Download USCIS I-589 Form in PDF
The USCIS I-589 form is a critical document for individuals seeking asylum or withholding of removal in the United States. This form serves as a formal request for protection, allowing applicants to present their case to immigration authorities. It is essential for individuals who fear persecution in their home countries due to factors such as race, religion, nationality, political opinion, or membership in a particular social group. Completing the I-589 form requires careful attention to detail, as it involves providing personal information, a thorough account of the reasons for seeking asylum, and any supporting evidence that may strengthen the application. Additionally, the form must be filed within one year of arriving in the United States, unless certain exceptions apply. Understanding the implications of this form is vital for applicants, as it can significantly impact their future and safety. The process can be daunting, but it is a crucial step toward finding refuge and rebuilding one’s life in a new environment.
Document Data
| Fact Name | Details |
|---|---|
| Purpose | The I-589 form is used to apply for asylum in the United States or for withholding of removal. |
| Eligibility | Individuals who fear persecution in their home country due to race, religion, nationality, political opinion, or membership in a particular social group can apply. |
| Filing Deadline | Applicants must file the I-589 form within one year of arriving in the U.S., unless they qualify for an exception. |
| Where to File | The completed form can be filed with the USCIS at designated service centers or during a credible fear interview. |
| Supporting Documents | Applicants should submit evidence supporting their claims, such as personal statements and documentation of threats or harm. |
| Interview Requirement | After filing, applicants may be required to attend an interview with an asylum officer. |
| Processing Time | Processing times can vary, but applicants typically wait several months for a decision. |
| Legal Representation | While not required, having an attorney can significantly help in navigating the asylum process. |
| Governing Law | The I-589 form is governed by U.S. immigration law, specifically under the Immigration and Nationality Act (INA). |
| Form Updates | The form and its instructions are updated periodically, so it’s important to use the most current version available on the USCIS website. |
How to Write USCIS I-589
Filling out the USCIS I-589 form is an important step in the process of seeking asylum in the United States. After completing the form, you'll need to gather supporting documents and submit everything to the appropriate USCIS office. Here are the steps to help you fill out the form accurately and efficiently.
- Begin by downloading the latest version of the I-589 form from the USCIS website to ensure you have the most current format.
- Read the instructions carefully before starting to fill out the form. Familiarize yourself with the information required.
- Provide your personal information in Section 1, including your full name, address, and date of birth. Make sure to write clearly and legibly.
- In Section 2, indicate your nationality and any other countries you may have citizenship in. Be honest and thorough.
- Section 3 asks about your family members. List your spouse and children, if applicable, providing their names and dates of birth.
- In Section 4, describe your reasons for seeking asylum. Be specific about your experiences and fears. This is a crucial part of your application.
- Complete Section 5, which asks about your immigration history. Include any previous applications or encounters with immigration authorities.
- In Section 6, you’ll need to provide information about any arrests or convictions. If you have a criminal history, be honest and provide details.
- Section 7 allows you to include any additional information that may support your application. Use this space wisely to strengthen your case.
- Review the entire form for accuracy. Ensure that all information is complete and correct before signing.
- Sign and date the form at the end. Make sure to sign in the designated area; unsigned forms will not be accepted.
- Gather any necessary supporting documents that you need to submit with your application, such as identification and evidence of your claims.
- Make copies of the completed form and all supporting documents for your records before mailing them to the USCIS.
- Mail the completed form and documents to the appropriate USCIS address, which can be found on the USCIS website.
USCIS I-589 Example
Department of Homeland Security
U.S. Citizenship and Immigration Services
U.S. Department of Justice
Executive Office for Immigration Review
START HERE - Type or print in black ink. See the instructions for information about eligibility and how to complete and file this application. There is no filing fee for this application.
NOTE: |
Check this box if you also want to apply for withholding of removal under the Convention Against Torture. |
Part A.I. Information About You
1. |
Alien Registration Number(s) |
2. U.S. Social Security Number (if any) 3. USCIS Online Account Number (if any) |
|
4. |
Complete Last Name |
5. First Name |
6. Middle Name |
7.What other names have you used (include maiden name and aliases)?
