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Application For Asylum And For Withholding Of Removal I-589 - Official Federal Forms
| Application For Asylum And For Withholding Of Removal Form. This is a national form and can be used in US Citizenship And Immigration Services . |
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Department of Homeland Security U.S. Citizenship and Immigration Services U.S. Department of Justice Executive Office for Immigration Review OMB No. 1615-0067; Expires 11/30/2014 I-589, Application for Asylum and for Withholding of Removal START HERE - Type or print in black ink. See the instructions for information about eligibilty 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) (A-Number) (if any) 3. Complete Last Name 4. First Name 2. U.S. Social Security Number (if any) 5. Middle Name 6. What other names have you used (include maiden name and aliases)? 7. Residence in the U.S. (where you physically reside) Street Number and Name City 8. Mailing Address in the U.S. (if different than the address in No. 7) In Care Of (if applicable): Street Number and Name City 9. Gender: Male Female State 10. Marital Status: 12. City and Country of Birth 14. Nationality at Birth 15. Race, Ethnic, or Tribal Group 16. Religion Single Married State Telephone Number ( ) Apt. Number Zip Code Telephone Number ( ) Apt. Number Zip Code Divorced Widowed 11. Date of Birth (mm/dd/yyyy) 13. Present Nationality (Citizenship) 17. Check the box, a through c, that applies: b. a. I have never been in Immigration Court proceedings. c. I am now in Immigration Court proceedings. I am not now in Immigration Court proceedings, but I have been in the past. 18. Complete 18 a through c. a. When did you last leave your country? (mmm/dd/yyyy) b. What is your current I-94 Number, if any? 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 Date Date Place Place Place 20. Passport # Travel Document # Status Status Status 21. Expiration Date (mm/dd/yyyy) Date Status Expires: 19. What country issued your last passport or travel document? 22. What is your native language (include dialect, if applicable)? 23. Are you fluent in English? 24. What other languages do you speak fluently? Yes No Action: For USCIS use only. Decision: Approval Date: Denial Date: Asylum Officer ID#: Referral Date: Form I-589 (Rev. 11/01/12) Y American LegalNet, Inc. www.FormsWorkFlow.com For EOIR use only. Interview Date: Part A.II. Information About Your Spouse and Children Your spouse I am not married. (Skip to Your Children below.) 3. Date of Birth (mm/dd/yyyy) 7. Middle Name 4. U.S. Social Security No. (if any) 1. Alien Registration Number (A-Number) 2. Passport/ID Card No. (if any) (if any) 5. Complete Last Name 9. Date of Marriage (mm/dd/yyyy) 12. Nationality (Citizenship) 15. Is this person in the U.S.? Yes (Complete Blocks 16 to 24.) 16. Place of last entry into the U.S. No (Specify location): 18. I-94 No. (if any) 19. Status when last admitted (Visa type, if any) 6. First Name 10. Place of Marriage 13. Race, Ethnic, or Tribal Group 8. Maiden Name 11. City and Country of Birth 14. Gender Male Female 17. Date of last entry into the U.S. (mm/dd/yyyy) 20. What is your spouse's current status? 21. What is the expiration date of his/her 22. Is your spouse in Immigration 23. If previously in the U.S., date of Court proceedings? authorized stay, if any? (mm/dd/yyyy) 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 (Attach one photograph of your spouse in the upper right corner of Page 9 on the extra copy of the application submitted for this person.) 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 I-589 Supplement A or attach additional sheets of paper and documentation if you have more than four children.) 1. Alien Registration Number (A-Number) 2. Passport/ID Card No. (if any) (if any) 3. Marital Status (Married, Single, Divorced, Widowed) 4. U.S. Social Security No. (if any) 5. Complete Last Name 9. City and Country of Birth 13. Is this child in the U.S. ? Yes (Complete Blocks 14 to 21.) 14. Place of last entry in the U.S. 6. First Name 7. Middle Name 8. Date of Birth (mm/dd/yyyy) 12. Gender Male 10. Nationality (Citizenship) 11. Race, Ethnic, or Tribal Group Female No (Specify location.) 15. Date of last entry in the U.S. (mm/dd/yyyy) 16. I-94 No. (if any) 17. Status when last admitted (Visa type, if any) 18. What is your child's current status? 19. What is the expiration date of his/her authorized stay, if any? (mm/dd/yyyy) 20. Is your child in Immigration Court proceedings? Yes No 21. If in the U.S., is this child to be included in this application? (Check the appropriate box.) Yes (Attach one photograph of your child in the upper right corner of Page 9 on the extra copy of the application submitted for this person.) No Form I-589 (Rev. 11/01/12) Y Page 2 American LegalNet, Inc. www.FormsWorkFlow.com Part A.II. Information About Your Spouse and Children (Continued) 1. Alien Registration Number (A-Number) 2. Passport/ID Card No. (if any) (if any) 5. Complete Last Name 9. City and Country of Birth 13. Is this child in the U.S. ? Yes (Complete Blocks 14 to 21.) 14. Place of last entry into the U.S. 6. First Name 10. Nationality (Citizenship) 3. Marital Status (Married, Single, Divorced, Widowed) 4. U.S. Social Security No. (if any) 7. Middle Name 11. Race, Ethnic, or Tribal Group 8. Date of Birth (mm/dd/yyyy) 12. Gender Male Female No (Specify location.) 16. I-94 No. (If any) 17. Status when last admitted (Visa type, if any) 15. Date of last entry into the U.S. (mm/dd/yyyy) 18. What is your child's current status? 19. What is the expiration date of his/her authorized stay, if any? (mm/dd/yyyy) 20. Is your child in Immigration Court proceedings? Yes No 21. If in the U.S., is this child to be included in this application? (Check the appropriate box.) Yes (Attach one photograph of your child in the upper right corner of Page 9 on the extra copy of the application submitted for this person.) No 1. Alien Registration Number (A-Number) 2. Passport/ID Card No. (if any) (if any) 5. Complete Last Name 9. City and Country of Birth 13. Is this child in the U.S.? Yes (Complete Blocks 14 to 21.) 14. Place of last entry into the U.S. 6. Fir
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