and I 

understood everything.

NOTE: Read the Penalties section of the Form I-600A and Form I-600 Instructions before completing this section.
Form I-600A/I-600 Sup 3 Edition 04/01/24 Page 6 of 9

Part 4. Your Spouse's Statement, Certification, Duty of Disclosure, and Signature (continued)

2. Your Spouse's Statement Regarding the Preparer (if applicable)

At my request, the preparer named in Part 6., , 

prepared this supplement for me based only upon information I provided or authorized.

Your Spouse's Certification

Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS may 

require that I submit original documents to USCIS at a later date. Furthermore, I authorize the release of any information from any 

and all of my records that USCIS may need to determine my suitability and eligibility to adopt and whether the child my spouse is 

petitioning for is an orphan and eligible to be classified as our immediate relative.

I furthermore authorize release of information contained in this supplement, in supporting documents, and in my USCIS records, to 

other entities and persons where necessary for the administration and enforcement of U.S. immigration law.

I certify under penalty of perjury under the laws of the United States, that I provided or authorized all of the information in this 

supplement, I understand all of the information contained in and submitted with this supplement, and that all of this information is 

complete, true, and correct.

3. Your Spouse's Signature Date of Signature (mm/dd/yyyy) 

Your Spouse's Signature

Your Spouse's Duty of Disclosure

I understand the ongoing duty to disclose information concerning my suitability and eligibility to adopt, as described in the Form 

I-600 and/or I-600A Instructions, and I agree to notify the home study preparer and USCIS of any new information that I am required 

to disclose.

1. Interpreter's Family Name (Last Name) Interpreter's Given Name (First Name)

Interpreter's Full Name

2. Interpreter's Business or Organization Name (if any)

Part 5. Interpreter's Contact Information, Certification, and Signature

If you and/or your spouse (if married) used an interpreter to read and complete this supplement, provide the following information 

about the interpreter.

3. Street Number and Name Apt. Ste. Flr. Number

Interpreter's Mailing Address

City or Town State ZIP Code

Province Postal Code Country 
Form I-600A/I-600 Sup 3 Edition 04/01/24 Page 7 of 9

Part 5. Interpreter's Contact Information, Certification, and Signature (continued)

Interpreter's Contact Information

4. Interpreter's Daytime Telephone Number 5.

6. Interpreter's Email Address (if any)

Interpreter's Mobile Telephone Number (if any)

Interpreter's Certification

I certify, under penalty of perjury under the laws of the United States, that:

I am fluent in English and ,which is the same language specified in 

Part 3. and/or 4., Item B. in Item Number 1., and I have read to this applicant/petitioner and/or the applicant's/petitioner's spouse in 

the identified language every question and instruction on this supplement, and his or her answer to every question. The applicant/

petitioner and/or the applicant's/petitioner's spouse informed me that he or she understands every instruction, question, and answer on 

this supplement, including the Applicant's/Petitioner's Certification and the Your Spouse's Certification, and has verified the 

accuracy of every answer.

7. Interpreter's Signature

Interpreter's Signature

Date of Signature (mm/dd/yyyy) 

Part 6. Contact Information, Declaration, and Signature of the Person Preparing this Application, If 

Other Than the Applicant/Petitioner and/or Spouse 

If you and/or your spouse (if married) used a preparer to complete this supplement, provide the following information about the 

preparer.

Preparer's Full Name

1. Preparer's Family Name (Last Name) Preparer's Given Name (First Name)

2. Preparer's Business or Organization Name (if any)

3. Street Number and Name Apt. Ste. Flr. Number

Preparer's Mailing Address

City or Town State ZIP Code

Province Postal Code Country 
Form I-600A/I-600 Sup 3 Edition 04/01/24 Page 8 of 9

Part 6. Contact Information, Declaration, and Signature of the Person Preparing this Application, If 

Other Than the Applicant/Petitioner and/or Spouse (continued)

Preparer's Contact Information

Preparer's Daytime Telephone Number Preparer's Mobile Telephone Number (if any)

Preparer's Email Address (if any)

4.

6.

5.

Preparer's Statement

7.

B.

I am not an attorney or accredited representative, but have prepared this supplement on behalf of the applicant/petitioner 

and/or the applicant's/petitioner's spouse with the applicant's/petitioner's and/or the applicant's/petitioner's spouse's consent.

I am an attorney or accredited representative and my representation of the applicant/petitioner and/or the applicant's/

extends

A.

petitioner's and/or the applicant's/petitioner's spouse in this case does not extend beyond the 

preparation of this supplement. 

Preparer's Certification

By my signature, I certify, under penalty of perjury under the laws of the United States, that I prepared this supplement at the request 

of the applicant/petitioner and/or the applicant's/petitioner's spouse. The applicant/petitioner and/or the applicant's/petitioner's spouse 

then reviewed this completed supplement and informed me that he or she understands all of the information contained in, and 

submitted with, his or her supplement, including the Applicant's/Petitioner's Certification and the Your Spouse's Certification, 

and that all of this information is complete, true, and correct. I completed this supplement based only on information that the 

applicant/petitioner and/or the applicant's/petitioner's spouse provided to me or authorized me to obtain or use.

8. Preparer's Signature 

Preparer's Signature

Date of Signature (mm/dd/yyyy) 
Form I-600A/I-600 Sup 3 Edition 04/01/24 Page 9 of 9

Part 7. Additional Information 

If you need extra space to provide any additional information within this supplement, use the space below. If you need more space 

than what is provided, you may make copies of this page to complete and file with this supplement or attach a separate sheet of paper. 

If you attach a separate sheet of paper, type or print your full name and A-Number at the top of each sheet; indicate the Page Number, 

Part Number, and Item Number to which your answer refers; and sign and date each sheet.

2. A-Number ► A1. Family Name (Last Name) Given Name (First Name) Middle Name 

5.

6. Page Number Part Number Item Number

Page Number B. Part Number Item Number

B.

C.

C.

D.

D.

A.

A.

3. Page Number B. Part Number C. Item Number

D.

A.

Page Number Part Number Item Number

D.

4. A. B. C.