8.Residence in the U.S. (where you physically reside)
Street Number and Name |
|
|
Apt. Number |
|
|||
|
|
|
|
|
|
||
City |
State |
Zip Code |
|
|
Telephone Number |
||
|
|
|
|
|
|
( |
) |
|
|
|
|
|
|
|
|
(NOTE: You must be residing in the United States to submit this form.) |
|
|
|
|
|
|
|
9. Mailing Address in the U.S. (if different than the address in Item Number 8) |
|
|
|
|
|
|
|
|
|
|
|
|
|
||
In Care Of (if applicable): |
|
|
|
Telephone Number |
|
||
|
|
|
|
( |
) |
|
|
|
|
|
|
|
|
||
Street Number and Name |
|
|
|
Apt. Number |
|
||
City
State
Zip Code
10. |
Gender: |
Male |
Female |
11. |
Marital Status: |
|
|
Single |
|
|
Married |
|
Divorced |
|
|
Widowed |
|||||||
|
|
|
|
|
|||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
12. |
Date of Birth (mm/dd/yyyy) |
|
13. |
City and Country of Birth |
|
|
|
|
|
|
|
||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||
14. |
Present Nationality (Citizenship) |
15. |
Nationality at Birth |
|
16. |
Race, Ethnic, or Tribal Group |
17. |
Religion |
|||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||
18. |
Check the box, a through c, that applies: |
a. |
|
|
I have never been in Immigration Court proceedings. |
|
|
|
|
|
|||||||||||||
|
b. |
|
|
I am now in Immigration Court proceedings. |
c. |
|
|
I am not now in Immigration Court proceedings, but I have been in the past. |
|||||||||||||||
|
|
|
|
||||||||||||||||||||
19.Complete 19 a through c.
a. When did you last leave your country? (mm/dd/yyyy)b. What is your current
c. List each entry into the U.S. beginning with your most recent entry. List date (mm/dd/yyyy), place, and your status for each entry. |
||||||||||||
(Attach additional sheets as needed.) |
|
|
|
|
|
|
|
|
||||
Date |
Place |
|
|
Status |
Date Status Expires |
|||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
Date |
Place |
|
|
Status |
|
|
|
|
||||
|
|
|
|
|
|
|
|
|
|
|
|
|
Date |
Place |
|
|
Status |
|
|
|
|
||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
20. What country issued your last passport or travel |
21. |
Passport Number |
|
22. Expiration Date |
||||||||
document? |
|
|
|
|
(mm/dd/yyyy) |
|||||||
|
|
|
|
|
|
|
|
|||||
|
|
|
|
|
Travel Document Number |
|
|
|
|
|||
23.What is your native language (include dialect, if applicable)? 24. Are you fluent in English? 25. What other languages do you speak fluently?
|
|
|
|
|
Yes |
|
No |
|||||
|
|
|
|
|
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
For EOIR use only. |
For |
Action: |
|
|
Decision: |
|||||||
|
USCIS |
Interview Date: |
|
|
|
Approval Date: |
|
|
||||
|
use only. |
Asylum Officer ID No.: |
|
|
|
Denial Date: |
|
|
||||
|
|
|
|
|
|
|
|
|
Referral Date: |
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
Form |
|
|
|
|
|
|
|
|
|
|
Page 1 |
|
Part A.II. Information About Your Spouse and Children
Your spouse |
I am not married. (Skip to Your Children below.) |
|
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
|
|
|
||||||||
1. |
Alien Registration Number |
2. |
|
Passport/ID Card Number |
3. |
Date of Birth (mm/dd/yyyy) |
4. |
U.S. Social Security Number |
||||||||
|
(if any) |
|
|
(if any) |
|
|
|
|
|
|
(if any) |
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5. |
Complete Last Name |
|
6. |
|
First Name |
7. |
Middle Name |
|
8. |
Other names used (include |
||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
maiden name and aliases) |
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
9. |
Date of Marriage (mm/dd/yyyy) |
|
10. |
Place of Marriage |
|
|
11. City and Country of Birth |
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
|
|
|||||
12. Nationality (Citizenship) |
|
|
|
|
13. Race, Ethnic, or Tribal Group |
14. Gender |
|
|
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Male |
|
Female |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
15.Is this person in the U.S.?
