Medical Certification for Disability Exceptions
Use this form if you are applying for U.S. citizenship and need to request an exception to the English and civics testing requirements for naturalization because of physical or developmental disability or mental impairment.
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This form is used in the process of becoming a U.S. citizen. Whether you're applying for naturalization, requesting a hearing after a denial, or obtaining a certificate of citizenship, this is your pathway to full U.S. citizenship with voting rights and a U.S. passport.
Quick Facts
Select: 5-year permanent resident, 3-year married to U.S. citizen, or military service.
Your name exactly as shown on your Green Card.
Found on your Green Card. Required.
MM/DD/YYYY from your Green Card.
All addresses for the past 5 years (or 3 years if married to U.S. citizen).
Calculate days outside the U.S. in the past 5 years — must total less than 30 months.
Answer questions about criminal history, taxes, and immigration violations honestly.
Certifies all answers are true under penalty of perjury.
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