|
Yes (Complete Blocks 16 to 24.) |
No (Specify location): |
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|||
16. |
Place of last entry into the |
17. |
Date of last entry into the |
18. |
19. Status when last admitted |
|
||||||
|
U.S. |
|
U.S. |
(mm/dd/yyyy) |
|
|
|
|
|
(Visa type, if any) |
|
|
|
|
|
|
|
|
|
|
|
|
|||
20. |
What is your spouse's |
21. |
What is the expiration date of his/her |
22. Is your spouse in Immigration |
23. If previously in the U.S., date of |
|
||||||
|
current status? |
|
authorized stay, if any? (mm/dd/yyyy) |
|
Court proceedings? |
previous arrival (mm/dd/yyyy) |
|
|||||
|
|
|
|
|
|
|
|
Yes |
|
No |
|
|
|
|
|
|
|
|
|
|
|
|
|
||
24.If in the U.S., is your spouse to be included in this application? (Check the appropriate box.)
Yes

No
Your Children. List all of your children, regardless of age, location, or marital status.
I do not have any children. (Skip to Part A.III., Information about your background.)
I have children. Total number of children:.
(NOTE: Use Form
1. |
Alien Registration Number |
2. |
Passport/ID Card Number |
|
3. Marital Status (Married, Single, |
4. |
|
U.S. Social Security Number |
||||||||||||||
|
(if any) |
|
|
(if any) |
|
Divorced, Widowed) |
|
(if any) |
|
|
|
|||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
5. |
|
Complete Last Name |
|
6. |
First Name |
|
7. Middle Name |
|
|
|
|
8. |
|
Date of Birth (mm/dd/yyyy) |
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
9. |
City and Country of Birth |
|
10. Nationality (Citizenship) |
|
11. Race, Ethnic, or Tribal Group |
12. Gender |
|
|
|
|||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Male |
|
Female |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
13. |
Is this child in the U.S. ? |
|
|
Yes (Complete Blocks 14 to 21.) |
|
No (Specify location): |
|
|
|
|
|
|
|
|||||||||
|
|
|
|
|
|
|
|
|
||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
14. |
Place of last entry into the U.S. |
|
15. Date of last entry into the |
|
16. |
17. Status when last admitted |
||||||||||||||||
|
|
|
|
|
|
|
U.S. (mm/dd/yyyy) |
|
|
|
|
|
|
|
|
(Visa type, if any) |
||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
18. |
What is your child's current status? |
|
|
19. What is the expiration |
date of his/her |
20. Is your child in |
Immigration Court proceedings? |
|||||||||||||||
|
|
|
|
|
|
|
|
authorized stay, if any? (mm/dd/yyyy) |
|
|
|
Yes |
|
|
|
No |
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
21. If in the U.S., is this child to be included in this application? (Check the appropriate box.)

Yes 
No
Form |
Page 2 |
Part A.II. Information About Your Spouse and Children (Continued)
|
1. |
Alien Registration Number |
2. |
Passport/ID Card Number |
|
3. Marital Status (Married, Single, |
4. |
U.S. Social Security Number |
|
|||||||||||||||
|
|
(if any) |
|
|
(if any) |
|
Divorced, Widowed) |
|
|
(if any) |
|
|
|
|
||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
5. |
Complete Last Name |
|
6. |
First Name |
|
7. Middle Name |
|
|
|
8. |
Date of Birth (mm/dd/yyyy) |
|
||||||||||||
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
9. |
City and Country of Birth |
|
10. Nationality (Citizenship) |
|
11. Race, Ethnic, or Tribal Group |
12. Gender |
|
|
|
|
||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Male |
|
Female |
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
13. Is this child in the U.S. ? |
|
|
Yes (Complete Blocks 14 to 21.) |
|
|
No (Specify location): |
|
|
|
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
14. Place of last entry into the U.S. |
|
15. Date of last entry into the |
|
16. |
17. Status when last admitted |
||||||||||||||||||
|
|
|
|
|
|
|
U.S. (mm/dd/yyyy) |
|
|
|
|
|
|
|
|
(Visa type, if any) |
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
|
18. What is your child's current status? |
|
|
19. What is the expiration |
date of his/her |
20. Is your child in |
Immigration Court proceedings? |
|||||||||||||||||
|
|
|
|
|
|
|
|
authorized stay, if any? (mm/dd/yyyy) |
|
|
Yes |
|
|
|
|
No |
|
|
|
|
||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
21.If in the U.S., is this child to be included in this application? (Check the appropriate box.)
Yes
|
No |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1. |
Alien Registration Number |
2. |
Passport/ID Card Number |
3. |
Marital Status (Married, Single, |
4. |
U.S. Social Security Number |
||||
|
(if any) |
|
(if any) |
|
Divorced, Widowed) |
|
(if any) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
5. |
Complete Last Name |
6. |
First Name |
7. |
Middle Name |
8. |
Date of Birth (mm/dd/yyyy) |
|
|||
|
|
|
|
|
|
|
|
|
|||
9. |
City and Country of Birth |
10. Nationality (Citizenship) |
11. Race, Ethnic, or Tribal Group |
12. Gender |
|
|
|
||||
|
|
|
|
|
|
|
|
Male |
|
Female |
|
|
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
13.Is this child in the U.S. ?
Yes (Complete Blocks 14 to 21.)
No (Specify location):
|
|
|
|
|
|
|
|
|
|
|
|
14. |
Place of last entry into the U.S. |
15. Date of last entry into the |
16. |
17. Status when last admitted |
|||||||
|
|
U.S. (mm/dd/yyyy) |
|
|
|
|
|
|
(Visa type, if any) |
||
|
|
|
|
|
|
|
|
|
|
|
|
18. |
What is your child's current status? |
|
19. What is the expiration |
date of his/her |
20. Is your child in Immigration Court proceedings? |
||||||
|
|
|
authorized stay, if any? (mm/dd/yyyy) |
|
|
Yes |
|
|
No |
||
|
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
21.If in the U.S., is this child to be included in this application? (Check the appropriate box.)
Yes
|
No |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
1. |
Alien Registration Number |
2. |
Passport/ID Card Number |
|
3. Marital Status (Married, Single, |
4. |
U.S. Social Security Number |
|||||||||||||||||
|
(if any) |
|
|
(if any) |
|
Divorced, Widowed) |
|
|
(if any) |
|
|
|
|
|
||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
5. |
Complete Last Name |
|
6. |
First Name |
|
7. Middle Name |
|
|
|
|
8. |
Date of Birth (mm/dd/yyyy) |
|
|||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
9. |
City and Country of Birth |
|
10. Nationality (Citizenship) |
|
11. Race, Ethnic, or Tribal Group |
12. Gender |
|
|
|
|
|
|||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Male |
|
Female |
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
13. Is this child in the U.S. ? |
|
|
Yes (Complete Blocks 14 to 21.) |
|
No (Specify location): |
|
|
|
|
|
|
|
|
|
|
|||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
14. Place of last entry into the U.S. |
|
15. Date of last entry into the |
|
16. |
17. Status when last admitted |
|
||||||||||||||||||
|
|
|
|
|
|
U.S. (mm/dd/yyyy) |
|
|
|
|
|
|
|
|
|
(Visa type, if any) |
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
18. What is your child's current status? |
|
|
19. What is the expiration |
date of his/her |
20. Is your child in |
Immigration Court proceedings? |
||||||||||||||||||
|
|
|
|
|
|
|
authorized stay, if any? (mm/dd/yyyy) |
|
|
|
Yes |
|
|
|
|
No |
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
21.If in the U.S., is this child to be included in this application? (Check the appropriate box.)
Yes

No
Form |
Page 3 |
Part A.III. Information About Your Background
1.List your last address where you lived before coming to the United States. If this is not the country where you fear persecution, also list the last address in the country where you fear persecution. (List Address, City/Town, Department, Province, or State and Country.)
(NOTE: Use Form
Number and Street
(Provide if available)
City/Town
Department, Province, or State
Country
Dates
From (Mo/Yr) To (Mo/Yr)
2.Provide the following information about your residences during the past 5 years. List your present address first. (NOTE: Use Form
Number and Street
City/Town
Department, Province, or State
Country
Dates
From (Mo/Yr) To (Mo/Yr)
3.Provide the following information about your education, beginning with the most recent school that you attended. (NOTE: Use Form
Name of School
Type of School
Location (Address)
Attended
From (Mo/Yr) To (Mo/Yr)
4.Provide the following information about your employment during the past 5 years. List your present employment first. (NOTE: Use Form
Name and Address of Employer
Your Occupation
Dates
From (Mo/Yr) To (Mo/Yr)
5.Provide the following information about your parents and siblings (brothers and sisters). Check the box if the person is deceased. (NOTE: Use Form
Full Name |
City/Town and Country of Birth |
|
|
Current Location |
|
|
|
|
|
Mother |
|
|
|
Deceased |
|
|
|
||
|
|
|
|
|
Father |
|
|
|
Deceased |
|
|
|
||
|
|
|
|
|
Sibling |
|
|
|
Deceased |
|
|
|
||
|
|
|
|
|
Sibling |
|
|
|
Deceased |
|
|
|
||
|
|
|
|
|
Sibling |
|
|
|
Deceased |
|
|
|
||
|
|
|
|
|
Sibling |
|
|
|
Deceased |
|
|
|
||
|
|
|
|
|
|
|
|
|
|
Form |
|
|
|
Page 4 |
Part B. Information About Your Application
(NOTE: Use Form
When answering the following questions about your asylum or other protection claim (withholding of removal under 241(b)(3) of the INA or withholding of removal under the Convention Against Torture), you must provide a detailed and specific account of the basis of your claim to asylum or other protection. To the best of your ability, provide specific dates, places, and descriptions about each event or action described. You must attach documents evidencing the general conditions in the country from which you are seeking asylum or other protection and the specific facts on which you are relying to support your claim. If this documentation is unavailable or you are not providing this documentation with your application, explain why in your responses to the following questions.
Refer to Instructions, Part 1: Filing Instructions, Section II, "Basis of Eligibility," Parts A - D, Section V, Completing the Form," Part B, and Section VII, "Additional Evidence That You Should Submit," for more information on completing this section of the form.
1.Why are you applying for asylum or withholding of removal under section 241(b)(3) of the INA, or for withholding of removal under the Convention Against Torture? Check the appropriate box(es) below and then provide detailed answers to questions A and B below.
I am seeking asylum or withholding of removal based on:
Race
Religion
Nationality
Political opinion
Membership in a particular social group Torture Convention
A.Have you, your family, or close friends or colleagues ever experienced harm or mistreatment or threats in the past by anyone?
No
Yes
If "Yes," explain in detail:
1.What happened;
2.When the harm or mistreatment or threats occurred;
3.Who caused the harm or mistreatment or threats; and
4.Why you believe the harm or mistreatment or threats occurred.
B.Do you fear harm or mistreatment if you return to your home country?
No |
Yes |
If "Yes," explain in detail:
1.What harm or mistreatment you fear;
2.Who you believe would harm or mistreat you; and
3.Why you believe you would or could be harmed or mistreated.
Form |
Page 5 |
Part B. Information About Your Application (Continued)
2.Have you or your family members ever been accused, charged, arrested, detained, interrogated, convicted and sentenced, or imprisoned in any country other than the United States (including for an immigration law violation)?
No |
Yes |
If "Yes," explain the circumstances and reasons for the action.
3.A. Have you or your family members ever belonged to or been associated with any organizations or groups in your home country, such as, but not limited to, a political party, student group, labor union, religious organization, military or paramilitary group, civil patrol, guerrilla organization, ethnic group, human rights group, or the press or media?
No |
Yes |
If "Yes," describe for each person the level of participation, any leadership or other positions held, and the length of time you or your family members were involved in each organization or activity.
3.B. Do you or your family members continue to participate in any way in these organizations or groups?
No |
Yes |
If "Yes," describe for each person your or your family members' current level of participation, any leadership or other positions currently held, and the length of time you or your family members have been involved in each organization or group.
4.Are you afraid of being subjected to torture in your home country or any other country to which you may be returned?
No |
Yes |
If "Yes," explain why you are afraid and describe the nature of torture you fear, by whom, and why it would be inflicted.
Form |
Page 6 |
Part C. Additional Information About Your Application
(NOTE: Use Form
1.Have you, your spouse, your child(ren), your parents or your siblings ever applied to the U.S. Government for refugee status, asylum, or withholding of removal?
No |
Yes |
If "Yes," explain the decision and what happened to any status you, your spouse, your child(ren), your parents, or your siblings received as a result of that decision. Indicate whether or not you were included in a parent or spouse's application. If so, include your parent or spouse's
2.A. After leaving the country from which you are claiming asylum, did you or your spouse or child(ren) who are now in the United States travel through or reside in any other country before entering the United States?
No |
Yes |
2.B. Have you, your spouse, your child(ren), or other family members, such as your parents or siblings, ever applied for or received any lawful status in any country other than the one from which you are now claiming asylum?
No |
Yes |
If "Yes" to either or both questions (2A and/or 2B), provide for each person the following: the name of each country and the length of stay, the person's status while there, the reasons for leaving, whether or not the person is entitled to return for lawful residence purposes, and whether the person applied for refugee status or for asylum while there, and if not, why he or she did not do so.
3.Have you, your spouse or your child(ren) ever ordered, incited, assisted or otherwise participated in causing harm or suffering to any person because of his or her race, religion, nationality, membership in a particular social group or belief in a particular political opinion?
No |
Yes |
If "Yes," describe in detail each such incident and your own, your spouse's, or your child(ren)'s involvement.
Form |
Page 7 |
Part C. Additional Information About Your Application (Continued)
4.After you left the country where you were harmed or fear harm, did you return to that country?

No
Yes
If "Yes," describe in detail the circumstances of your visit(s) (for example, the date(s) of the trip(s), the purpose(s) of the trip(s), and the length of time you remained in that country for the visit(s).)
5.Are you filing this application more than 1 year after your last arrival in the United States?

No
Yes
If "Yes," explain why you did not file within the first year after you arrived. You must be prepared to explain at your interview or hearing why you did not file your asylum application within the first year after you arrived. For guidance in answering this question, see Instructions, Part 1: Filing Instructions, Section V. "Completing the Form," Part C.
6.Have you or any member of your family included in the application ever committed any crime and/or been arrested, charged, convicted, or sentenced for any crimes in the United States (including for an immigration law violation)?

No
Yes
If "Yes," for each instance, specify in your response: what occurred and the circumstances, dates, length of sentence received, location, the duration of the detention or imprisonment, reason(s) for the detention or conviction, any formal charges that were lodged against you or your relatives included in your application, and the reason(s) for release. Attach documents referring to these incidents, if they are available, or an explanation of why documents are not available.
Form |
Page 8 |
Part D. Your Signature
I certify, under penalty of perjury under the laws of the United States of America, that this application and the evidence submitted with it are all true and correct. Title 18, United States Code, Section 1546(a), provides in part: Whoever knowingly makes under oath, or as permitted under penalty of perjury under Section 1746 of Title 28, United States Code, knowingly subscribes as true, any false statement with respect to a material fact in any application, affidavit, or other document required by the immigration laws or regulations prescribed thereunder, or knowingly presents any such application, affidavit, or other document containing any such false statement or which fails to contain any reasonable basis in law or fact - shall be fined in accordance with this title or imprisoned for up to 25 years. I certify that I am physically present in the United States or seeking admission at a Port of Entry when I execute this application. I authorize the release of any information from my immigration record that U.S. Citizenship and Immigration Services (USCIS) needs to determine eligibility for the benefit I am seeking.
WARNING: Applicants who are in the United States unlawfully are subject to removal if their asylum or withholding claims are not granted by an asylum officer or an immigration judge. Any information provided in completing this application may be used as a basis for the institution of, or as evidence in, removal proceedings even if the application is later withdrawn. Applicants determined to have knowingly made a frivolous application for asylum will be permanently ineligible for any benefits under the Immigration and Nationality Act. You may not avoid a frivolous finding simply because someone advised you to provide false information in your asylum application. If filing with USCIS, unexcused failure to appear for an appointment to provide biometrics (such as fingerprints) and your biographical information within the time allowed may result in an asylum officer dismissing your asylum application or referring it to an immigration judge. Failure without good cause to provide DHS with biometrics or other biographical information while in removal proceedings may result in your application being found abandoned by the immigration judge. See sections 208(d)(5)(A) and 208(d)(6) of the INA and 8 CFR sections 208.10, 1208.10, 208.20, 1003.47(d) and 1208.20.
Print your complete name.
Write your name in your native alphabet.
Did your spouse, parent, or child(ren) assist you in completing this application? |
No |
Yes (If "Yes," list the name and relationship.) |
(Name)(Relationship)
Did someone other than your spouse, parent, or child(ren) prepare this application?
Asylum applicants may be represented by counsel. Have you been provided with a list of persons who may be available to assist you, at little or no cost, with your asylum claim?
Signature of Applicant (The person in Part. A.I.)
[ |
] |
|
|
Sign your name so it all appears within the brackets |
|
(Name) |
|
(Relationship) |
No |
Yes (If "Yes,"complete Part E.) |
|
No |
Yes |
|
Date (mm/dd/yyyy)
Part E. Declaration of Person Preparing Form, if Other Than Applicant, Spouse, Parent, or Child
I declare that I have prepared this application at the request of the person named in Part D, that the responses provided are based on all information of which I have knowledge, or which was provided to me by the applicant, and that the completed application was read to the applicant in his or her native language or a language he or she understands for verification before he or she signed the application in my presence. I am aware that the knowing placement of false information on the Form
Signature of Preparer |
|
|
|
Print Complete Name of Preparer |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Daytime Telephone Number |
Address of Preparer: |
Street Number and Name |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
( |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Apt. Number |
|
City |
|
|
|
|
State |
Zip Code |
|||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
To be completed by an |
|
|
Select this box if |
|
|
Attorney State Bar Number (if |
|
Attorney or Accredited Representative |
|||||||||||||||||
|
|
Form |
|
|
applicable) |
|
|
|
USCIS Online Account Number (if any) |
||||||||||||||||
attorney or accredited |
|
|
|
|
|
|
|
||||||||||||||||||
|
|
attached. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
representative (if any). |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Form |
Page 9 |
Part F. To Be Completed at Asylum Interview, if Applicable
NOTE: You will be asked to complete this part when you appear for examination before an asylum officer of the Department of Homeland Security, U.S. Citizenship and Immigration Services (USCIS).
I swear (affirm) that I know the contents of this application that I am signing, including the attached documents and supplements, that they are
all true or
not all true to the best of my knowledge and that correction(s) numbered to were made by me or at my request. Furthermore, I am aware that if I am determined to have knowingly made a frivolous application for asylum I will be permanently ineligible for any benefits under the Immigration and Nationality Act, and that I may not avoid a frivolous finding simply because someone advised me to provide false information in my asylum application.
|
Signed and sworn to before me by the above named applicant on: |
|
|
|
|
|
|
Date (mm/dd/yyyy) |
Signature of Applicant |
|
|
|
|
|
Write Your Name in Your Native Alphabet |
|
Signature of Asylum Officer |
Part G. To Be Completed at Removal Hearing, if Applicable
NOTE: You will be asked to complete this Part when you appear before an immigration judge of the U.S. Department of Justice, Executive Office for Immigration Review (EOIR), for a hearing.
I swear (affirm) that I know the contents of this application that I am signing, including the attached documents and supplements, that they are
all true or
not all true to the best of my knowledge and that correction(s) numbered to were made by me or at my request. Furthermore, I am aware that if I am determined to have knowingly made a frivolous application for asylum I will be permanently ineligible for any benefits under the Immigration and Nationality Act, and that I may not avoid a frivolous finding simply because someone advised me to provide false information in my asylum application.
|
Signed and sworn to before me by the above named applicant on: |
|
|
|
|
Signature of Applicant |
|
Date (mm/dd/yyyy) |
|
|
|
Write Your Name in Your Native Alphabet |
|
Signature of Immigration Judge |
Form |
Page 10 |
Common PDF Documents
Progressive Supplement - This form serves to clarify your repair needs for service providers.
When entering into a rental arrangement in Arizona, it is crucial to utilize the Arizona Residential Lease Agreement, which can be conveniently found at Arizona PDF Forms. This document outlines the essential terms and conditions that protect both landlords and tenants, covering vital details such as the rent amount, lease duration, and maintenance responsibilities.
Aia A305 Form Pdf - The A305 is an essential tool for both contractors and project owners.